Many expatriates worry about dental clinics pushing unnecessary treatments to increase profits.
One way to protect yourself is to separate diagnosis from treatment—getting a checkup at one clinic, then deciding where (or if) to get work done.
This article will guide you through that process, including which X-rays to request, how to document findings, and how to assess an old mercury filling.

Step 1: Booking a Checkup

 

When scheduling an appointment, make it clear you’re there for an evaluation, not immediate treatment.
You can say:

“I’d like a routine checkup with bitewing X-rays, but I’m not planning on having work done today.
I’d also like a digital or printed copy of my X-rays for my records.”

 

This signals that you’re comparing recommendations rather than committing to whatever they suggest.

Step 2: Choosing the Right X-Rays

 

The right type of X-ray depends on your needs:

• Routine Checkup: Request bitewing X-rays (2-4 images). These detect hidden decay, check existing fillings, and monitor bone levels.
• Specific Tooth Problem: Request periapical X-rays (1-2 images of the problem area) to examine the full tooth, including roots.
• Full Assessment (Optional): A panoramic X-ray captures the entire mouth, useful for jaw issues, wisdom teeth, or major dental work.

 

For a general checkup without known issues, bitewing X-rays are enough.

Step 3: Documenting Findings

 

During the checkup, take notes on what the dentist finds.
Use the FDI tooth numbering system to track which teeth they mention.

Tooth Name	Upper Right (1X)	Upper Left (2X)	Lower Left (3X)	Lower Right (4X)
Central Incisor	11	21	31	41
Lateral Incisor	12	22	32	42
Canine (Cuspids)	13	23	33	43
First Premolar (Bicuspid)	14	24	34	44
Second Premolar (Bicuspid)	15	25	35	45
First Molar	16	26	36	46
Second Molar	17	27	37	47
Third Molar (Wisdom)	18	28	38	48

 

Ask for written details of any recommended treatments.
If they refuse to provide a written diagnosis, that’s a red flag.

Step 4: Common Issues & How to Assess Their Severity

 

Condition	Severity	Questions to Ask
Cavities (Decay)	Mild-High	Is this visible or only on X-ray? How deep is it? Can it be monitored?
Cracked Tooth	Medium-High	Is it a surface crack or deep? Do I need urgent care or just monitoring?
Worn Filling	Low-Medium	Is there decay under it? Is it structurally weak or just old?
Gum Disease	Low-High	Is it gingivitis (reversible) or periodontitis? How severe is bone loss?
Tooth Sensitivity	Low-Medium	Is the cause enamel wear, recession, or something else?
Impacted Wisdom Teeth	Low-High	Are they causing pain or pushing other teeth?

 

Step 5: Evaluating an Old Mercury Filling

 

Some dentists push for replacing old amalgam (mercury) fillings, even if they’re intact.
If a dentist recommends this, ask:

• Is there visible damage (cracks, gaps, leakage)?
• Is there decay underneath (confirmed by X-ray)?
• Is there any pain or sensitivity from this tooth?
• What happens if I leave it alone?
• How long could it last if left untouched?
• If replaced, what material would you use, and does it have a shorter lifespan than amalgam?

 

Step 6: Getting a Second Opinion

 

If you’re unsure about a recommendation:

• Take your X-rays and notes to another dentist for review.
• Avoid mentioning what the first dentist said—see if the second one independently finds the same issue.
• Compare recommendations and look for inconsistencies.

 

If two dentists independently recommend the same treatment with clear evidence, it’s likely needed.
If not, you may be avoiding unnecessary work.

Final Thoughts

 

Expatriates, especially in unfamiliar healthcare systems, need to be cautious about unnecessary dental work.
Separating diagnosis from treatment, keeping records, and asking the right questions can help you make informed decisions about your dental health.

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Template enquiy email:

 

Subject: Inquiry for Dental Checkup and X-ray (Second Opinion)

Hi [Dentist’s Name or Clinic Team],

I’m looking to get a dental checkup and X-ray for a second opinion. I’d like the following:

• General checkup and visual exam.
• X-rays (please confirm what’s recommended for a first visit).
• A breakdown of the costs for the checkup and X-rays.

This is just for a checkup; I won’t be proceeding with any treatments at this time. I’d also like a written summary of the findings for comparison with another opinion.

Could you confirm:

• Availability within the next week or two?
• Total cost for the checkup and X-rays?
• Any prep I need to do before the visit?

Thanks,

[Your Full Name]

[Your Contact Information]