A Dentist and Dental Assistant perform surgery on a patient.
is the known evaluation,
diagnosis, prevention, and treatment of
diseases, disorders and conditions of the soft and hard tissues of the jaw (
mandible), the
oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body. Dentistry is a part of
stomatology. Dentistry is widely considered necessary for complete overall health.
Those in the practice of dentistry are known as dentists.
Other people aiding in oral health service include
dental assistants,
dental hygienists,
dental technicians, and
dental therapists.
Dentistry is that branch of medicine which deals with the study and practice of diagnosis, prevention, and treatment of diseases of the mouth, the
maxilla, and the face.
Overview
Surgery
Dentistry usually encompasses very important practices related to the oral cavity. The most common treatments involve the
dental surgery on the teeth as a treatment for
dental caries. Decayed teeth can be filled with
dental amalgam,
dental composite,
dental porcelain and precious or non-precious metals.
Oral and maxillofacial surgery is a more specialized form of dental surgery. Dentists can prescribe medication,
radiographs (x-rays), and devices for home or in-office use. Many oral diseases (such as bilateral
odontogenic keratocysts) and abnormalities (such as several unerupted teeth) can indicate systemic, neural, or other diseases. Most general practitioners of dentistry perform restorative,
prosthetic,
endodontic therapy,
periodontal therapy, and
exodontia, as well as performing examinations. Many general practitioners are comfortable treating complex cases, as well as placing implants and extracting third molars (wisdom teeth). All dentists must achieve a certain degree of skill in various disciplines in order to graduate from dental school and become an accredited dentist.
Prevention
Dentists also encourage prevention of dental caries through proper
hygiene (
tooth brushing and
flossing),
fluoride, and
tooth polishing, although excessive brushing can cause damage to the
gums.
Dental sealants are plastic materials applied to one or more teeth, for the intended purpose of preventing dental caries (cavities) or other forms of tooth decay. Recognized but less conventional preventive agents include
xylitol, which is
bacteriostatic,
[American Academy of Pediatric Dentistry. (2006) .] casein derivatives,
and proprietary products such as Cavistat BasicMints.
Education and licensing
The first dental school,
Baltimore College of Dental Surgery, opened in Baltimore, Maryland, USA in 1840. Philadelphia Dental College was founded in 1863 and is the second in the United States. In 1907 Temple University accepted a bid to incorporate the school.
Studies showed that dentists graduated from different countries, or even from different dental schools in one country, may have different clinical decisions for the same clinical condition. For example, dentists graduated from
Israeli dental schools may recommend more often for the removal of asymptomatic impacted
third molar (wisdom teeth) than dentists graduated from Latin American or Eastern European dental schools.
In England, the 1878 British Dentists Act and 1879 Dentists Register limited the title of "dentist" and "dental surgeon" to qualified and registered practitioners.
[Gelbier, Stanley. . British Dental Journal (2005); 199, 470-473. Page accessed 11 December 2007. The 1879 register is referred to as the "Dental Register".] The practice of dentistry in the United Kingdom became fully regulated with the 1921 Dentists Act, which required the registration of anyone practicing dentistry. The British Dental Association, formed in 1880 with Sir John Tomes as president, played a major role in prosecuting dentists practicing illegally.
[Gelbier, Stanley. . British Dental Journal (2005); 199, 470-473. Page accessed 11 December 2007.]In the United States, a dentist is a healthcare professional qualified to practice dentistry after graduating with a degree of either Doctor of Dental Surgery (
DDS) or Doctor of Dental Medicine (
DMD). In other countries, some can practice after graduating with Bachelor of Dentistry (
BDent), Bachelor of Dental Science (
BDSc), or Bachelor of Dental Surgery/Chirurgiae (
BDS) or (
BChD) or equivalent. In most western countries, to become a qualified dentist one must usually complete at least 4 years of postgraduate study; within the
European Union the education has to be at least 5 years. Dentists usually complete between 5 to 8 years of postsecondary education before practicing. Though not mandatory, many dentists choose to complete an internship or residency focusing on specific aspects of dental care after they have received their dental degree.
Specialties
Official specialties
In addition to general dentistry, there are about 9 recognized dental specialties in the US, Canada, and Australia. To become a specialist requires one to train in a residency or advanced graduate training program. Once residency is completed, the doctor is granted a certificate of specialty training. Many specialty programs have optional or required advanced degrees such as a masters degree: (MS, MSc, MDS, MSD, MDSc, MMSc, or MDent), doctoral degree: (DClinDent, DMSc, or PhD), or
medical degree: (MD/MBBS specific to
Maxillofacial Surgery and sometimes
Oral Medicine).
- Periodontics (study and treatment of diseases of the periodontium (non-surgical and surgical), and placement and maintenance of dental implants),
- Prosthodontics (dentures, bridges and the restoration of implants. Some prosthodontists further their training in "oral and maxillofacial prosthodontics"--a discipline concerned with the replacement of missing facial structures—such as ears, eyes, nose, etc.)
Specialists in these fields are designated registrable (U.S. "Board Eligible") and warrant exclusive titles such as orthodontist, oral and maxillofacial surgeon, endodontist, pediatric dentist, periodontist, or prosthodontist upon satisfying certain local (U.S. "Board Certified"), (Australia/NZ: "FRACDS"), or (Canada: "FRCD(C)") registry requirements.
The
American Board of Dental Sleep Medicine (ABDSM) provides board-certification examinations annually for qualified dentists. These dentists collaborate with sleep physicians at accredited sleep centers and can provide oral appliance therapy and upper airway surgery to treat sleep-related breathing disorders. While Diplomate status granted by the ABDSM is not one of the recognized dental specialties, it is recognized by the
American Academy of Sleep Medicine (AASM).
A few other post-graduate formal advanced education programs:
GPR, GDR, MTP residencies (advanced clinical and didactic training with intense hospital experience) and
AEGD, SEGD, and GradDipClinDent programs (advanced training in clinical dentistry) are recognized but do not lead to specialization.
Other dental education exists where no postgraduate formal university training is required:
cosmetic dentistry,
dental implant,
temporo-mandibular joint therapy. These usually require the attendance of one or more continuing education courses that typically last for one to several days. There are restrictions on allowing these
dentists to call themselves specialists in these fields. The specialist titles are registrable titles and controlled by the local dental licensing bodies.
Other specialties
- Dental anesthesiology, the study of how to relieve pain through advanced use of local and general anesthesia techniques is not yet considered to be one of the recognized dental specialties. However, CODA is in the process of accrediting all dental anesthesiology programs.
- Special needs dentistry is dentistry for those with developmental and acquired disabilities. It is a recognized specialty by the Royal Australasian College of Dental Surgeons. It has also been recently recognised as a specialty by the General Dental Council in the United Kingdom. The American Board of Special Care Dentistry is hoping to also obtain accreditation for special needs dentistry by CODA.,
- Forensic odontology consists of the gathering and use of dental evidence in law. This may be performed by any dentist with experience or training in this field. The function of the forensic dentist is primarily documentation and verification of identity.
- Geriatric dentistry or geriodontics is the delivery of dental care to older adults involving the diagnosis, prevention, and treatment of problems associated with normal ageing and age-related diseases as part of an interdisciplinary team with other health care professionals.
- Aviation dentistry, a subcategory of (military) aviation medicine deals with dental topics related to aircrews, e.g., dental barotrauma and barodontalgia. In addition, the aircrew population is a unique high-risk group to several diseases and harmful conditions due to irregular work shifts with irregular self-oral care habits and irregular meals (usually carbonated drinks and high energy snacks) and work-related stress.
History
Medieval
dentist extracting a tooth. London; c. 1360-75.
The
Indus Valley Civilization in
Pakistan has yielded evidence of dentistry being practiced as far back as 7000 BCE.
[Coppa, A. et al. 2006. . Nature. Volume 440. 6 April, 2006.] This earliest form of dentistry involved curing tooth related disorders with
bow drills operated, perhaps, by skilled bead craftsmen. The reconstruction of this ancient form of dentistry showed that the methods used were reliable and effective.
A
Sumerian text from 5000 BC describes a "tooth worm" as the cause of
dental caries.
[, hosted on the website. Page accessed 9 January 2007.] Evidence of this belief has also been found in ancient
India,
Egypt,
Japan, and
China. The legend of the worm is also found in the writings of
Homer, and as late as the 1300s AD the surgeon
Guy de Chauliac still promoted the belief that worms cause tooth decay.
[Suddick, Richard P. and Norman O. Harris. . Critical Reviews in Oral Biology and Medicine, 1(2), pages 135-151, 1990.]The
Edwin Smith Papyrus, written in the 17th century BC but which may reflect previous manuscripts from as early as 3000 BC, includes the treatment of several dental ailments. In the 18th century BC, the
Code of Hammurabi referenced dental extraction twice as it related to punishment. Examination of the remains of some
ancient Egyptians and
Greco-Romans reveals early attempts at dental
prosthetics and
surgery.
Ancient Greek scholars
Hippocrates and
Aristotle wrote about dentistry, including the eruption pattern of teeth, treating decayed teeth and
gum disease, extracting teeth with
forceps, and using wires to stabilize loose teeth and fractured jaws. The first use of dental appliances or
bridges comes from the
Etruscans from as early as 700 BC.
Roman medical writer
Cornelius Celsus wrote extensively of oral diseases as well as dental treatments such as narcotic-containing emollients and astringents.
Historically, dental extractions have been used to treat a variety of illnesses. During the
Middle Ages and throughout the 19th century, dentistry was not a profession in itself, and often dental procedures were performed by barbers or general
physicians.
Barbers usually limited their practice to extracting teeth which alleviated
pain and associated chronic tooth
infection. Instruments used for dental extractions date back several centuries. In the 14th century,
Guy de Chauliac invented the dental pelican
(resembling a
pelican's beak) which was used up until the late 18th century. The pelican was replaced by the
dental key which, in turn, was replaced by modern forceps in the 20th century.
The first book focused solely on dentistry was the "Artzney Buchlein" in 1530, and the first dental textbook written in English was called "Operator for the Teeth" by Charles Allen in 1685.
[, hosted on the British Dental Association website. Page accessed 11 December 2007.] It was between 1650 and 1800 that the science of modern dentistry developed. It is said that the 17th century French physician
Pierre Fauchard started dentistry science as we know it today, and he has been named
"the father of modern dentistry". Among many of his developments were the extensive use of
dental prosthesis, the introduction of
dental fillings as a treatment for
dental caries and the statement that sugar derivate acids such as
tartaric acid are responsible for dental decay.
There has been a problem of
quackery in the history of dentistry, and accusations of quackery among some dental practitioners persist today.
Priority patients
UK NHS priority patients include patients with congenital abnormalities (such as
cleft palates and
hypodontia), patients who have suffered orofacial trauma and those being treated for
cancer in the head and neck region. These are treated in a multidisciplinary team approach with other hospital based dental specialties
orthodontics and
maxillofacial surgery. Other priority patients include those with infections (either third molars or necrotic teeth which can often infect the brain) or avulsed permanent teeth, as well as patients with a history of smoking or smokeless tobacco with ulcers in the oral cavity also.
Geography
Organizations
See also
Lists
