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A dentist and dental assistant in action

Dentistry 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.[1] 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.

Contents

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.

Dentist and a patient

Prevention

Dentists also encourage prevention of dental caries through proper hygiene (tooth brushing and flossing), fluoride, and tooth polishing. 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,[2] casein derivatives,[3] and proprietary products such as Cavistat BasicMints.[4]

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,[5] or even from different dental schools in one country,[6] 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.[7]

In the United Kingdom of Great Britain and Ireland, the 1878 British Dentists Act and 1879 Dentists Register limited the title of "dentist" and "dental surgeon" to qualified and registered practitioners.[8][9]However, others could legally describe themselves as "dental experts" or "dental consultants".[10] The practice of dentistry in the United Kingdom became fully regulated with the 1921 Dentists Act, which required the registration of anyone practicing dentistry.[11] The British Dental Association, formed in 1880 with Sir John Tomes as president, played a major role in prosecuting dentists practising illegally.[8]

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/Baccalaureus Dentalis Chirurgiae (BDS) or (BChD) or equivalent.[citation needed] In most western countries, to become a qualified dentist one must usually complete at least 4 years of postgraduate study[citation needed]; within the European Union the education has to be at least 5 years. Dentists usually complete between 5 to 8 years of post-secondary education before practising. 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 USA, 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).

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.[1] 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). (See sleep dentistry in the section of sleep medicine about the US.)

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, the Commission on Dental Accreditation (CODA) is in the process of accrediting all dental anesthesiology programs.[citation needed]
  • 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.[2],[3]
  • Oral Biology - Research in Dental and Craniofacial Biology
  • 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.
  • Veterinary dentistry, a speciality of veterinary medicine, is the field of dentistry applied to the care of animals.[12][13]
  • Aviation dentistry, a subcategory of (military) aviation medicine deals with dental topics related to aircrews, e.g., dental barotrauma[14] and barodontalgia.[15][16] 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.[17]

History

Farmer at the dentist, Johann Liss, c. 1616-17.
Medieval dentist extracting a tooth. London; c. 1360-75.
Army Dental Surgery. Display at Army Medical Services Museum. Typical of dental surgeries, civil and military, during the 1940s and 1950s.
A modern Dentist's chair in a Public Hospital Na Wa, Nakhon Phanom province, Thailand.

The Indus Valley Civilization has yielded evidence of dentistry being practiced as far back as 7000 BC.[18] This earliest form of dentistry involved curing tooth related disorders with bow drills operated, perhaps, by skilled bead craftsmen.[19] The reconstruction of this ancient form of dentistry showed that the methods used were reliable and effective.[20]

A Sumerian text from 5000 BC describes a "tooth worm" as the cause of dental caries.[21] 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.[22]

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.[23][24] In the 18th century BC, the Code of Hammurabi referenced dental extraction twice as it related to punishment.[25] Examination of the remains of some ancient Egyptians and Greco-Romans reveals early attempts at dental prosthetics and surgery.[26]

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.[27] The first use of dental appliances or bridges comes from the Etruscans from as early as 700 BC.[28] Roman medical writer Cornelius Celsus wrote extensively of oral diseases as well as dental treatments such as narcotic-containing emollients and astringents.[29][30]

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[31] (resembling a pelican's beak) which was used up until the late 18th century. The pelican was replaced by the dental key[31] which, in turn, was replaced by modern forceps in the 20th century.[citation needed]

The first book focused solely on dentistry was the "Artzney Buchlein" in 1530,[32] and the first dental textbook written in English was called "Operator for the Teeth" by Charles Allen in 1685.[9] 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".[33] 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.[34]

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

At Wikiversity you can learn more and teach others about Dentistry at:
Sagittal section of a tooth

Lists

References

  1. ^ Dentistry Definitions, hosted on the American Dental Association website. Page accessed 11 December 2007. This definition was adopted the association's House of Delegates in 1997.
  2. ^ American Academy of Pediatric Dentistry. (2006) Policy on the Use of Xylitol in Caries Prevention.
  3. ^ Azarpazhooh, A.; Limeback, H. (1 July 2008). "Clinical Efficacy of Casein Derivatives: A Systematic Review of the Literature". The Journal of the American Dental Association (Am Dental Assoc) 139 (7): 915. PMID 18594077. http://www.adajournal.com/cgi/content/abstract/139/7/915. 
  4. ^ Experimental chewy mint beats tooth decay
  5. ^ Zadik Yehuda, Levin Liran (January 2008). "Clinical decision making in restorative dentistry, endodontics, and antibiotic prescription". J Dent Educ 72 (1): 81–6. PMID 18172239. 
  6. ^ Zadik Yehuda, Levin Liran (April 2006). "Decision making of Hebrew University and Tel Aviv University Dental Schools graduates in every day dentistry--is there a difference?". J Isr Dent Assoc 23 (2): 19–23. PMID 16886872. .
  7. ^ Zadik Yehuda, Levin Liran (April 2007). "Decision making of Israeli, East European, and South American dental school graduates in third molar surgery: is there a difference?". J Oral Maxillofac Surg 65 (4): 658–62. doi:10.1016/j.joms.2006.09.002. PMID 17368360. http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WKF-4N8JDW3-J&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=734474d0fe654970b56c219106722fb6. Retrieved 2008-07-16. 
  8. ^ a b Gelbier, Stanley. 125 Years of Developments in Dentistry. British Dental Journal (2005); 199, 470-473. Page accessed 11 December 2007. The 1879 register is referred to as the "Dental Register".
  9. ^ a b The story of dentistry: Dental History Timeline, hosted on the British Dental Association website. Page accessed 2 March 2010.
  10. ^ "Failure of Act". The Glasgow Herald. 8 February 1955. http://news.google.com/newspapers?nid=2507&dat=19550208&id=Ihc1AAAAIBAJ&sjid=9aULAAAAIBAJ&pg=2264,3628076. Retrieved 2 March 2010. 
  11. ^ History of Dental Surgery in Edinburgh, hosted on the Royal College of Surgeons of Edinburgh website. Page accessed 11 December 2007.
  12. ^ AVDC Home
  13. ^ EVDC web site
  14. ^ Zadik Y; Einy, S; Pokroy, R; Bar Dayan, Y; Goldstein, L (June 2006). "Dental Fractures on Acute Exposure to High Altitude". Aviat Space Environ Med 77 (6): 654–7. PMID 16780246. http://www.ingentaconnect.com/search/article?title=zadik+dental&title_type=tka&year_from=1998&year_to=2008&database=1&pageSize=20&index=5. Retrieved 2008-07-16. 
  15. ^ Zadik Y (August 2006). "Barodontalgia due to odontogenic inflammation in the jawbone". Aviat Space Environ Med 77 (8): 864–6. PMID 16909883. http://www.ingentaconnect.com/content/asma/asem/2006/00000077/00000008/art00013. Retrieved 2008-07-16. 
  16. ^ Zadik Y, Chapnik L, Goldstein L (June 2007). "In-flight barodontalgia: analysis of 29 cases in military aircrew". Aviat Space Environ Med 78 (6): 593–6. PMID 17571660. http://www.ingentaconnect.com/content/asma/asem/2007/00000078/00000006/art00009. Retrieved 2008-07-16. 
  17. ^ Lurie, Orit; Zadik, Yehuda; Tarrasch, Ricardo; Raviv, Gil; Goldstein, Liav (February 2007). "Bruxism in Military Pilots and Non-Pilots: Tooth Wear and Psychological Stress". Aviat Space Environ Med 78 (2): 137–9. PMID 17310886. http://www.ingentaconnect.com/content/asma/asem/2007/00000078/00000002/art00010. Retrieved 2008-07-16. 
  18. ^ Coppa, A. et al. 2006. Early Neolithic tradition of dentistry. Nature. Volume 440. 6 April 2006.
  19. ^ BBC (2006). Stone age man used dentist drill.
  20. ^ MSNBC (2008). Dig uncovers ancient roots of dentistry.
  21. ^ History of Dentistry: Ancient Origins, hosted on the American Dental Association website. Page accessed 9 January 2007.
  22. ^ Suddick, Richard P. and Norman O. Harris. "Historical Perspectives of Oral Biology: A Series". Critical Reviews in Oral Biology and Medicine, 1(2), pages 135-151, 1990.
  23. ^ Arab, M. Sameh. Medicine in Ancient Egypt. Page accessed 15 December 2007.
  24. ^ Ancient Egyptian Dentistry, hosted on the University of Oklahoma website. Page accessed 15 December 2007.
  25. ^ Wilwerding, Terry. History of Dentistry, hosted on the Creighton University School of Dentistry website, page 4. Page accessed 15 December 2007.
  26. ^ Medicine in Ancient Egypt 3
  27. ^ History of Dentistry Ancient Origins
  28. ^ History of Dentistry Research Page, Newsletter
  29. ^ Dentistry - Skill And Superstition
  30. ^ Dental Treatment in the Ancient Times
  31. ^ a b Antique Dental Instruments
  32. ^ History of Dentistry Middle Ages
  33. ^ History of Dentistry Articles
  34. ^ Ring, Malvin E (1998). "Quackery in Dentistry -- Past and Present". Journal of the California Dental Association. http://www.cda.org/library/cda_member/pubs/journal/jour1198/quackery.html. Retrieved 21 March 2009. 

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