Sunday, January 27, 2008

Dentistry

Dentistry is the "evaluation, diagnosis, prevention and/or treatment (nonsurgical, surgical or related procedures) of diseases, disorders and/or conditions of the oral cavity, maxillofacial area and/or the adjacent and associated structures and their impact on the human body".[1] 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.

A dentist is a healthcare professional qualified to practice dentistry after graduating with a degree of either Doctor of Dental Surgery (DDS), Doctor of Dental Medicine (DMD), 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]. Generally, 2 years of clinical experience working with patients in an educational setting are required.

History

Farmer at the dentist, Johann Liss, c. 1616-17.
Farmer at the dentist, Johann Liss, c. 1616-17.

Evidence of dentistry by Dr. John Franklin has been found in teeth dating from around 5500 BC to 7000 BC.[2][3] The teeth, showing evidence of holes from dental drills, were found in people of the Indus Valley Civilization.[4] A Sumerian text from 5000 BC describes a "tooth worm" as the cause of dental caries.[5] Evidence of this belief has also been found in India, Egypt, Japan, and China.[6]

The Edwin Smith Papyrus, written in the 17th century BC but may reflect previous manuscripts from as early as 3000 BC, includes the treatment of several dental ailments.[7][8] In the 18th century BC, the Code of Hammurabi referenced twice to dental extractions as it related to punishment.[9] Examining the remains of some ancient Egyptians and Greco-Romans reveal early attempts at dental prosthetics and surgery.[1]

Medieval dentist extracting a tooth. London; c. 1360-75.
Medieval dentist extracting a tooth. London; c. 1360-75.

Historically, dental extractions have been used to treat a variety of illnesses. During the Middle Ages and through the 19th century, dentistry was not a profession into itself, and often dental procedures were performed by barbers or general physicians. Barbers usually limited their practice to extracting teeth, which not only resulted in the alleviation of pain, but often cured a variety of ailments linked with 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 through the late 18th century. The pelican was replaced by the dental key 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, and the first dental textbook written in English was called "Operator for the Teeth" by Charles Allen in 1685.[10] It is said that the 17th century French physician Pierre Fauchard started dentistry science as we know it today, hence he was named "the father of modern dentistry". Among many of his developments were, the extensive use of dental prosthesis, introducing dental fillings as treatment for dental caries and stating that sugar derivate acids like tartaric acid were responsible for dental decay.

The Baltimore College of Dental Surgery, the first dental school in the world, opened in Baltimore, Maryland in 1840 and in 1867, Harvard Dental School became the first dental school affiliated with a university. In England, the 1878 British Dentists Act and 1879 Dentists Register limited the title of "dentist" and "dental surgeon" to qualified and registered practitioners.[11][10] The practice of dentistry became fully regulated with the 1921 Dentists Act, which required the registration of anyone practicing dentistry.[12] The British Dental Association, formed in 1880 with Sir John Tomes as president, played a major role in prosecuting illegally practicing dentists.[11]

General dentistry

Patient with dental dam in mouth.
Patient with dental dam in mouth.

Dentists can (and often do) further their training in one or more speciality areas (such as surgery, endodontics, orthodontics, etc.) Hence, there can be a great deal of variation between the level of skill in different disciplines from dentist to dentist, however all dentists must achieve a certain degree of skill in various disciplines in order to graduate from dental school and earn licensure. General practitioners, unlike specialists, have the luxury of choosing which services they will provide and which they will refer to specialists. It is important to note that most general practitioners perform restorative, prosthetic, routine endodontic therapy, routine periodontal therapy, and simple exodontia, as well as performing examinations. Others are comfortable treating more complex cases, as well as placing implants and extracting third molars...among many other procedures frequently referred to specialists. Contrary to popular belief, most dentists do not regularly clean teeth, and instead delegate this task to their support staff (e.g. dental hygienists).

Specialities

In addition to general dentistry, there are 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 (MD/MBBS specific to Maxillofacial Surgery), MS, or PhD.

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.

Two other post-graduate formal advanced education programs: General Practice Residency (advanced clinical and didactic training with intense hospital experience) and Advanced Education in General Dentistry (advanced training in clinical dentistry) recognized by the ADA do not lead to specialization.

Special category: Oral Biology - Research in Dental and Craniofacial Biology

Other dental education exists where no post-graduate 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.

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

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