DENTAL SPECIALTIES
With advances in a variety of dental techniques
and with the current focus on preventive
and restorative dentistry, the need for special
expertise in the various branches of den-
tistry has significantly increased. While
general practitioners have training in and fre-
quently do work in specialty areas, there are
currently about 20,000 dentists whose prac-
tice is limited exclusively to one specialty.
These dentists have had from one to four
years of additional training (depending on the
specialty), during which time their diag-
nostic and operative skills were further
developed to achieve a superior degree of com-
petence.
The following eight areas of specialization are
recognized by the American Dental
Association. (They are listed in order of the
number of practitioners in each specialty.)
Orthodontics
This specialty has about 6,500 practitioners.
It is concerned with correcting irregular
and abnormal dental development. Orthodontic
procedures are applicable to patients in
any age group, but treatment is more easily and
effectively achieved on youngsters. The
goal is not only to improve appearance, but to
correct the functioning of the teeth by
altering the bite. Correcting a bad bite, or
malocclusion, will aid in eating and speaking,
and will prevent eventual loosening or even
loss of teeth, in addition to having a posi-
tive cosmetic effect. A bad bite is generally
the result of an incorrect relationship that
developed during childhood between jaw shape
and teeth size. It may also result from
habits such as thumb-sucking, nail-biting, or
night grinding. Since teeth are moved to
improper positions by forces that are out of
balance in the mouth, they can be moved
back by opposing forces. This is done by the
use of various fixed orthodontic appliances
such as metal braces, rubber bands, or plastic
brackets. Removable appliances may also
be used on occasion.
Oral Surgery
There are more than 3,600 practitioners in this
specialty. They use surgical procedures
to deal with defects and diseases of the entire
maxillofacial region--the middle and
lower face. Their work encompasses the jaws,
cheekbones, and other skeletal elements
and their surrounding structures. In addition,
the oral surgeon diagnoses and treats
injuries, deformities, and growths in and
around the jaw. When a tooth (or teeth) must
be extracted, the procedure is usually carried
out in an oral surgeon's office. Another
common surgical procedure is apicoectomy, or
surgical removal of a tooth's root tip.
Reemplanting teeth knocked out in an accident
and treating simple or compound jaw
fractures are types of traumatic-injury
treatments requiring an oral surgeon's skills.
Periodontics
This specialty has about 2,000 practitioners.
It is concerned with the diagnosis and
treatment of diseases affecting the periodontal
tissues that support the teeth, namely the
gum, periodontal membrane, and surrounding
bone. These diseases are very insidious
and become increasingly prevalent with age. The
earlier treatment is instituted, the
more likely it is that teeth loss can be
prevented. Periodontal diseases are diagnosed by
several procedures; probing the depth of the
space around a tooth, comparing bone
level as reflected in X-rays taken at two
different dates, and examining for tooth mobil-
ity. Slight or somewhat moderate disease can be
readily treated by scaling--the
removal of plaque or tartar, or root planing--a
fine smoothing of the surface of the
root. More advanced cases require
curettage--scraping of the tissues lining the
infected tooth pocket. In severe cases,
surgical intervention to expose teeth, or even
bone grafting, may be necessary. Various
splinting techniques that join loose teeth to
firm ones are also utilized.
Pedodontics
The specialty also has about 2,000
practitioners. It is concerned with the treatment of
children, adolescents, and young adults
exclusively. Pedodontists are in a sense equiva-
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