Dental Specialties Health Article

Definition

There are nine dental specialties approved by the Council on Dental Education and Licensure of the American Dental Association (ADA). These are:

• Dental public health: Dental public health is the dental specialty devoted to promoting public dental health and preventing and controlling dental diseases through community and public education.
• Endodontics: Endodontics is the dental specialty focused on the morphology, physiology, and pathology of the periradicular (tooth root) tissues and human dental pulp.
• Oral and maxillofacial pathology: Oral and maxillofacial pathology deals with the nature, identification, and management of diseases affecting the regions of the mouth, jaw and adjacent parts of the face.
• Oral and maxillofacial surgery: Oral and maxillofacial surgery is the dental specialty that focuses on the diagnosis, surgical, and related treatment of diseases, injuries and deficiencies of the hard and soft tissues of the oral and maxillofacial regions. These specialists address functional and esthetic aspects of the areas treated.
• Orthodontics and dentofacial orthopedics: Orthodontics and dentofacial orthopedics is the specialty concerned with guiding and correcting children's and adults dentofacial structures.
• Pediatric dentistry: Pediatric dentistry is the dental specialty that is devoted to providing primary and comprehensive preventive and therapeutic dental health care from infancy through adolescence. Pediatric dentists also provide dental care to children with special health care needs.
• Periodontics: Periodontics involves the prevention, diagnosis, and treatment of diseases affecting the tissues supporting and surrounding the teeth. The specialty also focuses on the maintenance of healthy gums and supporting dental tissues.
• Prosthodontics: Prosthodontics is the specialty concerned with the restoration of natural and replacement teeth, as well as contiguous oral and maxillofacial tissues.
• Oral and maxillofacial radiology: No definition has yet been approved by the ADA House of Delegates for this newly granted dental specialty. However, these specialists use imaging techniques to assist general dentists and other oral health specialists in the diagnostic assessment of diseases of the head and neck.

While there are overlapping responsibilities among the specialties, each focuses on an aspect of the oral cavity, maxillofacial area, or adjacent associated structures.

Description

According to the ADA, about 20% of all dentists practice a dental specialty, while the rest remain general dentists. Orthodontics and dentofacial orthopedics and oral and maxillofacial surgery make up nearly half of all specialties.

Dental public health specialists view the community, rather than the individual, as their patient. Their roles are to educate the public, using applied dental research, and initiate community-wide dental care and preventive programs.

Endodontics encompasses basic and clinical sciences of normal pulp biology and the causes, diagnosis, prevention, and treatment of diseases and injuries to the pulp and associated periradicular conditions. Endodontists specialize in root canal treatments to remove damaged tissue from inside tooth root canals. Root canal treatment, a nonsurgical endodontic treatment, treats the soft inner tissue of the tooth, called the pulp, when it becomes inflamed or infected. During a root canal, endodontists remove the damaged pulp, clean the area and fill and seal it to preserve the tooth. Surgical procedures performed by endodontists include apicoectomy, which removes infection or inflammation of the bony area surrounding the tooth's end.

Oral and maxillofacial pathologists research the causes, processes, and effects of diseases that affect the oral and maxillofacial regions, which include the head, face, mouth, teeth, gums, jaws, and neck. These specialists use clinical, radiographic, microscopic, biochemical, and other examinations to research and diagnose disease. The practice of oral and maxillofacial pathology includes research; clinical, radiographic, microscopic, biochemical or other disease diagnosis; and patient management.

Oral and maxillofacial surgeons treat patients who have problems with wisdom teeth, facial pain and misaligned jaws. They treat accident victims with facial injuries, perform reconstructive and dental implant surgery, offer treatments for tumors and cysts of the jaws, and specialize in functional and cosmetic conditions of the head, face, mouth, teeth, gums, jaws, and neck. Oral and maxillofacial surgeons also offer preventive care of the teeth, mouth, jaws, and facial structures.

These specialists offer a wide variety of surgical procedures performed in the office and hospital, including dentoalveolar surgery to treat impacted teeth and reconstructive surgery to address inadequate bone structure of the upper or lower jaws, which can result from injury, some types of surgery, and dentures. They place dental implants, which are an option for replacing missing teeth, and treat facial infections, which can develop into life-threatening conditions if not addressed. Oral and maxillofacial surgeons are often called in to treat trauma of the face, jaws, mouth, and teeth, often from injuries such as falls, as well as facial pain from such things as temporomandibular joint (TMJ) disorders. Other conditions treated by oral and maxillofacial surgeons include deformities in skeletal growth between the upper and lower jaws, which can affect chewing and swallowing, and snoring or obstructive sleep apnea, a condition that can lead to excessive daytime sleepiness. Not all procedures performed by oral and maxillofacial surgeons are covered by dental or health insurance because they also offer some cosmetic procedures of the face, mouth, and neck.

Orthodontists and dentofacial orthopedic specialists specialize in diagnosing, preventing, and treating dental and facial irregularities, known as malocclusions. Orthodontists represent about 6% of all dentists. Orthodontists treat children and adults. The American Association of Orthodontists recommend that all children have an orthodontic screening no later than age seven.

Malocclusions are often inherited but can be caused by trauma, pacifier sucking, airway obstruction, dental disease, or premature loss of primary or permanent teeth. Orthodontists most commonly treat crowding of the teeth, overbites, open bites (when upper and lower incisor teeth do not touch when biting down), spacing problems, crossbite and underbites, or lower jaw protrusion. Orthodontic treatment, often involving the placement of braces, helps not only cosmetically, but also functionally.

Pediatric dentists provide primary and specialty oral care for healthy, normal children, as well as those with special needs. Much of what the pediatric dentist does involves educating parents and children. The pediatric dentist will advise parents about thumb sucking and pacifier habits, dental decay in the early years, proper brushing habits, bottle and breast-feeding, and more. In a child's later years, they'll advise children and their parents about protecting teeth during sports and other preventive dental issues. Pediatric dentists offer techniques that can protect children's teeth, such as dental sealants, which fill the crevices on the surfaces of the teeth to protect teeth from decay.

Periodontists specialize in preventing, diagnosing, and treating periodontal disease. Periodontal diseases are bacterial infections of the tissues around the tooth, which, if untreated, can result in tooth loss. Periodontists place dental implants, which replace missing teeth and look and feel like natural teeth, and they perform periodontal surgery used to treat severe cases of periodontal disease. While simple procedures might suffice to remove the plaque and calculus below the gum line and remove bacteria, surgical procedures are often necessary if periodontal disease has caused deep pockets in the gums and loss of supporting bone structure. Cosmetic periodontal procedures include treatments to improve a gummy smile, as well as treatment to correct long teeth, or receding gums.

Prosthodontists understand dental laboratory procedures and work closely with dental technicians to create comfortable and attractive custom-made prostheses for patients. Prosthodontists offer patients options for replacing missing teeth. Sometimes this involves the placement of dentures or fixed bridges, while other patients prefer dental implants. Prosthodontists receive training in diverse dental conditions, including complex care management involving many specialties, post-oral cancer reconstruction, some children's dental problems, jaw joint conditions, traumatic injuries, and snoring and sleep disorders. Prosthodontists are also trained in some types of cosmetic dentistry, including bleaching techniques, tooth bonding, and veneers.

Oral and maxillofacial radiologists are dentists who specialize in the use of imaging and other technologies to diagnose and manage dental and associated diseases. They also advise state agencies and dental professionals about regulatory compliance in the use of and advances in radiologic technology.