This article will explain what is involved in dental specialties and what the specialists can provide. A person has to meet qualifications to be labeled a specialist. This is governed by each dentist's licensing body.
A general practitioner has a Doctor of Dental Surgery or a Doctor of Dental Medicine degree from an accredited university. Both degrees are similar, neither implies a superiority in studies. As well they have to attained a certificate at the national level and in some cases they have to have exam certification at the Provincial or State level.
An Endodontist is certified through post graduate studies in the area of root canal therapy and is registered in this specialty according to licensing requirements. Most general practitioners are trained in basic root canal treatment but they often refer more challenging cases to these specialists. When I refer patients to any specialist I take care to explain to my patients that I am not referring them because I don't want to see them; but, in fact, it is because I want them to received the finest treatment possible and at times cases present that may require more expertise.
A Paedodontist is a children's specialist. They are trained in sedation techniques in most cases, as young children may need to have more than just local anesthesia to have treatment performed. A nice option is to use nitrous oxide which is known colloquially,as "Laughing gas". It acts like a mild tranquilizer enabling the patient to perform dental services. In severe cases the Paedodontist will use intravenous sedation. This is an anaesthetic injected into the veins of the patient. It has to be administered with care and usually. Some feel they want to "go to sleep " while being treated. But it could cause serious problems. As a result there are many precautions taken and often a nurse is present. With increased awareness of oral hygiene procedures most children have sufficient home care to avoid major problems. But, some children are not properly supervised and have considerable dental problems. A serious problem occurs when children are given a bottle of milk before bed. The milk will cause tooth breakdown. Paedodontist often perform orthodontic treatment as well as regular restorations. As well they will do extraction treatment.
Orthodontists are dental specialists who are trained in the movement of teeth. Some people have crowding, others have severe spacing. In most cases the correction of these conditions are esthetic in nature. But in many instances a 'malocclusion' or a misaligned bite, can cause severe functional problems in addition to poor appearance.. I do not do orthodontic treatment and I rejoice in the great results they provide my patients. When I graduated it was felt that orthodontics cannot be performed on patients over 15. Now I regularly refer patients who are even in their 60's, with great results.
Endodontists are specialists who do root canal treatment. When a tooth dies due to trauma, severe decay, or a long standing deep filling, the nerve in the tooth may die. It is a wise decision to preserve the tooth. An Endodontist will remove the nerve tissue and allow the patient to retain the tooth. I do most of my root canal treatments; but, there are instances where the intervention of a specialist is ideal.
Oral Surgeons are specialists who perform surgery as the name implies. They do challenging extractions, take tissue biopsies when there is a suspicious lesion. As well they do sinus surgery and in some interesting surgery they will correct 'mal-collusions". The latter are cases when a person may have a protruding or receding chin. This usually involves sectioning the lower jaw and moving it and anchoring it in a retruded or advanced position. They also can place "implants" to create a 'chin'. Oral surgeons also place the implants on which crowns are added. Implants are a great addition to our practices. They are titanium and the bone sees them as part of the body structure. After the implant is integrated by the tissue we complete the treatment by taking very accurate impressions and place crowns on the structures the laboratories produce with the impressions. It is a very satisfying and well researched procedure.
Oral Pathologists are specialists who evaluate, microscopically, tissue samples they receive from dentists. Some lesions can have serious consequences so this specialty is particularly important.
Dental radiologists are people who are trained in the evaluation of x-rays which can have important diagnostic significance. Some may involved pathologies ranging from cancer to cysts. Their input is another important element in proper oral treatment.
Periodontists are specialists in gum problems. Many people have receding gum tissue due to poor hygiene, secondary responses to disease such as diabetes and hereditary factors such as periodontitosis. The latter is an hereditary condition where the bone tissue around the teeth recedes, this can result in loosening and loss of teeth. I do minor gum surgery and when I was in the Royal Canadian Dental Corps I was more involved; but, it is always a nice feeling to refer to our fine specialists in Ottawa. As well periodontists place implants for me. All in all a multidisciplined specialty who contribute to my patient's dental health.
Prosthodontists are specialists who are trained in the provision of tooth replacement appliances such as complex dentures and complex crowns and bridges. They are a specialty who often provide appliances for patients who have problems such as cleft palates.
Public Health specialists are administrators who are dentists. They are often involved in the planning of programs which provide dental care for the overall general public., These often include people who are less advantages. In the Canadian Forces they planned what became a seminal program to ensure forces members were brought to and kept at operational fitness. This was a program that was studied by military Dental services world wide.
There are a lot of so called specialties that are prevalent on the net and in advertising. But they are not accredited by any official licensing body. I personally find their assertions a bit of a stretch. Most dentists are 'family' dentists in that we will treat all members of the family; but, to present this as a specialty is a tad tacky, at best. There are many so called "Cosmetic" dentists. This is definitely not a recognized or accredited specialty. Most dentists are trained to provide aesthetic results so to claim to be a specialist in such an area is also an ethical problem in my estimation. Many dentists, myself included, take advanced courses in the use of materials. There are many courses that emphasize the latest materials and techniques. A professor in McGill once told us, "Don't be the first, nor the last to try something new." A great piece of advice as I have seen many "latest" techniques vanish when they were proven to be less than reliable. So if you see, "We use only the latest techniques", look askance. Go for the dentist who advertises, " We use only proven technology". There are many excellent study promotion organizations. Some offer fellowships on the attainment of specific courses attended;but, again they are not officially recognized accreditation.
Patients are always interested in the scope and limits of dental specialists. There is a limit to what is authorized by dental licencing boards. Many dentists do limit their practices to certain treaments, such as TMJ problmes; But these are not recognzied specialties.
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