Dentistry


Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the teeth, gums, and mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, disorders, and conditions of the mouth, most commonly focused on dentition as well as the oral mucosa. Dentistry may also encompass other aspects of the craniofacial complex including the temporomandibular joint. The practitioner is called a dentist.
The history of dentistry is almost as ancient as the history of humanity and civilization, with the earliest evidence dating from 7000 BC to 5500 BC. Dentistry is thought to have been the first specialization in medicine which has gone on to develop its own accredited degree with its own specializations. Dentistry is often also understood to subsume the now largely defunct medical specialty of stomatology for which reason the two terms are used interchangeably in certain regions. However, some specialties such as oral and maxillofacial surgery may require both medical and dental degrees to accomplish.
Dental treatments are carried out by a dental team, which often consists of a dentist and dental auxiliaries. Most dentists either work in private practices, dental hospitals, or institutions.
The modern movement of evidence-based dentistry calls for the use of high-quality scientific research and evidence to guide decision-making such as in manual tooth conservation, use of fluoride water treatment and fluoride toothpaste, dealing with oral diseases such as tooth decay and periodontitis, as well as systematic diseases such as osteoporosis, diabetes, celiac disease, cancer, and HIV/AIDS which could also affect the oral cavity. Other practices relevant to evidence-based dentistry include radiology of the mouth to inspect teeth deformity or oral malaises, haematology to avoid bleeding complications during dental surgery, cardiology, etc.

Etymology

The term dentistry comes from dentist, which comes from French dentiste, which comes from the French and Latin words for tooth. The term for the associated scientific study of teeth is odontology – the study of the structure, development, and abnormalities of the teeth.

Dental treatment

Dentistry usually encompasses practices related to the oral cavity. According to the World Health Organization, oral diseases are major public health problems due to their high incidence and prevalence across the globe, with the disadvantaged affected more than other socio-economic groups.
The majority of dental treatments are carried out to prevent or treat the two most common oral diseases, which are dental caries and periodontal disease. Common treatments involve the restoration of teeth, extraction or surgical removal of teeth, scaling and root planing, endodontic root canal treatment, and cosmetic dentistry.
By nature of their general training, dentists, without specialization, can carry out the majority of dental treatments such as restorative, prosthetic, endodontic therapy, periodontal therapy, and extraction of teeth, as well as performing examinations, radiographs, and diagnosis. Dentists can also prescribe medications used in the field such as antibiotics, sedatives, and any other drugs used in patient management. Depending on their licensing boards, general dentists may be required to complete additional training to perform sedation, dental implants, etc.
File:Enamel celiac.jpg|thumb|right|Irreversible enamel defects caused by an untreated celiac disease. They may be the only clue to its diagnosis, even in absence of gastrointestinal symptoms, but are often confused with fluorosis, tetracycline discoloration, acid reflux or other causes. The National Institutes of Health include a dental exam in the diagnostic protocol of celiac disease.
Dentists also encourage the prevention of oral diseases through proper hygiene and regular, twice or more yearly, checkups for professional cleaning and evaluation. Oral infections and inflammations may affect overall health, and conditions in the oral cavity may be indicative of systemic diseases, such as osteoporosis, diabetes, celiac disease or cancer. Many studies have also shown that gum disease is associated with an increased risk of diabetes, heart disease, and preterm birth. The concept that oral health can affect systemic health and disease is referred to as "oral-systemic health".

Education and licensing

John M. Harris started the world's first dental school in Bainbridge, Ohio, and helped to establish dentistry as a health profession. It opened on 21 February 1828, and today is a dental museum. The first dental college, Baltimore College of Dental Surgery, opened in Baltimore, Maryland, US in 1840. The second in the United States was the Ohio College of Dental Surgery, established in Cincinnati, Ohio, in 1845. The Philadelphia College of Dental Surgery followed in 1852. In 1907, Temple University accepted a bid to incorporate the school.
Studies show that dentists who graduated from different countries, or even from different dental schools in one country, may make different clinical decisions for the same clinical condition. For example, dentists that graduated from Israeli dental schools may recommend the removal of asymptomatic impacted third molar more often than dentists that graduated from Latin American or Eastern European dental schools.
In the United Kingdom, the first dental schools, the London School of Dental Surgery and the Metropolitan School of Dental Science, both in London, opened in 1859. The British Dentists Act of 1878 and the 1879 Dentists Register limited the title of "dentist" and "dental surgeon" to qualified and registered practitioners. However, others could legally describe themselves as "dental experts" or "dental consultants". The practice of dentistry in the United Kingdom became fully regulated with the 1921 Dentists Act, which required the registration of anyone practising dentistry. The British Dental Association, formed in 1880 with Sir John Tomes as president, played a major role in prosecuting dentists practising illegally. Dentists in the United Kingdom are now regulated by the General Dental Council.
Dentists in many countries complete between five and eight 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. In a few countries, to become a qualified dentist one must usually complete at least four years of postgraduate study; Dental degrees awarded around the world include the Doctor of Dental Surgery and Doctor of Dental Medicine in North America, and the Bachelor of Dental Surgery/Baccalaureus Dentalis Chirurgiae in the UK and current and former British Commonwealth countries.
All dentists in the United States undergo at least three years of undergraduate studies, but nearly all complete a bachelor's degree. This schooling is followed by four years of dental school to qualify as a "Doctor of Dental Surgery" or "Doctor of Dental Medicine". Specialization in dentistry is available in the fields of Anesthesiology, Dental Public Health, Endodontics, Oral Radiology, Oral and Maxillofacial Surgery, Oral Medicine, Orofacial Pain, Pathology, Orthodontics, Pediatric Dentistry, Periodontics, and Prosthodontics.

Continuing education

Many countries require licensed dentists to undertake continuing education or continuing professional development after graduation. These structured activities help maintain clinical competence, support patient safety, and keep practitioners up to date with current standards of care, with government regulators typically specifying minimum hours or points per cycle and mandating core topics such as infection control, radiography, and medical emergencies.

Specialties

Some dentists undertake further training after their initial degree in order to specialize. Exactly which subjects are recognized by dental registration bodies varies according to location. Examples include:
  • Anesthesiology – the specialty of dentistry that deals with the advanced use of general anesthesia, sedation and pain management to facilitate dental procedures.
  • Cosmetic dentistry – focuses on improving the appearance of the mouth, teeth and smile.
  • Dental public health – the study of epidemiology and social health policies relevant to oral health.
  • Endodontics – root canal therapy and study of diseases of the dental pulp and periapical tissues.
  • Forensic odontology – 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 – the delivery of dental care to older adults involving the diagnosis, prevention, and treatment of problems associated with normal aging and age-related diseases as part of an interdisciplinary team with other health care professionals.
  • Oral and maxillofacial pathology – the study, diagnosis, and sometimes the treatment of oral and maxillofacial related diseases.
  • Oral and maxillofacial radiology – the study and radiologic interpretation of oral and maxillofacial diseases.
  • Oral and maxillofacial surgery – extractions, implants, and surgery of the jaws, mouth and face.
  • Oral biology – research in dental and craniofacial biology
  • Oral implantology – the replacement of extracted teeth with dental implants.
  • Oral medicine – the clinical evaluation and diagnosis of oral mucosal diseases
  • Orthodontics and dentofacial orthopedics – the straightening of teeth and modification of midface and mandibular growth.
  • Pediatric dentistry – dentistry for children
  • Periodontology – the study and treatment of diseases of the periodontium as well as placement and maintenance of dental implants
  • Prosthodontics – dentures, bridges and the restoration of implants.
  • * Some prosthodontists super-specialize in maxillofacial prosthetics, which is the discipline originally concerned with the rehabilitation of patients with congenital facial and oral defects such as cleft lip and palate or patients born with an underdeveloped ear. Today, most maxillofacial prosthodontists return function and esthetics to patients with acquired defects secondary to surgical removal of head and neck tumors, or secondary to trauma from war or motor vehicle accidents.
  • Special needs dentistry – dentistry for those with developmental and acquired disabilities.
  • Sports dentistry – the branch of sports medicine dealing with prevention and treatment of dental injuries and oral diseases associated with sports and exercise. The sports dentist works as an individual consultant or as a member of a sports medicine team.
  • Veterinary dentistry – the field of dentistry applied to the care of animals. It is a specialty of veterinary medicine.