Understanding different dental specialties and what they do best

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With rapid advances in dentistry, evolution of specialization, and marketing trends, choosing the right dentist for a specific need has become increasingly difficult for many people.


Choosing the right dentist for a specific problem or need is an important part of our oral health. Everyone deserves the best treatment dentistry can offer and making engaged decisions is an integral part of this process. Here is a guide in understanding various dental specialties and what they do best to help you pick the right dentist for the job. Here are the various Specialties recognized by American Dental Association:


Prosthodontics:
A prosthodontist has received three additional years of postdoctoral training in dentistry gaining advanced skills in both cosmetic and restorative procedures. Some may also perform common periodontal or oral surgery procedures, but most focus on treatment of patients with complex cosmetic and restorative needs. In a patient with multi-disciplinary needs (e.g a patient who needs crowns, implants, root canal treatment, and gum surgery), a prosthodontist will act as both the restorative dentist and the coordinator of the overall treatment and other team dentists. You will benefit from a prosthodontist if you have the following needs:


- Both simple and complex restorative needs (crowns, bridges, veneers, etc.)
- Dental implants and reconstructive dentistry
- Rehabilitation of patients with partial or complete missing teeth
- Advanced cosmetic procedures (bleaching, veneers, tooth reshaping, bonding)
- Multi-disciplinary complex dental needs


Oral and Maxillofacial Surgery:
Oral surgeons receive 4–6 years (6 years for combined DDS / MD programs) of post-doctoral training in accredited residency programs. They receive hospital-based training in oral and facial surgical procedures and anesthesia, in addition to extensive medical training to care for the medically compromised patients. Most are board certified as necessary for obtaining hospital privileges. Oral surgeons are limited to performing surgical procedures and anesthesia and offer key role in the overall care of dental patients.You will benefit from an oral surgeon if you have the following needs:


- Extraction of teeth (wisdom teeth and others)
- Dental implant placement (surgical aspect)
- Minor and major bone grafting procedures to create site for implants
- Oral biopsies
- Corrective Jaw surgery (orthognathic surgery)
- Oral and facial infections
- Oral and facial trauma
- TMJ related treatments
- IV sedation / Anesthesia
- Procedures requiring hospitalization
- Surgical treatments in pediatric patients


Endodontics:
Endodontists are root canal treatment specialists. They receive 2–3 years of post-graduate training on treatment of conditions affecting teeth’s root canal system. Endodontists have advanced surgical and non-surgical skills that make them uniquely qualified to treat routine as well as complex cases. The root canal contains the blood supply and nerve tissue vital to a healthy tooth. Insults such as decay, trauma, or other infections can compromise its health, therefore requiring root canal treatments. Current techniques, instrumentations, and technology (such as microscopes) allow
endodontists achieve high treatment success. You will benefit from an endodontist if you have the following needs:


- Saving a non-vital or irreversibly inflamed tooth and avoid extraction
- Root canal treatment for teeth that exhibit temperature sensitivity or pain due to decay or trauma
- Teeth with abscess due to necrotic root or other types of pathology (such as cysts) compromising its health


Orthodontics:
Orthodontists receive 2–3 years of post-graduate training, specializing in straightening teeth and management of jaw relations in both children and adults. Crooked and crowded teeth are prone to decay, periodontal disease, and possible loss. Misalignment of the teeth and jaws can lead to premature wear, further damage and chronic facial and joint pain. Through use of braces or other techniques such as invisalign, orthodontists can align teeth for improved function and aesthetics. Orthodontic related treatments may start in patients in as early as 8 years old or adult patients. You will benefit from an orthodontist if you have the following needs:


- Straighten and align teeth for improved bite and aesthetics
- Correction of misaligned or asymmetrical jaws
- Retainers or night guards
- Treatment of TMJ and facial muscles related pain


Periodontics:
Periodontists receive 2 years of post-graduate training for treatment of gum disease, various gingival procedures (functional and cosmetic), and dental implants for teeth replacement. Periodontists often work along with general dentists or prosthodontists for long term periodontal care of patients (bone and gum tissue surrounding teeth). They provide both preventive periodontal care as well as both surgical and non-surgical management of periodontal disease. While some procedures are performed by both periodontists and oral surgeons, they often work in collaboration on patients with complex needs requiring both expertise. You will benefit from a periodontist if you have the following needs:


- Surgical and non-surgical treatment of gum disease
- Preventive periodontal procedures
- Treatment of gum recession via grafting procedures
- Cosmetic gingival procedures
- Minor bone grafting procedures for implants


Pediatric Dentistry:
Pediatric dentists receive 2–3 years of specialized training after dental school, and are dedicated to the oral health of children from infancy through the teenage years. The very young, pre-teens, and teenagers all need different approaches in dealing with their behavior, guiding their dental growth and development, and helping them avoid future dental problems. Some may provide oral sedation for increased patient comfort. Pediatric dentists may work in collaboration with orthodontists to treat growth related teeth or jaw misalignment. You will benefit from a pediatric dentist if you have the following needs:


- Any dental related procedures in patients from infancy to early teen-age years
- Fillings, crowns, and root canal procedures on primary teeth
- Knocked out or fractured primary teeth (may require an oral surgeon)
- Treatment of minor trauma to primary teeth
- Routine cleaning and preventive dental procedures


The ‘DDS’ vs. ‘DMD’ Question
A common question is what is the difference between a dentist who is a DDS vs. one who is a DMD!


DDS: Doctor of Dental Surgery


DMD: Doctor of Medical Dentistry


DDS or DMD Indicates the degree awarded upon graduation from dental school to become a general dentist. There is no difference between the two degrees; dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association’s Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist, such as an orthodontist, periodontist or oral and maxillofacial surgeon.


The following fields are not recognized specialties:
- Cosmetic dentistry
- Implant dentistry or implantology


You may find dentists who advertise as cosmetic or implant dentists. This does not imply specialization or even expertise. It may be used more as a marketing title, rather than true expertise. Some dentists, although not formally trained, may have received in-depth studies on cosmetic techniques or implant dentistry which provides them more knowledge and skills in these fields. Patients should ask questions about such trainings and dentist’s expertise to help them make better and more engaged decisions.

Article by
Bethesda Oral & Maxillofacial Surgeon