Dental specialists are a strange breed. I mean no disrespect, as some of my good dentist friends are specialised, but they're a bit crazy. My patients often ask me if I would one day like to specialise, and my answer is a clear and resounding "No!". I truly love general dentistry. I love the variety, both in the clientele and the treatment. I can't imagine spending my entire work day on one particular area. I also can't imagine undertaking between three and ten years more study in order to obtain the masters or doctorate degree required to register as a dental specialist. For those strange few though, there can be an appeal to a particular specialty, or a lust for the challenge of the most complex cases and treatment in a field.
It seems it's not only me who is confused by dental specialties. I've had a number of patients tell me they're off to see the orthodontist, when they've in fact been referred to a periodontist. So what's the difference? Here's a brief description of what's involved with the dental specialists patients are commonly referred to:
Problems with the pulp, which is the living part at the centre of the tooth made up of blood vessels and nerves, sometimes just called the "nerve". Patients are usually referred to an endodontist for complications arising around root canal therapy.
Oral and maxillofacial surgery
These amazing people have a medical degree as well as a dental degree, and then their specialist training on top of that. They diagnose and surgically treat a range of problems involving the face and jaws. This includes fixing birth defects, traumatic injuries such as car accidents, removal of cancers and reconstruction afterwards. The more common things that people are referred for are removal of stubborn wisdom teeth, and placement of dental implants.
Oral medicine specialists get all the weird stuff. They deal with the oral health of people who have diseases affecting their mouth. This can include infections, autoimmune conditions, oral cancer, as well as myriad other weird rashes, lumps and bumps.
In WA this qualification is combined with oral medicine. In other places though, as a standalone specialty it means spending a lot of time looking at tissue samples from biopsies under a microscope. An oral pathologist can then come up with a report and diagnosis, which is sent back to the referring dentist or specialist who took the sample. In general, orthodontists straighten teeth. Sometimes this involves braces, sometimes it's about guiding the growth of the jaws using various appliances. Their practice is not restricted to kids and teenagers, with many adults now deciding to undergo orthodontic treatment.
Children who need complex treatment, who are very young, or who are frightened of dental treatment are often referred to a specialist paedodontist. Their practices are set up to be child friendly, and a number of options will be available for behaviour management. Paedodontists also treat adults with special needs that can complicate treatment in a general dental setting, such as intellectual disability.
Gums are the territory of the periodontist. Periodontists take care of periodontitis, (gum disease), as well as carrying out surgery such as gum grafts, gum lifts, and dental implants.
Patients are referred to a prosthodontist when the reconstruction of their teeth becomes too complex for a general dentist. Prosthodontists deal in the reconstruction of heavily broken down teeth, and the replacement of missing ones. This can include treatment with crowns, bridges, veneers, dentures, and implants.
If you would like further information on this subject please visit my previous blog article "Specialists"