Addressing Spacing Issues for Dental Harmony

Addressing Spacing Issues for Dental Harmony

Types of Malocclusions: Overview of common types such as overbite, underbite, and crossbite in pediatric patients.

When it comes to children's dental health, spacing issues are a common concern that can significantly impact dental harmony. These spacing irregularities often manifest as gaps between teeth, known as diastemas, or as crowded teeth where there is insufficient room for proper alignment. Interceptive orthodontics can guide facial and jaw development Early orthodontic intervention patient. Understanding these issues is crucial for ensuring the long-term health and aesthetics of a child's smile.


One of the most frequently observed spacing issues in children is the presence of diastemas. These gaps can occur due to a variety of reasons, including the premature loss of baby teeth, which can lead to neighboring teeth shifting into the empty space. While some diastemas may close naturally as permanent teeth erupt, persistent gaps may require orthodontic intervention to prevent future complications such as misalignment or speech difficulties.


On the other end of the spectrum, crowded teeth can also pose significant challenges. Crowding often results from a discrepancy between the size of the jaw and the size of the teeth. When there is not enough space for all the teeth to align properly, they can become twisted or overlap, leading to aesthetic concerns and functional problems like difficulty in cleaning the teeth properly, which can increase the risk of decay and gum disease.


The impact of these spacing issues on dental harmony cannot be overstated. Dental harmony refers to the ideal alignment and spacing of teeth, which contributes to both the aesthetic appeal and the functional efficiency of the mouth. When teeth are well-spaced and aligned, it facilitates proper biting, chewing, and speaking. Moreover, a harmonious smile can boost a child's confidence and self-esteem, which are crucial during their developmental years.


Addressing spacing issues in children early on is vital for achieving and maintaining dental harmony. Orthodontic treatments, such as braces or clear aligners, can be employed to correct these issues. In some cases, space maintainers may be used to hold space for permanent teeth after the premature loss of baby teeth. Additionally, regular dental check-ups and consultations with an orthodontist can help monitor the development of a child's teeth and intervene as necessary.


In conclusion, common spacing issues in children's teeth, such as diastemas and crowding, can have a profound impact on dental harmony. By understanding these issues and seeking timely intervention, parents and caregivers can help ensure that their children enjoy the benefits of a healthy, harmonious smile that lasts a lifetime.

Early orthodontic interventions play a crucial role in addressing spacing problems in young children, paving the way for dental harmony. These interventions, often initiated when a child's primary teeth are still in place, aim to correct issues before they become more complex and costly to treat in adulthood.


One common spacing problem in young children is the presence of gaps between teeth, which can be caused by a variety of factors, such as thumb sucking, tongue thrusting, or the premature loss of baby teeth. If left unaddressed, these gaps can lead to misalignment of permanent teeth, bite problems, and even speech difficulties.


Early orthodontic interventions can help prevent these issues by guiding the growth and development of the jaw and teeth. For example, a child with a narrow upper jaw may benefit from a palatal expander, which gradually widens the jaw to create more space for teeth to come in properly. Similarly, a space maintainer can be used to hold the space for a permanent tooth if a baby tooth is lost prematurely.


Another benefit of early intervention is that it can reduce the need for more invasive treatments later on. By addressing spacing problems at a young age, orthodontists can often guide teeth into their proper positions without the need for extraction or extensive orthodontic work.


Moreover, early orthodontic interventions can boost a child's self-confidence by improving the appearance of their smile. Children who feel good about their teeth are more likely to take better care of them, leading to improved oral health overall.


In conclusion, early orthodontic interventions are essential for addressing spacing problems in young children and promoting dental harmony. By guiding the growth and development of teeth and jaws, these interventions can prevent more serious issues down the line, reduce the need for invasive treatments, and boost a child's self-confidence. Parents should consult with an orthodontist if they notice any spacing issues in their child's teeth to ensure the best possible outcome for their child's oral health.

Early Detection and Diagnosis: The importance of regular dental check-ups for identifying malocclusions in children.

In the quest for dental harmony, addressing spacing issues plays a pivotal role. The misalignment of teeth, often manifesting as gaps or overcrowding, can not only affect the aesthetic appeal of one's smile but also lead to functional problems such as difficulty in chewing and maintaining oral hygiene. This is where the use of braces and aligners comes into play, offering effective solutions to correct spacing issues and achieve optimal dental alignment.


Braces, traditionally made of metal or ceramic, work by applying continuous pressure on the teeth to move them into the desired position. They consist of brackets bonded to each tooth and connected by a wire that can be adjusted periodically by an orthodontist. This gradual process helps in closing gaps and aligning teeth in a way that enhances both the function and appearance of the smile. For those concerned about the visibility of braces, clear or tooth-colored options are available, blending more seamlessly with the natural teeth.


On the other hand, aligners represent a more modern approach to correcting spacing issues. Made from clear plastic, these removable devices are custom-fitted to the patient's teeth and are changed every few weeks to reflect the gradual movement of the teeth. Aligners offer the advantage of being nearly invisible, making them a popular choice among adults and teens who are self-conscious about wearing traditional braces. Additionally, their removable nature allows for easier cleaning and the ability to eat without restrictions, enhancing the overall experience of orthodontic treatment.


Both braces and aligners are effective in correcting spacing issues, but the choice between them depends on individual needs and preferences. Factors such as the severity of the spacing, the patient's age, lifestyle, and aesthetic concerns all play a role in deciding the most suitable treatment. Regardless of the method chosen, the ultimate goal remains the same: to achieve dental harmony by correcting spacing issues and ensuring optimal alignment.


In conclusion, braces and aligners serve as essential tools in the journey towards a well-aligned smile. By addressing spacing issues, they not only enhance the aesthetic appeal but also contribute to better oral health and function. As such, they are indispensable in the pursuit of dental harmony, offering personalized solutions that cater to the diverse needs of patients seeking to improve their smiles.

Orthodontic Treatment Options for Kids: Discussing braces, aligners, and other corrective measures suitable for young patients.

Regular dental check-ups and monitoring play a crucial role in achieving dental harmony, particularly during orthodontic treatment aimed at addressing spacing issues. These routine visits are essential not only for maintaining oral health but also for ensuring the success of orthodontic interventions.


Orthodontic treatment, which often involves the use of braces, aligners, or other devices to correct spacing problems, requires meticulous monitoring to track progress and make necessary adjustments. Regular check-ups allow orthodontists to assess the movement of teeth, ensuring they are shifting according to plan. This is vital in preventing complications such as uneven spacing or misalignment, which could compromise the final outcome.


Moreover, these appointments provide an opportunity for dental professionals to identify and address any issues that may arise during treatment. For instance, brackets may become loose, or wires might need adjustments. Prompt attention to these matters can prevent delays and ensure the treatment remains on track.


Beyond the mechanical aspects, regular dental visits also focus on maintaining overall oral health. Orthodontic appliances can make it challenging to clean teeth effectively, increasing the risk of plaque buildup and gum disease. During check-ups, dental hygienists can clean areas that are difficult to reach at home and offer personalized advice on oral hygiene practices tailored to the patient's specific needs.


Furthermore, these visits allow for the early detection of any dental issues unrelated to the orthodontic treatment, such as cavities or gum inflammation. Addressing these problems promptly can prevent them from interfering with the orthodontic process and contributing to further spacing issues.


In essence, regular dental check-ups and monitoring are indispensable components of orthodontic treatment aimed at achieving dental harmony. They ensure that spacing issues are addressed effectively, while also safeguarding the overall health of the teeth and gums. By committing to these routine visits, patients can enhance their chances of achieving a beautifully aligned and healthy smile.

The Role of Parents in Orthodontic Care: How parents can support their child's orthodontic treatment and encourage good oral habits.

As a parent, supporting your child's orthodontic treatment and maintaining good oral hygiene are crucial steps in addressing spacing issues for dental harmony. Orthodontic treatment, such as braces or aligners, can correct misaligned teeth and improve overall oral health, but it requires diligent care and support from both the child and the parents.


First and foremost, it's essential to encourage your child to maintain excellent oral hygiene throughout their orthodontic treatment. This means brushing their teeth at least twice a day, using fluoride toothpaste, and spending extra time cleaning around brackets and wires. A soft-bristled toothbrush or an electric toothbrush can help remove plaque and food particles more effectively. Additionally, flossing daily with the help of floss threaders or orthodontic flossers is crucial to prevent gum disease and tooth decay.


Parents can also support their child's orthodontic treatment by ensuring they attend all scheduled appointments with their orthodontist. Regular check-ups and adjustments are necessary to monitor progress and make any necessary changes to the treatment plan. If your child is experiencing discomfort or issues with their braces, encourage them to communicate openly with their orthodontist, as timely adjustments can make a significant difference in their overall experience.


Another way to support your child's orthodontic journey is by helping them make healthy food choices. Sticky, hard, or sugary foods can damage braces or lead to tooth decay, so it's best to avoid these items. Instead, encourage your child to eat soft, nutritious foods like fruits, vegetables, lean proteins, and dairy products. If they do indulge in sugary treats, remind them to brush their teeth immediately afterward to minimize the risk of cavities.


Lastly, be patient and supportive throughout the orthodontic treatment process. It's normal for children to feel self-conscious about their appearance with braces, so offer them encouragement and remind them that the end result will be a beautiful, healthy smile. Celebrate milestones along the way, such as the removal of braces or the completion of aligner treatment, and praise your child for their dedication to their oral health.


By following these tips and working closely with your child's orthodontist, you can help them achieve dental harmony and maintain good oral hygiene throughout their orthodontic treatment. Remember, your support and guidance play a vital role in ensuring a successful outcome and a lifetime of healthy smiles.

Long-term Benefits of Early Orthodontic Intervention: How treating malocclusions in childhood can prevent more serious issues in adulthood.

Addressing spacing issues early can have profound long-term benefits for achieving a harmonious and healthy smile. When we consider dental harmony, it's not just about aesthetics; it's about ensuring the overall health and functionality of our teeth and jaws.


One of the primary advantages of early intervention in spacing issues is the prevention of more complex dental problems down the line. For instance, gaps between teeth can lead to food accumulation, increasing the risk of decay and gum disease. By addressing these spaces early, we can maintain better oral hygiene and reduce the likelihood of these conditions developing.


Moreover, correcting spacing issues early can positively impact the alignment of the teeth and jaws. Properly spaced teeth are less likely to shift out of place, which can prevent issues such as overbites, underbites, and crossbites. This not only contributes to a more aesthetically pleasing smile but also ensures that the bite remains functional, reducing strain on the jaw muscles and temporomandibular joints.


Another significant benefit is the boost in self-confidence that comes with a harmonious smile. Children and adults alike can feel more comfortable and confident in social and professional settings when they are not self-conscious about their teeth. Early intervention can save individuals from the emotional and psychological impact of dental insecurities.


In terms of treatment, early action often means less invasive and more cost-effective solutions. Orthodontic treatments like braces or clear aligners can be more straightforward and efficient when applied early, potentially reducing the need for more extensive procedures like surgery or veneers later in life.


In conclusion, the long-term benefits of addressing spacing issues early are clear. From preventing dental diseases and ensuring proper alignment to enhancing self-esteem and optimizing treatment outcomes, early intervention is a crucial step toward achieving a harmonious and healthy smile. By prioritizing dental health from a young age, we set the foundation for a lifetime of confident smiles and optimal oral health.

 

  • Sub-Millimeter Surgical Dexterity
  • Knowledge of human health, disease, pathology, and anatomy
  • Communication/Interpersonal Skills
  • Analytical Skills
  • Critical Thinking
  • Empathy/Professionalism
  • Private practices
  • Primary care clinics
  • Hospitals
  • Physician
  • dental assistant
  • dental technician
  • dental hygienist
  • various dental specialists
Dentistry
A dentist treats a patient with the help of a dental assistant.
Occupation
Names
  • Dentist
  • Dental Surgeon
  • Doctor

[1][nb 1]

Occupation type
Profession
Activity sectors
Health care, Anatomy, Physiology, Pathology, Medicine, Pharmacology, Surgery
Description
Competencies  
Education required
Dental Degree
Fields of
employment
 
Related jobs
 
ICD-9-CM 23-24
MeSH D003813
[edit on Wikidata]
An oral surgeon and dental assistant removing a wisdom tooth

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 (the development and arrangement of teeth) as well as the oral mucosa.[2] 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.[3] 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.[4] Dentistry is often also understood to subsume the now largely defunct medical specialty of stomatology (the study of the mouth and its disorders and diseases) for which reason the two terms are used interchangeably in certain regions. However, some specialties such as oral and maxillofacial surgery (facial reconstruction) may require both medical and dental degrees to accomplish. In European history, dentistry is considered to have stemmed from the trade of barber surgeons.[5]

Dental treatments are carried out by a dental team, which often consists of a dentist and dental auxiliaries (such as dental assistants, dental hygienists, dental technicians, and dental therapists). Most dentists either work in private practices (primary care), dental hospitals, or (secondary care) institutions (prisons, armed forces bases, etc.).

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 (study of blood) to avoid bleeding complications during dental surgery, cardiology (due to various severe complications arising from dental surgery with patients with heart disease), etc.

Terminology

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The term dentistry comes from dentist, which comes from French dentiste, which comes from the French and Latin words for tooth.[6] The term for the associated scientific study of teeth is odontology (from Ancient Greek: á½€δούς, romanized: odoús, lit. 'tooth') – the study of the structure, development, and abnormalities of the teeth.

Dental treatment

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Dentistry usually encompasses practices related to the oral cavity.[7] 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.[8]

The majority of dental treatments are carried out to prevent or treat the two most common oral diseases which are dental caries (tooth decay) and periodontal disease (gum disease or pyorrhea). Common treatments involve the restoration of teeth, extraction or surgical removal of teeth, scaling and root planing, endodontic root canal treatment, and cosmetic dentistry[9]

By nature of their general training, dentists, without specialization can carry out the majority of dental treatments such as restorative (fillings, crowns, bridges), prosthetic (dentures), endodontic (root canal) therapy, periodontal (gum) therapy, and extraction of teeth, as well as performing examinations, radiographs (x-rays), 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.

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.[10][11][12] The National Institutes of Health include a dental exam in the diagnostic protocol of celiac disease.[10]

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.[7][10][13][14] 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

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A sagittal cross-section of a molar tooth; 1: crown, 2: root, 3: enamel, 4: dentin and dentin tubules, 5: pulp chamber, 6: blood vessels and nerve, 7: periodontal ligament, 8: apex and periapical region, 9: alveolar bone
Early dental chair in Pioneer West Museum in Shamrock, Texas

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.[15] 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.[16] The Philadelphia College of Dental Surgery followed in 1852.[17] In 1907, Temple University accepted a bid to incorporate the school.

Studies show that dentists that graduated from different countries,[18] or even from different dental schools in one country,[19] 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 (wisdom teeth) more often than dentists that graduated from Latin American or Eastern European dental schools.[20]

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.[21] The British Dentists Act of 1878 and the 1879 Dentists Register limited the title of "dentist" and "dental surgeon" to qualified and registered practitioners.[22][23] However, others could legally describe themselves as "dental experts" or "dental consultants".[24] The practice of dentistry in the United Kingdom became fully regulated with the 1921 Dentists Act, which required the registration of anyone practising dentistry.[25] The British Dental Association, formed in 1880 with Sir John Tomes as president, played a major role in prosecuting dentists practising illegally.[22] Dentists in the United Kingdom are now regulated by the General Dental Council.

In many countries, dentists usually 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;[26] Dental degrees awarded around the world include the Doctor of Dental Surgery (DDS) and Doctor of Dental Medicine (DMD) in North America (US and Canada), and the Bachelor of Dental Surgery/Baccalaureus Dentalis Chirurgiae (BDS, BDent, BChD, BDSc) 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" (DDS) or "Doctor of Dental Medicine" (DMD). 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 (Pedodontics), Periodontics, and Prosthodontics.[27]

Specialties

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A modern dental clinic in Lappeenranta, Finland

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[28] – 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 (also called endodontology) – 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 (also called oral surgery) – Extractions, implants, and surgery of the jaws, mouth and face.[nb 2]
  • Oral biology – Research in dental and craniofacial biology
  • Oral Implantology – The art and science of replacing 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 (also called pedodontics) – Dentistry for children
  • Periodontology (also called periodontics) – The study and treatment of diseases of the periodontium (non-surgical and surgical) as well as placement and maintenance of dental implants
  • Prosthodontics (also called prosthetic dentistry) – 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 (microtia). 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 (also called special care 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.[29] The sports dentist works as an individual consultant or as a member of the Sports Medicine Team.
  • Veterinary dentistry – The field of dentistry applied to the care of animals. It is a specialty of veterinary medicine.[30][31]

History

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A wealthy patient falling over because of having a tooth extracted with such vigour by a fashionable dentist, c. 1790. History of Dentistry.
Farmer at the dentist, Johann Liss, c. 1616–17

Tooth decay was low in pre-agricultural societies, but the advent of farming society about 10,000 years ago correlated with an increase in tooth decay (cavities).[32] An infected tooth from Italy partially cleaned with flint tools, between 13,820 and 14,160 years old, represents the oldest known dentistry,[33] although a 2017 study suggests that 130,000 years ago the Neanderthals already used rudimentary dentistry tools.[34] In Italy evidence dated to the Paleolithic, around 13,000 years ago, points to bitumen used to fill a tooth[35] and in Neolithic Slovenia, 6500 years ago, beeswax was used to close a fracture in a tooth.[36] The Indus valley has yielded evidence of dentistry being practised as far back as 7000 BC, during the Stone Age.[37] The Neolithic site of Mehrgarh (now in Pakistan's south western province of Balochistan) indicates that this form of dentistry involved curing tooth related disorders with bow drills operated, perhaps, by skilled bead-crafters.[3] The reconstruction of this ancient form of dentistry showed that the methods used were reliable and effective.[38] The earliest dental filling, made of beeswax, was discovered in Slovenia and dates from 6500 years ago.[39] Dentistry was practised in prehistoric Malta, as evidenced by a skull which had a dental abscess lanced from the root of a tooth dating back to around 2500 BC.[40]

An ancient Sumerian text describes a "tooth worm" as the cause of dental caries.[41] Evidence of this belief has also been found in ancient India, Egypt, Japan, and China. The legend of the worm is also found in the Homeric Hymns,[42] and as late as the 14th century AD the surgeon Guy de Chauliac still promoted the belief that worms cause tooth decay.[43]

Recipes for the treatment of toothache, infections and loose teeth are spread throughout the Ebers Papyrus, Kahun Papyri, Brugsch Papyrus, and Hearst papyrus of Ancient Egypt.[44] The Edwin Smith Papyrus, written in the 17th century BC but which may reflect previous manuscripts from as early as 3000 BC, discusses the treatment of dislocated or fractured jaws.[44][45] In the 18th century BC, the Code of Hammurabi referenced dental extraction twice as it related to punishment.[46] Examination of the remains of some ancient Egyptians and Greco-Romans reveals early attempts at dental prosthetics.[47] However, it is possible the prosthetics were prepared after death for aesthetic reasons.[44]

Ancient Greek scholars Hippocrates and Aristotle wrote about dentistry, including the eruption pattern of teeth, treating decayed teeth and gum disease, extracting teeth with forceps, and using wires to stabilize loose teeth and fractured jaws.[48] Use of dental appliances, bridges and dentures was applied by the Etruscans in northern Italy, from as early as 700 BC, of human or other animal teeth fastened together with gold bands.[49][50][51] The Romans had likely borrowed this technique by the 5th century BC.[50][52] The Phoenicians crafted dentures during the 6th–4th century BC, fashioning them from gold wire and incorporating two ivory teeth.[53] In ancient Egypt, Hesy-Ra is the first named "dentist" (greatest of the teeth). The Egyptians bound replacement teeth together with gold wire. Roman medical writer Cornelius Celsus wrote extensively of oral diseases as well as dental treatments such as narcotic-containing emollients and astringents.[54] The earliest dental amalgams were first documented in a Tang dynasty medical text written by the Chinese physician Su Kung in 659, and appeared in Germany in 1528.[55][56]

During the Islamic Golden Age Dentistry was discussed in several famous books of medicine such as The Canon in medicine written by Avicenna and Al-Tasreef by Al-Zahrawi who is considered the greatest surgeon of the Middle Ages,[57] Avicenna said that jaw fracture should be reduced according to the occlusal guidance of the teeth; this principle is still valid in modern times. Al-Zahrawi invented over 200 surgical tools that resemble the modern kind.[58]

Historically, dental extractions have been used to treat a variety of illnesses. During the Middle Ages and throughout the 19th century, dentistry was not a profession in itself, and often dental procedures were performed by barbers or general physicians. Barbers usually limited their practice to extracting teeth which alleviated pain and associated chronic tooth infection. Instruments used for dental extractions date back several centuries. In the 14th century, Guy de Chauliac most probably invented the dental pelican[59] (resembling a pelican's beak) which was used to perform dental extractions up until the late 18th century. The pelican was replaced by the dental key[60] which, in turn, was replaced by modern forceps in the 19th century.[61]

Dental needle-nose pliers designed by Fauchard in the late 17th century to use in prosthodontics

The first book focused solely on dentistry was the "Artzney Buchlein" in 1530,[48] and the first dental textbook written in English was called "Operator for the Teeth" by Charles Allen in 1685.[23]

In the United Kingdom, there was no formal qualification for the providers of dental treatment until 1859 and it was only in 1921 that the practice of dentistry was limited to those who were professionally qualified. The Royal Commission on the National Health Service in 1979 reported that there were then more than twice as many registered dentists per 10,000 population in the UK than there were in 1921.[62]

Modern dentistry

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A microscopic device used in dental analysis, c. 1907

It was between 1650 and 1800 that the science of modern dentistry developed. The English physician Thomas Browne in his A Letter to a Friend (c. 1656 pub. 1690) made an early dental observation with characteristic humour:

The Egyptian Mummies that I have seen, have had their Mouths open, and somewhat gaping, which affordeth a good opportunity to view and observe their Teeth, wherein 'tis not easie to find any wanting or decayed: and therefore in Egypt, where one Man practised but one Operation, or the Diseases but of single Parts, it must needs be a barren Profession to confine unto that of drawing of Teeth, and little better than to have been Tooth-drawer unto King Pyrrhus, who had but two in his Head.

The French surgeon Pierre Fauchard became known as the "father of modern dentistry". Despite the limitations of the primitive surgical instruments during the late 17th and early 18th century, Fauchard was a highly skilled surgeon who made remarkable improvisations of dental instruments, often adapting tools from watchmakers, jewelers and even barbers, that he thought could be used in dentistry. He introduced dental fillings as treatment for dental cavities. He asserted that sugar-derived acids like tartaric acid were responsible for dental decay, and also suggested that tumors surrounding the teeth and in the gums could appear in the later stages of tooth decay.[63][64]

Panoramic radiograph of historic dental implants, made 1978

Fauchard was the pioneer of dental prosthesis, and he invented many methods to replace lost teeth. He suggested that substitutes could be made from carved blocks of ivory or bone. He also introduced dental braces, although they were initially made of gold, he discovered that the teeth position could be corrected as the teeth would follow the pattern of the wires. Waxed linen or silk threads were usually employed to fasten the braces. His contributions to the world of dental science consist primarily of his 1728 publication Le chirurgien dentiste or The Surgeon Dentist. The French text included "basic oral anatomy and function, dental construction, and various operative and restorative techniques, and effectively separated dentistry from the wider category of surgery".[63][64]

A modern dentist's chair

After Fauchard, the study of dentistry rapidly expanded. Two important books, Natural History of Human Teeth (1771) and Practical Treatise on the Diseases of the Teeth (1778), were published by British surgeon John Hunter. In 1763, he entered into a period of collaboration with the London-based dentist James Spence. He began to theorise about the possibility of tooth transplants from one person to another. He realised that the chances of a successful tooth transplant (initially, at least) would be improved if the donor tooth was as fresh as possible and was matched for size with the recipient. These principles are still used in the transplantation of internal organs. Hunter conducted a series of pioneering operations, in which he attempted a tooth transplant. Although the donated teeth never properly bonded with the recipients' gums, one of Hunter's patients stated that he had three which lasted for six years, a remarkable achievement for the period.[65]

Major advances in science were made in the 19th century, and dentistry evolved from a trade to a profession. The profession came under government regulation by the end of the 19th century. In the UK, the Dentist Act was passed in 1878 and the British Dental Association formed in 1879. In the same year, Francis Brodie Imlach was the first ever dentist to be elected President of the Royal College of Surgeons (Edinburgh), raising dentistry onto a par with clinical surgery for the first time.[66]

Hazards in modern dentistry

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Long term occupational noise exposure can contribute to permanent hearing loss, which is referred to as noise-induced hearing loss (NIHL) and tinnitus. Noise exposure can cause excessive stimulation of the hearing mechanism, which damages the delicate structures of the inner ear.[67] NIHL can occur when an individual is exposed to sound levels above 90 dBA according to the Occupational Safety and Health Administration (OSHA). Regulations state that the permissible noise exposure levels for individuals is 90 dBA.[68] For the National Institute for Occupational Safety and Health (NIOSH), exposure limits are set to 85 dBA. Exposures below 85 dBA are not considered to be hazardous. Time limits are placed on how long an individual can stay in an environment above 85 dBA before it causes hearing loss. OSHA places that limitation at 8 hours for 85 dBA. The exposure time becomes shorter as the dBA level increases.

Within the field of dentistry, a variety of cleaning tools are used including piezoelectric and sonic scalers, and ultrasonic scalers and cleaners.[69] While a majority of the tools do not exceed 75 dBA,[70] prolonged exposure over many years can lead to hearing loss or complaints of tinnitus.[71] Few dentists have reported using personal hearing protective devices,[72][73] which could offset any potential hearing loss or tinnitus.

Evidence-based dentistry

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There is a movement in modern dentistry to place a greater emphasis on high-quality scientific evidence in decision-making. Evidence-based dentistry (EBD) uses current scientific evidence to guide decisions. It is an approach to oral health that requires the application and examination of relevant scientific data related to the patient's oral and medical health. Along with the dentist's professional skill and expertise, EBD allows dentists to stay up to date on the latest procedures and patients to receive improved treatment. A new paradigm for medical education designed to incorporate current research into education and practice was developed to help practitioners provide the best care for their patients.[74] It was first introduced by Gordon Guyatt and the Evidence-Based Medicine Working Group at McMaster University in Ontario, Canada in the 1990s. It is part of the larger movement toward evidence-based medicine and other evidence-based practices, especially since a major part of dentistry involves dealing with oral and systemic diseases. Other issues relevant to the dental field in terms of evidence-based research and evidence-based practice include population oral health, dental clinical practice, tooth morphology etc.

A dental chair at the University of Michigan School of Dentistry

Ethical and medicolegal issues

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Dentistry is unique in that it requires dental students to have competence-based clinical skills that can only be acquired through supervised specialized laboratory training and direct patient care.[75] This necessitates the need for a scientific and professional basis of care with a foundation of extensive research-based education.[76] According to some experts, the accreditation of dental schools can enhance the quality and professionalism of dental education.[77][78]

See also

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  • Dental aerosol
  • Dental instrument
  • Dental public health
  • Domestic healthcare:
    • Dentistry in ancient Rome
    • Dentistry in Canada
    • Dentistry in the Philippines
    • Dentistry in Israel
    • Dentistry in the United Kingdom
    • Dentistry in the United States
  • Eco-friendly dentistry
  • Geriatric dentistry
  • List of dental organizations
  • Pediatric dentistry
  • Sustainable dentistry
  • Veterinary dentistry
 

Notes

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  1. ^ Whether Dentists are referred to as "Doctor" is subject to geographic variation. For example, they are called "Doctor" in the US. In the UK, dentists have traditionally been referred to as "Mister" as they identified themselves with barber surgeons more than physicians (as do surgeons in the UK, see Surgeon#Titles). However more UK dentists now refer to themselves as "Doctor", although this was considered to be potentially misleading by the British public in a single report (see Costley and Fawcett 2010).
  2. ^ The scope of oral and maxillofacial surgery is variable. In some countries, both a medical and dental degree is required for training, and the scope includes head and neck oncology and craniofacial deformity.

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