This follows on from a previous article explaining the simple difference between dentists and orthodontists in terms of other subjects like doctors and surgeons and police officers and detectives. This article outlines the types of work that dentists and orthodontists do.
Years ago, hundreds of years ago, dentistry was a fairly unsophisticated subject. It required good physical skill, but the range of treatments available was fairly small – if your tooth was badly hurting, you saw someone to take it out. There weren’t any anaesthetics, so if you were lucky, the dentist took out the tooth quickly, and it didn’t break on the way out, and it didn’t hurt too much, and if you were very lucky he took out the correct tooth first time.
There wasn’t the option of modern fillings or root treatments, or gum treatments. There weren’t even antibiotic medicines to stop infections and abscesses. In fact, dental infections were a significant cause of death in the middle ages. Back then, a lot of dentistry, like a lot of surgery, was carried out by barbers, who had a good collection of blades and steel instruments.
Eventually dentistry moved on. More treatments were developed and some teeth could be saved. Advances in anaesthetics meant that more work could be done on teeth without upsetting the patients. After a while examinations were brought in to make sure that the people carrying out dentistry were fit to do so and this helped protect the public from poor dentists.
Over the years dentistry became even more advanced. Nowadays, a dentist would leave dental school and expect to know about:
- Tooth whitening
- Root treatments
- Gum diseases
- Jaw muscle problems
- Problems involving the lining of the mouth, including the tongue, and including monitoring for mouth cancer
- Dental Surgery
- Children’s dentistry
- Dental X-Rays
- Medical problems related to dentistry
- Dental problems related to medicine
- Medications needed to treat dental problems
That’s a lot to stay on top of, and it also is a lot of instruments to keep in order to provide all of these treatments, so many dentists tend to concentrate on the areas that interest them most. The area I know best is orthodontics, and here are some of the areas of orthodontics that orthodontists need to think about when planning, organising, and carrying out treatment for a patient:
- Invisible braces (like INVISALIGN))
- Tooth coloured braces (like DAMON CLEAR)
- Metal Fixed Braces (train tracks like DAMON Q or MX)
- Lingual Braces (Braces on the inside of the teeth)
- Removable braces
- Retainer braces
- Twin block braces
- Headgear braces
- Developing teeth
- Extra teeth (supernumerary teeth)
- Missing teeth
- Teeth with abnormal roots
- Teeth in an abnormal position
- Abnormal jaw bone
- Abnormal tooth shape
- Abnormal jaw sizes
- Abnormal gums
- How the growth of the face and jaws will affect the treatment
- How to tell if a patient’s face is still growing
- If the patient needs surgery for the teeth
- If the patient needs surgery for the jaws
- If the patient needs surgery for the gums
- If the wisdom teeth will affect things
- Is there any special reason why the finished result won’t be stable
- If treatment is going well or not
So you can see there is plenty to think about when you are doing orthodontics, and doing all of these things well takes a big range of instruments and dental gadgets, and I think any dental specialist will tell you it is the same for the area that they work in.
Staying up to date with the best way of working out what the problems are, and the best way of treating them can take a while, so orthodontists usually spend all their time working in this one area. That way we can keep learning and stay up to date with the subject, and we get more comfortable with the details of treating orthodontic problems because we do it every day, and have a full range of equipment for looking after the details in the most comfortable way for the patient too.
I do update myself on the other areas of dentistry, so that I know how to interact with other dentists to get the best results for our patients, but I don’t do the other areas of dentistry myself because that would start to get me out of my “performance zone” as an orthodontist – if I spent an hour doing fillings or making dentures for a patient, that would be an hour that I wouldn’t be doing orthodontics, and I would be getting out of practice with my own instruments.
New wires? New braces? New technology? New techniques? Most orthodontists are reading journals every week, going to lectures every few months to learn about them. We don’t do the other bits of dentistry, so we can concentrate on the area we love to do.