Science and Profession (Magill’s Medical Guide, Sixth Edition)
The practice of dentistry is a highly specialized area of medicine that treats the diseases of the teeth and their surrounding tissues in the oral cavity. Dental education normally takes four years to complete, with predental training preceding it. Prior to entering a dental school, students are usually required to have a bachelor’s degree from a college or university. This degree should have major emphasis in biology or chemistry. Predental courses are concentrated in both inorganic and organic chemistry. The biology courses can cover such subjects as comparative anatomy, histology, physiology, and microbiology. Other courses that can help students to prepare for both dental school and the future practice of dentistry are English, speech skills, economics, physics, computer technology, and subjects, such as sculpture, that teach spatial relationships. Upon entering dental school, students are faced with two distinct parts of their education: didactics and techniques.
The didactic courses offered in dental schools are required to achieve knowledge of the human body, most particularly the head and neck. Some of the courses required are human anatomy (including dissection of a human cadaver), physiology, biochemistry, microbiology, general and oral histology and pathology, dental anatomy, pharmacology, anesthesiology, and radiology. One course specific to dental school is occlusion, which emphasizes the structure of...
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Diagnostic and Treatment Techniques (Magill’s Medical Guide, Sixth Edition)
The practice of dentistry is quite different in modern times compared to the past. While some techniques and materials are still in use, there have been improvements in materials and instruments because of expanded knowledge in many scientific fields. This knowledge has increased to such an extent that dentistry has divided into several specialties. While the general dentist uses all disciplines of dentistry to treat patients, complex problems often require referral and the expertise of a specialist.
The general dentist is involved primarily in the treatment of caries or tooth decay and the replacement of missing teeth. Bacterial acids that dissolve the enamel and dentin of teeth cause caries. A diseased or damaged tooth must be prepared mechanically by the removal of the decayed material using a dental drill and tough, sharp bits called burs. The amount of damage and the position of the tooth in the mouth determine the type of restoration. In the posterior or back teeth, initial cavities may be restored with silver amalgam or bonded composite resins. In addition to removing the decayed tooth structure, the dentist must take into consideration the closeness of the dental pulp, the chewing forces of the opposing teeth, and the aesthetics of the finished restoration. In the anterior or front teeth, aesthetic restorative materials are used to fill small cavities. In this case also, the size and position of...
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Perspective and Prospects (Magill’s Medical Guide, Sixth Edition)
In the past, dentistry only treated pain caused by a diseased tooth; the usual mode of treatment was extraction. Today, the prevention of disease, the retention of teeth, and the restoration of the dentition are the treatment goals of dentists.
The development of composite resins has successfully addressed many aesthetic problems associated with restorations. Although metal fillings of silver amalgam (actually a mixture of silver, lead, and a small amount of mercury) and cast-gold restorations are often the treatments of choice, the display of metal is offensive to some patients. Plastic composite materials that are chemically bonded to the enamel and dentin of teeth are more aesthetically pleasing than metals. They have also shown great promise for longevity. There is still some concern about the resistance of these materials to chewing forces and leakage of the bonding to the tooth, but the techniques and materials are improving.
Dental porcelains improved greatly in the last half of the twentieth century. Although porcelain fused to metal crowns is often the material of choice, in certain cases crowns, inlays, and fixed bridges of a newer type of porcelain are being used. Thin veneers of porcelain are also used to restore front teeth that are congenitally or chemically stained. The result is cosmetically more appealing. Through a similar bonding process of composites, these veneers on the front surfaces of...
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For Further Information: (Magill’s Medical Guide, Sixth Edition)
Foster, Malcolm S. Protecting Our Children’s Teeth: A Guide to Quality Dental Care from Infancy Through Age Twelve. New York: Insight Books, 1992. This book is written for parents and other interested readers. It gives insights and suggestions for promoting general dental health.
Gluck, George M., and William M. Morganstein. Jong’s Community Dental Health. 5th ed. St. Louis, Mo.: Mosby, 2003. Explores the role of dentistry in public health, examining such topics as dental care delivery, demographic shifts and dental health, distribution of dental disease and prevention, and research in dental public health.
Kendall, Bonnie L. Opportunities in Dental Care Careers. Edited by Blythe Camenson. New York: McGraw-Hill, 2006. This text provides guidance for students interested in the field of dentistry. It provides information about careers in all allied dentistry fields. Admission requirements for different careers and the names of professional schools that can supply the training are listed.
Moss, Stephen J. Growing Up Cavity Free: A Parent’s Guide to Prevention. New York: Edition Q, 1994. This rather brief book is written in easy-to-understand language. There are standard suggestions for preventing dental problems.
Parker, James N., and Philip M. Parker, eds. The Official Patient’s Sourcebook on Gingivitis. San Diego, Calif.: Icon Health, 2002....
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Dentistry (Encyclopedia of Science)
Dentistry is the medical field concerned with the treatment and care of the teeth, the gums, and the oral cavity. This includes treating teeth damaged by tooth decay, accidents, or disease. Dentistry is considered an independent medical art, with its own licensing procedure. Orthodontics is the branch of dentistry concerned with tooth problems such as gaps between the teeth, crowded teeth, and irregular bite. Periodontics, another branch, focuses on gum problems.
Historical dental practices
Dental disease has been one of the most common ailments known to humankind. Ancient men and women worked hard to alleviate dental pain. As early as 1550 B.C., Egyptians used various remedies for toothache, which included such familiar ingredients as dough, honey, onions, incense, and fennel seeds.
The Egyptians also turned to superstition for help in preventing tooth pain. The mouse, which was considered to be protected by the Sun and capable of fending off death, was often used by individuals with a toothache. A common remedy involved applying half of the body of a dead mouse to the aching tooth while the body was still warm.
The Greek physician Hippocrates (C. 460. 377 B.C.), considered the father of medicine, believed that food lodged between teeth was responsible for tooth decay. He suggested pulling teeth that were loose and...
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Dentistry (Encyclopedia of Food & Culture)
DENTISTRY. Food and dental health interact, with each having effects on the other. Patterns of eating affect the health of the teeth and other tissues in the mouth, while the ability to chew a variety of foods without discomfort influences a person's nutritional state as well his or her enjoyment of eating.
Sugar and Dental Caries
The clearest link between food and dental health is between sugar consumption and caries (cavities). A study in the 1940s compared the dental health of children in an area of northern India, where food was scarce and malnutrition common, to that of better-nourished children in Lahore and in Rochester, New York. The poorly nourished children had the fewest cavities. Subsequent research confirmed that populations who enjoyed a good nutritional status had more caries than less well-nourished populations.
Researchers then looked at the mechanism of caries development to discern the role of diet. Cavities are the end result of a process that involves bacteria and sugars in the mouth over time. Streptococcus mutans, bacteria that are normally present in plaque, a very fine film which covers the surfaces of the teeth, metabolize sugar and form acid. When a person consumes sugar in foods or beverages, acid is formed that can dissolve minute amounts of minerals from the enamel surface of the tooth. When this happens repeatedly over time, enough minerals are lost for a cavity to form.
This relationship between sugar consumption and caries was tested in a classic study conducted at Vipeholm, a mental institution in Sweden, and reported in 1954. Although modern ethical standards would preclude a study in which subjects were unable to give informed consent, it remains a landmark piece of research. Residents were assigned to several groups. All ate the standard diet of the institution, but some were given additional sweets in varying quantities and frequency, up to twenty-four sticky toffee candies per day. After five years of observation, the researchers concluded that the stickiness of the sweets and the frequency with which they were consumed, both increasing the amount of time that the bacteria in plaque could produce acid, were more important than the total amount of sugar.
Streptococcus mutans can feed on any carbohydrate, not just sugars. The bacteria make no distinction between "natural" carbohydrates, such as the sugars in fruit, and refined sugars; they make acid from any of them.
Oral bacteria also make acid from sugar in liquids. This can lead to a particular pattern of caries called "baby-bottle caries," which develops when a baby is put to bed with a bottle filled with sugar-containing liquid, including milk. When the baby falls asleep, the liquid pools in the mouth, leading to decay, most often of the front upper teeth.
Since sugar has been shown to play such a significant role in the development of tooth decay, a basic preventive measure is to limit the frequency of sugar consumption. Because it is the action of bacteria on the sugar that is of concern, minimizing the bacteria by careful attention to oral hygiene is equally important. Fluoride, a mineral that is naturally present in water in some areas, has a strong protective effect as well. It binds to the other minerals to become part of the enamel, making the enamel harder and more resistant to decay. It also slows acid formation and promotes repair of places on the teeth where acid has dissolved some of the minerals.
In areas where the naturally occurring level of fluoride in water is low, it is often added during water treatment. Although there have been controversies about water fluoridation, public health authorities, including the American Dental Association, the United States Public Health Service, and the World Health Organization, all support it as a safe and effective preventive measure. One can see its effectiveness in the fact that, although sugar consumption in the United States has been increasing, children have fewer cavities than they had in the years before fluoridation became widespread.
Sugar substitutes are used to produce candies, chewing gum, and beverages that taste sweet without harming the teeth. Chewing gum containing xylitol, one of these alternative sweeteners, has been shown to be protective.
Diet and Periodontal Disease
Gingivitis, or periodontal disease, is the other common dental disorder. The bacteria in dental plaque cause an infection of the gums and structures that hold the teeth in place. The gums become red, swollen, and tender. Food does not play an important role in the development of gum disease, as it does in the formation of caries. Good oral hygiene is the most important preventive measure. A nutritious diet, which supplies generous amounts of vitamins and minerals, can offer some benefit by helping to maintain the immune system's ability to fight the infection.
Dental Status and Eating
The other side of the food and dental health interaction is the importance of healthy dentition in enabling people to eat and enjoy a wide variety of foods. The absence of a significant number of teeth or a condition such as periodontal disease or poorly fitting dentures, which makes chewing uncomfortable, may limit a person's food choices and compromise his or her nutritional status. This problem occurs most frequently in elderly and low-income populations, who are more likely to be at risk for nutritional problems.
Some researchers do not find this effect, possibly because the subjects with poor dentition have chosen nutritious foods that are easy to chew, or because the comparison population ate no better in spite of good dental status. In general, however, poor dental health increases the risk of poor nutritional health. Good dental care can correct most of these problems and enable individuals to enjoy eating a nutritious diet.
See also Digestion; Fluoride.
American Dental Association web site. Available at .
Burt, B. A., and S. Pai. "Sugar Consumption and Caries Risk: A Systematic Review." Paper presented at the Consensus Development Conference on Diagnosis and Management of Dental Caries throughout Life, Bethesda, Md., March 2001.
FDI Working Group. "Nutrition, Diet, and Oral Health: Report of and FDI Working Group." International Dental Journal 44 (1994): 59912.
Gustaffson, B. E., C. E. Quensel, L. S. Lanke, et al. "The Vipeholm Dental Caries Study: The Effect of Different Levels of Carbohydrate Intake on Caries Activity in 436 Individuals Observed for Five Years." Acta Odontologica Scandinavica 11 (1954): 23264.
Mona R. Sutnick