You may or may not know that there are many different types of dentists who care for the public’s dental health. Dentists are highly trained medical providers who specialize in treating your teeth and mouth. Oral health is essential to your overall health, and our oral health might contribute to various diseases and conditions including: endocarditis, cardiovascular disease, pregnancy and birth complications and pneumonia.
Why Are Different Types of Dentists Needed?
Over the years, many patients have asked me what the difference is among all of the different clinical dental specialists and a general dentist. Some also ask why one office doesn’t have all the different types of dentists working full time under the same roof.
Think of it this way: a woman sees her OB/GYN for her annual check up. This doctor can not only perform a breast exam and pap smear, but can also care for her when she’s pregnant and deliver her baby. Some doctors in this specialty choose not to practice obstetrics but only gynecology. Say the patient receives some questionable test results during an annual exam, and they appear to be cancerous. The woman would see a gynecologic oncologist, who would likely only see patients diagnosed with cancer in the female anatomy and practice in a separate office. In addition, an OB/GYN and gynecologic oncologist each perform so many procedures, use so many different types of equipment and supplies, and see patients with different emotional needs, that it’s a better decision to have the subspecialty under a different roof. This is similar to how different types of dentists can work.
To help understand the different types of dentists, here’s a basic explanation of the focus and education required for each.
Education Needed for Different Types of Dentists
Dental school is a four-year postgraduate program to obtain a dental degree which is either DDS (Doctor of Dental Surgery) or DMD (Doctor of Dental Medicine) depending on what school one attends. After graduation, a burgeoning dentist has to take the respective state dental board to become a licensed dentist in that state. If someone wants to become a specialist in one of the six other dental clinical specialties, they need to then attend a residency program in that field similar to the additional education that medical doctors require for their specialties.
Now that I’ve discussed the education needed to become a dentist, let’s explore the different types of dentists and how they can help you.
Every graduate from dental school can practice as a general dentist. I am a general dentist in Coral Gables, and with my license I can perform any dentistry procedure in my office. For example, some general dentists love to perform root canals, others love to do extractions. In my opinion, the typical general dentist will stick mostly to restorative dentistry and hygiene care in their office. This includes, but is not limited to, initial and emergency exams, including oral cancer screenings, cleanings and periodic hygiene exams, gum treatments for gum disease, white fillings to repair decayed or broken teeth, porcelain crowns, bridges and veneers, implant porcelain crowns and teeth whitening. We personally also offer Invisalign, a cosmetic type of orthodontic treatment, in our office. Because many of our patients require more specialized dental services in addition to the general dentist services offered, we work closely with periodontic, endodontic and general dentist associates who perform a wide array of dental treatments – from botox treatments to simple extractions to complex All-on-4 treatments – right in our office. Our patients experience personalized care, all in their general dentist’s office with the dentist overseeing their treatments.
A periodontist focuses on problems that patients have with their gums, bone and tissues which support the teeth. To explain bone loss to our patients, I compare the support of the teeth with bone around them in the mouth like a fence post that is placed into the ground with concrete around it. When a six foot fence post has four feet of supportive concrete around it in the ground, it is very strong and stable. If the same six foot fence post only has six inches of concrete around it in the ground, it can be moved very easily and is neither stable nor strong. A similar situation occurs when patients lose bone around a tooth; the tooth becomes mobile and the patient can eventually lose the tooth.
When it is determined that our patients have signs of bone loss around their teeth during their routine, preventative, hygiene cleaning visit, we will generally schedule a deep cleaning – many times using local antibiotics – to make the gums healthy again and train our patients how to improve their home care. The difference between a routine cleaning and a deep cleaning is that a deep cleaning is usually necessary when a patient hasn’t visited any types of dentists for awhile, they’re experiencing excessive bleeding and inflammation, or they may have unhealthy levels of bacteria or tartar under the gums. If the gums and teeth do not respond or need further treatment, then we will have our periodontist perform an exam. Periodontists are trained to treat these diseased areas, and they will work to save teeth unless they have passed a point of no return. Periodontists perform many procedures such as reducing excess gums, evening out the level of the gums for esthetics, adding gum grafts to areas that are recessed and lack tissue, bone grafting on areas lacking bone, extractions of hopeless teeth, placing dental implants to support crowns for replacing missing teeth (including the All-on-4 procedure which restores an entire mouth of teeth in one day) and biopsies on suspicious tissue areas.
An endodontist is also known as a root canal specialist. They treat the sick, dead, inflamed or infected nerve of a tooth that can cause excruciating pain. The inside of each tooth has living blood vessels and cells called the pulp. If a cavity, a crack or trauma affect the pulp, the nerve dies and becomes infected and can cause a pressure and inflammation in the bone and tissue supporting the tooth. Sometimes patients will present with a swollen area and pus will actually drain from around the root. When an endodontist performs a root canal treatment they will actually drill a small access hole into the top of the tooth, remove the infected tissue, clean and shape the canals with small shaping files and place a rubber material called gutta percha into the canal to seal it from any further bacteria invading the space. Generally this will immediately remove all the pain in the area and with the help of antibiotics the tooth will usually feel better very soon. After the endodontist has completed the root canal, a temporary filling is placed in the access area. The general dentist will then fabricate a porcelain crown on top of the back tooth to protect it from fracturing. Endodontists also perform surgery – an apicoectomy – on teeth that have a chronic infection that won’t heal with regular root canal treatments.
An orthodontist in the past only did braces on kids and adults to straighten their teeth. Now the field includes dentofacial orthopedics as well. The goal of both of these modalities is to correct a bad bite or a malocclusion. The bite is the way that the upper and lower set of teeth actually come together. The teeth are ideally designed to bite in the front and chew in the back and are shaped with that function in mind. If the bite relationship is not set up properly, the tooth structure can actually wear out the wrong way or even break. Jaw and neck problems like TMD (Temporomandibular joint dysfunction) or TMJ (temporomandibular joint) can also occur. Bad bites can be caused by irregular jaw growth patterns, crowded or misaligned teeth or bad habits. Fortunately orthodontists now have several ways to correct these bad bites, including appliances that children can wear to actually change the growth patterns in their jaws to a more ideal position. As far as methods to move the actual teeth themselves, we now have many choices. Traditional metal braces, brackets and wires still remain an option, clear brackets with metal wires are now available. Many patients opt for an Invisalign dentist and subsequent treatment which uses a series of removable clear trays that cover all of the teeth and progressively line up the teeth to an ideal bite. The benefit of the Invisalign is that you can remove the trays for any event. Orthodontists also make different types of retainers to keep your teeth lined up over time.
An oral and maxillofacial surgeon is best known for wisdom tooth extractions. This is an important treatment, but oral surgeons do much more than this. Generally wisdom teeth do not have the room that they need to erupt and come into place as the last teeth in the mouth on the upper and the lower arches. If they are allowed to remain they can crowd your teeth, cause infection or even damage other teeth or bone in your mouth. They can be fully impacted, which means that they are covered by the bone and the gums, partially impacted or fully erupted in the mouth. Generally if teeth are more impacted, a more involved surgery would be needed to remove them. Oral surgeons now have operating rooms set up in their offices instead of using a hospital like when I was a teenager. Oral surgeons also perform extractions anywhere needed in the mouth, corrective jaw surgery to better align misaligned jaws, facial trauma surgery in accident cases, biopsies on suspicious areas in the mouth, bone grafts and implant procedures, and TMD surgeries.
A prosthodontist is a dental specialist who makes prostheses, or replacement teeth that are removable or non-removable for patients who are missing some or all of their teeth. These include porcelain crowns and bridges, partial dentures and full dentures. Most general dentists do all of these procedures and some dentists, like in our office, have advanced training and do larger cases as well involving implants or natural teeth. Prosthodontists also build specialized dentures for patients who have lost part of their jaw due to accidents, cancer or physical defects.
After reviewing the types of dentists who can see either adults or children, a pediatric dentist or pedodontist is a type of dentist who treats mainly children. As anyone who has kids knows, children usually have increased anxiety when visiting any types of dentists and need some extra care. Some general dentists do not see children in their office and will refer to a pedodontist. We treat children in our office for routine cleanings, x-rays, white fillings and extractions. When we see a child who has special needs and cannot be treated in a general dentist office, we will refer them to the pedodontist. The child can be mildly sedated and the work will be completed safely there.
Find a Dentist in Coral Gables, FL
Thank you for reading our blog about the different types of dentists. Whether you need a general dentist, cosmetic dentist, periodontist, endodontist, orthodontist, oral surgeon, prosthodontist or pedodontist, the team at South Gables Dental can help!
Don’t hesitate to contact us to schedule an appointment for all of your Coral Gables or Miami dentist needs.
I’m Dr. Lawrence Lesperance, a Coral Gables dentist who specializes in preventative dentistry, general dentistry services, and cosmetic dentistry services. My team and I provide personalized dental services for the whole family and offer orthodontic treatments, implant dentistry, periodontic services and botox treatments (for TMJ and migraines and cosmetic botox) and much more. Contact us to experience the South Gables Dental difference today!