The Fourth Orthodontic Toast: Orthodontics
In various navies, the fourth toast of the week is “Our Navy” specifically the service they are in.
As in yesterday’s blog I talked about “ourselves” as the profession we’re in: dentistry. I will consider today’s theme as the specialties we choose to work in.
And off the bat, I say specialty which is an area of special expertise within a profession, not speciality which is something a restaurant is good at.
This naval toast has been modified a bit over the years –it was classically “a bloody war or a sickly season”. This made absolutely no sense to me until I found an explanation: It was only the officers making these toasts and they realised that their most rapid means of promotion was the untimely demise of other officers superior to them – either by war or disease.
In the dental specialties there is an element of career development, but it’s less dependent on another dentist’s departure from this mortal coil. All dental students graduate with a basic understanding and competency in many areas of dentistry. The balance of those areas depends on the dental school they trained at, but organisations like The Dental Council of Ireland or General Dental Council in the UK ensure the minimum standards are consistent throughout their respective countries. It also depends on the era - most dental students in Ireland will probably only have extracted a fraction of the teeth that any of my class in dental school extracted.
Most dentists work in what’s referred to as General Practice, but despite the name it’s a discipline in itself. It has its own faculty and sets of exams in the world of post-graduate dentistry. The other areas of dentistry (and some basic explanations) that tend to be demarcated as specialties to different extents in different countries are usually:
- Dental Radiology (study of X-ray imaging)
- Dental Public Health (studying and devising ways to improve the dental health of large groups of people)
- Oral Surgery (removal of teeth or cysts, taking biopsies or other surgical intervention in the mouth)
- Oral Medicine (treatment of disorders of the mouth that don’t need surgery – this may be related to the systemic health of the patient)
- Oral Pathology (study of diseases of tissues in the mouth, particularly at the microscopic level)
- Oral Microbiology (study of infections and germs that relate to the mouth)
- Orthodontics (treatment of abnormal positions or relations of the teeth)
- Restorative Dentistry (replacement and repair of damaged or missing teeth – this often combines the areas of Periodontics, Prosthodontics and Endodontics)
- Endodontics (root canal treatments)
- Periodontics (treatment of disorders of the gums and how the teeth attach to the jaw)
- Prosthodontics (replacement of absent teeth)
- Paediatric Dentistry (treatment of children)
- Special Care Dentistry (dental treatment for patients with disabilities or impairment)
There’s a certain overlap between these. Sometimes a child loses a baby tooth early and that can lead to crowding when the adult teeth come through – whether it’s a general dentist, a paediatric dentist or an orthodontist that looks after the space the decision and treatment is usually the same, but it would come down to which of us is more able to provide it and which of us the patient and their parent would rather attend.
Any dentist can do work in any area of dentistry but they can’t use words like specialist unless their regulating organisation allows them to. In Ireland, the only officially recognised dental specialties are Oral Surgery and Orthodontics. This means that anyone calling themselves an Oral Surgeon or an Orthodontist is on a separate list compiled by the Dental Council of Ireland that verifies that they have passed extra exams and done years of work exclusively in those areas in addition to the regular dental degree.
What draws someone to a particular specialty is hard to define. I love orthodontics because of the transformative effect it has on people and how happy it makes them when they see the final result and the sense that I have done something for someone that they really appreciate and may improve the way they engage with the world for the rest of their lives.
So to my orthodontist colleagues, lift your tankards....