Who's Who In Dentistry?

OK, you've found a dentist you like--one with two arms no less. But now your dentist wants you to see a specialist. So who's who and what's what in the glorious world of oral care? Let me break it on down for you my peeps. Check it:

Endodontist: An endodontist takes care of you when you need a root canal. But that’s not all endondontists do – they also deal with the prevention, diagnosis and treatment of a wide variety of other diseases and injuries to the pulp, which is the internal soft tissue of the tooth.

Oral and Maxillofacial Radiology: This type of specialist helps to diagnose a wide variety of diseases in the head and neck through the use of X-rays, computed tomographic investigations (CT scans), magnetic resonance imaging (MRIs), and other imaging technologies.

Oral & Maxillofacial Surgeon: An oral surgeon diagnoses and operates on disease, injuries and defects in the mouth, jaw and face, generally through surgical extraction and reconstruction.

Oral Pathologist: An oral pathologist deals with the identification and management of diseases that affect your mouth and face. These specialists rely on clinical, radiographic, microscopic and biochemical examinations for diagnosis.

Orthodontist: If your dentist says you need to see an orthodontist, it means you have some irregular dental development, missing teeth or other developmental abnormalities that are in need of correction. Chances are you’ll be fitted for braces, a frequently relied upon treatment designed to establish normal function and appearance of your teeth and jaws.

Pediatric Dentist: A pediatric dentist specializes in providing comprehensive dental treatment to children, adolescents and young adults.

Periodontist: If your dentist thinks you have a disease that could seriously damage your gums, bone or other tissues that support your teeth, she’ll send you to a periodontist for diagnosis and treatment.

Prosthodontist: If you need to have a missing tooth or other oral structure replaced, your dentist will refer you to a prosthodontist.

Got it? Good.

Oral Specialist Terms courtesy MDA

Tips For Choosing A Dentist

So, you need a dentist? Here are some tips from the experts:

1. Are the office hours convenient for your schedule?

2. Is the dental office close to your home or office?

3. Does the office appear to be clean, neat and well organized?

4. How are dental emergencies handled?

5. Does the office staff appear to be friendly and helpful?

6. What is the office policy for rescheduling an appointment?

7. What is the policy on fees and payment plans?

8. Does the dental office staff explain ways to help prevent dental problems?

9. Does the office have dental health education materials available?

10. Was your medical and dental history recorded and placed in a permanent file?

Red Flag: The dentist is a double amputee.

What about proper sterilization techniques? Here are some things to look for:

1. Is the dental office clean and orderly?

2. Is the dental staff helpful and willing to answer your questions about their sterilization techniques?

3. Do the dentist and staff wear gloves and other appropriate protective gear during all actual patient treatment?

4. Do the dentist and staff wash their hands before donning a clean pair of gloves?

5. Do all surfaces and equipment in the treatment room appear clean?

6. Are needles and other sharp items disposed of in special puncture-resistant containers?

7. Is everything that is used in the patient's mouth either heat sterilized or disposable?

Red Flag: the dentist looks like this

Tips courtesy the ADA and MDA

Father Of Modern Dentistry: One Magnificent French Bastard

Pierre Fauchard (1678-1761), considered the father of modern dentistry, was indeed French and probably a frenchy french bastard. More about this French son of a bitch from The British Dental Journal:

Pierre Fauchard was born in Brittany,
France, in 1678. He was originally
apprenticed as a surgeon in the French
Navy, following which he began working
as a dentist in Western France. He read
widely and studied crafts such as watchmaking
and jewellery, from which he
adapted techniques and instruments that
he felt useful to his practice. Fauchard’s
unprecedented competency and conscientiousness
earned him an outstanding reputation,
attracting discerning patients who
journeyed great distances to see him.

In 1719 he established a practice at the University
Circle in Paris. Eighteenth century
Paris was regarded as the centre of learn-
ing and enlightenment in Europe. Quickly
recognised as a dentist of unparalleled skill
and acumen, Fauchard’s advice and talents
were regularly in demand by some of the
city’s most accomplished surgeons.
The practitioners of dentistry at that time
could broadly be described in two categories.
The first was the untrained ‘toothpuller’
who attended village fairs, and on
whom the poor relied. These frequently
employed the use of magic potions and
spells to treat dental diseases and
toothaches.

Members of the middle and
upper classes could afford the skills of more
reputable practitioners who had some form
of training, albeit in surgery rather than in
dentistry. The practice of dentistry in these
circles had been stifled by jealousy. Knowledge
and techniques were regarded as valuable
property by the more competent and
skilled practitioners, and were rarely shared
with colleagues.

In a significant break with
tradition, Fauchard published a textbook in
1728 entitled Le Chriurgien Dentiste ou
Traité des Dent (The Surgeon Dentist or
Treatise on the Teeth). This comprised two
volumes of over 800 pages and included
many illustrations. In this way Fauchard
shared his considerable knowledge and
wealth of observations with colleagues and
students, describing his techniques with
exceptional clarity and detail. Many of his
suggestions were radical for practice in
those days. For example, he advised the
seating of patients for dental procedures
when the conventional approach was to lay
the patient on the floor. He demonstrated the
presence of roots on deciduous teeth, something
that was not readily accepted at the
time. Fauchard’s openness was unprecedented.

Subsequent editions of his textbook
appeared in both French and German over
the following years, but the first English
translation was not published until 1946.
Fauchard adopted a rigorously scientific
approach to his practice. For example, the
presence of worms as the causative agent in
dental decay had been an accepted fallacy
for centuries. Fauchard demonstrated that
this was erroneous, as he studied decayed
teeth with a magnifying glass and was
unable to detect the presence of worms
within the carious lesion. His dedication to
precise and logical thinking, his conscientiousness
in treating patients and his clinical
skills led to his name becoming a byword for
excellence in the practice of dentistry.

The ‘Pierre Fauchard Academy’ was founded in
his honour in the 1930s as an international
dental honour society to recognise and
acknowledge the more dedicated and conscientious
dentists throughout the world.

Hey wow thanks Pierre.

Photo of Pierre Fauchard Courtesy of The National Library of Medicine. Pierre Fauchard and his Role in the Development of Obturators: British Dental Journal 2005;199:603-605.

Dentistry Through The Ages: 1523: The Tooth Drawer

Above is a 1523 woodcut by Lucas van Leyden. A man, standing before an open-air dentist's shop, is having a tooth extracted by a public toothdrawer; a young woman is standing behind the patient picking his pocket. The dentist's tools are arranged on a table.

Ah, the more things change... just replace the pickpocket with any health insurance company.

Credit: Courtesy of The National Library of Medicine

Oral History: George "Puffy" Washington

Actual George Washington dental facts from Prologue Magazine by Richard Norton Smith, The Surprising George Washington, Part 2:

About those teeth . . . According to John Adams, Washington lost his teeth as the result of cracking Brazil nuts between his jaws. By the time he became President, he had but a single tooth left and a set of dentures fashioned from cow's teeth. In hopes of finding something better, Washington contacted a leading dentist in Philadelphia, who produced a state-of-the-art set carved, not from wood, but from hippopotamus tusk. The new dentures were thoughtfully drilled with a hole to fit over his one remaining tooth. Unfortunately, they also rubbed against this natural tooth, causing more or less constant pain for which the President took laudanum. A bulging set of dentures contributed to this famous--if unflattering--portrait of Washington by Gilbert Stuart

And from the Smithsonian National Portrait Gallery:

When George Washington became the first President of the United States in 1783, he had only one of his teeth left in his mouth. As a boy, he had cracked walnut shells with his teeth and, as a result, many of them fell out before he was thirty! Over the years, Washington wore several sets of false teeth [see photos above.] Even though many people today believe that these teeth were made out of wood, there is no proof that he ever had wooden teeth. His dentures were made of many things. They were often a combination of human teeth, animal teeth, and ivory. They were put together with wire and a spring, which allowed the dentures to open and close. Throughout his life, Washington had trouble speaking, chewing food, and smiling. The false teeth could be painful and they sometimes made his cheeks and lips puff out. Fortunately modern dentistry now allows painless smiles for even the greatest of walnut lovers.

And from the senate.gov:

In this replica, Stuart paints Washington’s face and hair more boldly and summarily than he does in some other replicas. For example, he emulates the fleshy bridge of Washington’s nose with a creamy swirl of paint. The flesh coloring is nicely balanced, without the strong crimson cheeks Stuart often favors, although his characteristic use of red in the shadows of the upper eyelids is apparent. The modeling of the mouth seems somewhat hesitant, as if the artist were trying to modify the puffy distortion caused by the president’s notorious false teeth. The paint is applied with particular fluency in the lacy shirtfront.

Um, quick question. Today would we elect any president who used his teeth to crack open walnuts? George Washington lived from 1732 to 1799. Perhaps nutcrackers weren't widely used, but I'm pretty confident we had a firm grasp on the use of hammers. Or how bout a rock George. It's the 18th century, there are rocks everywhere. Rocks galore. You fall outta bed in the 18th century and a rock falls on top of you.

photo credits: Gilbert Stuart portrait via senate.gov. George Washington's dentures via Mt. Vernon Ladies Association and the NIH

Howard Wolfson:Battered Political Strategist Syndrome

I was watching Nightline last night and caught this interview with Clinton strategist Howard Wolfson. I noticed Mr. Wolfson was sporting a massive front tooth gap. Two plausible explanations here:

1. Mr. Wolfson has an enormous natural diastema a la Lauren Hutton and David Letterman, or Mr Wolfson

2. Was wupped upside the head with a frying pan by some unnamed Ms. Cranky Pantsuit post one certain Iowa caucus.

Oh Howard, for God sake, get out of this abusive relationship before it's too late. We're all praying for your well being Howard. In the mean time, go here for guidance, comfort and support.

Hail Caesar

Feeling inadequate dog owners? No? Let me help with that. This dog gets his teeth brushed everyday. Every. Frackin. Day. My dad is a dentist. My mom is a flippin hygienist. The few times we tried to brush our dog's teeth was like trying to control a greased pig on meth. There are some people who don't brush their teeth everyday. I may be guilty of dog dental fail. Gotta start'em young I guess. Everyday. Geez.

Go Here But Don't Go There

Massive British dental fail here.

Control Yourselves Ladies

I. Am. A dentist. Thank you God!
Photo credit unknown

Brought To You By Sporox

Sporox. The official unofficial unsanctioned mascot of the Dentist's Daughter blog. Yes ladies and gentlemen, it's Sporox, the powerful hydrogen peroxide formula for all your dental sterilization needs. Sporox. No odor. No headaches. No glutaraldehydes. No kidding!

Get yours here, here, or here. Hurry!

Dental Fail

Remember, nothing ages you more than the sun. And meth. The sun and meth. Nothing ages you more than the sun and meth. Or just meth.

methmouth photo: Jim Cecil

The University of Kentucky School of Dentistry

The Dour Virgin Lands: But Who Is The Pope's Dentist?

Pope Benedict XVI has been on U.S. soil for a few days now. It took me awhile to get a drop on the Papal Choppers as the pope isn't often photographed showing full frontal dental. The pope is now 81 and his teeth look great. I don't think he wears dentures. I believe these are his teeth. Thankfully, dentures are not inevitable in old age. We know His Holiness is no stranger to the dental chair. In 2005, the Catholic News Service reported that Pope Benedict was caught on an open microphone during an assembly telling Archbishop Nikola Eterovic of his 4 p.m. dental appointment.

Is it a crowded waiting room and stale magazines for Pope Benedict? Hardly. What I did suss out about The Holy Oral Care comes from a 2006 renovation of the papal apartment located in the Apostolic Palace. The ten room apartment includes the papal bedroom as well as a medical studio which supposedly includes emergency surgery and dentistry equipment. I have visions of the pope enrobed in a light blue paper dental bib gently gobbing into the papal cuspidor--holy spit!

Which brings us to the great mystery of our time: Who is the pope's dentist?

I searched the Vatican Secret Archives here and shockingly found nothing regarding the identity of the papal dentist. What new grim Vatican dental conspiracies are afoot here? What exactly is the church trying to hide from us this time? I can only hope that Dan Brown is on the case feverishly working to unravel this byzantine Vatican cover up. Papal dentist---Reveal thyself!

Photo: imageshack

A Public Service Announcement from The Dude

Hey man, the Dude here. You know a study in the Journal of the American Medical Association, found a strong association between cannabis use and periodontal disease in adults who were heavy youth pot smokers. In fact, regular ganja smokers are three times more likely to have periodontal disease by age 32 than non spliff users. So what is periodontal disease? It's an unholy infection of the tissues and bones that surround and support the teeth--gum disease man, gum disease.

In summary, major weed usage could lead to massive dental fail. So listen to the Dude, and step away from the bong from time to time.

Cannabis Smoking and Periodontal Disease Among Young Adults

JAMA. 2008;299(5):525-531.

Movie still: The Big Lebowski

Political Teeth: Barack Obama

Typical white teeth.

Guest blogger Reverend Jeremiah Wright: Hold Up! White teeth?! WHITE teeth! Is Barack being controlled by his white teeth? It just came to me y'all--why so many people are hatin' on Barack Obama. His teeth don't fit the model. Barack Obama is not being controlled by his Rich.White.Teeth. Hillary fits the mold. Europeans fit the mold. McCain fits the mold. Rich White Teeth fit the mold. Hillary never had a tooth wiz past her and not pick her up. Hillary never had to worry about being pulled over in her car by a Rich White Tooth because she was in the wrong neighborhood...Barack knows what it means to be living in a country and a culture that is controlled by RICH. WHITE. TEETH! No No No y'all---America's teeth... are comin' home... to roost.

Or something.

photo:senate.gov

Political Teeth: John McCain

Nice choppers Johnny. Maple or oak? Like Zoinks Scooby--it's old man McCain, run for it!

photo credit unknown

Political Teeth: Hillary Clinton

Hillary Clinton is blessed with perfect political teeth. The lies fall through like rocks through a cloud. Toothala er Tuzla?

A fun photoshop lesson here on how to whiten Hillary's naturally yellow teeth.

photo: Janet Mayer

Moderate Dental Fail

They said I had to get braces but I said....

Amy Winehouse

Photo credit unknown

Fat Kids Have Better Teeth, Fewer Cavities

A study in this month's issue of Community Dentistry and Oral Epidemiology, suggests that fat kids may have healthier teeth and fewer cavities.
Huh. Perhaps these husky little darlings secrete biologically awesome saliva that protects porky's pearly whites.

Or, as I've long suspected, Count Chocula possesses secret anti-cavity properties. Note to the journal of Community Dentistry and Oral Epidemiology:
Explore the positive oral health properties of Cap'N Crunch, Ding Dongs, and pudding.

Community Dentistry and Oral Epidemiology Volume 36 Issue 2 Page 157-167, April 2008

A 19th Century Mugging

A photo print of an actual tooth extraction circa 1892. Think of it the next time you find yourself filled with dread sitting in the pristine sterile operatory cocoon of your dentist's office inconvenienced by the prick of a numbing shot.

Image courtesy of the National Library of Medicine