One of the frustrating things about health care, either dentistry or medicine, is when you need to see a specialist. For most of us, that means going to a new office, interacting with an unfamiliar staff, and of course, a new doctor. We sometimes wonder why our own doctor could not treat us, and how serious our condition is. These doubts, coupled with the unusual environment of the specialist's office, can increase the stress and anxiety associated with the office visit. To help ease these concerns, I will provide some information about what types of procedures are most likely to be referred from a general dentist to a dental specialist.
Before we get into the specifics about what procedures should be referred to a dental specialist, we need to define what the dental specialties are, and what makes them different from general dentistry. To become a dentist, you generally need to complete four years of college and four years of dental school. If you want to specialize, you need to complete an additional two to six more years.
Here's the breakdown of the main dental specialties: oral surgery (3-4 years after dental school, an M.D. degree can be obtained in a 6-year program): treatment involving the removal of teeth and jaw surgery; periodontics (2-3 years): treatment of gum disease; prosthodontics (2 years): rebuilding teeth and replacing missing teeth; pediatric dentistry (2 years): dental treatment of children; orthodontics (2-3 years): straightening teeth with dental braces; and endodontics (2 years): root canal therapy and the surgery associated with saving teeth. All of these dental specialties can be a useful resource for you and your family dentist.
What most people want to know is "what procedures should my family dentist refer to a specialist?" and the short answer is "whatever procedures he or she cannot do, or feels that a specialist can do significantly better." The most common procedures that a general dentist refers to a specialist include, extraction of impacted wisdom teeth and other complex dental extractions; most biopsies and other jaw surgeries; surgical placement of dental implants; almost all orthodontics (braces); complex root canal procedures often on the back teeth (molars), including apicoectomy (surgical removal of the root tip); most gum surgeries; complicated dental rehabilitations (especially involving dental implants); dental treatment of phobic children or those with physical or mental handicaps; and other difficult dental treatments.
The degree to which a general dentist will refer to a specialist varies widely from dentist to dentist. Some general dentists, myself included, perform the vast majority of treatment needed by their patients. In contrast, other dentists refer a high percentage of their difficult procedures to dental specialists, electing to do only routine treatment. The main reason for this disparity has to do with the training and experience of the general dentist. In most cases, dentists who have had hospital or other residencies, and have taken many hours of continuing education are more likely to perform procedures that are sometimes referred to specialists. In fact, the recent trend is for the general dentist to do more of these advanced procedures, providing most of their patient's dental needs "under one roof." Even so, in some cases, the dental specialist is the best person to treat a difficult dental problem.
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