A question for everyone about dentistry.....?

Question

I'm a dentist.

I want to know: if you went to your dentist for a toothache and he told you that you had to see an endodontist for the root canal, would you find it ridiculous that there is a doctor who specializes in doing root canals?

If you went to your dentist and he told you that you had gum disease and referred you to a periodontist, would you find it ridiculous that there is a doctor who specializes in gum disease?

If you came to your dentist about a toothache, and he told you that the tooth was broken down and required a surgical extraction, and he was going to refer you to an oral surgeon despite the fact that you didn't want to be sedated during the extraction, would you find it ridiculous that your dentist would be unable to extract the tooth?

What I want to know is this: do any of you, the public, find it ridiculous that the dental profession has NINE specialists, in addition to general dentists?

Answer 1

It's because of the old fashioned belief that dentists are like barbers. Cutting hair isn't that difficult is it? Filling a tooth can't be that hard to do.

The main reasons why people refuse a referral to a specialist are financial and fear of the unknown. Advances in dentistry these days, however, have produced techniques and knowledge that only specialists know best.

Having a root canal done by your family dentist on a tooth with heavily calcified canals or curved roots is no different than having a rhinoplasty done by your family physician versus a plastic surgeon.

Answer 2

No I dont think its ridiculous, well, the oral surgeon one may be because pulling a tooth isnt that hard, but for the others I would def prefer to see someone who knows what they are doing, rather then a general dentist who does a root canal every now and again, or someone who sees gum disease once a year. I want someone who knows how to help me and does this all the time so he knows what he is doing, and more importantly so his assistants know what they are doing.

Answer 3

No, I do not find it ridiculous that the dental field has specialists in addition to general dentists. I can't speak for all the different specialists,but I can speak of an endodontic specialist since I have been the assistant for one for over fifteen years.

I'm sure all the different specialists require a different amount of years but I know that an endodontist has at least two additional years of advanced education and training in root canal techniques and procedures.In addition to treating routine cases,they are experts in performing complicated procedures including surgery. They often treat difficult cases-such as teeth with unusual or complex root structure or small,narrow canals. Endodontists are also experienced at finding the cause of oral and facial pain that has been difficult to diagnose.

I also have to add that the amount of patients referred to our office from general dentists that have tried to perform a root canal on their patient and have totally messed the tooth up is unbelievable. He has to fix their mistakes on a daily basis.

Answer 4

Would you take your BMW to a Ford mechanic? Do you buy your Thanksgiving turkey at the mall snack-bar? Would you go to Costco to purchase one apple?
What's ridiculous is when a general dentist thinks he can extract an impacted wisdom tooth, or an ankylosed root canal-treated tooth, and the patient has to endure hours in the chair because he doesn't have the instruments or the training! He specializes in saving teeth, not extracting.

Answer 5

No. it's called progress. 21st century. Dr., u don't mind if i call u dr.!!! patients who happen to find it ridiculous or think that u don't know ur own profession are ignorant. They're not intellectual and probably education to them is reading how much a football team has scored, or what this week hold for them, according to their sun sign...!!!

Patients who have a background of.. well education, would know about the specialists, and would actually respect you and thank you for your honesty and your help in telling them exactly what kind of dentist they need to go to....

My sister-in-law is a dentist, an ortho. my dentist refer us to many other dentists according to the kind of problem we have, he did 3 surgeries to remove my wisdom teeth which were growing under the gum and not in the right direction. First surgery took 5 minutes to be completely done, second, took about 10 or 15 minutes because it had to be chopped and it did ... into 5 pieces inside my mouth.. ughhh... Last one, within two minutes, he just pull it out...

Answer 6

You might not be aware that judgements are now being awarded for malpractice because of failure to diagnose AND REFER for treatment of periodontal disease.

http://professional.protectorplan.com/pdfs/RiskManagement/Periodontal%20disease.pdf

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2374013&dopt=Abstract

http://www.hanisgreaney.com/PracticeAreas/Dental-Malpractice.asp

I see a list of the top three reasons for dental liability claims are:
- Dissatisfaction with prosthesis
- Failure to treat or improper treatment of endodontic pathology
- Periodontal neglect
( http://www.nysdental.org/img/pdf_files/riskmtg2006webhandout.pdf )

SINCE THE SPECIALTIES EXIST, whenever a general dentist performs the work of a specialist, he/she will be held to the same standards as the specialist who has passed a specialty-certifying board of examiners.

If I undertake the root canal treatment of an upper third molar and find that it has an open figure-eight apex with no apical constriction, I must still instrument and fill it to the standard of the specialist.

If I find that a patient has refractory periodontal disease that is not responding to conventional treatment with or without the patient's cooperation in home therapy, I will still be held to the standard of the specialist when that patient loses his/her teeth.

If I see a third molar that is clearly impinging on the inferior alveolar nerve creating great risk for parasthesia and I endevour to remove the tooth, I will still be held to the standard of the specialist. If a patient is left with residual parasthesia, I guarantee you that the plaintif lawyers have a thousand dental experts lined up just waiting to say that the tooth should have ONLY been removed by a specialist.

This is a little difficult for me, as I am in a town that does not have an endodontist or periodontist and only one oral surgeon. If they were right next door, I'd use them more than I do, as it is both in the patient's best interest as well as my own, due to liabilty concerns associated with difficult cases.

Answer 7

Well, it seems that is the development of most professions, that we have specialties withing the profession that one needs referring to. I remember when I came back to Texas after losing my leg in a railroad accident and was in severe pain, that the only way I could get any pain medicine that was worth swallowing was to go to a doctor who specialized in treating pains and had the license to prescribe stronger pain medicine. All the while, my leg that I had lost in the accident kept "reliving" the pain of having been crushed and severed by a railroad car, and I can tell you that "life's a bittch" when you're feeling that kind of pain. Then, when I finally got to go to one of those pain specialists, he wanted to do a surgery similar to what many women get during child birth, and guaranteed (almost) that the surgery would do the job. I had told him I was tired of being poked at and prodded at and cut on and asked would he PLEEEEEZE write a prescription for a stronger pain medicine. He had a valid concern for any patient's addiction to said medicines, and yet my severe pain in my leg was valid concern for having the medicine. Once he realized I had no history with alcohol and drug problems and that, in fact, had been an alcohol and drug counselor among other issues for 20+_years, he finally wrote the prescriptions. I took them for a short while till I realized I could make it through the night without them, and then dumped them unceremoniously in the toilet and flushed them to China, and have done well since. I have also been to a dentist who referred me to another dentist-type who would do the root canal. I was okay with that since the surgeon had nice chairs in his waiting room and I was more assured of a painless and effective job. The same was true when one dentist referred me to one of those guys who work on your gums, but then my pharmaceutical friend told me how to treat my problem with a special type "tooth brush" with baking soda and hydrogen peroxide, so I did that and did just fine. I know all the specializations can be "bumfuzzeling" at times, and more costly too. Sometimes it's worth it, and sometimes it's a pain-in-the-asss. God Bless you.

Answer 8

Well yes because I always feel it is a way for my insurance company to make more money off of me. Not only that but I have had the same dentist for goodness, almost 20 years and I have a good relationship with him. It is uncomfortable having to go see a perfect stranger to have a pretty major procedure done. I am just more comfortable having my dentist work on me. Good question!

Answer 9

yes and I am in the medical profession as well-also amazed at the primitive nature of root canals period much less a specialty area-like the last doc I went to for two dental implants-no sedation-just local-piece of cake-the dental profession is very strange in this respect-
Very mechanistic.

Answer 10

What I have to ask is, if there are nine specialty categories for dentist, what the hell does "general" dentistry involve? From what your post says, a DDM does nothing but cleanings and gives referals. What a gig! No wonder there are SO many dentists out there!!