Why Do I need to See a Specialist?
December 7, 2000

Dear Dr. Mady: I recently had an appointment with my dentist who I have not visited for ten years. He found all kinds of problems with my teeth and referred me out to three different types of dental specialists. One was for my gums, another was for my wisdom teeth and the third was for a root canal. From what I can remember, a general dentist office was a one-stop shop where everything was done in one office. Does this sound right to you, is this normal protocol and what are dental specialists for? -Louise in Sandwich South

Dear Louise: Many individuals feel that the general dentist can and should do anything with respect to their teeth and mouths. It is also a fact that all general dentists are educated and qualified to provide comprehensive services ranging from examinations and cleanings, all the way to oral surgery.

But it is important to understand that while your dentist can perform most forms of dental treatment, he or she may at times refer you out to a dental specialist for specific procedures if they feel that the expertise of a specialist is necessary.

Dental specialists limit their practice to their specialty and usually do no other forms of dentistry. This, along with their years of extra training in their field, enables your dentist to comfortably place you in the hands of this clinician at certain times with the confidence that you will receive excellent clinical results.

In terms of the types of dental specialists that exist and what they do, there are at least nine that I can think of and I will tell you a little about each one starting with the specific types that you were referred to. They are all recognized by the Canadian and Ontario Dental Associations.

A Periodontist is a specialist who deals with diseases of the periodontal tissues that support your teeth. These tissues include the gums and the bone that surround our teeth. They also surgically place dental implants along with many other functional and esthetic procedures.

An Oral Surgeon extracts teeth, treats injuries and deformities, and performs most types of surgery of the mouth jaw and face including implant placement. Oral surgeons are an extremely important part of our health care system. They perform in their office, in the emergency room and in hospital settings.

Endodontists spend most of their day diagnosing dental pain and infection. They deal mainly with diagnosis and treatment of injury and disease of the pulp (nerve tissue) and perform root canals on teeth.

A fourth specialty field in dentistry is Orthodontics. As most people know, orthodontists place braces on teeth but in this day and age they do a lot more than just this. The don't just straighten teeth but also correct improper occlusion or bite, and treat facial irregularities to help achieve a better facial balance and appearance for their patients.

For children and young teens that are apprehensive about dental treatment or uncooperative, there is a Pediatric Dentist. Referring a child to a clinician of this type may save them from a lifetime of dental anxiety and fear. They will also provide a healthy experience and excellent clinical treatment for children and adolescents who do not have any fear of the dentist.

If your dentist feels that you require a specialist who has expertise in the area of replacements for missing teeth, you will be sent to a Prosthodontist. Although they mostly place dentures, bridgework and restore surgically placed implants, they also spend a considerable amount of time placing crowns on teeth and completing full mouth restorations.

A dentist who is concerned with the oral and dental health of the public is known as a Public Health Dentist. They coordinate and administer community-wide dental care programs including public education on the prevention of dental disease. We do have a program of this type in our city at the Windsor Essex County Health Unit on Ouellette Avenue.

Oral Pathologists diagnose oral diseases. They also research the causes, development and effects of oral diseases. To assist in diagnosis, they don't only look at the clinical aspects of disease, but also at the radiographic, microscopic and immunological findings.

Lastly, Oral Radiologists are specialists who take and interpret many types of radiographic images involved in diagnosis. Along with these diagnoses they will provide reports to your dentist or medical professional.

No matter what type of specialist you are referred to, you should be comfortable that you are getting the best possible treatment that your dentist can provide for you. These specialists not only will work with your dentist but also with each other as a team if necessary. In Windsor we are very fortunate to have a large number of dental specialists. They help to provide our community with the best care possible, and they should be recognized for their dedication.

This column is reprinted with the permission of the author and The Windsor Star. "Ask the Dentist" is written by Windsor dentist (and ECDS member), Dr. David Mady Jr.. The column appears the first Thursday of each month in the Windsor Star. Readers with questions can write to "Ask The Dentist", c/o The Windsor Star, 167 Ferry St., Windsor Ontario, N9A 4M5



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