Dental Care
According to the American Dental Association (ADA), “dentistry is the evaluation, diagnosis, prevention, and/or treatment of diseases and disorders of the oral cavity.” This includes the mouth (oral: teeth, tongue, and gums) and facial area (maxillofacial: jaws and lips). In essence, dentists help people “maintain and improve their oral health, quality of life, and appearance” (ADA).
Dentists as Specialists
There are many opportunities for specialization in dentistry. Aside from general dentistry, the field most are familiar with is orthodontics, the practice concerned with conditions that require moving teeth or correcting malformations of teeth and their relationship to facial bones.
Other specializations include periodontics (the prevention, diagnosis, and treatment of diseases of the tissue supporting and surrounding the teeth); oral and maxillofacial pathology, radiology, and surgery (the nature, identification, and management of diseases affecting the oral and maxillofacial regions); endodontics (diseases of the pulp); and prosthodontics (maintaining or restoring oral functions, comfort, and appearance). Pediatric dentists work specifically with children.
Oral Health and Disease of the Body
Most dentists do more than take care of teeth and the facial area. They can also be the key diagnosticians for other health issues that are often first evidenced in the mouth. The Centers for Disease Control and Prevention (CDC) reports that mouth lesions and other oral conditions may often be the first sign of HIV infection. The Center also reports that recent studies indicate associations between oral infections and diabetes, heart disease, and stroke. Saliva, which can be used to detect and measure many compounds in the body, can alert a dentist of diseases such as hepatitis A and B or identify antibodies against bacteria. Scientists at the CDC say saliva testing can “potentially replace blood testing for diagnosis and monitoring of diseases such as Parkinson’s disease, alcoholic cirrhosis, and many infectious diseases.”
According to the Academy of General Dentistry (AGD), a person suffering from the eating disorder bulimia is often discovered by the family dentist. The constant use of vomiting after a session of binge eating erodes tooth enamel, which is “a telltale sign of frequent self-induced vomiting” (AGD). According to Karl F. Woodmansey, spokesperson for AGD, “Bulimics can melt their teeth away over time.” Additionally, Woodmansey says, the gastric acid from self-induced vomiting causes sores to appear on the sides of the mouth, which may only be apparent to the family dentist.
Dental Care and Public Health
Some dentists choose to work in public health. They are instrumental in preventing and controlling dental diseases and promoting dental health through organized community efforts. Public health dentists educate the public and implement community-based preventive programs such as community water fluoridation and oral cancer screening; they treat the community as their patient rather than the individual.
In an April 2003 news release, the U.S. Department of Health and Human Services (HHS) released its National Call to Action to Promote Oral Health report. HHS Secretary Tommy G. Thomson said, “Oral health is integral to overall health. It’s critical that we all work together to improve the nation’s health, especially among children.” The report finds that many Americans suffer from poor oral health but “among children, dental caries (tooth decay) is the single most common chronic childhood disease” (HHS, 2003). This becomes a significant public health issue when our nation’s children lose more than 51 million school hours per year (HHS, 2000).
Oral diseases affect children’s appearance and their ability to eat and communicate effectively. Left untreated, oral diseases are progressive and many children will needlessly loose teeth, endure pain, and develop oral infections that compromise their overall health and wellbeing. Studies indicate that children with compromised health and wellbeing are unable to work productively at school (HHS, 2000).
Careers in Dentistry
There are many options in dentistry. The ADA states that “Dentistry is changing rapidly, creating many opportunities and challenges. Dentists treat a diverse group of patients in a variety of settings using a variety of techniques and procedures.” Many dentists work in private practice or in partnership with other dentists. Some work in academia, combining research, teaching, and community service, while others choose public health dentistry, international health care, or hospital dentistry.
Several factors have increased the demand for dental care. As our population ages and older adults keep their teeth longer, the demand for dental care is on the rise. The ADA reports that large numbers of dentists are projected to retire and new dentists will be needed in all sectors of the dental field. A growing demand for cosmetic services (such as bonding) means the need for an increased number of dentists to fill the void. Finally, new information about the relationship of oral health to general health makes dentistry an important health profession for the future.
Careers in dentistry are extremely lucrative—the average income of a dentist falls in the highest five percent of U.S. family incomes. General practitioners earn slightly less than dental specialists.
The Face of Dentistry in the Future
Women are a growing force in dental care, representing 40 percent of all students enrolled in U.S. dental schools (ADA). HHS’s National Call to Action to Promote Oral Health outlines a plan to achieve a more balanced workforce to adequately serve the public. To achieve this balanced workforce, HHS suggests that universities need to attract more minorities to dental schools and offers recommendations on how to make dental school more affordable to minority and low-income students. According to the ADA, “[the] outlook is favorable for new dentists, and exceptional career opportunities exist for minority students.”
Preparing for a Career in Dentistry
High school students should opt for broad exposure to science and math. The ADA recommends that high school students enroll in college preparatory classes with a special emphasis in biology, chemistry, and algebra.
A college degree with an emphasis on natural sciences such as biology, organic and inorganic chemistry, and physics will help prepare the college student for dental school. The ADA recommends that college students take the Dental Admissions Test one year prior to entering dental school.
Other careers in dental care include dental hygiene, dental assisting, and dental laboratory technology. All vary in scope, depth, and education. For more information, go to the ADA Web site at http://www.ada.org or the Academy of General Dentistry at http://www.agd.org.
Expanding Dental Health Services Through School-Based Health Centers
As reported above, good oral health serves as the gateway to overall health and general wellness in children. Although fluoridation is the most effective way to prevent dental caries, more than 100 million Americans do not have an optimally fluoridated water supply (National Center for Education in Maternal and Child Health). Additionally, the lack of access to proper dental care for children who are disadvantaged by poverty, minority status, or social conditions makes tooth decay the most common chronic childhood disease.
One way to address the oral health needs of disadvantaged children is through school-based programs. In February, 2002, The Robert Wood Johnson Foundation awarded grants to 15 organizations through its Caring for Kids: Expanding Dental and Mental Health Services Through School-Based Health Centers program. Organizations in Alabama, Michigan, Missouri, New Jersey, New York, and Texas received three-year grants to test and promote new models to expand dental health services in existing school-based health centers. Currently, there are more than 1,400 centers across the country. To find out more about the program, go to the Caring for Kids Web site at http://www.healthinschools.org/dental.asp. Another resource for school-based health centers, Addressing oral health needs: A how-to guide, can be found on the Community Catalyst, Inc. Web site at http://www.communitycatalyst.org.
References
Academy of General Dentistry. Dentists may be first to detect eating disorders. Retrieved June 2, 2003, from http://www.agd.org/consumer/topics/overallhealth/eatingdisorders.html.
American Dental Association. Dentistry definitions: Definition of dentistry. Retrieved June 2, 2003, from http://www.ada.org/prof/ed/specialty/definition.html.
Centers for Disease Control. (2000). Fact sheet: Links between oral and general health. Retrieved June 2, 2003, from http://www.cdc.gov/OralHealth/factsheets/sgr2000-fs4.htm.
Community Catalyst, Inc., & Health Care for All. (2002). Addressing oral health needs: A how to guide. Retrieved June 2, 2003, from http://www.communitycatalyst.org/acrobat/Dental_How_To_Guide.pdf.
National Center for Education in Maternal and Child Health. (1999). Trends in Children’s Oral Health. Arlington, VA.
U.S. Department of Health and Human Services. (2003, April 29). National strategy seeks to improve America’s oral health. Retrieved June 2, 2003, from http://www.hhs.gov/news/press/2003pres/20030429.html.
U.S. Department of Health and Human Services. (2000). Oral health in America: A report of the Surgeon General. Retrieved June 2, 2003, from http://www.surgeongeneral.gov/library/oralhealth/default.htm.
Additional Resources
Career Focus:Public Health Dentist
Project Spotlight: West Virginia Public Health Pipeline
