Dentistry: The Art & Science of Diagnosis, Treatment & Prevention of Oral Cavity Diseases

Dentistry is a branch of medicine that deals with the study, diagnosis, prevention, and treatment of diseases of teeth, oral cavity, jaw and facial area. It is the art of managing dental problems. Dentistry is important for overall health, some oral cavity diseases can affect the rest of the body and cause complications such as cellulitis, Ludwig’s angina, and septicemia (blood infection). Also, many diseases (such as blood diseases, cancer, infections) may manifest some symptoms in the oral cavity.The most common diseases in dentistry are dental caries, dental abscess, malocclusion, and gum disease. The dental team is responsible for the diagnosis and treatment of oral cavity diseases. The dental team consists of dentists (doctors of oral health), dental assistants, dental hygienists, and dental technicians.

The History of Dentistry: An Overview of the History of Dentistry

The history of dentistry is a part of medical history and dates back to prehistoric times. The earliest evidence of dental treatment was found in a 14000-year-old male from the cave of Riparo Villabruna at Sovramonte in northern Italy. Also, in Neolithic graveyard in ancient Pakistan from around 5500 – 7000 BC, the decayed tooth was drilled by bow drills and followed by tooth filling. Etruscans and Phoenicians have made the first dental prosthesis in 166 – 201 AD. They used gold crowns and bridge work. The Sumerians believed That “Tooth Worm” is the cause of dental caries (tooth decay). In the early 18 century, scientists especially the french Pierre Fauchard placed the scientific basis of dentistry in the modern era.

The dental treatment under anesthesia was performed in the 19th century with nitrous oxide, which has been synthesized in 1776. Ether and chloroform anesthesia followed the laughing gas. In November 1895, Wilhelm Conrad Röntgen discovered Röntgen rays also known as x-rays. It simplified the examination of jaws. The German chemist Alfred Einhorn and Emil Julius Uhlfelder have developed the local anesthetic procaine in 1905. Then dentistry experienced a rapid progress from the development of numerous oral surgical procedure to the manufacture of dental prostheses by CAD/CAM methods.

Pierre Fauchard (1678 – March 22, 1761) was a french dentist and known as “The father of modern dentistry”. He considered the first person who introduce dentistry on a scientific basis in his book “The surgeon dentist”, published in 1728.

Dentistry Timeline:

  • 7000 BC: In Indus valley civilization, the earliest evidence of dental treatments were found in a neolithic graveyard, in ancient Pakistan. Dental caries was treated by bow drills.
  • 5000 BC: “Tooth Warm” this term is used to describe the cause of dental caries and pain, in a text belongs to Sumerians.
  • 2600 BC: Hesy-Ra is the first known dentist in Egyptian history. The title “The greatest of those who deal with teeth and of physicians” is an inscription on his tomb.
  • 1700 – 1550 BC: The Ebers papyrus is an Egyptian medical text that mentions the dental diseases and tooth remedies.
  • 500-300 BC: Ancient Greek scholars (Hippocrates and Aristotle) wrote about teeth eruption pattern, dental caries, gum disease, teeth extraction with forceps and the stabilization of loose tooth and broken jaw by using wires.
  • 166 – 201 AD: The Etruscans in ancient Italy, used crowns made of gold and fixed bridge work as a dental prosthesis.
  • 600s: The first bristle toothbrushes were made in china from hogs hair.
  • 500 – 1000: The monks practiced dentistry during the early middle ages. The monks were the most educated people of this period.
  • 1530: Artzney Buchlein published the first dental book ever in Germany. It contains topics such as oral hygiene, the extraction of tooth and gold restoration.
  • 1683: Antonie Philips van Leeuwenhoek was a dutch scientist who first identified oral bacteria using a microscope.
  • 1685: The first dental book was written in English by Charles Allen. The name of the book is “ The operator for the teeth”.
  • 1723: Pierre Fauchard was a french dentist and is known as “the father of modern dentistry”. He considered the first person who introduce dentistry on a scientific basis in his book “The surgeon dentist”, published in 1728.
  • 1780: William Addis was an English entrepreneur who produced the first modern toothbrush.
  • 1850: Washington Sheffield was an American dental surgeon who invented the world’s first toothpaste using glycerol. His son Lucius Tracy Sheffield observed while studying in Paris, the use of collapsible metal tubes for paints. In 1876, he filled his father’s toothpaste in collapsible tubes for public sale.
  • 1867: Lucy Hobbs Taylor became the first woman to graduate from Ohio dental school.
  • 1895: Wilhelm Conrad Röntgen was a German physicist and engineer who discovered Röntgen rays also known as x-rays. C. Edmund Kells was an American dentist and a pioneer in the use of x-rays in dentistry in 1836.
  • 1905: Alfred Einhorn was a German chemist who developed the local anesthetic procaine.
  • 1938: Wallace Carothers was an american chemist who invented the nylon in 1934. DuPont is an American company that used the nylon in the manufacture of nylon toothbrush in 1938.
  • 1954: In Switzerland, Dr. Philippe Guy Woog developed the first electric toothbrush “Broxodent”.

Branches of Dentistry: Dental Specialties

Every branch of dentistry deals with specific oral cavity disease or condition. So, you should know the branches of dentistry. It is divided into many branches, such as:

  1. Dental Public Health: Also known as “preventive and community dentistry”. It is a branch of dentistry that deals with the prevention and control of dental diseases and promotes dental health through organized community initiatives. It is a form of dental practice serving the community rather than the individual. It deals with public education, dental researches, and public oral health protection.
  2. Conservative Dentistry: Also known as “Restorative dentistry”. This term is used to describe all therapeutic measures that preserve natural teeth, except surgical procedures that are classified under the term oral surgery such as apicoectomy – is the removal of a tooth’s root tip. The conservative dentistry is concerned with the tooth preservation, it is divided into:
    • Cariology and Restorative Therapy: The cariology is the study of the causes, the origin and the consequences of dental caries, for example the influence of food on the demineralization of a tooth. During dental caries treatment, the dentist removes dental caries bacteria, infected and damaged tooth structure. Then, the tooth is reconstructed with filling materials.
    • Endodontics: It is concerned with the study, diagnosis, prevention, and treatment of dental pulp diseases. Tooth pulp contains blood and lymph vessels, nerves, and connective tissues. Pulpitis is acute or chronic inflammation of the pulp. The most common treatment in endodontics is root canal treatment “RCT”.
    • Crowns: Single and partial crowns are used to restore damaged tooth structures that can’t be reconstructed by dental fillings.
  3. Pediatric Dentistry: It is the branch of dentistry that deals with the study, diagnosis, treatment, and prevention of disease in teeth, oral cavity, and jaws during childhood (from birth to puberty). Pediatric dentistry can be divided into:
    • Preventive measures: such as dietary advice, teeth fluoridation and fissure sealants (fissure sealant is a thin layer that placed on the chewing surface of a tooth to prevent dental caries).
    • Treatment of dental caries, pulp inflammation and gum disease.
    • Early childhood orthodontic treatment.
    • The treatment of accidents.
  4. Periodontics: Also known as periodontology. It is a branch of dentistry that deals with the study, diagnosis, treatment, and prevention of periodontal diseases. The periodontium is the surrounding and supporting tissues of teeth. It consists of gum, bone, cementum, and periodontal ligaments.
  5. Oral and Maxillofacial Surgery: Also known as cranio-maxillo-facial surgery. It is a medical specialty that deals with the diagnosis, treatment, and prevention of diseases, injuries, malformation, and deformation involving both functional and aesthetic aspect of the hard and soft tissues of the teeth, oral cavity, jaw and face region. It includes surgical procedures such as tooth extraction, surgical removal of wisdom tooth, periodontal surgery, surgical endodontics (apicectomy), implantology, treatment of jaw fractures, tumors, cysts, cleft lip and palate and temporomandibular joint (TMJ) disorders.
  6. Dental Prosthesis: Tooth loss can occur due to dental caries, periodontal disease and accidents. The dental prosthesis can replace a missing tooth such as dental bridge or denture to restore the function of teeth (chewing and speaking) and improve aesthetics. Some examples of dental prosthesis: full and partial dentures, dental crown, bridge, and implant.
  7. Orthodontics: Also known as braces. It is the branch of dentistry that deals with the diagnosis, treatment, and prevention of deformities of teeth and jaws (malocclusion).
  8. Oral and Maxillofacial Pathology: it is a branch of dentistry that deals with the study, diagnosis and management of diseases located in the oral cavity and maxillofacial region. It is a science that studies the causes, processes and effects of diseases affecting the oral and maxillofacial complex. Examples of oral and maxillofacial pathologies:
    • Cleft lip and palate – congenital disease
    • Scarlet fever – bacterial infection
    • Herpes simplex – viral infection
    • Oral candidiasis – fungal infection
    • Oral cancer – neoplastic disease
  9. Oral and Maxillofacial Radiology: it is a branch of dentistry that deals with the diagnosis and management of diseases located in the oral cavity and maxillofacial region by the production and interpretation of diagnostic imaging. It includes intraoral radiographs (such as periapical and bite-wing x-rays), panoramic x-ray, cone beam CT, MRI, and sialographs.

Branches of Dentistry | Dental Specialties
Branches of Dentistry |Dental Specialties

Dental Team: The Dentist’s Supporting Team

The dental team consists of a dentist, dental assistant, dental hygienist and dental technician. The dental team aids in providing dental health service.

  1. Dentist: He/She is a healthcare provider who specializes in dentistry. The activities of dentist include the diagnosis, treatment and prevention of dental, oral cavity and jaw diseases.
  2. Dental Assistant: He/She has the task of assisting dentist during the treatments of patients. The main task of dental assistant:
    • The preparation of treatments.
    • Advise the patient before, during and after the treatment.
    • Collecting the data of patients and management of patients records.
    • The sterilization of instruments
    • The cleaning and disinfection of dental chair and the room.
    • Equipment maintenance.
    • Taking an impression of patient’s jaw.
    • Creating a temporary restoration and provisional crowns.
    • Taking dental radiographs.
    • Holding dental suction.
  3. Dental Hygienist: He/She is a dental professional who is responsible for performing dental treatments and prevention of oral diseases. Only the dentist and dental hygienist are trained to work directly in patient’s mouth. The tasks of dental hygienist are:
    • Application of topical fluoride.
    • Application of pits and fissure sealants.
    • Administration of local anesthesia.
    • Health education.
    • Treatment of periodontal disease by scaling and root planing.
    • Removal of tartar that is attached to the teeth and below the gum line.
    • Polishing of dental fillings and elimination of any excess.
    • Placement and removal of the rubber dam.
    • Taking dental radiographs.
    • Removal of the orthodontic appliance.
  4. Dental Technician: He\She is a healthcare professional who designs, develops, manufactures and adapts restorative and dental appliances, for example full and partial denture, orthodontic appliances, dental splints, impression trays, dental crown, and bridges. Dental technician work requires:
    • Knowledge of the physical and chemical properties of the materials.
    • Knowledge of the work techniques and the use of machinery and instruments.
    • Knowledge of the oral and facial anatomy.

Dental Diseases and Conditions

Some common diseases in dentistry:

  1. Dental Caries: It is a multifactorial disease. It can lead to the destruction of tooth tissues. The oral bacteria break down carbohydrates and produce acids. The bacterial acids will lead to tooth tissues destruction and cavities. If dental caries left untreated, it can lead to inflammation of the area surrounding the root end, and may cause a dental abscess.
  2. Gum Disease: It is an inflammatory condition of the gums. It is divided into gingivitis and periodontitis.
    • Gingivitis: is the inflammation and bleeding of gums caused by bacteria and remaining foods.
    • Periodontitis: If gingivitis left untreated, the inflammation will spread to the periodontium (tooth supporting and surrounding tissues) and may cause tooth loss.
  3. Bad Breath: It is not a disease. It is a sign of lack oral hygiene or triggered by various disease.
  4. Malocclusion: It is a misalignment of the teeth. Most people have some degree of malocclusion, but usually not serious enough to require treatment. People with more severe malocclusion may require an orthodontic treatment. Malocclusion may place the temporomandibular joint under excessive pressure.
  5. Bruxism: It is an involuntary habit of clenching or grinding the teeth without functional purpose. Bruxism can lead to headache, teeth wear and pain of the muscles of jaw, neck and ear.
  6. Dental Trauma: The mechanical trauma can cause damage to the teeth, especially upper anterior teeth. It can affect people at any age, but it common in children. The most common dental injuries are damaged teeth, bone, and surrounding gums.

Employed adults lose more than 164 million hours of work each year due to oral health problems or dental visits.

Dental Treatments

Some common treatments in dentistry:

  1. Professional Teeth Cleaning: It is the removal of plaque and tartar by a dentist or dental hygienist. Dental plaque and tartar can promote dental caries and gum disease. So, you should visit your dentist every 6 months for professional teeth cleaning.
  2. Dental Restoration: The dental caries can cause defects in tooth structure. Dental filling materials are used to fix the defects and restore the function and shape of the tooth. Examples of dental filling materials: amalgam and composite restorations.
  3. Root Canal Treatment: Dental caries if not treated, it will spread to the pulp, causing inflammation or necrosis of pulp tissues. RCT is the removal of vital but irreversibly inflamed or non-vital pulp tissues Then, the root canal is cleaned and filled.
  4. Dental Crown: It is a fixed dental prosthesis. Dental caries and trauma can cause damage to tooth structure. The dental crown is used to restore damaged tooth structures (that can’t be reconstructed by dental filling).
  5. Dental Bridge: It is a fixed dental prosthesis. Tooth loss can occur because of dental caries, gum disease, and accidents. The dental bridge is used to restore the function of teeth (speaking and chewing) and improve aesthetics.
  6. Denture: It is a removable prosthesis that is used to restore the function of teeth (speaking and chewing) and improve aesthetics. Dentures can be partial or complete.
  7. Dental Implant: It is an artificial tooth root. It is inserted into the jaw bone to support fixed or removable prosthesis such as dental crown, bridge, and dentures.
  8. Tooth Extraction: It is the removal of a tooth from jaw bone. It can be simple or surgical. The indications of tooth extraction can be:
    • Tooth mobility because of gum disease.
    • Need a space for orthodontic treatment
    • Removal of the third molar, if there is no enough space in the oral cavity
    • Longitudinal fracture of the tooth crown and tooth root

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