Filling in the Gaps of Dentistry

Emma Christensen

English III Honors Pd. 5

Mr. Daniel Alburger

February 23, 2017

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Emma Christensen

Mr. Daniel Alburger

English III Honors

23 February 2017

Filling in the Gaps of Dentistry

The history of dentistry dates back to the Egyptian era and has evolved over an extensive

period of time after many advancements made in science and technology. These advancements

have produced many specialties within the profession. These specialties include pediatric

dentistry, orthodontics, periodontics, oral and maxillofacial surgery, and cosmetic dentistry.

Each field requires a specific education and major to comprehend all of the needed material.

Within each field, these doctors specialize in treating specific diseases and conditions using

techniques learned through multiple years in dental school. The field of dentistry focuses on the

general health of ones teeth and gums which dates back far into history which, in turn, affects

the education of dental students in the field today.

Dentistry holds a long, rich history filled with a multitude of failures and successions.

The earliest documented dental procedures date back to the Egyptians in 5000 BC (History).

Within the Egyptian era, the first known dentist Hesy-Ren developed numerous procedures

resulting in the discovery of cavities and various other diseases of the teeth and gums

(History). Famous philosophers, Hippocrates and Aristotle, wrote about the topic of dentistry

in 500-300 BC (History). Their writings consisted of the basic procedures performed during

that time period. These procedures included the treatment plan for treating teeth and gum

disease, pulling unhealthy teeth, and re-stabilizing broken jaws using wires. The Roman time
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period contributed to the discovery and importance of oral hygiene. Romans later on developed

a procedure aimed to help in the stabilization of loose teeth. Treatment plans for toothaches and

teething pains followed later on (History). The developments helped pave the road to more

advanced procedures using modern technology and techniques.

The first dental surgeons came from a guild of barbers out of France. These two forms of

surgeons varied from the amount of education and training achieved to the type of procedures

performed on a regular basis. The surgeons who achieved a higher amount of education and

training performed more complex and advanced operations. These complex procedures included

root canals, wisdom teeth removal, and all procedures resulting in cutting into a patients oral

cavity. The group of surgeons who achieved a smaller amount of education and training

performed more routine procedures. These routine procedures included hygienic services such

as tooth extractions and any less invasive procedures in high demand. Years later, a decree

prohibiting barbers from performing surgical procedures forced them to focus more on the basic

procedures originally taught (History). This small start to the specialized fields in dentistry

would spark dentists to specialize in different aspects of dentistry rather then practice basic

procedures in general dentistry.

Throughout the development of the United States, key leaders and officials played a

tremendous role in the process and the findings of dentistry. The first dentist to perform dental

procedures in the United States went by the name of John Baker. His practice aimed to help out

citizens in a small populated area on the basic understandings and treatment plans for the most

common dental procedures and conditions (History). Baker led the way for American dentists

to arise in the future of medicine and in the inventions of more advanced dental tools. In
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1768-1770, Paul Revere discovered the use of dental forensics to identify fallen soldiers

(History). This made it possible for soldiers bodies to return back to their loved ones. In the

1790s, John Greenwood and Josiah Flagg invented two extremely useful devices dentists still

used today when treating patients (History). Greenwood invented a dental foot engine which

he developed from his mothers foot treadle off of her spinning wheel. He redirected this

technology to operate a dental rotating drill. This equipment went into use when dentists needed

to evacuate infection from a tooth and reshape the tooth if needed. Flagg invented the first dental

chair for patients. This chair featured an adjustable headrest allowing a dentist to achieve an

easier and more maneuverable working space to work on a patient's oral cavity. This chair also

featured an arm extension allowing dentists to keep their needed tools in close range for the

procedure (History). These inventions helped significantly cut down the procedure time and

help improve the quality of patient care.

During the 19th century, more modern approaches and procedures developed to make

recovery and procedure times shorter and more efficient for dental patients (History). Samuel

Stockton became the first person to develop and manufacture porcelain teeth. With this

development, patients regained the use of their teeth. Stocktons White Dental Manufacturing

Company became the first main profiter of the innovation and the sales made from its

distribution. The Crawcour brothers became the first people to introduce amalgam filling,

otherwise known as silver fillings, in the United States. This product also went by the name

Royal Mineral Succedaneum (History). With amalgam fillings, patients do not have to suffer

through the loss of losing any teeth or a part of any teeth, the filling replaces the dead tooth and

all of the functions the tooth used to go through.

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After the multitude of advancements made in dentistry, a journalist's company created the

first American Journal of Dental Science in 1839 (History). This journal became the first

public dental journal to spread advancements throughout the entire dental society. Charles

Goodyear developed the process of hardening rubber, allowing dentists to take molds of patient's

teeth. This hardened rubber called Vulcanite uses an inexpensive material that many describe as

effortlessly maneuverable. This procedure provides dentists with molds to use as a base to create

false teeth. In 1840, Chapin Harris and Horace Hayden founded the worlds first dental school

called the Baltimore College of Dental Surgery (History). They later established the Doctor of

Dental Surgery degree (History). This degree allowed dentists to legally treat patients with the

proper dental care.

Advancement in medicine led to the development of anesthesia during surgeries to make

patients unconscious and experience less trauma during procedures. The need for the use of

anesthesia increased because of increasingly refined diets and large amounts of sugar consumed.

Dr. Horace Wells became the first to attempt to demonstrate this procedure, but ended up failing

when the patient began to cry out during the demonstration. The first successful demonstration

came from dentist William Morton in 1846 (History). Within Mortons demonstration, his

patient successfully made it through the entire procedure without feeling any intense pain or ever

awakening mid surgery.

During times of segregation and the fight for womens rights, many advancements arose

showcasing the progress that the United States of America began to start to allow and accept into

society. In 1866, Lucy Beaman Hobbs becomes the first female to earn a dental degree

(History). Hobbs earned her degree from the Ohio College of Dental Surgery. This
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achievement would become the first of many more female achievements to arise. With this

advancement, the role of women in dentistry would slightly increase, only to have women

making a less amount money for the same job (Prasanna). In 1869, Dr. Robert Tanner Freeman

graduated from Harvard University Dental School, becoming the first African-American to earn

a dental degree (History). Harvard University Dental School became the first university

specifically aimed to become a dental institution. Harvard called their degree the Dentarie

Medicinae Doctore (DMD), this started the controversy over DDS vs. DMD (History). This

created controversy over the type of degree a dentist needs to achieve to become successful in

the dental field.

Throughout many years, a multitude of new diagnoses, treatment plans, and technology

became beneficial for patients in need of dental care. During the 20th century, more helpful

inventions became available to the dental world, yet, not nearly as many new inventions

discovered in previous centuries (History). These new developments mostly consisted of

improvements to already existing procedures and treatment options. Novocaine, a drug

developed from the already existing anesthetic and jacket crowns developed from casting

machines aimed to have more precise cast fillings. These examples do not even begin to

describe how much dentistry advanced during this time period with already existing procedures

and treatment plans. The early 1900s consist of the major developments of the different fields

and branches in dentistry (History). In 1917, Irene Newman became the worlds first dental

hygienist (History). This important discovery holds a significant impact on the execution of

dentistry and the carrying out of day-to-day procedures (History). In the late 20th century,

more technology became available for dentists to use (History). In 1960, two significant
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inventions of technology became accessible, these inventions including the first commercial

electric toothbrush and the use of lasers in the oral cavity (History). The use of lasers aimed

toward the treatment of periodontal disease and had approval for soft tissue work. With all of the

advancements made over tools and procedures in dentistry, the advancements allowed dentists

options of how they wanted to treat and care for their patients (History). These options

allowed patients to have a bigger say in the decision making of which approach presents itself

best for their needs.

The importance of maintaining a healthy oral cavity originates from a desire to have a

clean, infection free mouth. The main contributor in the loss of teeth originates from fracturing

the main base of a tooth, or not maintaining healthy hygiene. The loss of teeth can result from the

process of tooth decay, whereas in these circumstances, oral hygiene and regular check-ups did

not occur as they should have (Stark). When a patient presents with tooth pain or any type of

oral discomfort, receiving a dental consultation as soon as possible will financially benefit the

patient. The longer a patient waits for treatment by a professional, the possibility of the

condition worsening increases. Only a specialist can determine the seriousness of the condition

or disease. The risk of infection or disease demonstrates the importance of a patient to see a

dentist who specializes in caring for the problem presented (Stark). With a specialized dental

personnel, a patient can receive more accurate results and solutions to the problems presented.

The occupation of dentistry requires many years of schooling. When seeking the

occupation of dentistry, schooling starts early. In high school, the subject of biology and

chemistry should remain a person's main focus and wanting to do well in those subjects (Dirig).

These achievements will later help prepare students for a smoother transition into college level
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science classes. In college, a students main goal should consist of an undergraduate degree

majoring in biology or chemistry. Once earning a bachelors degree in the science field, a

student can then apply for dental school. Dental school normally takes four years to complete.

During this time, students will learn more detail of the human structures, how to perform

procedures, and the technologies used, allowing the future dentist the opportunity to choose the

best options for their patient. After completing dental school, a student can earn a doctorate in

dentistry and begin practicing on patients. At this point, a student has achieved the title of

General Dentist. After this achievement, students can continue their education and choose to

specialize in a certain field of dentistry. The chosen specialty field depicts how long their

education and school one needs to attend to gain the knowledge needed and reach the

requirements (Dirig). Without reaching the required amount of education, the dentist can not

perform any procedure within the original field aimed to complete and specialize in.

Mentorships and Internships in the occupation of dentistry can aid students in gaining a

broader perspective of the occupation. While mentoring, a student has the luxury of shadowing

the doctor throughout their day and gaining insight on what a doctor endures (Dirig). When

discussing the procedure plans, patients often came to dental offices with extreme anxiety.

When this situations arises, the dentist will sit with the patient and decipher what options they

should proceed with in this case (Yildirim). These situations make the best learning

opportunities for students. When performing specific procedures, the mentor will allow the

student to visualize the field and help the student distinguish healthy tissue against unhealthy and

infected tissue. Mentors often assist students with the basic techniques of dentistry by using

dummies and providing additional help in the process of reading scans while determining the
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diagnosis and treatment. This perspective can result in the realization of an undesirable path they

do not want to follow or, the student realizing their love for the field. This educational

experience allows students to decide if they would like to pursue a future in dentistry. The

mentoring dentists philosophy determines what the student will learn most during of the time

spent mentoring. Mentoring helps students gain an insight as to what their future career may

emulate with the help of their mentors experience and learning from their mistakes (Dirig). This

experience allows a chance to save time and malpractices.

If a student chooses to continue and specialize in dentistry, he has five options to choose

from. These five options include: pediatric dentistry, orthodontists, periodontists, oral and

maxillofacial surgeon, and cosmetic dentistry. Each specialized field has specific education

requirements. When a student aims to specialize in pediatric dentistry, an additional two to three

years of education lies ahead. With this specialization, doctors practice on adolescents

(Carrington). When aiming to specialize in orthodontics, students complete an additional two to

three years of advanced specialty education. Within the field of orthodontics, the main

procedures performed include jaw alignments and working with the positioning of the teeth.

They address problems in these areas using braces, retainers, or other useful devices used in the

correctional process (Carrington). When aiming to specialize as a periodontist, students

complete dental school and obtain a postdoctoral certificate, which takes two to three years to

obtain. Periodontists specialize in the care of the supporting structures of teeth including the

periodontium, gums, the alveolar bone, and the periodontal ligament (Carrington). When aiming

to specialize in oral and maxillofacial surgery, students complete a minimum of four years in a

hospital-based residency program after graduating from dental school. Oral and maxillofacial
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surgeons specialize in surgical care for teeth, jaws, and facial bones. Few doctors proceed to

specialize in microvascular reconstruction craniofacial surgery and cranio-maxillofacial trauma

treatment (Carrington). To specialize in cosmetic dentistry, the requirement to complete

additional schooling does not exist. Cosmetic dentists aim to help improve the appearance rather

than the patients health. They typically treat aesthetic issues surrounding the patients gums,

teeth, and bite (Carrington). All of the specialties aid patients in dealing with the overall health

and appearance of the patient's oral cavity and the supporting structures.

Within the fields of dentistry, each one specifically treats certain conditions and or

diseases. The most common conditions seen in a dental office include tooth decay, gum disease,

oropharyngeal cancer, mouth sores, wisdom teeth, and effects from eating disorders. For most of

these conditions and diseases, specific protocols ensure that patients receive the best care

possible. Tooth decay consists of the development of cavities on the tooth. Over time, the

enamel deteriorates, causing the tooth to become weak. Undergoing a filling brings an end to the

growth of bacteria on the tooth. Left untreated can later result in a root canal procedure. To

prevent the development of a cavity, the patient should brush ones teeth twice a day and floss

regularly (Castillo). Long-term exposure to plaque formation on the teeth, eventually proceeding

to the gums, can cause the formation of gum disease. The most commonly-used method of

treating gum disease involves root planning. Within root planning, a dentist scrapes below the

gum line to smooth the roots. This process helps the gums reattach themselves to the tooth

structure giving the tooth a stronger base (Castillo). When treating these diseases, dentists have

to keep an eye out for psychodynamic illnesses that may occur after completing their procedure.

During a patient's follow up, the dentist will check for signs and address with the illness with a
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prescription or by reevaluation the previously performed procedure (Akira). Once assessing the

situation, the dentist will decide whether or not he patient is cleared for not having any

psychodynamic illness.

Oropharyngeal cancer mainly appears on the tongue, but can occur on the lips, gums, and

other soft tissues in the oral cavity. The use of tobacco, alcohol abuse, or hereditary means can

cause oropharyngeal cancer. Treatment options open to this cancer include chemotherapy, and

radiation. The absence of tobacco and alcohol use can prevent this form of cancer (Castillo).

Mouth sores can form on the inside of a patient's mouth, the base consisting of a light color with

a red exterior. Prevention options and treatment plans include a healthy diet, good oral hygiene,

and in some cases, patients can use special mouth rinses.

The formation of wisdom teeth develop at birth but do not present themselves until the

adolescent years. Wisdom teeth erupt in the back corners of the oral cavity causing a shift in

ones permanent teeth. Wisdom teeth eruption can cause a multitude of problems including

crowding, improper bites, and impaction. When impaction occurs, the patient experiences severe

pain. Patients almost always require the extraction of this final set of molars to avoid future

problems (Castillo). This procedure occurs more often than most people think.

Oral health problems can result from eating disorders. Patients that suffer with eating

disorders can experience repeated episodes of vomiting, causing harmful stomach acids to

deteriorate healthy tooth enamel leading to tooth decay. Poorly fitting fillings and braces can

then result. Brushing after an episode of vomiting can negatively impact the teeth. Proper

treatment of a rinse following a vomiting episode consists of a mixture of baking soda and water
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(Castillo). This mixture will sanitize the oral cavity of any bacteria and distinguish any

unwelcoming scents.

Dentists today have the options of choosing to practice in a private practice or working in

a large practice. Each practice holds specific values when it comes to dental care (Dental).

When a dentist owns a practice, they hold the top position. This mean that a large amount of

pressure rests on their shoulders. Dentists not only perform long and short appointments, but

they also collaborate with other specialists and assistants, refill prescriptions, and complete tasks

such as billing and paperwork outside of the office (Dirig). These tasks are a part of the job and

can affect a doctor's social life.

Without specialized dentistry, patients would suffer from diseases such as gum disease,

tooth decay, and cavities. The knowledge dentists possess, combined with modern dental

equipment allow dentists to detect any abnormal conditions present in the mouth. Dentistry

focuses on the conditions of the oral cavity and maxillofacial areas and its impact on the human

body. Maintaining proper dental care proves necessary in a patients everyday health needs.

The field of dentistry focuses on the general health of ones teeth and gums which dates back far

into history which, in turn, affects the education of dental students in the field today.
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Works Cited

Akira, Toyofuku. "Psychosomatic Problems In Dentistry." Biopsychosocial Medicine 10.(2016):

1-5. Academic Search Complete. Web. 3 Jan. 2017.

<http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=115062972&site=ed

s-live&scope=site>.

Carrington Author. "Working in Dentistry - List of Careers & Jobs in the Dental Field." Working

in Dentistry. Carrington College, 26 Jan. 2015. Web. 13 Feb. 2017.

<http://carrington.edu/blog/dental/working-in-dentistry-list-of-careers-jobs-in-dental-fiel

d/>.

Castillo, Fred, Dan Drake, and Henry Kraski. "Dental Problems & Treatments." Drs. Costello &

Drake. Atlantic Dentists, Web. 13 Feb. 2017.

<http://www.atlanticdentists.com/dental-problems-and-treatments.php#Cavities>.

"Dental Professionals." Washingtonian Magazine 50.6 (2015): 113. MasterFILE Complete. Web.

3 Jan. 2017.

<http://search.ebscohost.com/login.aspx?direct=true&db=f6h&AN=101207683&site=eds

-live&scope=site>.

Dirig, Christopher. Interview Questions and Answers. Google Document Interview. 14 Feb.

2017.

<https://docs.google.com/document/d/1XxKd9cdr7XX5tTevsHFHO9O43MEb2YRn3v_

kA69MvqY/edit?usp=sharing>.

Gambhir, Ramandeep Singh. "Primary Care In Dentistry - An Untapped Potential." Journal Of

Family Medicine & Primary Care 4.1 (2015): 13-18. Academic Search Complete. Web. 3
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Jan. 2017.

<http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=108682739&site=ed

s-live&scope=site>.

"History of Dentistry Timeline." History of Dentistry Timeline. American Dental Association,

Web. 02 Feb. 2017.

<http://www.ada.org/en/about-the-ada/ada-history-and-presidents-of-the-ada/ada-history-

of-dentistry-timeline>.

Prasanna, Jammula Surya, et al. "Women Dentists: Changing The Face Of Dentistry." Journal

Of

Oral Research & Review 7.2 (2015): 69-73. Academic Search Complete. Web. 3 Jan.

2017.

<http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=112148060&site=ed

s-live&scope=site>.

Stark, William D., DDS, and L. Fleming, Jr., MD Fallon. "Dentistry." MagillS Medical Guide

(Online Edition) (2016): Research Starters. Web. 29 Nov. 2016.

<http://search.ebscohost.com/login.aspx?direct=true&db=ers&AN=89093384&site=eds-l

ive&scope=site>.

Yildirim, Tuba Talo. "Evaluating The Relationship Of Dental Fear With Dental Health

Status And Awareness." Journal Of Clinical & Diagnostic Research 10.7 (2016):

105-109. Academic Search Complete. Web. 3 Jan. 2017.

<http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=117410458&site=ed

s-live&scope=site>.