Traditional orthodontic treatment methods have long been the cornerstone for correcting misaligned teeth and jaw discrepancies. These methods primarily include the use of braces, headgear, and removable appliances. Braces, consisting of brackets, wires, and bands, apply continuous pressure to gradually move teeth into their correct positions. Headgear, often used in conjunction with braces, applies external force to modify growth patterns, especially in growing children. Some orthodontic issues are inherited while others develop over time Child-friendly orthodontic solutions thumb sucking. Removable appliances, such as aligners and retainers, offer a less invasive option for minor corrections.
Despite their effectiveness, traditional orthodontic treatments come with several limitations. One significant drawback is the reliance on patient compliance, particularly with removable appliances like headgear and aligners. Inconsistent use can lead to prolonged treatment times and less predictable outcomes. Additionally, traditional methods often require the use of anchorage-teeth or other structures that provide a stable point from which to apply force. This can lead to unwanted movement of anchor teeth, compromising the overall treatment plan.
Another limitation is the aesthetic concern associated with metal braces, which can be a deterrent for many patients, especially adults. The visibility of traditional braces can lead to self-consciousness and a reluctance to pursue necessary treatment. Moreover, the duration of treatment can be quite lengthy, often spanning several years, which can be inconvenient and discomforting for patients.
In response to these limitations, the introduction of Temporary Anchorage Devices (TADs) represents a significant advancement in orthodontic treatment. TADs are small, titanium screws temporarily placed in the jawbone to serve as fixed points of anchorage. This innovation allows orthodontists to apply precise forces without relying on patient compliance or the movement of anchor teeth. The use of TADs can significantly reduce treatment time and improve the predictability of outcomes.
In conclusion, while traditional orthodontic treatments have been effective, they are not without limitations. The advent of TADs offers a promising solution to many of these challenges, providing a more efficient, patient-friendly, and aesthetically pleasing alternative for correcting dental misalignments.
Temporary Anchorage Devices, or TADs, have revolutionized orthodontic treatment by providing a stable foundation for moving teeth. In pediatric orthodontics, understanding how TADs work and recognizing the types commonly used is crucial for effective treatment.
TADs function as mini-implants that are temporarily placed into the jawbone. These devices act as anchors, allowing orthodontists to apply force in precise directions to move teeth or modify the jaw's growth pattern. Unlike traditional orthodontic methods that rely on the cooperation of other teeth for anchorage, TADs offer a more reliable and controlled approach.
There are several types of TADs used in pediatric orthodontics. The most common ones include miniscrews and miniplates. Miniscrews are small, screw-like implants that are easy to place and remove. They are often used for minor tooth movements or to provide temporary anchorage during more complex treatments. Miniplates, on the other hand, are slightly larger and are used for more significant orthodontic corrections. They are typically placed in areas with thicker bone and are ideal for patients requiring substantial tooth movement.
In pediatric orthodontics, TADs are particularly beneficial because they can help correct issues more efficiently, reducing the overall treatment time. They are also less invasive than traditional surgical methods, making them a preferred option for young patients. Additionally, TADs allow for more predictable outcomes, as they provide a stable point of force application, which is especially important in growing jaws.
In conclusion, TADs are a valuable tool in modern orthodontics, offering a more efficient and reliable way to correct dental issues in children. Understanding the different types and how they work is essential for both orthodontists and parents to make informed decisions about treatment options.
In recent years, the field of orthodontics has seen significant advancements, one of which is the introduction of Temporary Anchorage Devices (TADs). These small, screw-like devices are proving to be a game-changer, especially when it comes to treating children. Let's delve into the benefits of using TADs in children's orthodontic treatment, focusing on improved efficiency and outcomes.
First and foremost, TADs offer enhanced control during orthodontic treatment. Traditional methods often rely on patient compliance with elastics or headgear, which can be cumbersome and uncomfortable. TADs, however, provide a stable anchor point within the jawbone, allowing orthodontists to move teeth with greater precision and less dependency on the patient's cooperation. This is particularly beneficial for children, who may find it challenging to adhere to strict orthodontic protocols.
Moreover, the use of TADs can significantly reduce the duration of orthodontic treatment. By providing a reliable anchor, TADs enable orthodontists to perform complex tooth movements more efficiently. This means that children can achieve their desired dental alignment in a shorter period, minimizing the time they spend in braces and reducing the overall burden of treatment.
Another notable advantage of TADs is the improvement in treatment outcomes. With the ability to exert controlled forces on specific teeth, orthodontists can achieve more predictable and stable results. This is crucial in growing children, where the goal is not only to correct current dental misalignments but also to guide the development of the jaw and facial structure for long-term stability.
Furthermore, TADs can help in addressing severe cases that might otherwise require more invasive surgical interventions. By providing additional anchorage, TADs allow orthodontists to correct complex malocclusions without the need for surgery, making the treatment process less daunting for young patients and their families.
In conclusion, the introduction of Temporary Anchorage Devices in children's orthodontic treatment represents a significant leap forward. With benefits like enhanced control, reduced treatment duration, improved outcomes, and the potential to avoid surgery, TADs are revolutionizing the way we approach orthodontic care for the younger population. As technology continues to evolve, it's exciting to think about the further possibilities TADs might unlock in the realm of pediatric orthodontics.
When it comes to orthodontic treatment, ensuring both safety and comfort for young patients is paramount. Temporary Anchorage Devices (TADs) have emerged as a valuable tool in modern orthodontics, providing orthodontists with enhanced control over tooth movement. However, it's essential to address concerns regarding the safety and comfort of TADs for young patients.
First and foremost, safety is a critical consideration when using TADs in orthodontic treatment. While TADs are generally considered safe when placed by trained professionals, there are potential risks associated with their use. These risks include infection at the placement site, damage to surrounding teeth or anatomical structures, and discomfort during placement and removal. However, with proper sterilization techniques, careful placement, and regular monitoring, these risks can be minimized.
Comfort is another crucial factor to consider when using TADs in young patients. Unlike traditional orthodontic appliances, TADs are minimally invasive and require only minor surgical procedures for placement and removal. While some patients may experience mild discomfort or soreness following placement, this typically subsides within a few days. Moreover, advancements in TAD design have led to smaller, more streamlined devices that are less noticeable and less likely to cause irritation.
It's essential for orthodontists to communicate openly with young patients and their parents about the potential benefits and risks associated with TADs. By providing clear information and addressing any concerns, orthodontists can help alleviate fears and ensure that patients feel comfortable throughout the treatment process.
In conclusion, while there are considerations to keep in mind regarding the safety and comfort of TADs for young patients, these devices offer significant advantages in orthodontic treatment. With proper care, monitoring, and communication, TADs can be a valuable tool in achieving optimal orthodontic outcomes while prioritizing patient safety and comfort.
In the ever-evolving field of orthodontics, the introduction of Temporary Anchorage Devices (TADs) has marked a significant advancement, especially in the treatment of children. These small, screw-like devices are temporarily placed in the jawbone to provide a stable point of anchorage for moving teeth with precision. This approach has proven particularly beneficial in complex cases where traditional methods may fall short. Here, we explore several case studies and examples that illustrate the successful use of TADs in children's orthodontic treatment.
One notable case involves a 12-year-old patient with a severe overbite and crowding. Traditional braces alone were insufficient to correct the overbite without risking the protrusion of the lower front teeth. By employing TADs, the orthodontist was able to apply forces that retracted the upper front teeth effectively, without affecting the lower teeth. This not only corrected the overbite but also improved the overall facial profile of the child. The treatment period was efficient, and the patient experienced minimal discomfort throughout the process.
Another example highlights the use of TADs in a case of open bite correction in a 10-year-old child. An open bite can significantly impact a child's ability to eat and speak properly. Utilizing TADs, the orthodontist was able to apply downward force on the upper front teeth, closing the bite effectively. This case underscores the versatility of TADs in addressing a wide range of orthodontic issues beyond what conventional braces can achieve.
Furthermore, TADs have been instrumental in treating cases of severe underbites in children. In one instance, a 13-year-old patient presented with a pronounced underbite, which not only affected his appearance but also led to jaw pain. Traditional treatment options would have required extensive jaw surgery. However, by strategically placing TADs, the orthodontist was able to gradually move the upper jaw forward, correcting the underbite without the need for surgery. This approach not only improved the patient's bite but also alleviated his jaw pain, demonstrating the therapeutic benefits of TADs beyond cosmetic improvements.
These case studies and examples vividly illustrate the transformative impact of TADs in children's orthodontic treatment. By providing a stable anchorage point, TADs enable orthodontists to correct complex dental issues with greater precision and efficiency. Moreover, the minimally invasive nature of TADs means that children can undergo treatment with less discomfort and a shorter recovery time compared to traditional methods. As the use of TADs continues to grow, it is clear that they represent a valuable tool in the orthodontist's arsenal, offering new possibilities for successful outcomes in pediatric orthodontic care.
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A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health care provider.
The word patient originally meant 'one who suffers'. This English noun comes from the Latin word patiens, the present participle of the deponent verb, patior, meaning 'I am suffering', and akin to the Greek verb πάσχειν (paskhein 'to suffer') and its cognate noun πάθος (pathos).
This language has been construed as meaning that the role of patients is to passively accept and tolerate the suffering and treatments prescribed by the healthcare providers, without engaging in shared decision-making about their care.[1]
An outpatient (or out-patient) is a patient who attends an outpatient clinic with no plan to stay beyond the duration of the visit. Even if the patient will not be formally admitted with a note as an outpatient, their attendance is still registered, and the provider will usually give a note explaining the reason for the visit, tests, or procedure/surgery, which should include the names and titles of the participating personnel, the patient's name and date of birth, signature of informed consent, estimated pre-and post-service time for history and exam (before and after), any anesthesia, medications or future treatment plans needed, and estimated time of discharge absent any (further) complications. Treatment provided in this fashion is called ambulatory care. Sometimes surgery is performed without the need for a formal hospital admission or an overnight stay, and this is called outpatient surgery or day surgery, which has many benefits including lowered healthcare cost, reducing the amount of medication prescribed, and using the physician's or surgeon's time more efficiently. Outpatient surgery is suited best for more healthy patients undergoing minor or intermediate procedures (limited urinary-tract, eye, or ear, nose, and throat procedures and procedures involving superficial skin and the extremities). More procedures are being performed in a surgeon's office, termed office-based surgery, rather than in a hospital-based operating room.
An inpatient (or in-patient), on the other hand, is "admitted" to stay in a hospital overnight or for an indeterminate time, usually, several days or weeks, though in some extreme cases, such as with coma or persistent vegetative state, patients can stay in hospitals for years, sometimes until death. Treatment provided in this fashion is called inpatient care. The admission to the hospital involves the production of an admission note. The leaving of the hospital is officially termed discharge, and involves a corresponding discharge note, and sometimes an assessment process to consider ongoing needs. In the English National Health Service this may take the form of "Discharge to Assess" - where the assessment takes place after the patient has gone home.[2]
Misdiagnosis is the leading cause of medical error in outpatient facilities. When the U.S. Institute of Medicine's groundbreaking 1999 report, To Err Is Human, found up to 98,000 hospital patients die from preventable medical errors in the U.S. each year,[3] early efforts focused on inpatient safety.[4] While patient safety efforts have focused on inpatient hospital settings for more than a decade, medical errors are even more likely to happen in a doctor's office or outpatient clinic or center.[citation needed]
A day patient (or day-patient) is a patient who is using the full range of services of a hospital or clinic but is not expected to stay the night. The term was originally used by psychiatric hospital services using of this patient type to care for people needing support to make the transition from in-patient to out-patient care. However, the term is now also heavily used for people attending hospitals for day surgery.
Because of concerns such as dignity, human rights and political correctness, the term "patient" is not always used to refer to a person receiving health care. Other terms that are sometimes used include health consumer, healthcare consumer, customer or client. However, such terminology may be offensive to those receiving public health care, as it implies a business relationship.
In veterinary medicine, the client is the owner or guardian of the patient. These may be used by governmental agencies, insurance companies, patient groups, or health care facilities. Individuals who use or have used psychiatric services may alternatively refer to themselves as consumers, users, or survivors.
In nursing homes and assisted living facilities, the term resident is generally used in lieu of patient.[5] Similarly, those receiving home health care are called clients.
The doctor–patient relationship has sometimes been characterized as silencing the voice of patients.[6] It is now widely agreed that putting patients at the centre of healthcare[7] by trying to provide a consistent, informative and respectful service to patients will improve both outcomes and patient satisfaction.[8]
When patients are not at the centre of healthcare, when institutional procedures and targets eclipse local concerns, then patient neglect is possible.[9] Incidents, such as the Stafford Hospital scandal, Winterbourne View hospital abuse scandal and the Veterans Health Administration controversy of 2014 have shown the dangers of prioritizing cost control over the patient experience.[10] Investigations into these and other scandals have recommended that healthcare systems put patient experience at the center, and especially that patients themselves are heard loud and clear within health services.[11]
There are many reasons for why health services should listen more to patients. Patients spend more time in healthcare services than regulators or quality controllers, and can recognize problems such as service delays, poor hygiene, and poor conduct.[12] Patients are particularly good at identifying soft problems, such as attitudes, communication, and 'caring neglect',[9] that are difficult to capture with institutional monitoring.[13]
One important way in which patients can be placed at the centre of healthcare is for health services to be more open about patient complaints.[14] Each year many hundreds of thousands of patients complain about the care they have received, and these complaints contain valuable information for any health services which want to learn about and improve patient experience.[15]
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Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the teeth, gums, and mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, disorders, and conditions of the mouth, most commonly focused on dentition (the development and arrangement of teeth) as well as the oral mucosa.[2] Dentistry may also encompass other aspects of the craniofacial complex including the temporomandibular joint. The practitioner is called a dentist.
The history of dentistry is almost as ancient as the history of humanity and civilization, with the earliest evidence dating from 7000 BC to 5500 BC.[3] Dentistry is thought to have been the first specialization in medicine which has gone on to develop its own accredited degree with its own specializations.[4] Dentistry is often also understood to subsume the now largely defunct medical specialty of stomatology (the study of the mouth and its disorders and diseases) for which reason the two terms are used interchangeably in certain regions. However, some specialties such as oral and maxillofacial surgery (facial reconstruction) may require both medical and dental degrees to accomplish. In European history, dentistry is considered to have stemmed from the trade of barber surgeons.[5]
Dental treatments are carried out by a dental team, which often consists of a dentist and dental auxiliaries (such as dental assistants, dental hygienists, dental technicians, and dental therapists). Most dentists either work in private practices (primary care), dental hospitals, or (secondary care) institutions (prisons, armed forces bases, etc.).
The modern movement of evidence-based dentistry calls for the use of high-quality scientific research and evidence to guide decision-making such as in manual tooth conservation, use of fluoride water treatment and fluoride toothpaste, dealing with oral diseases such as tooth decay and periodontitis, as well as systematic diseases such as osteoporosis, diabetes, celiac disease, cancer, and HIV/AIDS which could also affect the oral cavity. Other practices relevant to evidence-based dentistry include radiology of the mouth to inspect teeth deformity or oral malaises, haematology (study of blood) to avoid bleeding complications during dental surgery, cardiology (due to various severe complications arising from dental surgery with patients with heart disease), etc.
The term dentistry comes from dentist, which comes from French dentiste, which comes from the French and Latin words for tooth.[6] The term for the associated scientific study of teeth is odontology (from Ancient Greek: á½€δοÃÂÂÂÂÂÂÂς, romanized: odoús, lit. 'tooth') – the study of the structure, development, and abnormalities of the teeth.
Dentistry usually encompasses practices related to the oral cavity.[7] According to the World Health Organization, oral diseases are major public health problems due to their high incidence and prevalence across the globe, with the disadvantaged affected more than other socio-economic groups.[8]
The majority of dental treatments are carried out to prevent or treat the two most common oral diseases which are dental caries (tooth decay) and periodontal disease (gum disease or pyorrhea). Common treatments involve the restoration of teeth, extraction or surgical removal of teeth, scaling and root planing, endodontic root canal treatment, and cosmetic dentistry[9]
By nature of their general training, dentists, without specialization can carry out the majority of dental treatments such as restorative (fillings, crowns, bridges), prosthetic (dentures), endodontic (root canal) therapy, periodontal (gum) therapy, and extraction of teeth, as well as performing examinations, radiographs (x-rays), and diagnosis. Dentists can also prescribe medications used in the field such as antibiotics, sedatives, and any other drugs used in patient management. Depending on their licensing boards, general dentists may be required to complete additional training to perform sedation, dental implants, etc.
Dentists also encourage the prevention of oral diseases through proper hygiene and regular, twice or more yearly, checkups for professional cleaning and evaluation. Oral infections and inflammations may affect overall health and conditions in the oral cavity may be indicative of systemic diseases, such as osteoporosis, diabetes, celiac disease or cancer.[7][10][13][14] Many studies have also shown that gum disease is associated with an increased risk of diabetes, heart disease, and preterm birth. The concept that oral health can affect systemic health and disease is referred to as "oral-systemic health".
John M. Harris started the world's first dental school in Bainbridge, Ohio, and helped to establish dentistry as a health profession. It opened on 21 February 1828, and today is a dental museum.[15] The first dental college, Baltimore College of Dental Surgery, opened in Baltimore, Maryland, US in 1840. The second in the United States was the Ohio College of Dental Surgery, established in Cincinnati, Ohio, in 1845.[16] The Philadelphia College of Dental Surgery followed in 1852.[17] In 1907, Temple University accepted a bid to incorporate the school.
Studies show that dentists that graduated from different countries,[18] or even from different dental schools in one country,[19] may make different clinical decisions for the same clinical condition. For example, dentists that graduated from Israeli dental schools may recommend the removal of asymptomatic impacted third molar (wisdom teeth) more often than dentists that graduated from Latin American or Eastern European dental schools.[20]
In the United Kingdom, the first dental schools, the London School of Dental Surgery and the Metropolitan School of Dental Science, both in London, opened in 1859.[21] The British Dentists Act of 1878 and the 1879 Dentists Register limited the title of "dentist" and "dental surgeon" to qualified and registered practitioners.[22][23] However, others could legally describe themselves as "dental experts" or "dental consultants".[24] The practice of dentistry in the United Kingdom became fully regulated with the 1921 Dentists Act, which required the registration of anyone practising dentistry.[25] The British Dental Association, formed in 1880 with Sir John Tomes as president, played a major role in prosecuting dentists practising illegally.[22] Dentists in the United Kingdom are now regulated by the General Dental Council.
In many countries, dentists usually complete between five and eight years of post-secondary education before practising. Though not mandatory, many dentists choose to complete an internship or residency focusing on specific aspects of dental care after they have received their dental degree. In a few countries, to become a qualified dentist one must usually complete at least four years of postgraduate study;[26] Dental degrees awarded around the world include the Doctor of Dental Surgery (DDS) and Doctor of Dental Medicine (DMD) in North America (US and Canada), and the Bachelor of Dental Surgery/Baccalaureus Dentalis Chirurgiae (BDS, BDent, BChD, BDSc) in the UK and current and former British Commonwealth countries.
All dentists in the United States undergo at least three years of undergraduate studies, but nearly all complete a bachelor's degree. This schooling is followed by four years of dental school to qualify as a "Doctor of Dental Surgery" (DDS) or "Doctor of Dental Medicine" (DMD). Specialization in dentistry is available in the fields of Anesthesiology, Dental Public Health, Endodontics, Oral Radiology, Oral and Maxillofacial Surgery, Oral Medicine, Orofacial Pain, Pathology, Orthodontics, Pediatric Dentistry (Pedodontics), Periodontics, and Prosthodontics.[27]
Some dentists undertake further training after their initial degree in order to specialize. Exactly which subjects are recognized by dental registration bodies varies according to location. Examples include:
Tooth decay was low in pre-agricultural societies, but the advent of farming society about 10,000 years ago correlated with an increase in tooth decay (cavities).[32] An infected tooth from Italy partially cleaned with flint tools, between 13,820 and 14,160 years old, represents the oldest known dentistry,[33] although a 2017 study suggests that 130,000 years ago the Neanderthals already used rudimentary dentistry tools.[34] In Italy evidence dated to the Paleolithic, around 13,000 years ago, points to bitumen used to fill a tooth[35] and in Neolithic Slovenia, 6500 years ago, beeswax was used to close a fracture in a tooth.[36] The Indus valley has yielded evidence of dentistry being practised as far back as 7000 BC, during the Stone Age.[37] The Neolithic site of Mehrgarh (now in Pakistan's south western province of Balochistan) indicates that this form of dentistry involved curing tooth related disorders with bow drills operated, perhaps, by skilled bead-crafters.[3] The reconstruction of this ancient form of dentistry showed that the methods used were reliable and effective.[38] The earliest dental filling, made of beeswax, was discovered in Slovenia and dates from 6500 years ago.[39] Dentistry was practised in prehistoric Malta, as evidenced by a skull which had a dental abscess lanced from the root of a tooth dating back to around 2500 BC.[40]
An ancient Sumerian text describes a "tooth worm" as the cause of dental caries.[41] Evidence of this belief has also been found in ancient India, Egypt, Japan, and China. The legend of the worm is also found in the Homeric Hymns,[42] and as late as the 14th century AD the surgeon Guy de Chauliac still promoted the belief that worms cause tooth decay.[43]
Recipes for the treatment of toothache, infections and loose teeth are spread throughout the Ebers Papyrus, Kahun Papyri, Brugsch Papyrus, and Hearst papyrus of Ancient Egypt.[44] The Edwin Smith Papyrus, written in the 17th century BC but which may reflect previous manuscripts from as early as 3000 BC, discusses the treatment of dislocated or fractured jaws.[44][45] In the 18th century BC, the Code of Hammurabi referenced dental extraction twice as it related to punishment.[46] Examination of the remains of some ancient Egyptians and Greco-Romans reveals early attempts at dental prosthetics.[47] However, it is possible the prosthetics were prepared after death for aesthetic reasons.[44]
Ancient Greek scholars Hippocrates and Aristotle wrote about dentistry, including the eruption pattern of teeth, treating decayed teeth and gum disease, extracting teeth with forceps, and using wires to stabilize loose teeth and fractured jaws.[48] Use of dental appliances, bridges and dentures was applied by the Etruscans in northern Italy, from as early as 700 BC, of human or other animal teeth fastened together with gold bands.[49][50][51] The Romans had likely borrowed this technique by the 5th century BC.[50][52] The Phoenicians crafted dentures during the 6th–4th century BC, fashioning them from gold wire and incorporating two ivory teeth.[53] In ancient Egypt, Hesy-Ra is the first named "dentist" (greatest of the teeth). The Egyptians bound replacement teeth together with gold wire. Roman medical writer Cornelius Celsus wrote extensively of oral diseases as well as dental treatments such as narcotic-containing emollients and astringents.[54] The earliest dental amalgams were first documented in a Tang dynasty medical text written by the Chinese physician Su Kung in 659, and appeared in Germany in 1528.[55][56]
During the Islamic Golden Age Dentistry was discussed in several famous books of medicine such as The Canon in medicine written by Avicenna and Al-Tasreef by Al-Zahrawi who is considered the greatest surgeon of the Middle Ages,[57] Avicenna said that jaw fracture should be reduced according to the occlusal guidance of the teeth; this principle is still valid in modern times. Al-Zahrawi invented over 200 surgical tools that resemble the modern kind.[58]
Historically, dental extractions have been used to treat a variety of illnesses. During the Middle Ages and throughout the 19th century, dentistry was not a profession in itself, and often dental procedures were performed by barbers or general physicians. Barbers usually limited their practice to extracting teeth which alleviated pain and associated chronic tooth infection. Instruments used for dental extractions date back several centuries. In the 14th century, Guy de Chauliac most probably invented the dental pelican[59] (resembling a pelican's beak) which was used to perform dental extractions up until the late 18th century. The pelican was replaced by the dental key[60] which, in turn, was replaced by modern forceps in the 19th century.[61]
The first book focused solely on dentistry was the "Artzney Buchlein" in 1530,[48] and the first dental textbook written in English was called "Operator for the Teeth" by Charles Allen in 1685.[23]
In the United Kingdom, there was no formal qualification for the providers of dental treatment until 1859 and it was only in 1921 that the practice of dentistry was limited to those who were professionally qualified. The Royal Commission on the National Health Service in 1979 reported that there were then more than twice as many registered dentists per 10,000 population in the UK than there were in 1921.[62]
It was between 1650 and 1800 that the science of modern dentistry developed. The English physician Thomas Browne in his A Letter to a Friend (c. 1656 pub. 1690) made an early dental observation with characteristic humour:
The Egyptian Mummies that I have seen, have had their Mouths open, and somewhat gaping, which affordeth a good opportunity to view and observe their Teeth, wherein 'tis not easie to find any wanting or decayed: and therefore in Egypt, where one Man practised but one Operation, or the Diseases but of single Parts, it must needs be a barren Profession to confine unto that of drawing of Teeth, and little better than to have been Tooth-drawer unto King Pyrrhus, who had but two in his Head.
The French surgeon Pierre Fauchard became known as the "father of modern dentistry". Despite the limitations of the primitive surgical instruments during the late 17th and early 18th century, Fauchard was a highly skilled surgeon who made remarkable improvisations of dental instruments, often adapting tools from watchmakers, jewelers and even barbers, that he thought could be used in dentistry. He introduced dental fillings as treatment for dental cavities. He asserted that sugar-derived acids like tartaric acid were responsible for dental decay, and also suggested that tumors surrounding the teeth and in the gums could appear in the later stages of tooth decay.[63][64]
Fauchard was the pioneer of dental prosthesis, and he invented many methods to replace lost teeth. He suggested that substitutes could be made from carved blocks of ivory or bone. He also introduced dental braces, although they were initially made of gold, he discovered that the teeth position could be corrected as the teeth would follow the pattern of the wires. Waxed linen or silk threads were usually employed to fasten the braces. His contributions to the world of dental science consist primarily of his 1728 publication Le chirurgien dentiste or The Surgeon Dentist. The French text included "basic oral anatomy and function, dental construction, and various operative and restorative techniques, and effectively separated dentistry from the wider category of surgery".[63][64]
After Fauchard, the study of dentistry rapidly expanded. Two important books, Natural History of Human Teeth (1771) and Practical Treatise on the Diseases of the Teeth (1778), were published by British surgeon John Hunter. In 1763, he entered into a period of collaboration with the London-based dentist James Spence. He began to theorise about the possibility of tooth transplants from one person to another. He realised that the chances of a successful tooth transplant (initially, at least) would be improved if the donor tooth was as fresh as possible and was matched for size with the recipient. These principles are still used in the transplantation of internal organs. Hunter conducted a series of pioneering operations, in which he attempted a tooth transplant. Although the donated teeth never properly bonded with the recipients' gums, one of Hunter's patients stated that he had three which lasted for six years, a remarkable achievement for the period.[65]
Major advances in science were made in the 19th century, and dentistry evolved from a trade to a profession. The profession came under government regulation by the end of the 19th century. In the UK, the Dentist Act was passed in 1878 and the British Dental Association formed in 1879. In the same year, Francis Brodie Imlach was the first ever dentist to be elected President of the Royal College of Surgeons (Edinburgh), raising dentistry onto a par with clinical surgery for the first time.[66]
Long term occupational noise exposure can contribute to permanent hearing loss, which is referred to as noise-induced hearing loss (NIHL) and tinnitus. Noise exposure can cause excessive stimulation of the hearing mechanism, which damages the delicate structures of the inner ear.[67] NIHL can occur when an individual is exposed to sound levels above 90 dBA according to the Occupational Safety and Health Administration (OSHA). Regulations state that the permissible noise exposure levels for individuals is 90 dBA.[68] For the National Institute for Occupational Safety and Health (NIOSH), exposure limits are set to 85 dBA. Exposures below 85 dBA are not considered to be hazardous. Time limits are placed on how long an individual can stay in an environment above 85 dBA before it causes hearing loss. OSHA places that limitation at 8 hours for 85 dBA. The exposure time becomes shorter as the dBA level increases.
Within the field of dentistry, a variety of cleaning tools are used including piezoelectric and sonic scalers, and ultrasonic scalers and cleaners.[69] While a majority of the tools do not exceed 75 dBA,[70] prolonged exposure over many years can lead to hearing loss or complaints of tinnitus.[71] Few dentists have reported using personal hearing protective devices,[72][73] which could offset any potential hearing loss or tinnitus.
There is a movement in modern dentistry to place a greater emphasis on high-quality scientific evidence in decision-making. Evidence-based dentistry (EBD) uses current scientific evidence to guide decisions. It is an approach to oral health that requires the application and examination of relevant scientific data related to the patient's oral and medical health. Along with the dentist's professional skill and expertise, EBD allows dentists to stay up to date on the latest procedures and patients to receive improved treatment. A new paradigm for medical education designed to incorporate current research into education and practice was developed to help practitioners provide the best care for their patients.[74] It was first introduced by Gordon Guyatt and the Evidence-Based Medicine Working Group at McMaster University in Ontario, Canada in the 1990s. It is part of the larger movement toward evidence-based medicine and other evidence-based practices, especially since a major part of dentistry involves dealing with oral and systemic diseases. Other issues relevant to the dental field in terms of evidence-based research and evidence-based practice include population oral health, dental clinical practice, tooth morphology etc.
Dentistry is unique in that it requires dental students to have competence-based clinical skills that can only be acquired through supervised specialized laboratory training and direct patient care.[75] This necessitates the need for a scientific and professional basis of care with a foundation of extensive research-based education.[76] According to some experts, the accreditation of dental schools can enhance the quality and professionalism of dental education.[77][78]
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Authority control databases
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|---|---|
| National |
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| Other |
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