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All dentists in the United States undergo four years of undergraduate studies, followed by four years of dental school to qualify as a "Doctor of Dental Surgery" (DDS) or "Doctor of Dental Medicine" (DMD). Dentists need to complete additional qualifications or training to carry out more complex treatments such as sedation, oral and maxillofacial surgery, and implants.
By nature of their general training they can carry out the majority of dental treatments such as restorative (fillings, crowns, bridges), prosthetic (dentures), endodontic (root canal) therapy, periodontal (gum) therapy, and exodontia (extraction of teeth), as well as performing examinations, radiographs (x-rays) and diagnosis. Dentists can also prescribe medications such as antibiotics, sedatives, and any other drugs used to manage the patient.
Pediatric Dentistry places special importance in preventing tooth decay. Studies show that poor oral health care in children can lead to impaired school performance and poor social relationships. Therefore, Pediatric Dentists give advice on how to make teeth strong the importance of developing healthy eating habits and other ways to prevent disease from occurring.
The most common reason for extraction is tooth damage due to breakage or decay. There are additional reasons for tooth extraction:
- Severe tooth decay or infection (acute or chronic alveolar abscess). Despite the reduction in worldwide prevalence of dental caries, still it is the most common reason for extraction of (non-third molar) teeth with up to two thirds of extractions.[1]
- Extra teeth which are blocking other teeth from coming in.
- Severe gum disease which may affect the supporting tissues and bone structures of teeth.
- In preparation for orthodontic treatment (braces)
- Teeth in the fracture line
- Fractured teeth
- Prosthetics; teeth detrimental to the fit or appearance of dentures
- Insufficient space for wisdom teeth (impacted third molars). Although many dentists remove asymptomatic impacted third molars, American as well as British Health Authorities recommended against this routine procedure, unless there are evidences for disease in the impacted tooth or the near environment. The American Public Health Association, for example, adopted a policy, Opposition to Prophylactic Removal of Third Molars (Wisdom Teeth) because of the large number of injuries resulting from unnecessary extractions.
- Cosmetic; teeth of poor appearance, unsuitable for restoration
- Receiving radiation to the head and neck may require extraction of teeth in the field of radiation.
- Deliberate, medically unnecessary, extraction as a particularly dreadful form of physical torture.
- It was once a common practice to remove the front teeth of institutionalized psychiatric patients who had a history of biting
Patients who require special needs dentistry form a diverse group, and may be found living at home, in hospital, in secure units, in residential or nursing homes, or they may be homeless or vulnerably housed. Their additional needs may be due directly to their impairment or disability, or to some aspect of their medical history that affects their oral health, or because their social, environmental or cultural context disables them with reference to their oral health.
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