What Accounts For The Existence Of Dentists

…as a profession separate from doctors? Every other part of your body is taken care of by people who went to medical school and then specialized to a greater or lesser extent on a particular organ or system. Bad knees? See a physician (orthopedist). Bad heart? See a physician (cardiologist). Bad skin? See a physician (dermatologist). Bad teeth? Don’t see a physician. See a dentist. Whole other ballgame.

Is there some historical reason dentists train separately from doctors? Are the teeth inherently less complicated than the rest of the body? Are dentists not doctors in other countries, as well?

And what’s up with podiatrists? If you have bad feet, you can certainly find a doc who will handle it. But then you have these podiatrists, who go to a separate school and everything. Well, maybe that’s for another thread.

Every dentist, orthodontist, periodontist, etc. I’ve been to has the title Dr.

The title “Doctor” as used for medical professionals doesn’t really mean anything. There’s no legal imposition against using the title “Doctor” whether you even have a doctorate or not (or else Dr. Demento would have been in trouble long ago). It’s just an honorific. The letters AFTER the name are more important. There isn’t any distinction made between Dr. Smith, the dentist, and Dr. Jones, the ENT specialist. There IS a distinction made between John Smith, DDS, and Richard Jones, MD.

Well, in the United States, dentists are called “Doctor,” but in the U.K. and in Ireland, dentists are addressed as “Mister,” as are almost all surgeons.

That may be a holdover from the days when surgery of almost all kinds was done by barbers, rather than by physicians with medical degrees. A few hundred years ago, if you needed a cyst removed or a tooth pulled or a finger amputated, you didn’t go to a medical doctor, who’d regard such a thing as beneath him. You’d go to a barber (the red stripes on a barber pole represent the blood that used to be a big part of a barber’s job).

Now, even though dentists and surgeons today are highly educated, highly skilled professionals, the difference in their titles in the U.K. is probably a holdover from the days when surgery and tooth-pulling were the duties of blue collar barbers, rather than medical professionals.

Over the centuries, surgery and dentistry came to be seen as trades unrelated to “real” medicine. Now, while medicine eventually reclaimed surgery, it never fully reclaimed dentistry. But dentists gradually embraced the new standards of medicine.

I saw an article in the papers recently that stated that surgeons in the UK are starting to prefer to be addressed as “Doctor”. Apparently the “Mister” appellation now confuses their patients, who are questioning whether their surgeons are appropriately qualified.

I’ve had the same question for years. Is it just a historical/cultural phenomenon? Could we just as easily have had dentologist physicians and dental surgeons the way we now have cardiologists and heart surgeons?

Where do oral surgeons fit in here?

Generally speaking, surgical specialties in medicine focus on areas where failure can mean a) death b) loss of mobility or c)loss of a vital sense - eyesight, hearing, smell.

Teeth don’t meet these criteria, but the teeth, the mouth, and the face are all part of one body system - problems in one area can affect all other areas. It seems like dentists, oral surgeons, ENT physicians, opthamologists, end up consulting with each other and referring patients to each other all the time.

It also has certain disturbing consequences such as the fact that dentistry is not covered by Medicare. As Hamish discovered to his sorrow, this is puzzling as dental problems are quite capable of making your life hell.

Here in the U.K., I’ve a friend who’s a dentist and he’s addressed as ‘Doctor’. Surgeons being called ‘Mister’ is inverted snobbery: early on they were barber-surgeons - and earlier likely the local torturer too - but these days they’re all medical doctors who’ve undergone further training.

http://www.dental-site.itgo.com/westerndent1750.htm
Apparently the Euros did have physician-dentists.

Looks to be a combination of sociological, cultural, economic, and technical factors leading to the current arrangement.

This is interesting to me; one of my old college roomies is a dentist however he is also a real, genuine doctor - med school, specializing in cranial trauma or surgery or whatnot. He worked in a Chicago hospital and dealt with a wide variety of “head stuff” (gunshots and nasty injuries). I thought that all dentists went to medical school (at least here in the US)?

Nope, dentists go to dentistry school and receive a D.D.S degree. Doctors go to medical school and get the M.D. degree.

That doesn’t mean that a dentist can’t also go to medical school, as in the case of your friend. Doesn’t mean that they can’t go to law school, either.

The link that **Belowjob ** submitted does an outstanding job of explaining how this came to be, and how the practice evolved differently in different places.

Not in France, where they aren’t physicians. They began their training in a medical school, though, but leave it after (I believe) the second year to be trained in dentistry. They get a doctorate (in “dental surgery”).

There is a lot of overlap. Common dental specialties such as oral and maxillofacial surgery require additional specialised training beyond the DDS degree. My sister used to work for an oral and maxillofacial surgery practice, and the surgeons there were frequently called in to consult on complex situations that involved other medical specialties - severe accidental trauma involving the teeth and jaw, for example, or gum overgrowth caused by anti-rejection drugs in an organ transplant patient, etc.

Some info on dental specialties from the American Dental Association:

http://www.ada.org/prof/ed/specialties/definitions.asp

http://www.ada.org/prof/ed/specialties/specorgs.asp

And on educational requirements for oral and maxillofacial surgery:

“After dental school, Oral and Maxillofacial Surgeons complete four or more years of hospital-based surgical residency training that includes rotations in the general surgical service working along side other physician surgeons.”

Interesting. I wonder if the oral surgeons actually assist in general surgery like other surgical residents? Are they then responisble for knowing gross anatomy as well as physician surgeons are? If you get heart surgery or some other major operation, is there a chance your wound was closed by an oral surgeon resident?

IIRC, both dentists and oral surgeons administer anesthesia on their own, whereas physician surgeons leave it to the specialized physicians called anesthesiologists. Would this be because the risks of anesthesia in non oral surgical procedures are greater? Or is it just the way things are done in different professions?

Well, if I can just slip in this bit of a hijack, recently the WSJ (I think) had an article about how dentists can be part of a public health mobilization if something awful happens (bioterror, pandemic, etc.). They’ve got some medical training and can do things like give shots. They could swell the ranks of innoculators in a heartbeat. I think of them as so separate from medical professionals that this article surprised me–until I gave it some thought.

Research suggests that good oral health plays a bigger role in overall health and wellbeing than previously believed. It will be interesting to see if the lines are blurred between “medicine” and “dentistry” as more connections come to light. Perhaps insurance companies and employers will extend their policies for coverage of dental visits.

Dentists also write prescriptions for pain killers. I’ve received Tylanol with codeine many times. I wonder if they are restricted as to what med, and what dose. Can they prescribe the heavy hitter pain meds that are abused by druggies?

Along those same lines, I’ve always been struck by the fact that you can have any number of physical ailments that would somehow be covered by your medical insurance (hopefully). But let that ailment occur in your mouth, and you have to have a separate type of insurance to just cover that region. We don’t have separate types of insurance for bones or for muscles. But we have a separate insurance policy when it comes to teeth. It is most peculiar.

Dentists have written me scripts for Valium, Lortab, Vicodin and Percoset to name a few, so, yes, they can write scripts that make druggies happy. My dentist also has that nice tank of happy gas that makes me feel all fuzzy.

In the spirit of the OP, we also have chiropractors, optometrists, psychologists, and osteopaths that are all called “Doctor” without being MDs. I’m sure I’m forgetting a few more examples.

Another health field treated similarly to teeth/dentistry is eyes. Seperate profession, seperate insurance.

Somehow, teeth and eyes aren’t really parts of our body, ya know.

I have been told that in France, many dentists start out with the intention of qualifying as a doctor, but if they do not get high enough marks at the end of their first year (pre-med) to continue, they are allowed to study to become dentists instead. Is this correct?