# Why doesn't the regular hospital do dentistry? **URL:** \ **Category:** Factual Questions\ **Created:** [February 11, 2010, 10:36pm UTC](https://boards.straightdope.com/t/why-doesnt-the-regular-hospital-do-dentistry/528612 "2010-02-11T22:36:40Z")\ **Posts on this page:** 5\ **Page:** 2
**Author:** ![Odesio](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/odesio/32/20003_2.png) [@Odesio](https://boards.straightdope.com/u/Odesio)\ **Post date:** [February 12, 2010, 6:59am UTC](https://boards.straightdope.com/t/why-doesnt-the-regular-hospital-do-dentistry/528612/21 "2010-02-12T06:59:20Z")
> [@RealityChuck](#): > > Probably for historical reasons. Dentists were considered somewhat less skilled than doctors and required less training. Dentists were considered tooth pullers and did not require the amount of training a doctor did. In 1617 John Woodall published _The Surgion’s Mate_ [sic] which was an instructional manual for young surgeons at sea. In the part about teeth pulling he lamented that some surgeons believe they are too good to be pulling teeth and couldn’t be bothered with it. Woodall didn’t cotton to that as a sailor with a sore tooth didn’t have many options for relief if the surgeon wouldn’t help him. ---
**Author:** ![KarlGauss](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/karlgauss/32/3713_2.png) [@KarlGauss](https://boards.straightdope.com/u/KarlGauss)\ **Post date:** [February 12, 2010, 11:31am UTC](https://boards.straightdope.com/t/why-doesnt-the-regular-hospital-do-dentistry/528612/22 "2010-02-12T11:31:28Z")
Back to the OP . . . Every hospital I’ve worked or trained in (all in Canada) had an active dentistry department. A number of medical conditions require the involvement of dentists - ranging from routine dental care for the severely (mentally) challenged to dealing with oral/dental manifestations of systemic disease (e.g. HIV) to trauma management to gum surgery (e.g. for [phenytoin-induced gingival hyperplasia](http://emedicine.medscape.com/article/1076264-overview)). ---
**Author:** ![MsRobyn](https://avatars.discourse-cdn.com/v4/letter/m/90ced4/32.png) [@MsRobyn](https://boards.straightdope.com/u/MsRobyn)\ **Post date:** [February 13, 2010, 3:18pm UTC](https://boards.straightdope.com/t/why-doesnt-the-regular-hospital-do-dentistry/528612/23 "2010-02-13T15:18:08Z")
Hospitals can and do bill for dental procedures, at least for the facility portion. When I worked for a large insurance company, I had to deal with such a claim. IIRC, the patient was a child with significant dental problems that were so bad that he had to undergo general anesthesia to repair them all. The dental portion of the policy covered the dentist, but we had to do the go-around to find out how to get the hospital paid, because there was medical reason to do the work there, versus in a dentist’s office. I also know that my local hospital has a dentist available on retainer to take care of patients who come to the ER with mouth trauma, as well as for untoward incidents involving badly-placed endotracheal tubes and endoscopes, so I’d imagine this to be the case at other hospitals. ---
**Author:** ![Belowjob2.0](https://avatars.discourse-cdn.com/v4/letter/b/b9e5f3/32.png) [@Belowjob2.0](https://boards.straightdope.com/u/Belowjob2.0)\ **Post date:** [February 13, 2010, 11:02pm UTC](https://boards.straightdope.com/t/why-doesnt-the-regular-hospital-do-dentistry/528612/24 "2010-02-13T23:02:17Z")
> [@Yersenia\_Pestis](#): > > Dentist checking in here.. > > The first 2 years of dental school used to be very similar to the first 2 years of medical school, the current trend is to move away from that and give those “basic” courses from a “dental perspective” > > Teeth are actually complicated in their own way, the current way of things of having dental school separate from medical school is best, trust me on this one. You should never really ask a physician a question about teeth, they are definitely not qualified to answer, a dentist, may be able to answer medical questions, though. > Oral surgeons go to dental school (4 years after the 4 years of undergrad college) and then go on to their residency. Most OS residencies are 4 years in length, while some are 6 years (they earn an MD from these). The 2 different types does NOT mean that the 4 years’ guys are less qualified, it just means that their program didn’t include “getting an MD” option, but as far as the actual skill set, they are very much similar. People choose the 6 year route from various: prestige of having that MD, also because they are also interested in working in a hospital as a career as opposed to an outside clinic (the MD makes getting hospital privileges that much easier). > We all become GENERAL dentists first and then we can choose to practice as such or get additional training. Endo- root canals (2 year residency), Oral Surgery (4 or 6 year residency), Orthodontist- braces (3 year residency), Periodontics- gums specialist/implants (3 year residency), Pedodontist- children specialist (2 year residency), etc.. > Physicians get VERY little training, a couple of lectures (depending on their medical school). They MAY be able to take a tooth out or pack giant cavities with some temporary material, but I personally never seem one do that. Go to the dentist for your dental needs. Thanks. Great info. Ignorance fought. ---
**Author:** ![Chief\_Pedant](https://avatars.discourse-cdn.com/v4/letter/c/a6a055/32.png) [@Chief\_Pedant](https://boards.straightdope.com/u/Chief_Pedant)\ **Post date:** [February 14, 2010, 3:51am UTC](https://boards.straightdope.com/t/why-doesnt-the-regular-hospital-do-dentistry/528612/25 "2010-02-14T03:51:12Z")
The simplest reason is that dentistry and medicine are two different professions, with entirely different training and certification structures in the US. The hospital medical staff is composed of MDs and DOs (“Physicians” in the US) who are privileged by a structure at the hospital to take care of patients within the governing structures of that hospital. Some hospitals do, in fact, grant staff privileges to dentists, but this is an added component not historically part of inpatient and hospital-based care. Medicine does encompass oral surgery, and some oral surgeons have DDS degrees in addition to their medical degree and surgical subspecialty training, but in general oral and maxillofacial surgery is somewhat distinct from the sort of routine dental care that can be done as an outpatient. Much of medicine is driven by various governing systems and regulatory agencies, and to a large extent this tends to drive who practices where. You don’t just walk into a hospital and tell them you will be treating patients there. In the ED, where I spent my career, we do get a fair amount of patients who come in with dental problems. For the most part, these issues are simpy temporized until an appropriate oral surgery or dental specialty follow up can be made for definitive care. I hope it’s not quite true that we in the ED just give a pain med and send the patient out; there are a number of acute dental problems that can be ameliorated in the ED. For really serious acute problems we do keep a list of dentists prepared to see patients on an emergency basis, but for the most part most non-traumatic dental emergencies can wait til the morning if the pain is treatable with a nerve block or medication. [Previous page](https://boards.straightdope.com/t/why-doesnt-the-regular-hospital-do-dentistry/528612.md?page=1)