There is considerable overlap between the various dental specialties. Because of this overlap, patients are often confused about what procedures a general dentist can and will perform, how this is distinguished from the procedures performed by an orthodontist and just what is the difference between a general dentist and an orthodontist.
Becoming a dentist
In order to become a dentist in the United States, a person must successfully complete dental school and pass standardized tests along the way. Accredited dental schools in the US and Canada include training on anatomy, physiology, pharmacology and various procedures that can be performed to treat patients with dental problems. In most states, once someone has graduated from dental school he or she can apply for and receive a license to practice dentistry. At this point the dentist can put out a plank and practice dentistry within the laws of the state or territory.
What is the difference between a DMD and a DDS degree?
When someone graduates dental school they are awarded one of two degrees, either a DMD or a DDS. A DMD degree is a Doctor of Dental Medicine degree. DDS, on the other hand, stands for Doctor of Dental Surgery. What is the difference between a DMD and a DDS degree? In a word: nothing. An individual dental school has the right to decide which degree to confer and have chosen one or the other over the years. Accreditation and standards applied to dental education mandate that the core requirements to attain either degree are the same. In other words, there is no difference between a DDS and a DMD degree.
Dentists that graduate from dental school and begin to practice are considered to be general dentists. However, there are two different programs that extend the training of dentists before they enter practice. While these are not considered dental specialties, they do provide dentists with additional knowledge, experiences and skills to enhance their practice of dentistry. One program is called Advanced Education in General Dentistry program (AEGD) and the other is a General Practice Residency in Dentistry (GPR). According to the ADA, the major distinction between the Advanced Education in General Dentistry and the General Practice Residency in Dentistry is that the emphasis in the AEGD program is on clinical training while the GPR program reinforces the skills needed to provide medical management of dental patients. These programs usually last one year (some up to two years) and are often completed immediately after dental school.
The ADA recognizes nine dental specialties:
- Dental Public Health
- Oral and Maxillofacial Pathology
- Oral and Maxillofacial Radiology
- Oral and Maxillofacial Surgery
- Orthodontics and Dentofacial Orthopedics
- Pediatric Dentistry
You will notice that general dentistry is not a recognized dental specialty, however Orthodontics and Dentofacial Orthopedics is recognized. In fact, it was the first recognized dental specialty. You will also notice that cosmetic dentistry is not a recognized dental specialty either. While this status may change if the field successfully petitions the ADA for inclusion as a specialty, as of right now, cosmetic dentistry is not recognized. Therefore if you meet a dentist that claims to be a specialist in cosmetic dentistry, you should be cautious and question how that person came about that designation or title.
How long is residency in orthodontics and what training does it include?
A dentist that completes a program in Orthodontics and Dentofacial Orthopedics can be called an orthodontist. The programs are rigorous and usually require between two to three years time commitment (30 months on average). During this time, dentists receive training in the diagnosis of jaw closure problems (malocclusion), improper eruption and movement of teeth, anomalies of the face and skull, speech pathology, and temporomandibular joint dysfunction. They learn about the various orthodontic treatment options including braces, retainers, various dental appliances, and extractions to facilitate tooth spacing and placement.
Is there a specific board certification in Orthodontics?
Yes, there is a board certification process that residents in board certification exam must pass at the end of residency in addition to satisfactorily completing all coursework within the program. In fact, the final months of residency training are devoted to preparing for the challenging board certification exam. The exam includes both a written (didactic) exam and a clinical exam. The clinical exam includes case reports and tests the resident’s ability to manage patients and their orthodontic treatment.
Who can perform orthodontic treatment?
That is the tricky, but important question. Under most state and federal laws, any licensed dentist with a DDS or a DMD degree can perform orthodontic treatment. While it is not done, even a person with an MD or DO degree and a license to practice medicine could perform orthodontic treatment. It would not be very skilled or very successful treatment, but they could do so legally. Just as an internist would not perform heart surgery, most dentists would not perform orthodontic treatment that is outside of their expertise or comfort level.
However, in dentistry there can be a bit of a gray area. Many general dentists perform orthodontic treatment routinely, even though they have not completed residency training in Orthodontics and Dentofacial Orthopedics nor are they board certified. Because of this, it is important for patients to determine if they should receive their orthodontics treatment from a general dentist or an orthodontist. In almost every case, the choice will be an orthodontist. If you are trying to decide which professional to choose for orthodontics treatment, there are several questions to ask both your general dentist and your prospective orthodontist(s) .