Dentistry (synonym: dentistry, stomatology) is the short name for the field of dentistry, oral and maxillofacial medicine. It includes the prevention, detection and treatment of diseases in the tooth, mouth and jaw area.
The field overlaps in part with the field of Oral and Maxillofacial Surgery and Otorhinolaryngology, but also with other specialties, as pathological changes in the oral cavity often affect the rest of the body. Conversely, many diseases (eg, blood disorders, cancer, infections) show symptoms, often as first symptoms, in the oral cavity. Forensic dentistry is used to identify corpses on the basis of the dentition.
The dentist acquires with his approbation the right to practice dentistry. He can practice his profession as a contract dentist, private dentist or as an employed dentist in a clinic or a dental practice. The dentist is in contrast to the doctor not entitled to practice the entire medical science, but limited to his field of expertise.
Completed studies in human and dental medicine are required for the acquisition of the specialist title of Oral and Maxillofacial Surgery in Germany. The five-year specialist training can already be started during the study of dentistry. Through a minimum of four years of training, the area names specialist dentist for orthodontics, specialist dentist for oral surgery or dentist for public health, are acquired – and in the chamber area Westphalia -Lippe the specialist dentist for periodontics.
Hesire, oldest historically handed down dentist, stone panels (CG 1426), necropolis of Saqqara, Egypt, Old Kingdom, 3rd dynasty (about 2700 to 2620 BC)
“The Tooth Worm”, hand illustration from a dental book, Ottoman Empire, 18th century
Already 3000 BC Teeth were treated in the area of Indus culture. The first proven dental interventions include, in particular, the treatment of toothache, but also the closure of anterior tooth gaps.In the sixteenth century BC, among other things, the Ebers papyrus gave instructions on dental treatment. Not only since the Middle Ages, people had the idea that a worm that eats through the tooth, cause the dental disease. Tormenting toothache was cured until 1829 with the cautery to harden the caries and nerves. Most patients lost consciousness in this treatment. Arsenic paste was used to kill the exposed pulp (in the vernacular parlance: nerve). The patient could thus take the pain. Also ether, chloroform and nitrous oxide were known. Cocaine later supplemented the painkillers. In 1905, the later Hoechst AG launched the novocain developed by Alfred Einhorn, which for a long time had a dominant position in local anesthetics (dentistry).
The patron saint of the dentist is St. Apollonia.
Dairy dentition and adult dentition in comparison
Anamnesis, the collection of the medical history in the form of a personal conversation between the dentist and the patient, takes place as an introduction. General conditions can have an impact on dental health and include special treatment risks. To determine the individual caries risk, a nutritional questionnaire can be completed in addition.
This is followed by the intraoral and extraoral findings, the determination of the actual condition of the teeth, the periodontium (gums), the remaining oral mucosa, the masticatory muscles and the temporomandibular joints. In individual cases, the salivary flow rate is determined, which is recorded in a documentation, the dental status.
The dental status is the detection of the condition of the teeth. Here, missing teeth, replaced teeth, caries, fillings, dentures including inlays, onlays, implants, gum disease and malposition of the teeth and other diseases in the tooth, mouth and jaw area are recorded in writing. In addition, a photo documentation can be carried out by means of intraoral and extraoral images. Diagnosis includes the sensitivity test of the teeth, X-rays with single shots, X-ray status, panoramic x-rays or digital volume tomography (DVT) as needed. The supplementary special diagnostic measures include the collection of periodontal status and functional diagnostics. The latter allows the diagnosis of temporomandibular joint disorders and occlusion disorders (clashes).
Dental prophylaxis deals with preventive measures intended to prevent the development or aggravation of diseases of the teeth and the periodontium. In addition to general recommendations for caries prophylaxis, the dentist or a specialist trained in prophylaxis or dental hygiene will initiate the correct brushing technique and professionally clean the teeth. A generally good oral hygiene reduces the caries risk and the risk of complications of teeth and periodontium. Dentist visits at regular intervals are useful in order to be able to identify and treat caries that has already occurred at an early stage, thereby minimizing consequential damage.
Pediatric dentistry is a branch of dentistry for the special treatment of all diseases in the tooth, mouth and jaw area during childhood, from birth to puberty.
Conservative dentistry deals with the preservation of teeth, it can be divided into:
Cariology and filling therapy
The Kariologie is the theory of the causes, the emergence and the consequences of the caries. All the factors that trigger demineralization processes are taken into account, for example the influence of food on the demineralization of the teeth. In the treatment of caries by a filling therapy, it is usually to remove the caries bacteria infected and destroyed hard tooth substance and to reconstruct the tooth with a filling material.
Endodontology is the study of dental pulp, its diseases, their diagnostics and therapies; Endodontics is the practical application of this teaching. It is called root canal treatment.
Periodontology is the study of the periodontium, the periodontium, its diseases and their treatment.
For dental surgery (oral surgery) include surgical procedures: z. Operative removal of teeth, periodontal surgery, surgical endodontics (root tip resection), implantology, treatment of jaw fractures, tumors and cysts.
Smaller procedures of this kind are carried out by the dentist under local anesthetic (local anesthesia). If he is not adequately versed in surgery, he will refer major surgeries to an oral surgeon or a specialist in oral and maxillofacial surgery.
Caries, periodontitis or injuries can lead to tooth loss. Replacing the missing teeth with bridges, full or partial dentures is the treatment area of prosthetics. The genetic disposition of teeth (hypodontia) may require dentures.
Orthodontics: braceed upper and lower jaw teeth
Orthodontics deals with the prevention, detection and treatment of deformities of the jaws and teeth (tooth or jaw regulation) – popularly with braces.
Forensic dentistry is used for the individual identification of corpses by comparing their dentition (teeth / jaw) ante and post mortem (before and after death). It is used in victims of natural, fire, aircraft, ship, train and traffic disasters as well as crime. In addition, she deals with the allocation of bite marks, age diagnostics, victims of abuse and in the broadest sense with treatment errors.
Ethno-dentistry deals with the teeth and oral health of indigenous cultures. Likewise, the study of the various procedures of tooth and lip changes belongs to the relatively new field of expertise.
Disciplines related to Dentistry
Traumatology is the study of injuries and wounds and their treatment. This includes the care of affected teeth, the jaw and the surrounding tissue.
Oral and Maxillofacial Surgery
Oral and Maxillofacial Surgery (MKG) is a medical specialty that includes diagnostics, therapy, prevention, functional (chewing, swallowing, speaking) and aesthetic rehabilitation for diseases, injuries, Bone fractures, malformations and changes in shape of the teeth, the oral cavity, the jaw and the face includes.
It includes general-dental surgery, the treatment of tumor diseases, disorders of the jaw and facial nerves and malformations. It includes diagnostics and therapy of inflammatory diseases, dysfunctions and pain syndromes in the jaw-facial area and dental implantology. Plastic-aesthetic operations, for example for the recovery of accidents or tumor operations, as well as purely cosmetic operations belong to this field.
Psychosomatics describes the connections between the psyche and physical illnesses of humans. Within the dental field, for example, a mental tension in nocturnal teeth grinding (bruxism) can be expressed. This can affect the functionality of the masticatory apparatus, especially the teeth and the temporomandibular joint. Similarly, pain in mental stress situations can be felt more.
Dental treatment phobia
Dental phobia is the phobia before dental treatment that has developed a small number of the population (so-called anxiety patients). Who suffers from this phobia, has in or before the triggering situation so severe anxiety that this can be reflected in sweating, tremors, difficulty concentrating, loss of appetite and / or sleep disorders.
The most common causes of this particular phobia are traumatic experiences during treatment and (rarely) tales of such experiences. The consequences include a pronounced avoidance behavior of the patients, which can extend to the extent that they avoid the dreaded situation for decades and do not seek out a dental practice. This affects the condition of the teeth, often including those of the gums, the rest of the oral mucosa and the periodontium. Many sufferers develop in addition to their phobia pronounced feelings of shame and suffer in everyday life by an enormous impairment of their quality of life. The approaches to the therapy of the phobia and thus of the teeth are manifold. They range from behavioral therapy to drug sedation or a combination of both to treatment under general anesthesia. Contact persons are dentists, psychologists or psychiatrists.
Cost of Dental Treatment
An international research project under the leadership of Heidelberger evaluated global treatment costs and productivity losses due to dental disease in a large-scale study from 2015. According to cost dental diseases annually 442 billion US dollars (as of 2010).
Germany Dental Treatments Cost
In 2003, the statutory health insurance gave almost 11.8 billion euros for dental treatment and dentures.
The fees for dental treatment in the case of cash patients are determined by the standard of assessment of dental services (BEMA), which determines the fee relationship between the individual services. The billing of additional services are specified in the fee schedule for dentists (GOZ) or in the fee schedule for doctors (GOÄ). In the fee works the individual achievements are rated with points. Multiplication of the points with a point value results in the respective fee.
Insofar as dental services are provided by statutory dentists in the form of benefits in kind, the health insurance funds pay a total compensation for the entire contract dental care of the members resident in the district of the Dentistry Association as in the case of medical treatment “in accordance with the overall contracts to the respective dentists’ association with liberating effect including the co-insured family members. “(Section 85 (1) SGB V in conjunction with Section 72 (1) Sentence 2 SGB V).
Between 2004 and 2011, this total remuneration was divided among the dentists participating in the dental health care treatment in accordance with the fee distribution agreements (HVV), which had to be concluded with the health insurance funds by mutual agreement (§ 85 (1) SGB V).
Since 2012, the fee distribution scale (HVM) within the framework autonomy of the Dentists’ associations by their representative meetings – in consultation with the health insurance – set. If the total reimbursement limit is exceeded, the fee distribution scale applies, which varies according to the concentration camp area. It either forces a reduction in the fees of the individual services (which may lead to recoveries) or a decrease in the amount of services provided by the dentists.
Basically, the patient is a debtor. Invoicing will only be made directly to the payers with whom the Swiss Dentists Association has concluded contracts. B. statutory accident insurer UVG, IV, military insurance or the health insurer KVG. If social circumstances justify it, an application for part of the costs can be submitted to state or private organizations.
In Austria the right of free choice of doctor and dentist applies. If you have health insurance and can be treated by a doctor with a cash contract, certain contractual services are free. Exceptions exist if you are insured with a health insurance fund that requires a deductible. For some services, which go beyond the catalog of the cash benefits, the health insurance company can grant a subsidy.