Evolution of Dentistry: From Ancient Times to Modern Practices

1. Chapter 5: Patient Care: Dental

2. Dentists • Early History • Ancient Egypt • Hesi-Re (died in 2600 BC): first dentist known to historians • Ancient Romans • Promoted oral hygiene • Used tooth-cleaning powders & toothpicks • Ancient India & Islamic countries • Physicians or surgeons performed dentistry

3. Dentists (cont’d) • The Middle Ages, the Renaissance, and the 17th Century • Medieval Europe • Monks provided dental care • Barbers were surgical assistants • Catholic Church forbade monks to practice medical/dental care • Barbers became dental care providers • Barber-surgeons extracted teeth • Renaissance: renewed study of human anatomy, including dental

4. Dentists (cont’d) • Dentistry in the U.S. • Colonial America: physicians provide dental care • Tooth-drawers, surgeon-dentists, barbers, & blacksmiths extracted teeth • Advertisements of services in newspapers (Paul Revere) • 1840: first dental college established, in Baltimore • 1859: American Dental Association formed • By 1880: 28 dental schools established • 1928: creation of national exam

5. Dentists (cont’d) • Education • 4-year accredited dental school is standard • 58 accredited programs in U.S. • Requirements for entering dental school: • At least 2 years of college education (most have bachelor’s) • Passing the Dental Admission Test (DAT) • Diagnosing & treating tooth & gum disease in first 2 years • Treatment of patients under supervision in last 2 years • Schools award DDS or DMD degree

6. Dentists (cont’d) • Course Work • Anatomy & physiology • Biochemistry • Microbiology • Laboratory techniques • Pharmacology • Histology

7. Dentists (cont’d) • Licensure • Required by all states • Requires: • Graduation from accredited dental school • Passing of written & practical exam

8. Dentists (cont’d) • General Duties • Examine a patient’s teeth, gums, & mouth • Interpret an x-ray • Formulate a plan of treatment • Administer an anesthetic • Fill a cavity • Apply a crown • Perform a root canal • Extract a tooth • Apply braces • Insert a dental implant

9. Dentists (cont’d) • Specialties • Orthodontics • Oral & maxillofacial surgery • Pediatric dentistry • Periodontics • Prosthodontics • Endodontics • Dental public health • Oral & maxillofacial pathology • Oral & maxillofacial radiology

10. Dentists (cont’d) • Personal Characteristics • Self-discipline • Strong work ethic • Good problem-solving skills • Attention to detail • Patience • Thoroughness • Focus • Manual dexterity • Communication skills • Genial personality • Positive attitude

11. Dentists (cont’d) • Employment Opportunities and Trends • 16% growth from 2008 to 2018 • In demand due to: • Population growth • Preventive care for younger people • Increasing dental coverage among private insurance companies • Rising popularity of cosmetic dental services

12. Dentists (cont’d) • Professional Organization: ADA • >157,000 members • Advocates for dental profession & oral health • Monitors policy issues in Congress, state legislatures, regulatory agencies, & foreign governments • Establishes standards for & accredits dental education programs • Issues Dental Admission Test and National Board Dental Examinations • Develops standards for dental products & testing them • Conducts scientific research

13. Dental Hygienists • History of the Profession • 1890: publication of Microorganisms of the Human Mouth by Willoughby D. Miller • 1896: Alfred C. Fones integrated oral hygiene into practice • 1913: Fones opened first oral hygiene school • 1916: first university program started at Columbia University • 1923: formation of American Dental Hygienists’ Association (ADHA) • 1951: all states required licensure • 1952: accreditation of schools begun • 1962: first national board exam administered

14. Dental Hygienists (cont’d) • Education • Most programs offer associate’s degree • Some offer certificate, bachelor’s degree, or master’s degree • Entrance requirements: HS diploma or equivalent • Academic classes & supervised clinical instruction

15. Dental Hygienists (cont’d) • Course Work • Basic science • Dental science • Dental hygiene science

16. Dental Hygienists (cont’d) • Licensure • Required in all states • Requires: • Graduation from accredited program • Passing written exam & clinical board exam • Renewal required periodically (continuing education)

17. Dental Hygienists (cont’d) • Work Responsibilities • Clean teeth • Remove plaque & other materials from teeth & below gum line • Polish teeth • Examine mouth for tooth decay & gum disease • Take x-rays • Apply fluoride treatments, sealants, & other materials • Make casts of patients’ teeth

18. Dental Hygienists (cont’d) • Personal Characteristics • Detail oriented • Manual dexterity • Efficient • Well-organized • Good people skills • Patient • Flexible

19. Dental Hygienists (cont’d) • Employment Opportunities and Trends • Rapid growth: 36% between 2008 & 2018 • Ranks first among all occupations requiring associate’s degree • Job growth due to: • Increase demand for dental services due to expanding population • Aging population • Growing focus on preventive care

20. Dental Hygienists (cont’d) • Professional Organization: ADHA • Three-tier structure: national, state, local • Monitors legislation & federal activities • Represents profession before Congress • Advocates on issues of scope of practice, education, & licensing • Promotes dental hygiene education & research through fellowships & grants • Offers continuing education programs, networking, employment assistance program

21. Dental Assistants • History of the Profession • C. Edmund Kells, dentist • Founder of dental assisting • Hired female assistant in 1885, starting a trend • Milestones in the American Dental Assistants Association (ADAA) • 1921: Juliette Southard started ADAA • 1930: educational guidelines & training developed • 1944: standards & a competency exam developed • 1946: first 140-hour training course adopted • 1948: certifying board established (DANB)

22. Dental Assistants (cont’d) • Education • Some trained on the job; most trained in programs • Programs: • At community/junior colleges, trade schools, technical institutes, & the military • Most last 1 year & award certificate or diploma • Some last 2 years & award associate’s degree • Require HS diploma • Include clinical practice with a dentist

23. Dental Assistants (cont’d) • Course Work • Oral & written communication • Oral health education • Anatomy and physiology • Microbiology • Oral pathology • Nutrition • Pharmacology • Dental materials • Chairside assisting • Dental radiology • Psychology • Practice management

24. Dental Assistants (cont’d) • Regulation, Licensure, and Certification • States regulate duties • Licensure or registration for expanded functions in some states • Licensure requires completing accredited program, passing exam • Continuing education required for renewal of license • Two certification credentials offered by DANB: • Certified Dental Association (CDA) • Certified Orthodontic Association (COA) • Two specialty areas: radiation health & safety and infection control

25. Dental Assistants (cont’d) • Work Responsibilities • Open office & daily routine • Prepare dental treatment room • Set up instrument trays • Seat patient • Take & develop x-rays • Hand instruments to dentist • Instruct patients in oral hygiene • Clean & polish removable appliances • Complete health history records • Prepare bank deposits

26. Dental Assistants (cont’d) • Personal Characteristics • Reliable • Comfortable working under supervision • Work well with others • Good communication skills • Manual dexterity

27. Dental Assistants (cont’d) • Employment Opportunities and Trends • >295,000 jobs in 2008 • 36% growth between 2008 & 2018 • More than one-third work part-time

28. Dental Assistants (cont’d) • Professional Organization: ADAA • Largest professional organization representing dental assistants • DANB: certifying board of ADAA • Credentials recognized or required in 37 states • Provides home-study continuing education classes