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What you need to know about tooth and toothache and the doctors who look after them

The tooth is arguably the most neglected part of the human body but ironically it becomes the most important when toothache sets in! However that was in in the past and nowadays as the pearly whites of Hollywood stars flashes in and out of our screens they have become an important asset and a new symbol of beauty. And if care is taken in looking after them, thay can cause little problem and last a lifetime.

Why are dentists called "dentists"?

"Teeth" is the plural of the singular component which is "tooth". Its latin term is "dens" and that is why tooth doctors are called "dentists" which loosely translated means "tooth specialists" much like "women healthcare specialists" are called gynaecologists. But dentists or dental surgeons as they are also known as do more than just tooth.

Nowadays dentists are trained in the oral cavity and the region surrounding it and they are called "general dentists". But dentistry have her own specialists namely periodontist, endodontist, prosthodontist, pedodontist, orthodontist and oral maxillofacial surgeons.

Periodontists refers to dental specialists who deals with the gums.

Endodontists refers to dental specialists who treats your root canals and the living part of your tooth.

Prosthosontists refers to dental specialists who does crowns, bridges and prosthesis for your mouth and also oral maxillofacial region.

Pedodontist refers to dental specialists who treats children and adolescents.

Orthodontists are dental specialists who deals with braces and the movement of tooth or teeth.

Oral Maxillofacial surgeons are dental specialists who specialises in oral surgery and surgery of the surrounding regions.

The dental surgeons and specialists are supported by dental auxillaries such as oral hygienists who does simple scaling and oral health education, dental surgery assistants or dental nurses who assist them, dental radiologists who deals with dental xrays and others.

Before we progress further to talk about oral maxillofacial surgery which is the focus of this website, lets talk about the anatomy of the tooth and its surrounding structures.

Anatomy of the tooth

The tooth is made up of three basic components and they are from the external part of the tooth to the internal; enamel, dentine and pulp.

Enamel is the outermost part of the tooth and its the hardest and most resilient structure of the tooth specially adapted to its function of withstanding large amounts of masticatory or biting forces.

Dentine lies beneath the enamel and this is the layer that gives rise to tooth sensitivity due to its tubular structure and underlying nerve endings. Dentine is not as strong as enamel and wears down faster.

Pulp is the innermost layer of the tooth and it is the living part of the tooth. This is the structure which is normally responsible for the pain associated with most but not all toothaches and they reside in the pulp chamber and root canals.

The tooth has two parts, one exposed in the mouth and the other buried in bone.

The part exposed is called the crown of the tooth not to be confused with the prosthesis crown used to cap your tooth.

The part buried is called the root of the tooth.

Anatomy of the structures surrounding tooth

The roots of the tooth are encased in bone specially termed alveolar bone.

Gums or gingival tissue overly this alveolar bone and some parts of the tooth whereas periodontal ligaments attaches bone to teeth and also links adjacent teeth.

And the upper tooth resides in the major bone called the maxilla whereby the lower tooth resides in the mandible.

What is Oral Maxillofacial Surgery?

Oral Maxillofacial Surgery refers to the branch of medicine and dentistry which deals with surgery of structures within the oral cavity and those immediately surrounding the oral cavity. The specialists dealing with this branch are called oral maxillofacial surgeons or simply oral surgeons and they undergo special surgical training to equip them with the necessary skills. In some countries like UK and Australia it is mandatory for oral surgeons to posess both a dental and medical qualification before they are allowed to practise as OMS surgeons.

What does OMS surgeons do?

Oral Maxillofacial Surgeons do a variety of procedures ranging from simple wisdom tooth surgery to complicated surgeries such as orthognathic surgery much like those done in the show "Extreme Makeover". Some are also trained in head and neck surgery.

Below are the list of the different procedures that an oral surgeon might do. This list is by no means exhaustible and there may be other procedures that an oral surgeon might do but is not listed.

1. Tooth extractions

2. Dento-alveolar surgery including Wisdom tooth surgery
3. Incision and Drainage ( I & D ) for infections

4. Dental and Oral Maxillofacial Implants

5. Orthognathic Surgery

6. Removal of soft tissue and hard tissue lesions

7. Biopsies

8. Facial trauma

9. TMJ disorders management ( eg myalgia or jaw pain)

10. Cleft/ Craniofacial Surgery

11. Reconstructive surgery
12. Cosmetic Dental Surgery

Oral Maxillofacial Surgery encompasses a wide variety of surgery and procedure in the mouth and the region surrounding it and as the discipline matures, more complex and complicated procedures will evolve. Even as this is being written, new techniques such as sialendoscopy which is endoscopy of the salivary gland duct is being introduced.

This article is written and contributed by an oral surgeon and any duplication, reproduction or plagiarism in any form is strictly prohibited without the author’s permission.