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Dental Specialties

Dental Specialties. Charles Spalding DMD Charlesspaldingdmd@gmail.com 907-272-6288. Dental Specialties . Endodontics- Root canals Periodontics- gums/bone, implants Orthodontics- braces Prosthodontics- crown/bridge/dentures Pedodontics - kids

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Dental Specialties

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  1. Dental Specialties Charles Spalding DMD Charlesspaldingdmd@gmail.com 907-272-6288

  2. Dental Specialties • Endodontics- Root canals • Periodontics- gums/bone, implants • Orthodontics- braces • Prosthodontics- crown/bridge/dentures • Pedodontics- kids • Oral maxillofacial surgery- EXT, implants, trauma, pathology

  3. Specialty Training • Training programs last 2-6yrs after dental school • General dentists can perform most specialty procedures without a full residency; however in a legal situation a specialist would be called as expert witness. • Example- Dr. X (a GP) performs a root canal and it fails and the patient sues. If the root canal was not performed using standard practices a specialist would point out that the technique used is not standard and Dr. X is liable. If the technique used IS standard and the failure was due to bad luck Dr. X would not be liable

  4. Endodontics • Root canals are performed if the pulp of a tooth dies • Pulpal death can be caused by bacterial invasion (deep cavity or fracture that exposes the pulp) • Pulpal death can be caused by trauma severing the nerve and blood supply at the apex of the tooth • Pulpal death can be idiopathic • Root canal procedure can be one appointment or multiple appointments with medicament left in the canal for weeks prior to final obturation

  5. Endodontics • Teeth have between 1 & 4 canals that need to be cleaned using files and disinfecting solution

  6. Endodontics • Disinfectant- NaOCl, EDTA, Chlorhexidine • Hand files, rotary files • Sealer and cone (guttapercha)

  7. Endodontics • Lateral Condensation • Warm Vertical Condensation • Thermafill/Guttacore • Sargenti (controversial)

  8. Periodontics • Controlling gum disease (caused by bacteria) • Replacing missing gum tissue (recession) • Implant placement

  9. Periodontics • Surgical vs non surgical therapy • Non Surgical- Deep cleaning with anesthesia • Surgical- pocket reduction or crown lengthening

  10. Periodontics • Gum Grafting- adds keratinized tissue where it has been lost. Keratinized tissue harvested from palate.

  11. Periodontics • Aesthetic crown lengthening • Restorative crown lengthening

  12. Orthodontics • Slow pressure over time to move teeth • Bands, Brackets, invisalign • Functional and Aesthetic driven

  13. Orthodonic Classification • Angle Class I, II, III (molar and canine relationship) • Cross bite • Overbite, Overjet

  14. Orthodontics • Interceptive ortho can solve problems before they get too bad. Doesn’t always involve full braces

  15. Prosthodontics • Crown, bridge, denture specialists • Complex cases (full mouth rehabilitation) • Opening Vertical dimension • Precision attachments for partials • Maxillofacial prosthetics

  16. Prosthodontics • Full mouth rehabilitation • Vertical Dimension of Occlusion- measured from chin to nose. Heavy wear or loss of teeth diminishes VDO

  17. Prosthodontics • Full mouth rehab (crowns bridges, implants…) • Expensive, but worthwhile

  18. Prosthodontics • Complex Bridges and partials. • Stress Breakers, Precision Attachments

  19. Prosthodontics • Maxillofacial prosthetics-

  20. Pedodontics • Specialize in kids • Sedation • Full mouth rehab • Space maintenance and early ortho

  21. Pedodontics • Early Childhood caries

  22. Pedodontics

  23. Pedodontics • Baby teeth have thinner enamel and larger pulp • Important for: chewing, saving space for adult teeth • Tooth aches can keep kids out of school and cause pain with eating

  24. Pedodontics • Various levels of sedation based on need • Patient safety is #1 • Nitrous oxide (laughing gas) • In office oral sedation (versed and demerol) • General anesthesia in the hospital

  25. Oral & Maxillofacial Surgery • Tooth removal • Trauma repair • Soft tissue • Hard tissue • Pathology • Soft tissue • Hard tissue • Implant placement • Orthognathic (jaw surgery)

  26. OMFS • Trauma- car accidents, falls, assault, gun shot wounds

  27. OMFS pathology • Cancers- Squamous cell is most common • Surgery, possible radiation and or chemo

  28. OMFS pathology • Ameloblastoma

  29. OMFS pathology • Odontoma

  30. OMFS- Orthognathic Surgery • Braces can only move the teeth in bone (ideally centered in bone) • Orthognathic surgery moves the bone

  31. OMFS- Orthognathic • Done in combination with braces

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