The Right Dentist For Oral Surgery
Your choice of a dentist is probably the single biggest decision you will make. The most appropriate dental specialist for performing oral surgery including wisdom teeth surgery, dental implants, bone grafting, and oral pathology and trauma is an oral surgeon specifically trained for these procedures.
There are several ways to find an oral surgeon that meets your needs and personality: Your dentist can recommend an oral surgeon that he or she knows, trusts, and, has had great experiences with. You might also get personal recommendations from family members, friends, or co-workers who have had the surgery. Online research has become an increasingly popular way to find dentists, and provides helpful information about their practice, in addition to patient reviews. Advertisements are another way. In some instances, your general dentist may have decided to perform oral surgery.
Questions to ask to help you make the right decision
Are you an oral surgeon?
An oral surgeon is the only dental specialist trained specifically for extraction of third molars, dental implant surgery, bone grafting, oral pathology, and trauma. Having treated thousands of patients, you can be certain that you are in the hands of an expert.
Here are the key reasons why you would want to select an oral surgeon to perform your surgery:
- Oral surgeons are the only dental specialists who can provide IV sedation anesthesia in the office.
- Oral surgeons can perform the procedure quicker and more conservatively, which translates into less pain, less swelling, and less overall complications*
- Oral surgeons use special instruments and equipment designed specifically for extractions, making it safe and easier to perform.
- Oral surgeons have the knowledge, experience, and the ability to handle challenges, complications, or unusual circumstances that may arise.
- The office is equipped with proper surgical equipment and staff is specifically trained for surgical procedures creating a safe environment.
How many wisdom teeth patients do you treat?
Some dentists may have specific interests and experience with wisdom teeth extractions and although not an oral surgeon, may perform the procedure with same predictability. However, this level of experience requires a dentist to treat at least three to five wisdom teeth patients a week. In his book, Outliers**, Malcolm Gladwell discusses the “10,000 Hour Rule”. It says achieving excellence at performing a complex task, with true mastery, greatness, and status as a world-class expert in anything, requires 10,000 hours of practice. Be cautious- ask if wisdom teeth surgery is an occasional procedure for them or something they do routinely. Also, your choice of anesthesia may be limited to local anesthesia only, therefore being awake.
What formal training do you have?
Oral surgeons receive four to six years of formal surgical training in hospital-based residency programs. Some dentists may take courses on extractions on dental implants. These courses vary in duration and intensity, from a short weekend course to a series over a year or more. Majority of courses are classroom style and do not provide surgical training to the participants. If your dentist is not an oral surgeon, ask about the extent of his or her training.
Do you specialized training in dental implants?
Successful dental implant surgery requires formal training and years of experience. While it’s a highly successful and predictable procedure, it’s not simple, requiring the skills of a trained specialist and restorative dentist working as a team. Oral surgeon and periodontists are the only two specialty who receive formal surgical training and spend intensive continuing education and practice to achieve predictable results. Beware of dentists how perform dental implant surgery after completing some weekend courses. Implants have a more than 98 percent success rate when performed by the right team of dentists that use quality implants, customized components, and reputable labs. This saves patients money by preventing complications and re-dos, and improving longevity.
What anesthesia options do you offer?
Decide whether you want to be sleep or not for the procedure. More than 98 percent of patients choose IV sedation for wisdom teeth surgery as offered by almost all oral surgeons. The alternative is being awake with use of local anesthesia (numbing) only. The decision for the type of anesthesia is often based on the complexity of the surgery as well as level of patient’s anxiety.
How long does the surgery take?
In most patients, extraction of all four wisdom teeth takes 15 to 20 minutes when performed by an experienced oral surgeon. Placement of a single dental implant can take 15 to 30 minutes if done properly. Increase in surgical time may contribute to additional pain and swelling following surgery. Depending on the level of experience, staff support, and type of instruments, treatment time may increase to 45 to 60 minutes if performed dentists other than oral surgeons.
The Right Dentist For Dental Implants
Successful implant dentistry requires collaboration of two experts in their own fields: A specialized surgeon placing the dental implants and a restorative dentist placing crowns, bridge, or dentures on the them.
Rarely, a person can achieve true mastery of both fields.
Team approach for success:
Dental implant therapy require expertise and knowledge in two different areas: Surgical placement of dental implant and restoration with an appropriate crown, bridge, or overdenture. Each discipline requires extensive formal training (residency programs) and education. It is for this reason that successful treatment requires a team of dentists working together and in close collaboration. This team consists of a surgeon placing the dental implant and a restoring dentist who will make the prosthetic aspect of it.
Choosing the right implant surgeon:
Dental implant surgery is a highly skilled discipline, best performed by specialized surgeons who are properly trained and perform this procedure daily. Oral surgeons and periodontists are the only two recognized dental specialties that can perform surgical placement of dental implants. Success of implants requires special attention to how teeth are extracted, preservation or augmentation of the underlying jaw bone, development of proper gum tissue profile, precision implant placement and use of well researched implants with specific features and characteristics.
Choosing the right restorative dentist:
The prosthetic aspect (crown, bridge, or dentures) is performed by your restorative dentist who may be a general dentist or a prosthodontist, a specialist trained in more complex aesthetic and reconstructive restorative dentistry. Other specialists may be involved in your overall treatment as well, including an endodontist (root canal specialist) or orthodontist to assist the restorative dentist in reaching your treatment goals.
Need a dentist? Ask us and we’ll be delighted to refer you to one of our trusted colleagues.
Choosing the right team:
Close collaboration and communication between all the dentists involved in your care is critical to ultimate success. There must be a common goal, strategy, and plan that meets your goals and has been discussed in detail. Poor results and complications often result when the surgeon and your dentist don’t communicate.
Researching for the right dentists:
When researching for your dental implant team, ask the following key questions to help you make an engaged decision about your treatment and ultimately your oral health:
- What is your specialty? Only oral surgeons and periodontists receive formal implant surgery training in accredited residency programs; some prosthodontists may also have advanced surgical training, but less common. Caution: An “Implantologist” is not a recognized and accredited specialty nor does it indicate proper training.
- What is the extent of your training in implant surgery? Ask specifically the names of the courses, dates, durations, and who sponsored them. Search these courses and see if they are legitimate programs endorsed or supported by professional associations.
- How many dental implants have you placed? A specialist or any skilled surgeon has placed hundreds if not thousands of implants. They do these procedures day-in and day-out. Question their qualifications if they have only placed a few of them in the past few months or year!!!
- Do you work with any specialists? Even if a dentist places some dental implants, they almost always work with specialists in their area; Ask if it’s OK for you to speak with them and get a different perspective. It’s your right.
- Ask to speak to other patients about their experience. Personal testimonials are very valuable and meaningful.
- Ask the assistants and receptionists about dental implants (how they work, how long it takes, what are the steps, etc); If they can not answer your questions or defer you constantly to the dentist, then they most likely do not perform many of them!
- Ask for brochures, supporting articles, before & after photos, and other detailed information. A practice with focus on dental implants will have all of these readily available. No need to look for it!!!
- If you hear or observe the following, be cautious:
- “This is an easy one, I can handle it”………It almost never is…that simple!
- Dental implant sales person in the office during your treatment! You can guess why they are there!!!
- ‘The lone star’……A dentist who seems to know everything and do everything!!!
Have you been given treatment recommendations but you are just not sure if it is right or the best approach?
Contact Dr. Kazemi for a complimentary second opinion.
Just send an on-line inquiry with available X-rays, photos, or the recommended treatments and he’ll evaluate them for you.
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The Right Dentist for Wisdom Teeth
Your choice of a dentist is probably the single biggest decision you will make. The most appropriate dental specialist for performing wisdom teeth surgery is an oral surgeon who is specifically trained for this procedure. There are several ways to find an oral surgeon that meets your needs and personality:
Your dentist can recommend an oral surgeon that he or she knows, trusts, and, has had great experiences with. You might also get personal recommendations from family members, friends, or co-workers who have had the surgery. Online research has become an increasingly popular way to find dentists, and provides helpful information about their practice, in addition to patient reviews. Advertisements are another way. In some instances, your general dentist may have decided to perform the wisdom teeth surgery.
Questions to ask to help you make the right decision
An oral surgeon is the only dental specialist trained specifically for extraction of third molars. Having treated thousands of patients, you can be certain that you are in the hands of an expert.
Here are the key reasons why you would want to select an oral surgeon to perform your surgery:
- Oral surgeons are the only dental specialists who can provide IV sedation anesthesia in the office.
- Oral surgeons can perform the procedure quicker and more conservatively, which translates into less pain, less swelling, and less overall complications*
- Oral surgeons use special instruments and equipment designed specifically for extractions, making it safe and easier to perform.
- Oral surgeons have the knowledge, experience, and the ability to handle challenges, complications, or unusual circumstances that may arise.
- The office is equipped with proper surgical equipment and staff is specifically trained for surgical procedures creating a safe environment.
How many wisdom teeth patients do you treat?
Some dentists may have specific interests and experience with wisdom teeth extractions and although not an oral surgeon, may perform the procedure with same predictability. However, this level of experience requires a dentist to treat at least three to five wisdom teeth patients a week. In his book, Outliers**, Malcolm Gladwell discusses the “10,000 Hour Rule”. It says achieving excellence at performing a complex task, with true mastery, greatness, and status as a world-class expert in anything, requires 10,000 hours of practice. Be cautious- ask if wisdom teeth surgery is an occasional procedure for them or something they do routinely. Also, your choice of anesthesia may be limited to local anesthesia only, therefore being awake.
What formal training do you have?
Oral surgeons receive four to six years of formal surgical training in hospital-based residency programs. Some dentists may take courses on extractions on dental implants. These courses vary in duration and intensity, from a short weekend course to a series over a year or more. Majority of courses are classroom style and do not provide surgical training to the participants. If your dentist is not an oral surgeon, ask about the extent of his or her training.
What anesthesia options do you offer?
Decide whether you want to be sleep or not for the procedure. More than 98 percent of patients choose IV sedation for wisdom teeth surgery as offered by almost all oral surgeons. The alternative is being awake with use of local anesthesia (numbing) only. The decision for the type of anesthesia is often based on the complexity of the surgery as well as level of patient’s anxiety.
How long does the surgery take?
In most patients, extraction of all four wisdom teeth takes 15 to 20 minutes when performed by an experienced oral surgeon. Placement of a single dental implant can take 15 to 30 minutes if done properly. Increase in surgical time may contribute to additional pain and swelling following surgery. Depending on the level of experience, staff support, and type of instruments, treatment time may increase to 45 to 60 minutes if performed dentists other than oral surgeons.
“Can I get referral to an oral surgeon?
If the response is “I can do it as well as the specialist with the same result,” then ask about the difference in care between a general dentist and an oral surgeon. If the rational is, “they are more expensive,” ask why. If the response is, “you don’t need to be asleep; you’ll be fine with just getting numbed,” inquire why and how anesthesia will benefit you. Get informed and make engaged decisions about your care.
What General Dentists Do
A general dentist has graduated from a 4-year dental school with no additional formal post-doctorate residency. Some may have completed a 1-year general practice residency program following dental school, providing them additional clinical experience and expertise.
Some general dentists may have also taken extensive courses on specific disciplines, such as cosmetic dentistry, periodontal surgery, dental implants, endodontics, or orthodontics. Therefore they may perform these specialty procedures with great proficiency and can provide excellent treatment even in the most complex patients. As there are no specific regulations, It is best for patients to inquire about the proficiency and experience of a general dentist regarding complex procedures that are more often performed by specialists.
You will benefit from a general dentist if you have the following needs
- General restorative needs (fillings, crowns, bridges, dentures, etc.)
- Routine periodontal care (Cleaning, management of early or moderate periodontal disease)
- Cosmetic procedures (bleaching, bonding, veneers, etc)
- If a general dentist has additional training and experience, they may provide:
- Simple extractions, root canals, orthodontics, periodontal procedures, and some pediatric dentistry.
- Complex restorative, cosmetic, and surgical procedures may also be offered depending on their experience, proficiency, and personal comfort.Most general dentists choose to refer all or most of the specialty or complex procedures to specialists.
Do you need a general dentist?
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Reconized Dental Specialties
With rapid advances in dentistry, evolution of specialization, and marketing trends, choosing the right dentist for a specific need has become increasingly difficult for many people.
Choosing the right dentist for a specific problem or need is an important part of our oral health. Everyone deserves the best treatment dentistry can offer and making engaged decisions is an integral part of this process. Here is a guide in understanding various dental specialties and what they do best to help you ʻpick the right dentist for the jobʼ:
Specialties recognized by the American Dental Association
Prosthodontics:
A prosthodontist has received three additional years of postdoctoral training in dentistry gaining advanced skills in both cosmetic and restorative procedures. Some may also perform common periodontal or oral surgery procedures, but most focus on treatment of patients with complex cosmetic and restorative needs. In a patient with multi-disciplinary needs (e.g a patient who needs crowns, implants, root canal treatment, and gum surgery), a prosthodontist will act as both the restorative dentist and the coordinator of the overall treatment and other team dentists.
You will benefit from a prosthodontist if you have the following needs:
- Both simple and complex restorative needs (crowns, bridges, veneers, etc.)
- Complete dental rehabilitation and reconstruction
- Dental implants and reconstructive dentistry
- Rehabilitation of patients with partial or complete missing teeth
- Advanced cosmetic procedures (bleaching, veneers, tooth reshaping, bonding)
- Multi-disciplinary complex dental needs
Oral and Maxillofacial Surgery:
Oral surgeons receive 4–6 years (6 years for combined DDS / MD programs) of post-doctoral training in accredited residency programs. They receive hospital-based training in oral and facial surgical procedures and anesthesia, in addition to extensive medical training to care for the medically compromised patients. Most are board certified as necessary for obtaining hospital privileges. Oral surgeons are limited to performing surgical procedures and anesthesia and offer key role in the overall care of dental patients.
You will benefit from an oral surgeon if you have the following needs:
- Extraction of teeth (wisdom teeth and others)
- Dental implant placement (surgical aspect)
- Minor bone grafting procedures- Extraction site bone graft and minor augmentations
- Major bone grafting procedures to develop site for implants: Sinus lift, onlay bone graft, guided bone regeneration, and other techniques for vertical and horizontal bone augmentation
- Soft tissue procedures (if has focused training)- Connective tissue graft, soft tissue revision, soft tissue augmentation
- Oral biopsies
- Corrective Jaw surgery (orthognathic surgery)
- Oral and facial infections
- Oral and facial trauma
- TMJ related treatments
- IV sedation / Anesthesia
- Procedures requiring hospitalization
- Surgical treatments in pediatric patients
Endodontics:
Endodontists are root canal treatment specialists. They receive 2–3 years of post-graduate training on treatment of conditions affecting teeth’s root canal system. Endodontists have advanced surgical and non-surgical skills that make them uniquely qualified to treat routine as well as complex cases. The root canal contains the blood supply and nerve tissue vital to a healthy tooth. Insults such as decay, trauma, or other infections can compromise its health, therefore requiring root canal treatments. Current techniques, instrumentations, and technology (such as microscopes) allow
endodontists achieve high treatment success.
You will benefit from an endodontist if you have the following needs:
- Saving a non-vital or irreversibly inflamed tooth and avoid extraction
- Root canal treatment for teeth that exhibit temperature sensitivity or pain due to decay or trauma
- Teeth with abscess due to necrotic root or other types of pathology (such as cysts) compromising its health
Orthodontics:
Orthodontists receive 2–3 years of post-graduate training, specializing in straightening teeth and management of jaw relations in both children and adults. Crooked and crowded teeth are prone to decay, periodontal disease, and possible loss. Misalignment of the teeth and jaws can lead to premature wear, further damage and chronic facial and joint pain. Through use of braces or other techniques such as invisalign, orthodontists can align teeth for improved function and aesthetics. Orthodontic related treatments may start in patients in as early as 8 years old or adult patients.
You will benefit from an orthodontist if you have the following needs:
- Straighten and align teeth for improved bite and aesthetics
- Correction of misaligned or asymmetrical jaws
- Retainers or night guards
- Treatment of TMJ and facial muscles related pain
Periodontics:
Periodontists receive 2–3 years of post-graduate training for treatment of gum disease, various gingival procedures (functional and cosmetic), and dental implants for teeth replacement. Periodontists often work along with general dentists or prosthodontists for long term periodontal care of patients (bone and gum tissue surrounding teeth). They provide both preventive periodontal care as well as both surgical and non-surgical management of periodontal disease. While some procedures are performed by both periodontists and oral surgeons, they often work in collaboration on patients with complex needs requiring both expertise.
You will benefit from a periodontist if you have the following needs:
- Surgical and non-surgical treatment of gum disease
- Preventive periodontal procedures
- Placement of dental implants (if has focused training)
- Treatment of gum recession via grafting procedures
- Cosmetic gingival procedures such as crown lengthening
- Minor bone grafting procedures for implants and teeth with bony defects
- Soft tissue procedures (if has focused training)- Connective tissue graft, soft tissue revision, soft tissue augmentation
Pediatric Dentistry:
Pediatric dentists receive 2–3 years of specialized training after dental school, and are dedicated to the oral health of children from infancy through the teenage years. The very young, pre-teens, and teenagers all need different approaches in dealing with their behavior, guiding their dental growth and development, and helping them avoid future dental problems. Some may provide oral sedation for increased patient comfort. Pediatric dentists may work in collaboration with orthodontists to treat growth related teeth or jaw misalignment.
You will benefit from a pediatric dentist if you have the following needs:
- Any dental related procedures in patients from infancy to early teen-age years
- Fillings, crowns, and root canal procedures on primary teeth
- Knocked out or fractured primary teeth (may require an oral surgeon)
- Treatment of minor trauma to primary teeth
- Routine cleaning and preventive dental procedures
The ‘DDS’ vs. ‘DMD’ Question
A common question is what is the difference between a dentist who is a DDS vs. one who is a DMD!
DDS: Doctor of Dental Surgery
DMD: Doctor of Medical Dentistry
DDS or DMD Indicates the degree awarded upon graduation from dental school to become a general dentist. There is no difference between the two degrees; dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association’s Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist, such as an orthodontist, periodontist or oral and maxillofacial surgeon.
The following fields are not recognized specialties:
- Cosmetic dentistry
- Implant dentistry
You may find dentists who advertise as cosmetic or implant dentists. This does not imply specialization or even expertise. It may be used more as a marketing title, rather than true expertise. Some dentists, although not formally trained, may have received in-depth studies on cosmetic techniques or implant dentistry which provides them more knowledge and skills in these fields. Patients should ask questions about such trainings and dentist’s expertise to help them make better and more engaged decisions.