Your Dentist's Education

In the United States, a dentist must complete four years of dental school. This comes after college. Dental school graduates receive either a D.D.S. or D.M.D. degree. D.D.S. stands for Doctor of Dental Surgery. D.M.D. comes from the Latin Dentariae Medicinae Doctor.

Today, students in both types of programs receive similar training. One degree is not better than the other.

After receiving a dental degree, a person must pass two board exams in order to practice dentistry. One is a national exam. The other is a state or regional exam. A dentist's license to practice is granted by the state where the practice is located.

After earning a D.D.S. or D.M.D., about 1 in 3 dentists go on for more training. Additional training beyond dental school is not required in most places for a dentist to practice.

Recently, New York and Washington state have instituted a one-year training requirement beyond dental school. Dentists can get this extra training in a general practice residency program in a hospital. Another option is an advanced education in general dentistry program. These are usually located in a dental school. These programs are typically one year long. Some include a second year. This training gives dentists more experience with different types of patients and dental procedures.

A dentist who wants to become a specialist — such as a pediatric dentist, endodontist, oral surgeon, orthodontist, prosthodontist, public health dentist or oral pathologist — must train for as many as five years after receiving a D.D.S. or D.M.D. This training occurs in an ADA accredited program, which is typically sponsored by a dental school or hospital. About 1 in 5 dentists are specialists. After completing an accredited program, a dentist is deemed board eligible. This is followed by a board exam. A specialist who passes the board exam receives the title "board certified."

Many states require dentists to keep learning throughout their careers. This is called continuing education. Dentists can take courses at a university or receive education credits by going to professional meetings. One example would be the annual meeting of the American Dental Association. Continuing education helps dentists keep up to date on the newest research and treatment options. Members of the Academy of General Dentistry who take these courses can become certified as a master in general dentistry.

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Illustrations: How a Tooth Decays

1. Healthy Tooth	2. White Spots
Enamel is the hard outer crystal-like layer. Dentin is the softer layer beneath the enamel. The pulp chamber contains nerves and blood vessels. It is considered the living part of the tooth.	Bacteria that are exposed to sugars or carbohydrates can make acid. The acid attacks the crystal-like substance in the tooth's outer surface. This process is known as demineralization. The first sign of this is a chalky white spot. At this stage, the decay process can be reversed. Using fluorides at home and in the dental office can help the tooth repair itself.
3. Enamel Decay	4. Dentin Decay
Demineralization continues. Enamel starts to break down. Once the enamel surface is broken, the tooth can no longer repair itself. The cavity has to be cleaned and restored by a dentist.	The decay reaches into the dentin, where it can spread and undermine the enamel.
5. Pulp Involvement

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450 Sutter street, Suite 1905
San Francisco, CA, 94108
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What are the Stages of Gum Disease?

 

What are the Stages of Gum Disease?

What is Gum Disease?
Gum disease is an inflammation of the gums that can progress to affect the bone that surrounds and supports your teeth. It is caused by the bacteria in plaque, a sticky, colorless film that constantly forms on your teeth. If not removed through daily brushing and flossing, plaque can build up and the bacteria infect not only your gums and teeth, but eventually the gum tissue and bone that support the teeth. This can cause them to become loose, fall out or have to be removed by a dentist.

There are three stages of gum disease:

• Gingivitis: this is the earliest stage of gum disease, an inflammation of the gums caused by plaque buildup at the gumline. If daily brushing and flossing do not remove the plaque, it produces toxins (poisons) that can irritate the gum tissue, causing gingivitis. You may notice some bleeding during brushing and flossing. At this early stage in gum disease, damage can be reversed, since the bone and connective tissue that hold the teeth in place are not yet affected.
• Periodontitis: at this stage, the supporting bone and fibers that hold your teeth in place are irreversibly damaged. Your gums may begin to form a pocket below the gumline, which traps food and plaque. Proper dental treatment and improved home care can usually help prevent further damage.
• Advanced Periodontitis: in this final stage of gum disease, the fibers and bone supporting your teeth are destroyed, which can cause your teeth to shift or loosen. This can affect your bite and, if aggressive treatment can't save them, teeth may need to be removed.

How do I Know if I Have Gum Disease?

Gum disease can occur at any age, but it is most common among adults. If detected in its early stages, gum disease can be reversed so see your dentist if you notice any of the following symptoms:

• Gums that are red, puffy or swollen, or tender
• Gums that bleed during brushing or flossing
• Teeth that look longer because your gums have receded
• Gums that have separated, or pulled away, from your teeth, creating a pocket
• Changes in the way your teeth fit together when you bite
• Pus coming from between your teeth and gums
• Constant bad breath or a bad taste in your mouth

How is Gum Disease Treated?

• The early stages of gum disease can often be reversed with proper brushing and flossing. Good oral health will help keep plaque from building up.
• A professional cleaning by your dentist or hygienist is the only way to remove plaque that has built up and hardened into tartar. Your dentist or hygienist will clean or "scale" your teeth to remove the tartar above and below the gumline. If your condition is more severe, a root planing procedure may be performed. Root planing helps to smooth irregularities on the roots of the teeth making it more difficult for plaque to deposit there.

By scheduling regular checkups, early stage gum disease can be treated before it leads to a much more serious condition. If your condition is more advanced, treatment in the dental office will be required.

	Healthy Gums - healthy gums are firm and don't bleed. They fit snugly around the teeth.
	Gingivitis - gums are mildly inflamed, may appear red or swollen and may bleed during brushing.
	Periodontitis - gums begin to separate and recede from the teeth. This allows plaque to move toward the roots, supporting fibers and bone.
	Advanced Periodontitis - supporting fibers and bone are destroyed. Teeth become loose and may need to be removed.
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What is Plaque?

What is Plaque?

Plaque is a sticky, colorless film of bacteria and sugars that constantly forms on our teeth. It is the main cause of cavities and gum disease, and can harden into tartar if not removed daily.

How Do I Know if I Have Plaque?
Everyone develops plaque because bacteria are constantly forming in our mouths. These bacteria use ingredients found in our diet and saliva to grow. Plaque causes cavities when the acids from plaque attack teeth after eating. With repeated acid attacks, the tooth enamel can break down and a cavity may form. Plaque that is not removed can also irritate the gums around your teeth, leading to gingivitis (red, swollen, bleeding gums), periodontal disease and tooth loss.

How Can I Prevent Plaque Buildup?
It's easy to prevent plaque buildup with proper care. Make sure to:

• Brush thoroughly at least twice a day to remove plaque from all surfaces of your teeth
• Floss daily to remove plaque from between your teeth and under your gumline, where your toothbrush may not reach
• Limit sugary or starchy foods, especially sticky snacks
• Schedule regular dental visits for professional cleanings and dental examinations

	During scaling, plaque and tartar are removed from the crown and root of the tooth.
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All About Cavities

All About Cavities What's in Your Mouth? How Your Teeth Decay Types and Stages of Decay Preventing Cavities What's in Your Mouth? To understand what happens when your teeth decay, it's helpful to know what's in your mouth naturally. Here are a few of the elements: Saliva — Your mouth and teeth are constantly bathed in saliva. We never give much thought to our spit, but this fluid is remarkable for what it does to help protect our oral health. Saliva keeps teeth and other parts of your mouth moist and washes away bits of food. Saliva contains minerals that strengthen teeth. It includes buffering agents. They reduce the levels of acid that can decay teeth. Saliva also protects against some viruses and bacteria. Plaque — Plaque appears as a soft, gooey substance that sticks to the teeth a bit like jam sticks to a spoon. It is, in fact, colonies of bacteria, protozoa, mycoplasmas, yeasts and viruses clumping together in a gel-like organic material. Also in the mix are bacteria byproducts, white blood cells, food debris and body tissue. Plaque grows when bacteria attach to the tooth and begin multiplying. Plaque starts forming immediately after a tooth is cleaned; it takes about an hour for plaque to build up to measurable levels. As time goes on, different types of microorganisms appear, and the plaque thickens. Calculus — If left alone long enough, plaque absorbs minerals from saliva. These minerals form crystals and harden the plaque into calculus. Then new plaque forms on top of existing calculus. This new layer can also become hard. Bacteria — We have many types of bacteria in our mouths. Some bacteria are good; they help control destructive bacteria. When it comes to decay, Streptococcus mutans and Lactobacilli are the bacteria that cause the most damage to teeth. How Your Teeth Decay The bacteria in your mouth need food to live and multiply. When you eat sugary foods and other carbohydrates, the bacteria use them as food, too. The bacteria then produce acids that can dissolve tooth enamel (outer layer of the tooth). It's not just candy and ice cream we're talking about. All carbohydrate foods eventually break down into simple sugars. These include glucose and fructose. Some of this process begins in the mouth. Foods that break down into simple sugars in the mouth are called fermentable carbohydrates. These include the obvious sugary foods, such as cookies, cakes, soft drinks and candy. But they also include pretzels, crackers, bananas, potato chips and breakfast cereals. Bacteria in your mouth turn the sugars in these foods into acids. These acids begin to dissolve the mineral crystals in teeth. The more times you eat each day, the more times your teeth are exposed to an acid attack. This attack can lead to tooth decay, also known as dental caries. First, the acid begins to dissolve calcium and phosphate crystals inside a tooth. A white spot may appear on the enamel in this weakened area. But the loss of minerals develops beneath the surface of the enamel. The surface may still be smooth. At this stage, the tooth can be repaired with the help of fluoride, proteins and minerals (calcium and phosphate) in the saliva. The saliva also helps reduce the acid levels from bacteria that attack the tooth. Once the decay breaks through the enamel to cause a cavity, the damage is permanent. A dentist must clean out the decay and fill the cavity. Left untreated, the decay will get worse. It can destroy a tooth all the way through the enamel, through the inside dentin layer and down to the pulp or nerve of the tooth. That's why it is important to treat caries at a very early stage, when the process can be reversed. Types and Stages of Decay Young children can get a type of decay called baby bottle tooth decay or early childhood caries. It destroys enamel quickly. This type of decay is common in children who are put to sleep with a bottle of milk or juice. The bottle exposes the teeth constantly to carbohydrates through the night. Bacteria can grow rapidly and produce acid that decays teeth. Decay can become worse if the parent does not clean the child's teeth. It can eat through enamel and leave a large cavity in a matter of months. In older adults, the exposed roots of teeth can develop cavities. This is called root caries. Older adults are more likely to have receding gums caused by years of hard brushing or periodontal disease. They also are more likely to have dry mouth (xerostomia). The decrease in saliva results in less protection of the teeth. This increases the risk of decay. Many common medicines can cause dry mouth. Be sure to ask the doctor or pharmacist if any of your medicines cause dry mouth. Decay can form beneath fillings or other tooth repairs, such as crowns. Sometimes bacteria and bits of food can slip between the tooth and a poorly placed filling or crown. This also can happen if the filling cracks or pulls away from the tooth, leaving a gap. Preventing Cavities Do you or your family members get cavities often? Dental research has found out that certain factors can affect your risk of tooth decay. These factors include The current number of decayed or filled teeth Your fluoride exposure Family history of decay How well you take care of your teeth The amount of saliva and the balance of minerals, enzymes and buffering agents it contains How often and what types of foods you eat (especially carbohydrates) Ask your dentist about the best ways to reduce your risks and limit dental decay. To prevent your teeth from decaying, you can do two things: Strengthen your teeth's defenses with fluoride, sealants and agents that contain calcium and phosphate ions. Reduce the number of bacteria in your mouth. Fluoride penetrates into teeth. It strengthens them by replacing minerals that acid has destroyed. The benefits of fluoride to teeth were first discovered in the 1930s. Dentists started to notice that people who drank water that naturally contained fluoride had less tooth decay. In 1945, communities started to add fluoride to water supplies. Adding fluoride to water systems has been the most successful cavity prevention method to date. In the early 1960s, fluoride also began to be added to toothpaste. This also had a major impact on cavity prevention. Now almost all toothpastes contain fluoride. Everyone should brush with a fluoride toothpaste every day. Dental offices sometimes recommend higher levels of fluoride in toothpastes, gels and mouth rinses for both children and adults. More recently, agents containing calcium and phosphate have been developed. MI Paste and MI Paste Plus both contain Recaldent (the calcium-phosphate ingredient). Your dentist can apply them to your teeth. Recaldent also also can be found in chewing gum (some Trident products) and toothpaste. These agents help prevent and reverse early decay that has not yet led to a cavity. Sealants are protective coatings placed over the tops of the back teeth — molars and premolars. They block bacteria and acids from sticking in the tiny grooves on the chewing surfaces of these teeth. Sealants can be placed in adults and children. Children can have sealants on their baby molars, and also on the permanent molars once they come in. Dentists can put sealants on molars with signs of early decay, as long as the decay hasn't broken through the enamel. You can never get rid of all the bacteria in your mouth. But you can take steps to control bacteria: Brush twice a day. Floss daily. Reduce the number of times each day that you consume fermentable carbohydrates. Some prescription mouthwashes (those that contain chlorhexidine) reduce bacteria in your mouth. This can help prevent decay. Chewing sugarless gums, especially those with xylitol, can help reduce bacteria levels and increase the flow of saliva. Most importantly, visit your dentist regularly. Then the dentist can find any decay early, when it can be treated and reversed. ©2002-2009 Aetna All rights reserved. 3/22/2009

Call Now San Francisco Dentist Request for appointment at: (415) 391 - 7751 450 Sutter street, Suite 1905 San Francisco, CA, 94108 http://malidds.com/