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

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 (gutta percha)

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
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