Dentistry

[[File:Medieval dentistry.jpg|thumb|right|200px|The people of the Middle Ages may have lacked [[germ theory]], but they could pull a tooth!]]
{{science}}
'''Dentistry''' is [[medicine]] of the teeth, gums, and mouth. Professional practitioners of dentistry, called dentists, may recommend preventative behaviors (like tooth-brushing) to avoid [[disease]] and decay in this region of the body. Alternatively, they might intervene with an anesthetic-filled<ref name="anesthetic">{{Cite journal |last=Decloux |first=Derek |last2=Ouanounou |first2=Aviv |date=2021-01-27 |title=Local Anaesthesia in Dentistry: A Review |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275172/ |journal=International Dental Journal |volume=71 |issue=2 |pages=87–95 |doi=10.1111/idj.12615 |issn=0020-6539 |pmid=32944974 |quote=Over the past century, there is perhaps no greater contribution to the practice of clinical dentistry than the development and application of local anaesthesia. What were once considered painful procedures have now been made routine by the deposition and action of local anaesthetics.}}</ref> procedure once you have gone and fucked that up.

In the Western countries, this profession evolved from the {{wpl|barber-surgeons}} of the [[Middle Ages]] who treated soldiers (and had oral health as one of their several duties).<ref name="HealthAffairs"/> That's probably why they like sharp stuff, and making people sit uncomfortably still.{{nofact}} Within the medical fields, modern dentistry is one of those professions that has had a somewhat peculiar evolution, even beyond its descent from barber-surgeons.<ref name="HealthAffairs"/>

The profession especially seems to have grown apart from the rest of medicine during the 1800s&nbsp;— traditionally explained as part of a [[schism]] occurring in 1839–1840 as medical schools rejected integration with dentistry.<ref name="StatGap">R. Bruce Donoff (July 17, 2017). [https://www.statnews.com/2017/07/17/dentistry-medicine-division/ "It’s time to break down the wall between dentistry and medicine"]. ''Stat News''.</ref><ref name="AtlantBeck">Julie Beck (March 9, 2017). [https://www.theatlantic.com/health/archive/2017/03/why-dentistry-is-separated-from-medicine/518979/ "Why Dentistry Is Separate From Medicine"]. ''The Atlantic''.</ref><ref name="HealthAffairs"/> In recent decades, this has become less the case, as dentistry has gradually moved in the direction of reintegration.<ref name="Istanbul"/><ref name="StatGap"/><ref name="AtlantBeck"/> Though, in many places, such as southern [[Europe]], the seclusion from the broader medical world simply never happened.<ref name="Istanbul"/>

==History==
===Early roots===
Dentistry has been practiced in some form since [[ancient Egypt]] where written records have been found,<ref name="Istanbul">{{Cite journal |last=Guven |first=Yegane |date=2017-10-02 |title=Scientific basis of dentistry |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624148/ |journal=Journal of Istanbul University Faculty of Dentistry |volume=51 |issue=3 |pages=64–71 |doi=10.17096/jiufd.04646 |issn=2149-2352 |pmid=29114433}}</ref> and even back then they realized the importance of oral health to health in other parts of the body.<ref name="ReturnWiley">{{Cite journal |last=Vieira |first=Clz |last2=Caramelli |first2=B |date=2009 |title=The history of dentistry and medicine relationship: could the mouth finally return to the body? |url=https://onlinelibrary.wiley.com/doi/10.1111/j.1601-0825.2009.01589.x |journal=Oral Diseases |language=en |publisher=Wiley |volume=15 |issue=8 |pages=538–546 |doi=10.1111/j.1601-0825.2009.01589.x |issn=1354-523X}}</ref> The earliest evidence of tooth fillings dates back 13,000 years, when bitumen was used on two teeth in what is now [[Italy]].<ref>[https://www.newscientist.com/article/2127300-oldest-tooth-filling-was-made-by-an-ice-age-dentist-in-italy/ Oldest tooth filling was made by an Ice Age dentist in Italy] by Brian Owens (7 April 2017) ''New Scientist''.</ref>

===Modern dentistry===
{{wpl|Pierre Fauchard}} is considered an early pioneer to modern dentistry.<ref>[https://www.adea.org/GoDental/Health_Professions_Advisors/History_of_Dentistry.aspx "History of dentistry"]. ''American Dental Education Association''.</ref> He denounced [[quackery]] in the field all the way back during the 1700s, although [[ironically]] some of his own solutions (like [[Urine therapy|swishing one's own fresh urine through one's own teeth]]) would be considered as such today as well (by reasonable minds, anyhow).<ref>{{Cite book |last=Gardner |first=Martin |url=https://books.google.com/books?id=4GJcAgAAQBAJ&pg=PA94#v=onepage&q&f=false |title=Did Adam and Eve Have Navels?: Debunking Pseudoscience |date=2001-10-17 |publisher=W. W. Norton & Company |isbn=978-0-393-24503-5 |pages=94 |language=en}}</ref> In 1778, the King of [[England]]'s surgeon, John Hunter, wrote about the importance of oral health in ''The Natural History of the Human Teeth''.<ref name="ReturnWiley"/>

====Seclusion and integration====
In many of the Western countries (excepting some places such as southern Europe), it is the case that dental medicine and mainstream medicine were separated from one another.<ref name="Istanbul"/><ref name="HealthAffairs"/> They had their own educational institutions, licensing programs, regulations, etc.<ref name="StatGap"/>

This has caused, or helped exacerbate, some problems today.<ref name="StatGap"/> Those include: gaps in health insurance coverage,<ref name="StatGap"/><ref name="AtlantBeck"/> gaps in the compatibility of health records,<ref name="HealthAffairs"/> a misconception that oral health is supplemental,<ref name="AtlantBeck"/> and a general lack of necessary collaboration between dentists and other sorts of doctors. Due to this historical evolution apart, it is unfortunately not that uncommon for patients to end up in a hospital emergency room with a dental problem, surrounded by professionals who can't address the issue.<ref name="AtlantBeck"/><ref>Lisa Simon (February 26, 2018). [https://oralhealth.hsdm.harvard.edu/blog/separation-medicine-and-dentistry "The Separation of Medicine and Dentistry"]. ''Harvard School of Dental Medicine Initiative: Integrating Oral Health & Medicine''.</ref>

Nonetheless, there have been efforts to increase collaboration between dentistry and the rest of medicine. Thus it can be seen that dentistry is on a (rather slow) trajectory to integrate into the broader medical field.<ref name="Istanbul"/><ref name="StatGap"/><ref name="AtlantBeck"/> As for why such progress has been slow: existing financial incentives and perceived threats to professional autonomy have been unhelpful factors.<ref name="HealthAffairs">{{Cite journal |last=Mertz |first=Elizabeth A. |date=2016 |title=The Dental–Medical Divide |url=https://www.healthaffairs.org/doi/10.1377/hlthaff.2016.0886 |journal=Health Affairs |language=en |publisher=Project HOPE |volume=35 |issue=12 |pages=2168–2175 |doi=10.1377/hlthaff.2016.0886 |issn=0278-2715}}</ref> Although dentists are often not certified as "MDs",<ref name="DiFoggio">Whitney DiFoggio (November 19, 2022). [https://www.teethtalkgirl.com/career/dentist/are-dentists-real-doctors/ "Are Dentists Even Real Doctors?"]. ''Teeth Talk Girl''.</ref> they will typically receive an education with many similarities to what is taught in medical school (perhaps even studying alongside medical students), though with limitations.<ref name="RitcheySBM"/><ref name="StatGap"/>

Looking back, there have been real pushes to integrate dentistry with the rest of the medical and scientific world since at least the 1920s, with {{wpl|William John Gies||.}}<ref name="Istanbul"/><ref name="AtlantBeck"/> Scientific advances have helped to drive specialization in dentistry,<ref name="Istanbul"/> and in such a way that it even encourages further integration with medicine.<ref name="DiFoggio"/> One of the most significant improvements has been the addition of anesthesia to the dentist's toolbelt, as without it there would be a whole lot more pain in the world.<ref name="anesthetic"/> More recently, there have been more advanced additions, such as that of the [[polymerase chain reaction]] (PCR).<ref name="Istanbul"/>

====Evidence-based dentistry====
There has been a suggestion that dentistry is not sufficiently [[Evidence-based medicine|evidence-based]] — this appeared in an article for ''The Atlantic'' in 2019.<ref>Ferris Jabr (May 2019). [https://www.theatlantic.com/magazine/archive/2019/05/the-trouble-with-dentistry/586039/ "The Truth About Dentistry"]. ''The Atlantic''.</ref> One dentist, H. Grant Ritchey Jr., wrote for the medical blog ''[[Science-Based Medicine]]'' to rebut this (not least to point out that the claim dentistry overall is focused on "procedure rather than prevention" is ludicrous), explaining some basic foundations of {{wpl|evidence-based dentistry||,}}<ref name="RitcheySBM">Grant Ritchey (May 17, 2019). [https://sciencebasedmedicine.org/is-dentistry-science-based/ "Is Dentistry Science Based?"]. ''Science-Based Medicine''.</ref> although he concedes there are occasional issues in the field of dentistry with "[[scam|grifty]]", profit-oriented behavior among some practitioners. In that vein, he added: "we need a little bit of a watch guard here."<ref>(June 10, 2019). [https://www.docseducation.com/blog/'-truth-about-dentistry'-lie "Is ‘The Truth About Dentistry’ a Lie?"]. ''DOCS Education''.</ref>

We regret that there's no strong case for avoiding the dentist's pointy little metal tools.

==See also==
*[[Dental woo]]
*[[Psychoanalysis]] — isolated from mainstream [[psychiatry]], though maybe it should be

==External links==
*[https://www.cebd.org/ The Center for Evidence-based Dentistry]
*[https://quackwatch.org/dental/ Dental Watch]
*[https://www.nature.com/ebd/ ''Evidence-Based Dentistry''] (journal)
*[https://sciencebasedmedicine.org/category/dentistry/ Posts tagged "dentistry" at ''Science-Based Medicine'']
*[https://dentistry.ucsf.edu/about/news/dentistry-science "Is Dentistry Science?"], UCSF School of Dentistry
*{{wpa|Dentistry}}

==Further reading==
*{{Cite journal |date=April 2023|title=Should dentistry play a larger role in general medicine|url=https://www.scielo.org.za/scielo.php?pid=S0011-85162023000300001&script=sci_arttext&tlng=en|journal=South African Dental Journal|publisher=The South African Dental Association |volume=78|issue=3}}
*Mark Grossman (January 31, 2020). [https://www.mcgill.ca/oss/article/health-pseudoscience/holistic-dentistry-full-ofwholes "Holistic Dentistry; Full of …… Wholes"]. ''Office for Science and Society''. McGill University.
*Michael Reddy (May 6, 2019). [https://dentistry.ucsf.edu/about/news/dentistry-science "Is Dentistry Science?"]. ''UCSF School of Dentistry''.
*John Dodes (September 5, 2011). [https://pointofinquiry.org/2011/09/john_dodes_the_tooth_about_dentistry/ "The Tooth About Dentistry"]. ''Point of Inquiry''.
*{{Cite journal |last=Dodes |first=John E. |date=Fall 1986 |title=Dentistry and Pseudoscience |url=https://cdn.centerforinquiry.org/wp-content/uploads/sites/29/1986/10/22165322/p53.pdf |journal=[[Skeptical Inquirer]] |volume=11 |issue=1 |pages=51–53}} (May be a bit outdated; makes for historical background reading if nothing else.)

==References==
{{reflist}}

[[Category:Dentists| ]]
[[Category:Medicine]]

Categories: Dentists, Medicine