Chapter 22- Specialists.

Your GDP [General Dental Practitioner]/ family dentist is like your GP. They see you ‘cradle to grave’ get you into good habits, teach you how to look after your teeth, keep on teaching you ‘till you can do it and they do most branches of ordinary dentistry to as [obviously] good a level as they can but dentistry like medicine has specialities. Some of them you will have heard of; – orthodontics [braces], oral surgery [things like wisdom teeth] and some you may not have.

A dentist can’t just call themselves a specialist, they have to be on the ‘Specialist Register’ kept by the GDC [General Dental Council- the regulatory body] and they have to have further qualifications in their particular subject, whatever that particular discipline requires.

These further qualifications are granted by the Royal Colleges of Surgeons of England [London], Edinburgh, Glasgow [Scotland being of course the home of medicine and surgery and incidentally veterinary surgery], Royal Collage of Radiologists and The Royal College of Pathologists amongst others.  It takes at least 5 years of further training from basic qualification to become a specialist.

There are 13 specialties recognised by the GDC and they are:-

  • Dental and Maxillofacial Radiology.
  • Dental Public Health.
  • Oral and Maxillofacial Pathology.
  • Oral Medicine.
  • Oral Microbiology.
  • Special Care Dentistry.

These specialists tend to work in specialist departments in hospitals, teaching facilities or specialist clinics.

  • Endodontics [root fillings].
  • Oral Surgery.
  • Orthodontics [braces].
  • Paediatric Dentistry [children].
  • Periodontics [gum disease].
  • Prosthodontics [false teeth].
  • Restorative dentistry [complicated restorations, crown and bridge, implants etc].

These specialists may work in specialist departments, teaching facilities, specialist clinics or in private practice [NHS and ‘private’] either as a specialist within a General Practice or in a ‘Specialist Practice’.

These are the only ‘Specialities’, all other expressions such as; – Cosmetic Dentist, Smile Specialist, Holistic Dentist are merely marketing expressions.

All qualified dentists are entitled to and are trained to perform all of the disciplines definitely in the 2nd list but part of being any good at anything is to recognise ones limitations. If your dentist suggests you see a specialist for some of your treatment it is not because they are hopeless but because they recognise you need the services of someone more qualified, knowledgeable or skilled for your particular problem. The skill in being a ‘generalist’ is to have an overview of all disciplines and to guide, advise and send the patient in the right direction so your needs are managed properly in your best interests. So you are looked after, advised and if need be treated by the best person for the job.

It’s funny how the public expect their GDP to be able to do everything. You would not expect your GP to pin you down in couch and operate on your knee if you had a problem with it. They might have a go with the aid of a text book if your appendix burst in the middle of an Artic expedition and it was a matter of life or death but under normal circumstances you would expect to be referred to the appropriate specialist. So it is with dentistry.

Some large general dental practices may have their own ‘in-house’ specialists. Just as your GP practice may have someone with further qualifications in something like dermatology. Some specialists work in ‘Specialist Practices’ all over the country.

‘Harley Street is an address it is not a qualification’.

There is no doubt about it that some very competent and highly skilled specialists and general dental practitioners work in Harley St and the surrounding areas either in practices that they are part of or in surgeries where they essentially rent the chair time like a hairdresser. Be aware though that a big chunk of the patient’s fee is the rent in Marylebone, Mayfair, Fitzrovia or Belgravia. One doesn’t eventually graduate to Harley St if one is a better dentist or specialist it is not part of the academic process. It simply means you can command the fees from whoever your patients are that cover the overheads incurred from practicing in that area of central London!

There are just as many, if not more, highly skilled general practitioners and specialists working all over the country. Perhaps some however just like to be able to pop into the back of John Lewis on the way home in the evening!

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