Choosing the Right Dentist For Your Needs

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. Here is a simple guide in understanding various dental specialties and what they do best to help you ‘pick the right dentist for the job’:

General dentist: 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 per their experience, proficiency, and personal comfort.

** Most general dentists choose to refer all or most of the specialty or complex procedures to specialists **

Specialties Recognized by the American Dental Association

Prosthodontics: A prosthodontist has received three additional years of post-doctoral 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.)
• 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 and major bone grafting procedures to create site for implants
• 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 tooth’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
• Treatment of gum recession via grafting procedures
• Cosmetic gingival procedures
• Minor bone grafting procedures for implants
• Dental implants placement

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 dental medicine

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.


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.

For more information, contact Dr. H. Ryan Kazemi at hkazemi@facialart.com

Visit our site: www.facialart.com

Office Telephone: (301) 654-7070

Office location: Bethesda, MD

Visit our video podcasts on:
1) iTunes: search word- 'dr. kazemi'
2) Vimeo.com: search 'dr. kazemi's oral surgery channel'
3) YouTube: search 'implantguru'

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Who is best for Placing Dental Implants? A Guide for Patients to Make Better & More Engaged Decisions About Their Oral Health

There are three things in life that we protect more than anything else: our family, money, and health. We carefully protect them with every resource we have to avoid irreversible loss. And we follow some innate behaviors: We don't hire a stranger to babysit our kids no more than trusting our attorney who took some accounting courses with managing our hard earned money. But somehow we have lost the grip on protecting our health. We blindly accept doctors' recommendations regardless of whether it's their area of expertise or not. We select a doctor because they accept our insurance and pay little attention to how good they are and what their training and qualifications are. It makes no sense any more than trusting our tv repairman to fix our computer logic board or have our internist do a bypass surgery! The reason behind this inconsistent behavior may be because for years people did not have a better option. Medical and dental knowledge and technology even up to two decades ago was a fraction of what is known now. Physicians and dentists managed to learn a lot and do a lot and it worked. And frankly it was not easy for people to access information, so they had to go with what their doctors told them.

But times have changed. We live in a specialized world, with an immense amount of knowledge in each field which continues to grow at a rapid rate. In-fact, there is so much information and knowledge that it is practically impossible for any one person to master any more than one or two disciplines in their lifetime. It's time to come to grip with reality and take more responsibility for our health and make decisions that make sense, protecting our health like we protect our families and money.

Dental implants have revolutionized dentistry and the way we as dentists can help millions of patients with missing teeth regain their confidence, function, aesthetics, and overall oral health. The science and knowledge of dental implants has evolved greatly since they were first introduced by the father of implant dentistry, professor Branemark almost 50 years ago. It has now become one of the most successful procedures that we perform, approaching 98% plus success rate. This is mainly related to highly skilled implant surgeons trained in accredited residencies, continued advancement in technology and techniques, and better understanding of its biology and healing. But this knowledge is not achieved easily. Some clinicians spend their lifetime doing and learning about dental implants, performing hundreds and thousands of procedures, attending many conferences, and reading endless numbers of related literature each year........to reach what I call a "Level of Mastery". Our great success is a reflection of this dedication and mastership by these clinicians.

Here is the problem and a potential disaster in the making: In the past few years, there has been increasing trend for dental implant companies and some study groups to sponsor "weekend" courses targeting the general practitioners to buy their products and perform these highly technical and demanding procedures on their own patients. There is huge profit for these companies to do so as the general dentists make up the majority of the dental practitioners and therefore potential sales.

The current state of economy has amplified this problem. For number of dentists patient flow and treatment acceptance has declined. With decrease in production, many decide to perform such procedures themselves where they would have previously referred them to specialists.

And we are starting to see the results of this: Failed implants, increased infection, poorly positioned implants that can not be restored, nerve damages, loss of jaw bone, etc. This is very concerning, because the industry has worked so hard and so long to bring this unique service to patients transforming their lives with such great predictability and success.

Weekend courses clearly do not cover appropriate areas of study to meet the legal standard of care for implant placement. Most expert clinicians attest, "implant surgery is never simple". In response to this alarming trend, the Institute for Dental Implant Awareness (IDIA) recently released new training guidelines for basic implant placement. It is hoped that implant companies and organizers of these "weekend" courses comply and change their protocols. But this will take time and will certainly not be an easy battle.

So what should you do as a patient if you are planning to get dental implants? Here are some key questions to ask your dentist to help you make an engaged decision about your treatment and ultimately your oral health:

1) What is your specialty? Oral surgeons and periodontists receive formal implant surgery training in accredited residency programs; some prosthodontists and general dentists may also have advanced surgical training. Caution: An "Implantologist" is not a recognized and accredited specialty nor does it indicate proper training.

2) 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.

3) How many dental implants have you placed? A specialist or any skilled clinician has placed hundreds if not thousands of implants. They do these procedures day-in and day-out. However there are some clinicians who are also excellent and skilled through indepth training who may not have yet placed significant number of implants.

4) 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

5) Ask to speak to other patients about their experience. Personal testimonials are very valuable and meaningful.

6) 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!

7) 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.

Such engaged questions can also be asked of other highly specialized procedures such as extractions, grafting procedures, wisdom teeth, root canal procedures, orthodontics, etc.

As dentists, we have the responsibility to provide the finest care that we can to serve the best interest of our patients and we must remain committed to this oath. But it is also the responsibility of every patient to get involved and make engaged decisions about their health.

Dr. H. Ryan Kazemi


To reach Dr. Kazemi for this story and others:

Email: Hkazemi@facialart.com
Tel: (301) 654-7070

web: www.facialart.com

Visit our video podcasts on:
1) iTunes: search word- 'dr. kazemi'
2) Vimeo.com: search 'dr. kazemi's oral surgery channel'
3) YouTube: search 'implantguru'

Read More