Careers With a Bite

JOWITA BYDLOWSKA, Staff Writer

Nobody likes going to the dentist. But sooner or later we all have to sit in that scary chair and let people deal with whatever's causing trouble in our mouths. And often we find that even the most unpleasant procedure ends up being okay (nobody is saying "fun" -- we're not that cheery) thanks to the people who get us through the process. From dental assistants, dental hygienists and dentists, through to dental specialists such as endodontists or orthodontists to oral and maxillofacial surgeons, dentistry is a thriving profession with "practically no unemployment in this field," according to the Service Canada site.

Dentists
As with any medical degree, the road to becoming a dentist is a long and difficult one (as well, as very expensive). According to the Canadian Dental Association (CDA), a prospective dentist should ask him/herself the following questions before pursuing this path:

• Do you enjoy interacting with and helping people?
• Would you like a career that offers challenge and variety?
• Would you enjoy being self-employed?
• Are you interested in helping people maintain and improve their oral health?
• Do you have good manual dexterity and spatial judgment?
• Do you have a keen memory and a strong interest and ability in science?

Dentistry is a licensed profession that requires many years of schooling. In exchange for hard work and serious financial sacrifice, dentists are able to enjoy special benefits such as work hour flexibility, ability to work in varied venues (private practice, federal government agencies, research programs, universities, corporations, and so on). Additionally, or perhaps most importantly, the income is very attractive -- it's a known fact that working as a dentist will make you financially secure, which may be the driving factor in choosing the profession. Many dentists are able to open their own practice, and, according to the CDA, dentists "can easily structure their personal and professional lives according to their individual needs and desires."

Being a dentist doesn't just mean drilling people's teeth -- there are many varied different specialties within this profession, which require additional years of educational training. According to the CDA, they are:

• Dental public health - A public health dentist promotes oral health through various community outlets. A public health dentist is a specialist who has completed an accredited advanced education program and holds a designation from a Provincial Dental Regulatory Authority (PDRA).
• Endodontics - An endodontist deals with what's inside the tooth (dental pulp and periradicular tissues). Most often this type of a dentist will deal with root canal procedures. An endodontist specialization requires a designation from the PDRA.
• Oral and Maxillofacial Surgery - An oral and maxillofacial surgeon deals with the diagnosis and treatment of various disorders and diseases and defects that affect the functional as well as the aesthetic aspects of teeth and jaws. According to the How to Become an Oral and Maxillofacial Surgeon article, "Oral and maxillofacial surgery developed out of the need for special management of facial injuries, especially broken jaws sustained by servicemen during the two world wars. Since then, the specialty has evolved to meet a clear demand for the management of an increasingly large range of pathological conditions of the face, notably facial deformities in adults and children, head and neck cancer, salivary gland disease, as well as the initial impetus: facial trauma." On the more popular end of things, one example of oral surgery that these specialists deal with is the removal of wisdom teeth. Designation from the PDRA is required to practice oral and maxillofacial surgery.
• Oral Medicine and Pathology - According to the CDA this is a branch of dentistry that deals with the "diagnosis, nature and primarily non-surgical management of oral, maxillofacial and temporomandibular diseases and disorders, including dental management of patients with medical complications." Oral medicine and pathology (PDF) practitioners have to have specialty designations from the PDRA.
• Oral and Maxillofacial Radiology - This is a branch of dentistry that is mainly concerned with "the acquisition and interpretation of radiographic imaging studies performed for diagnosis of treatment guidance for conditions affecting the maxillofacial region," according to the The American Academy of Oral and Maxillofacial Radiology (AAOMR) (Check this Wikipedia link as well for extra references). As with all the other specific niches of dentistry a specialty designation from the PDRA is required.
• Orthodontics and Dentofacial Orthopedics - Braces anyone? This specialty focuses on the diagnosis, prevention and treatment of the growing or mature dentofacial structures and deals with any abnormalities. According to the Canadian Association of Orthodontists, "Without treatment, orthodontic problems may lead to tooth decay, gum disease, bone destruction and chewing and digestive difficulties. A 'bad bite' can contribute to speech impairments, tooth loss, chipped teeth and other dental injuries." A designation from the PDRA is required to practice as an orthodontist.
• Pediatric Dentistry - Even the little guys have dental problems. Pediatric dentistry deals with oral health care and consultation for anyone from an infant (for example, by defining the impact of nursing on dental health and development) to an adolescent as well as anyone with special care needs. A pediatric dentist is trained in child psychology to be able to work with kids and is well prepared to deal with educating parents and kids in the proper oral care. A PDRA designation is required to practice.
• Periodontics - A periodontics specialist deals with diagnosis, prevention and treatment of gum diseases as well as the placement of dental implants. A PDRA designation is required to practice in this specialty.
• Prosthodontics - A prosthodontist deals with a variety of issues related to the replacement of missing teeth -- from complete dentures, to removable partials to bridges as well as with the practice of cosmetic surgery related to the appliance of veneers, bonding techniques, reshaping of teeth and whitening. A designation from PDRA is required to practice as a prosthodontist.

Dental Staff
Of course it's not only dentists who deal with people's teeth. In order for any doctor to be successful, she or he usually needs a team of people to assist them. And in the dental profession there are at least three different experts other than the dentist that make sure you get treated like gold in that awful dental chair.

Dental Assistant
Based on figures from the Canadian Dentist Assistants' Association (CDAA) there are between 26,000 and 29,000 dental assistants in Canada. Like with dentists, dental assistant programs offer different specializations and a dental assistant can end up working in a hospital, a private periodontic practice, an insurance company, a dental supply company, in a school, and more. The CDAA says, "Dental assistant programs provide training in such areas as microbiology and infection control, dental radiography, clinical assisting procedures and preventive dentistry."

According to Manitoba Job Futures, a dental assistant may perform some or all of the following duties:

• Preparing patients for the dental procedures as well as assisting the dentist during the procedure
• Preparing dental instruments and filling materials as well as sterilizing equipment
• Ordering dental and office supplies
• Scheduling and invoicing patients and recording dental procedures
• Taking and developing X-rays
• Taking impressions for diagnostic casts as well as fabricating temporary crowns and restorations
• Polishing teeth and applying fluoride and sealant

According to Working in Canada, to work as a dental assistant you have to complete a three-month to one-year college program in dental assistance or complete secondary school with on-the-job training. Licensing is not mandatory in Ontario but it is required to perform intraoral duties. The Ontario Dental Association says that "with the exception of Ontario, every province in Canada regulates dental assisting. The ODAA is working with the Ontario government to change this."

In Canada, licensing is done by acquiring National Dental Assisting Examining Board (NDAEB) certification. Internationally trained professionals are also required to pass the NDAEB Clinical Practice Evaluation to be able to practise in Canada (except for Quebec). In order to work as a dental professional you will also have to have your credentials assessed before attempting the NDAEB examinations.

Dental Hygienist
According to Working in Ontario, dental hygiene is a profession that is regulated by the College of Dental Hygienists of Ontario (CDHO), and "there are approximately 9,050 active registered dental hygienists in Ontario." Dental hygienists may work in a number of different settings -- from public health to education to research to administration as well as private practice. They may be employed by more than one dentist or facility -- in Ontario, dental hygienists who work on contract with dental clinics need to meet self-employment criteria that are set by the Canada Revenue Agency. Some of the duties of a dental hygienist involve:

• Consulting with other health care providers
• Initializing a dental hygiene assessment as well as planning treatment and evaluating it
• Educating patients about oral health
• Cleaning the gums to prevent gum disease
• Applying fluoride and other therapeutic treatments
• Working in collaboration with a dentist on restorative or orthodontic procedures

The Working in Ontario site points out that "in Ontario, dental hygiene is considered a separate and distinct health profession from dentistry" Human Resources and Skills Development Canada (HRSDC) stresses that unlike dental assistants, dental hygienists have to complete a college program (one to three years) and they have to be licensed through CDHO.

Dental Lab Technician/Technologist
This is one profession in which you don't have to work with patients directly. Dental lab technologists "are regulated health care professionals whose scope of practice includes the design, construction, repair or alteration of dental prosthetic, restorative and orthodontic devices. These devices include bridges, crowns, dentures, implants, orthodontic and other dental appliances, prescribed by dentists or other regulated health practitioners to replace or enhance their patients' teeth. Dental technologists also supervise the technical aspects of dental laboratory operation." Additionally, according to HRSDC, a dental technician may also be responsible for:

• Consulting with dentists and other professionals on problematic dental cases
• Training other dental technicians in fabricating dentures
• Performing administrative duties

A dental technician needs to complete a college program in dental technology or have four-plus years of the on-the-job training under the supervision of a registered dental technologist or technician. This is a regulated profession, through the College of Dental Technologists of Ontario.