Should I see a dental specialist or my general dentist?
Good question. Let’s get into the differences.
A general dentist is one that has completed dental school with courses, lessons, and hands-on experience in each of the dental specialties. Sometimes a general dentist will also complete one more year in general dental education as a GPR (General Practice Residency) or AEGD (Advanced Education in General Dentistry).
The job of a general dentist is to do a little bit of everything; provided the level of difficulty is within their scope. If it’s not, a referral should be made to a specialist. If general dentists weren’t able to do anything a specialist is trained to do, then you would only be able to visit your dentist’s office for simple fillings and only if you’re a middle-aged adult.
A dental specialist has completed their general dental studies as well as completing an additional 2-6 years studying in their specialty field. The ADA recognizes 9 dental specialties including: endodontics (root canals), orthodontics and dentofacial orthopedics (braces and Invisalign), oral and maxillofacial surgery (extractions and implants), pediatric dentistry (kids), periodontics (gums), prosthodontics (dentures, full-mouth rehabilitation), dental public health, oral and maxillofacial pathology, and oral and maxillofacial radiology.
The specialties in bold are the ones you are more likely to be aware of or have visited for braces, wisdom tooth extractions, as a child or with your child, for deep cleanings or gum grafts, for implant placement, for a root canal, or for dentures.
The job of a specialist is to only do treatments within their specialty, especially the difficult cases.
Both general dentists and specialists are required to complete continuing education (CE) courses in order to maintain their licenses. Typically, specialists tend to choose courses in their specific field because the information they learn will be in topics regarding work that they do daily. (It really wouldn’t make much sense for an oral surgeon to take a course about Invisalign if they never intend to treat a patient with Invisalign …but they could if they wanted to!).
General dentists tend to choose subjects that appeal to them. Since general dentists are licensed to complete easy to moderate cases in any of the dental specialties, they can choose a course in just about any field of dental studies. In some cases, that can be a little bit about each of the specialties, or they can focus their time in one specialty that interests them. For example, I find root canals and clear aligners like Invisalign interesting, so many of my CE credits are in these subjects.
When it comes to knowing who can treat your condition, your general dentist is often a good place to start.
A general dentist serves as your gatekeeper to determine what your overall needs are.
Typically, this includes a complete exam that involves taking a look at all of your teeth and gums. Once your overall needs are considered, they are then prioritized. If your crooked teeth are bothering you, but you have a tooth with a large cavity approaching your nerve, this should be addressed first. On the other hand, if you’re having excruciating pain with one tooth that is infected, smaller cavities can wait.
Once your needs are prioritized, each of the treatments required can be evaluated on their own merits whether it is something better treated by a specialist or if it is straightforward enough for treatment in-office with the same people you are familiar with. Your general dentist is trained in each of the recognized specialties. This means that if they have an interest in a particular specialty that you require for treatment (root canals, for example), they can assess the level of difficulty to determine if it is something that they can predictably treat or if they should make a referral to a trusted specialist for you.
Often the determining factor of who should treat your tooth/teeth/gums is the level of difficulty.
If your crooked teeth include just a few lower teeth, your bite does not need correction, and your general dentist has taken continuing education in orthodontic courses, they may be able to complete your short treatment for you. However, if your general dentist does not have an interest in orthodontics, or if your treatment is not straightforward, a specialist is who you will want to be referred to.
Too often patients go straight to a specialist for treatment and the specialist focuses only on the tooth or teeth concerning the patient. An orthodontist or oral surgeon will take a panoramic x-ray to look at the teeth in question but will not take bitewing x-rays to look for decay in between your teeth. This may mean that braces are placed on teeth with cavities and those cavities continue to grow while in treatment until they are too obvious to ignore. Placing fillings can be difficult while you are in full-orthodontic treatment and we may need to interrupt your orthodontic treatment or delay your fillings – which can then require more treatment, such as a root canal.
Or, with an oral surgeon, it can mean that your wisdom teeth are removed but the cavities in your remaining teeth continue to grow unmonitored.
Similarly, you may go to a root canal specialist because a tooth is causing you so much pain that you want to have the root canal completed, only to find out later that your money would have been better spent on a partial denture and extracting that aching tooth after considering the condition of the other teeth in your mouth.
Or you may see a prosthodontist for a partial denture, and if all of your x-rays aren’t taken and your gum and bone levels aren’t measured and assessed, you may pay to have a partial denture made only to find out that one of the retaining teeth needs to be extracted and now your new partial denture can’t sit without rocking.
Long story short, see your general dentist first.
Have them assess your entire mouth and then, if a treatment they are suggesting is something that a specialist is trained to do (deep cleanings, gum treatments, crowns/bridges, dentures, braces/Invisalign, treatment of children, extractions, root canals, or implants), ask your dentist how comfortable they are providing that treatment for you in their office. If they do not have enough training to feel comfortable, or if you simply want to see a specialist because you want the most qualified person for the job, ask your dentist for a referral. They will be more than happy to send you to whomever you feel most comfortable with. At the end of the day, it’s your mouth and your choice and you will have these teeth, hopefully, forever – at least that’s the plan! – so don’t go cheap on them.
And one final, very important note: if you are looking to visit a specialist due to the level of difficulty or the expertise that you are seeking, be careful to ensure that the dentist you are seeing who claims to have a “special interest” in a particular field of study is an actualspecialist – i.e. with additional formal training. Some general dentists will, unfortunately, try to falsely give the impression that their continuing education courses in a particular field of study makes them a “specialist.” Ensure that you ask the right questions to determine if they are, in fact, the specialist that you are seeking.