Why is Dentistry Separate from Medicine
When the
NHS was set up in 1948 dental care was included as free healthcare and three
services became available and are still available today. The first was the
local health authority dental service which provides dental inspection and
treatment to school children, pre-school children, pregnant women and mothers
of infants under one-year-old. The second is general practitioner services
which are almost all in private practice. And the last is hospital dental
service, with access to specialist maxillo-facial and oral surgeons.
When these services were set up there was a huge demand as
so few people before regularly went to the dentist and most people needed some
form of treatment. Eventually, charges were introduced in 1951 and have
increased since as it became too expensive to pay for everyone, though some
groups of people are still exempt. You’re exempt if you are under 18 or under
19 and in full-time education, pregnant or have had a baby in the previous 12
months, being treated in an NHS hospital by a hospital dentist or if you are
receiving low income benefits or you’re under 20 and are dependent of someone
receiving low income benefits.
In 1956 the General Dental Council was established in
Westminster to protect the general public and to have a list of all regulated
dentist, dental hygienists, dental therapists, dental nurses and technicians.
Presently, all important treatments are widely available on the NHS but since
2006 treatments are not as available as before so many resorts to private
treatments. In 2006 a new system was introduced to the general dental service
that meant dental practitioners had to provide an agreed level of activity, a
three-tier payment structure was introduced to cover all charges and dentists now
received an annual income in return for an agreed amount of dental treatments
(units of dental activity). This meant that dentists carrying out one filling
will earn the same fee as if that patient required a dozen fillings. The aim
was to allow dentists to focus more on prevention that intervention.
So how is dentistry different from medicine? First of all,
dentistry is a lot more specialised as medicine can cover everything whereas
dentistry is solely focused on the mouth, head and neck. However, because medicine
isn’t as specialised there are more specialties graduates can go into after
they earn their degree whereas there is less of a range for dental graduates. There’s
also the fact that lots of people go to dentists for cosmetic reasons (e.g.
teeth whitening, implants, veneers) and this does not occur in medicine. This
usually happens in private dental practices which is another route for dentists
that medical graduates do not necessarily have as although there are private
hospitals they are not as in demand as private dentists are.
Dental care is included in NHS healthcare but it has a
different structure. The NHS provides clinically necessary treatment needed to
keep your mouth, teeth and gums healthy and free of pain but what is considered
to be necessary is determined by the dentist. Only some treatments can be
provided on the NHS. If you are exempt all dental care is on the NHS. Dental
treatments often involve payment whereas most NHS medical care is free to
patients.
It is also not viewed as important as medicine so often
people avoid going until absolute necessary. A lot of dental issues can exist
without causing pain to the patient. Therefore, the problems usually go ignored
unless you have regular check-ups with a dentist. For patients that are not
exempt it costs £21.60 for a dental check-up and there is also usually a longer
wait to see a dentist. This means that it is just less hassle to not regularly
see a dentist and only go if you are experiencing any pain. There is also the
fact that dental issues aren’t seen as important as medical issues. Poor oral
care can lead to more serious health problems such as respiratory infections,
cardiovascular disease and diabetic complications but these kind of issues
aren’t very well known. Patients are more willing to go to the doctors as it is
free to have an appointment and usually can be arranged near the time.
Treatment also doesn’t occur during a doctor’s appointment so there is less
fear than there is going to see the dentist where it does.
Salaries also contrast between GP’s who generally earn
between £55,000 and £80,000 and dentists that earn between £39,000 and £83,000
with the NHS. A lot of dentists tend to go private after a few years with the
NHS where they can then earn £140,000+.
A dental practice usually follows normal working hours where
the dentist could see around 20 patients. Common procedures carried out are
check-ups, fillings and extractions. X-rays and administering anaesthetic are
essential in a dental practice so dentists have to be dully trained for both.
Dentists generally have a lot of independence in where they work and for how
long. This means many dentists divide their time between working in surgeries,
hospitals and providing private care. Most GPs work from around 8am to 6.30pm
or later. The doctors spend their time providing individual consultations,
paperwork and making phone calls to patients and healthcare professionals. The
difference for dentists and doctors is that dentists can actually provide
treatment and a continuation of care where as doctors just provide
consultations.
Many people avoid going to the dentist due to costs, fear
and time. This means that some people can get very ill from tooth and gum
infections that they ignore. For example, gingivitis is a minor form of gum
disease caused by the build up of plaque. It may not cause pain initially but
if ignored it can develop into periodontitis or even acute necrotising
ulcerative gingivitis (ANUG) which are more serious forms of gum disease that
could lead to tooth loss. It is a lot harder to ignore a medical issue compared
to a dental issue so it is seen as more necessary to go to the doctor, which
means the NHS is in high demand and many doctors are overworked. Some people
may also not be able to afford to regularly have dental check ups where as the
NHS cover medical consultations.
To become a dentist you spend five years in a dental school
and then one or two years of supervised practice. After that you are qualified
and can either start practising or train further for any specialties you’d like
to pursue in dentistry. To become a doctor you spend five years at a medical
school, two years of foundation training where you’ll be put into practice as a
junior doctor in a hospital and then two years of core medical training where
you choose what kind of care you would like to be placed into and train there.
Overall, it takes longer for you to pursue medicine compared to dentistry and
you gain independence over practice with dentistry a lot faster.
Medicine isn’t as specialised which means there are more
specialties graduates can go into after they earn their degree where as there
is less of a range for dental graduates. This means there is more freedom in
your variety but there are still specialities for dentists to go into (e.g.
orthodontics, endodontics, paediatric dentistry, etc.)
Dentistry and medicine are very different in practice. They
can overlap though. If someone wanted to become an oral and maxillofacial
surgeon they would require a dual qualification in medicine and dentistry
followed by general and specialist surgical training. To become a consultant in
this department it would take 17 years if a dentistry degree is obtained first
and 19 years if a medical degree is the first degree.
In conclusion, dentistry is different to medicine as it is
more specialised, has a different charging system and the public has a
different attitude towards it. However, they are both essential for a healthy
population and should be readily available and accessible. There is a stigma
around going to both kinds of appointments due to fear. It should be made more
known how vital it is to have check-ups and make appointments if there are
issues.
I hope you found this article interesting.
Written by Lizzie Nash
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