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Radiology—a dental specialty awaiting its just recognition
Vol. 87 No. 5 May 1999
ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY
GUEST EDITORIAL Radiology—a dental specialty awaiting its just recognition The first dental radiograph was made in January 1896, a mere 2 weeks after the public announcement of the discovery of the x-ray by Wilhelm Conrad Röntgen. Since then, both dentistry as a whole and oral and maxillofacial radiology in particular have made major advances. Dentistry has become more than the extraction and replacement or restoration of teeth, and oral and maxillofacial radiology has moved well beyond simple periapical and bitewing radiographs. In 1896, there were no recognized specialties in dentistry. However, advances in biology, pathology, and technology have resulted in such an overwhelming amount of knowledge and such an abundance of technical innovations that few dentists would consider themselves capable of providing all possible dental services at the expert level. Hence, specialty areas developed as individual dentists pursued their intellectual and professional interests, mastering advanced knowledge and skills to provide high-quality care for the public’s benefit. Since 1947, the American Dental Association (ADA) has granted formal recognition to some of these specialties. Table I, adapted from the American Academy of Oral and Maxillofacial Radiology’s ADA specialty recognition application, shows the year, the number of specialists, and the percentage for those specialists with respect to the total number of US dentists in the year in which the specialty was formally recognized by the ADA. As can be seen, oral and maxillofacial radiology compares favorably with the 8 current ADA-recognized specialties. In terms of absolute numbers, there are now more oral and maxillofacial radiologists than there were specialists in any of the other disciplines at the time of their ADA recognition. In terms of the ratio of specialists to all dental practitioners, only 3 of the current 8 ADA-recognized specialties had representations in the profession at the time of their ADA recognition that were higher than the representation that oral and maxillofacial radiology has now. The first 7 of the 8 ADA-recognized specialties were all recognized within a 5-year period; the eighth was given recognition 13 years later. Since 1963—more than a third of a century ago—the ADA has not recognized a single new specialty. Over the last 4 decades there have been significant advances in dentistry, especially in the areas of temporomandibular disorders, implants, and
Table I. Number of specialists and percent of total US dental manpower at time of ADA specialty recognition for each specialty
Specialty
Year
Total no. of US dentists
Certified specialists at time of recognition No. % of US dentists
1. Oral Surgery 2. Pediatric Dentistry 3. Prosthodontics 4. Periodontics 5. Orthodontics 6. Oral Pathology 7. Dental Public Health 8. Endodontics Oral & Maxillofacial Radiology
1947 1948 1948 1948 1950 1950 1951
75,000 76,500 76,500 76,500 79,190 79,190 80,000
7 15 69 88 98 7 12
0.01 0.02 0.09 0.12 0.12 0.01 0.02
1964 1995
95,000 155,000
34 112
0.04 0.07
Figures are based on ADA and Specialty Organization data. Data in bold have been extrapolated.
craniofacial surgery. Similarly, there have been remarkable advances in radiology—including computed tomography, magnetic resonance imaging, digital imaging, and image reformatting—that now provide diagnostic information essential to the advanced dental services that the public has come to expect. Oral and maxillofacial radiologists have dedicated their professional lives to acquiring and refining the knowledge and skills necessary to provide these specialty-level services. It is time for the ADA and other branches of organized dentistry to rise above political and economic self-interest and formally acknowledge and recognize the specialty of Oral and Maxillofacial Radiology. A. Ruprecht, DDS, MScD, FRCD(C) Professor and Director, Oral & Maxillofacial Radiology College of Dentistry Professor of Radiology, College of Medicine University of Iowa Mel L. Kantor, DDS, MPH Associate Professor, Division of Oral & Maxillofacial Radiology New Jersey Dental School University of Medicine and Dentistry of New Jersey 525
ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY
GUEST EDITORIAL Radiology—a dental specialty awaiting its just recognition The first dental radiograph was made in January 1896, a mere 2 weeks after the public announcement of the discovery of the x-ray by Wilhelm Conrad Röntgen. Since then, both dentistry as a whole and oral and maxillofacial radiology in particular have made major advances. Dentistry has become more than the extraction and replacement or restoration of teeth, and oral and maxillofacial radiology has moved well beyond simple periapical and bitewing radiographs. In 1896, there were no recognized specialties in dentistry. However, advances in biology, pathology, and technology have resulted in such an overwhelming amount of knowledge and such an abundance of technical innovations that few dentists would consider themselves capable of providing all possible dental services at the expert level. Hence, specialty areas developed as individual dentists pursued their intellectual and professional interests, mastering advanced knowledge and skills to provide high-quality care for the public’s benefit. Since 1947, the American Dental Association (ADA) has granted formal recognition to some of these specialties. Table I, adapted from the American Academy of Oral and Maxillofacial Radiology’s ADA specialty recognition application, shows the year, the number of specialists, and the percentage for those specialists with respect to the total number of US dentists in the year in which the specialty was formally recognized by the ADA. As can be seen, oral and maxillofacial radiology compares favorably with the 8 current ADA-recognized specialties. In terms of absolute numbers, there are now more oral and maxillofacial radiologists than there were specialists in any of the other disciplines at the time of their ADA recognition. In terms of the ratio of specialists to all dental practitioners, only 3 of the current 8 ADA-recognized specialties had representations in the profession at the time of their ADA recognition that were higher than the representation that oral and maxillofacial radiology has now. The first 7 of the 8 ADA-recognized specialties were all recognized within a 5-year period; the eighth was given recognition 13 years later. Since 1963—more than a third of a century ago—the ADA has not recognized a single new specialty. Over the last 4 decades there have been significant advances in dentistry, especially in the areas of temporomandibular disorders, implants, and
Table I. Number of specialists and percent of total US dental manpower at time of ADA specialty recognition for each specialty
Specialty
Year
Total no. of US dentists
Certified specialists at time of recognition No. % of US dentists
1. Oral Surgery 2. Pediatric Dentistry 3. Prosthodontics 4. Periodontics 5. Orthodontics 6. Oral Pathology 7. Dental Public Health 8. Endodontics Oral & Maxillofacial Radiology
1947 1948 1948 1948 1950 1950 1951
75,000 76,500 76,500 76,500 79,190 79,190 80,000
7 15 69 88 98 7 12
0.01 0.02 0.09 0.12 0.12 0.01 0.02
1964 1995
95,000 155,000
34 112
0.04 0.07
Figures are based on ADA and Specialty Organization data. Data in bold have been extrapolated.
craniofacial surgery. Similarly, there have been remarkable advances in radiology—including computed tomography, magnetic resonance imaging, digital imaging, and image reformatting—that now provide diagnostic information essential to the advanced dental services that the public has come to expect. Oral and maxillofacial radiologists have dedicated their professional lives to acquiring and refining the knowledge and skills necessary to provide these specialty-level services. It is time for the ADA and other branches of organized dentistry to rise above political and economic self-interest and formally acknowledge and recognize the specialty of Oral and Maxillofacial Radiology. A. Ruprecht, DDS, MScD, FRCD(C) Professor and Director, Oral & Maxillofacial Radiology College of Dentistry Professor of Radiology, College of Medicine University of Iowa Mel L. Kantor, DDS, MPH Associate Professor, Division of Oral & Maxillofacial Radiology New Jersey Dental School University of Medicine and Dentistry of New Jersey 525