It's a bit off topic but I often wonder why dentistry is not a specialization of medicine (like e.g. dermatology) but is its own separate thing, with separate insurance, etc.
Dental health is part of being healthy. A lot of dental work is surgery. To me, it should be part of regular medical care.
To be clear I agree that as a matter of policy dentistry and optometry should be treated the same as everything else. There is no historical or policy-based excuse for untreated tooth decay in developed economies.
Dentistry is the earliest specialization of medicine and the first to be studied with modern scientific rigor - dental problems are universal in agricultural societies, and it's much easier to see what's going on without modern tech. So its separation from other branches of medicine is a natural historical accident. (Likewise with early optometrists being "applied opticians" vs early ophthalmologists guessing about the biology of the eye.)
The fact that minor dental treatments are physically invasive compared to other branches of medicine means that dental training will always be different from other physicians, and this naturally extends to professional organizations. But it shouldn't extend to insurance companies.
As I recall, when "modern medicine" was first forming, there was a push to make it part of what we would consider standard medical care, but another, more influential party decided (incorrectly) that teeth weren't living tissue and should be excluded.
The divide took hold and we ended up with the system we have today, where teeth are independent of the rest of the medical field. It's especially noticeable when you have dentists, orthodontists, and oral surgeons, each separate specialties referring between each other, but only oral surgeons falling under medical insurance.
The reason I remember (I don’t know which of us or both are right) is that modern doctors came out of the “medical”/healing specialty where as dentists came out of the barber/surgeon tradition.
So I believe doctors didn’t want to admit their inferiors (barbers who pull teeth) to the profession and so that’s why dentists were kept out.
Overtime they’ve both grown in parallel since they end up covering a lot of the same things. X-rays, infections, medications + dosages. but dentist still get different training than “real“ doctors.
It does seem like dentistry should probably be a specialty of a normal doctor program at this point, but it’s not for some kind of historical reason as you mentioned.
I did a bit more digging and think I might have gotten the story a tiny bit muddled, but maybe not?
Most the articles I find talk about the barber vs doctor distinction, but they also all bring up a story about a proposal to add dentistry to the University of Maryland's medical school.
Evidently this proposal was put before the state legislature, was rejected, and thus was born the Baltimore College of Dentistry. From their own website:
> With the founding of the college, dentistry became a profession separate from medicine. Dentistry could have become a medical specialty if the Maryland legislature had approved a request to incorporate it as a department at the University of Maryland’s medical school, but the request was rejected owing to cost. Dentistry then set its own course.
Dentistry is not a specialization of medicine, because if it were the dentist would be required to go through a full medical doctor education including hospital residency and then become a dentist on top of this, so it wouldn’t benefit the consumer in that the current policy is fine and actually it might make more sense to break other specializations off from medicine so that you can get more affordable treatments from people with specialized skills without needing an entire set of generalized skills.
Regarding funding, I agree that preventative care should be covered under health insurance like physical exams, because if you go for a cleaning twice a year you probably aren’t going to have many problems and if you don’t go for a cleaning twice a year you probably are going to have a lot of problems. But many dental treatments are cosmetic in nature and not medically necessary and probably would not be covered under the current health insurance regime in the United States, but are covered under the dental insurance regime. It’s important to note that dental coverage in the US is widely available as a separate part of “Obamacare” subsidized by the government and children’s coverage on the marketplace is even stronger without waiting periods and limits on max out of pockets in a way that is generous compared to most private offerings.
I kinda feel the opposite about some specializations in medicine. Why does a psychiatrist need to know about the bone structure of the ankle? They're never going to use half their medical training.
One imagines the same reasons you would learn Unix and DSA even if your job is writing GET handlers and wrestling Python venvs. Gives you some base system-level context even if rarely immediately useful.
I think the parent comment was referencing that, at least in the US, dentistry is treated differently in many ways. For example, it’s a different health insurance with its separe premiums and limits, and you’ll never find a dentist in a hospital; instead they have their own offices.
In the US, dentistry isn't a specialization of medicine. Medical specializations have to go to medical school then residency first before specializing. Dentists just go to dental school. Dentists in the US aren't medical doctors any more than JDs or PhDs are.
Not sure that is the case. The base science and recommended practices seems pretty much as a solid as any other speciality (imperfect as they all are). It really is the case that cavities are bad. We understand what causes them, how they grow, risk factors and how to treat them.
But ... the business model and incentives are different. A general practice MD, doesn't get a cut of revenue when they write a prescription. The incentives are closer to a plastic surgeons. And you can see similar lapses of ethics in that field.
Dental health is part of being healthy. A lot of dental work is surgery. To me, it should be part of regular medical care.