Dental Anatomy: Primary Dentition and parts of a tooth

Dental Anatomy is one of the most important classes of your first year. If you came into dental school knowing nothing about teeth like I did, then this is where you learn the basics of dentistry. It's important to have a strong foundation in this to pass your boards, do well in pre-clinical simulation lab, and to be a competent dentist!


I'm just going to go over the main sections here in case you were curious or just want a refresher.



Primary Dentition: 

- Deciduous, meaning it is meant to shed
- Considered the dentition of kids from 0 - 6 years old
- Starting at the most upper right tooth, which is a primary second molar, you number / letter that tooth 'A', then the tooth next to it which is a primary first molar, is 'B' and so on until you get to the most upper left primary second molar, which is 'J.'
- The two maxillary central incisors (two front teeth) are E & F.
- Then, continuing from J, you drop down t the opposing tooth of the upper left molar - the lower left primary second molar. That tooth is 'K'. Then you continue across the arch until you get to the lower right primary second molar, which is T.
- This system is referred to as Universal Numbering. Helpful hint: I always use my fingers when I'm counting! 

- Another system that we don't use that often in the US is the FDI system (also known as the International Dental Federation system). For Primary teeth, you would start at the midline (between the maxillary central incisors). The right incisor tooth is '51' and you count up until you reach the right second molar, which would be '55.' Then you start back at the midline, and the left incisor tooth is '61', and you count up until you reach the left second molar, which would be '65'. The bottom teeth order in a similar way, except you start with '71' on the lower left and '81' on the lower right.

- The last system you should know is the Palmer Notation System. This is more similar to the Universal System, but instead uses only 5 letters and indicates the location of the tooth with markings shaped like L's.




Parts of a Tooth: 

A: Apex (Plural apices) or the root tip(s)
AF- Apical Foramen
SC - Supplementary canal
B- Bone
C- Cementum
PM: Periodontal Ligament
PC: Pulp Canal
G - Gingiva
GC- Gingival Crevice
GM - Gingival Margin
PCH: Pulp Chamber
D: Dentin
E: Enamel
CR: Crown
CEJ: Cementoenamel junction. Separates the enamel of the crown from the cementum of the root and is where the gums start
PH: Pulp Horn
F: Fissure
CU: Cusp
BI: Bifurcation of roots

GPR vs AEGD

So after graduation,  it is strongly recommended that dentists complete a residency program. There are many benefits, including:

1. Learning to work with an assistant
2. Discover what you really like doing and what you'd rather refer out
3. Increase speed and efficiency
4. Work on time management
5. You'll get experience under your belt so that patients will be more comfortable with you 


GPR: Treat medically complex patients
Location: Typically in a hospital setting
Trains you on how to work with patients who are medically compromised and have limitations on the type of dental work they can receive. This is good for preparing you how to treat any patient that comes to you. You may do rotations (anesthesiology) or have to be on call. 

AEGD : Advanced training as general practitioner 
Location: typically associated with a dental school 
Basically a fifth year of dental school where you do more challenging procedures and focus on comprehensive care and improve your hand skills. Usually no rotations and rarely on call. 

In order to apply for most residencies, you'll have to take the Advanced Dental Admission Test (ADAT) - a 4.5 hour test with 4 subjects:

1. Biomedical Sciences
2. Clinical Sciences
3. Data, Research Interpretation, and Evidence-Based Dentistry
4. Principles of Ethics and Patient Management

Other residencies may require the GRE test, which tests verbal reasoning, analytical writing, and qualitative reasoning. 

Another step during the application to residency is doing an externship there to get to know the program and people there. 

Residencies are looking for team players hat step up when it gets busy, for humble students who are still eager to learn, and those willing to give their time and b devoted to improving patient lives.

If you have more questions about specific residencies. igniteDDS has a comprehensive guide about what dental residencies require and consist of.   

ignitedds: What you need to know for Orthodontics Residency

https://ignitedds.com/orthodontics-quick-sheet/

NBDE I: What You Need to Know

So in order to become a dentist, all students have to pass a national test called the NBDE that covers everything we learn during our dental education. The subjects on Part I of the exam include biochemistry, anatomy, dental anatomy, physiology, pathology, and microbiology (as well as some ethics). It consists of 400 questions that are given to you in shuffled order over the course of 8 hours (so unlike the DAT, it isn't given by subject). The good news is, if you pass, they just tell you 'you pass' and you move on. However, if you fail, they will tell you which subjects you did poorly on and need to study more intensely so that you can retake it at a later date. Later on, ideally after 3rd year is complete, we will take Part II of the exam (about 500 questions). This is the last year that this version of the test will be given before they start testing using a new version (the new test begins August 2020). Some facts about the new INBDE, is that it will be an integrated exam covering more about safe dentistry and clinic, it will only be 500 questions, compared the 900 questions of the NBDE and it's given after 3rd year. It's going to be more like Part 2, so less of the basic sciences and more patient care. 

I've heard from upperclassman how difficult the NBDE Part I was, and some students don't pass on their first try. This makes me nervous to do well, especially since I really struggled in some of the subjects being tested during my first year.



Some advice I've heard about this exam is to:

1. make a schedule
2. schedule free time
3. keep reviewing as you go
4. time yourself during the test and take breaks
5. bring brain food (high in protein)
6. check your answers before submitting

I'm hoping to share all the resources I can that I am using to study, and I'll keep you guys updated about my schedule, and most importantly, if I pass!!

In the meantime, here's a link to the ADA website's 2019 NBDE I Guide if you have any questions!