Counterpoint: The 21st-century paradigm for recognition of dental specialties is not much different than the existing paradigm.

BACKGROUND: The basis and rationale for recognition of specialties in the health care-related professions are similar. Recognition criteria are common across health care-related professions and include the demonstrated ability to form a certifying board, a distinct and well-defined field that requires unique knowledge and skills beyond general professional education, knowledge and skills that are separate and distinct from any other specialty, active contribution to research needs of the profession, direct benefit to some aspect of patient care, and the existence of formal, advanced education programs. A new paradigm that has been outlined does not appear to be significantly different from this existing paradigm. METHODS: The authors used archived, historic transcripts, transactions, and reports from the American Dental Association House of Delegates that are housed in the American Dental Association Library and Archives. In addition, information on specialty recognition from other health care-related professions was cited from the respective health care-related profession Web sites. RESULTS: The authors believe the current paradigm of specialty recognition in dentistry comports with the paradigm of other health care-related professions. CONCLUSIONS: The new paradigm that has been outlined does not appear to be significantly different from the existing paradigm. Subspecialization may be right for medicine but not necessarily needed for dentistry. Given that specialty recognition standards are virtually identical in all the health care-related professions, it begs the question as to what other factors unique to other health care-related professions have driven the development of subspecialties. PRACTICAL IMPLICATIONS: There is no need to radically restructure the criteria or process of specialty recognition in dentistry.

Restoring erosion associated with gastroesophageal reflux using direct resins: case report.

Gastroesophageal reflux disease (GERD) is a condition where stomach acids are chronically regurgitated into the esophagus and oral cavity, resulting in pathology, such as esophagitis, varices or ulcers. Continual exposure of the teeth to these acids can also cause severe dental erosion. This condition frequently is asymptomatic, and the only evident sign may be the irreversible erosion of tooth structure. The dentist often is the first health care professional to identify the affected dentition. Knowledge of this cause and effect relationship between GERD and dental erosion will better prepare the practitioner to refer patients for appropriate diagnosis and treatment of the underlying medical condition and provide treatment for the affected teeth. This article presents a case report where dental erosion was present due to GERD. After management of the disease with medication, dental treatment of the eroded dentition is described, including diagnosis, treatment planning and restorative reconstruction.