What does an opthalmologist or an orthodontist do?

What does an opthalmologist or an orthodontist do?

Mon, Mar 02, 2009 The Straits Times

By Margaret Lee

Ophthalmologist

What should this specialist be consulted for?

Dr Jacob Cheng, senior consultant ophthalmologist at Eagle Eye Centre, says ophthalmologists may be consulted for many reasons that can be generally categorised by age.

For children, common problems include squints or crossed eyes, lazy eyes, refractive errors that cannot be corrected by glasses as well as those with a family history of eye diseases.

Young adults with floaters, who see flashes of light and have problems with contact lenses should see an ophthalmologist. Other issues an ophthalmologist deals with for those aged between 18 and 30 include screening for colour deficiency for the purpose of obtaining a driver's licence and poor night vision.

For the middle-aged and above, common problems include cataracts, glaucoma, diabetic retinopathy and eye-related macular degeneration.

In any age group, anyone with vision problems such as blurring - whether transient or partial - or double vision, or eye symptoms like pain, persistent redness, discharge, itchiness, tearing and bulging eyes should see an ophthalmologist.

Eyelid problems like droopy or retracted lids and swelling or growth on the lid should be seen by an ophthalmologist too.

When should you consult one?

When you are presented with any of the conditions mentioned above.

Ideally, a check-up should start from a young age. Since myopia is common among school-going children in Singapore, it is recommended that children undergo an eye examination before starting school to exclude refractive problems, lazy eyes or squints.

Any vision impairment can lead to learning disabilities and disruption of studies over time. Children with a family history of eye diseases should also consult an ophthalmologist to determine the risk of their developing the diseases.

How often?

Everyone should have an eye screening at least once every decade of his life. A regular annual eye examination is recommended for those who have eye pathologies or certain diseases that predispose them to eye diseases, such as diabetes.

Glaucoma usually occurs in the elderly but the young can also suffer from it. By the time glaucoma is noticeable to the patient, a large proportion of his vision has been destroyed. Screening helps pick up such pathologies before it is too late.

--------------------------------------

Oral maxillofacial surgeon

What should this specialist be consulted for?

1. A consultation is advised for any of the following procedures:
2. Complicated dental extractions (in particular, wisdom teeth);
3. Insertion of dental implants;
4. Grafting of bone in preparation for dental implant surgery;
5. Treatment of facial injury or facial trauma (like jaw fracture);
6. Treatment of facial pain related to disorders of the temporomandibular joint (joint connecting the jaw to the skull);
7. Removal of cysts and tumours of the mouth and jaw;
8. Orthognathic surgery (surgery done to correct conditions of the jaw and face related to structure, growth or other disorders);
9. Treatment of obstructive sleep apnoea (difficulty in breathing while a person is asleep because of tissue obstruction in the upper airway).

When should you consult one?

1. An oral maxillofacial surgeon should be consulted if:
2. You are particularly nervous or sensitive regarding dental extraction and need special management or sedation;
3. You need to have wisdom teeth extracted;
4. You are interested in having dental implants;
5. You have insufficient bone in your jaw to support dental implants and need a bone graft;
6. You have been in an accident and have suffered injury or trauma to your mouth, face or jaw;
7. You have a clicking sensation/sound and/or pain in the jaw when laughing, yawning or opening and closing your mouth;
8. Your upper and lower jaws are not aligned;
9. You snore or have obstructive breathing patterns during sleep;
10. You have reddish or whitish patches in the mouth, a sore that fails to heal or bleeds easily, a lump or thickening on the skin lining the inside of the mouth, a chronic sore throat or hoarseness, or difficulty chewing or swallowing.

How often?

Oral maxillofacial surgeons do not need to be seen on a regular basis, unlike general dentists. You should go for regular dental check-ups with your dentist once every six months and need only consult an oral maxillofacial surgeon if your regular dentist refers you to one, or if you are suffering from one of the conditions described above.

--------------------------------------

Orthodontist

What should this specialist be consulted for?

Orthodontists may be consulted for a variety of problems. The more common ones are crooked teeth, protruding teeth and, in the case of children, problems with emerging teeth. Other instances include growing children or adults with jaw disharmonies, such as a protruding or receding chin, facial asymmetry, gummy smiles, or facial elongation. In addition, children born with conditions like a cleft lip and palate should be seen by an orthodontist.

When should you consult one?

This depends on the type of orthodontic problem, says Dr Boey Pui Yunn, a registrar at the department of restorative dentistry, National Dental Centre of Singapore. For most young patients who have misaligned teeth - and who do not have a jaw problem - treatment can usually be delayed until all the primary or milk teeth have changed to permanent ones. This usually occurs around the age of 11 to 13 years.

In certain situations, treatment may be started earlier. For growing children with developing jaw disharmonies, orthodontic treatment may sometimes be done to assist the growth of the jaws. This usually takes place between nine and 11 years of age. For children with permanent teeth that are not emerging properly, early treatment may be needed to guide these into their proper positions. This may take place anytime from seven to 11 years of age.

In addition, anyone who wants to improve the appearance of his or her teeth and face can consult an orthodontist, who will advise on the most appropriate way to manage the problem, and, if necessary, engage the help of other dental specialists. Many of the patients seen in an orthodontic clinic are adolescents who are getting their teeth straightened. Of course, adults who did not receive treatment earlier can benefit from orthodontic treatment too.

How often?

Upon consultation, the orthodontist can advise on the most appropriate time to start treatment, as well as how often the patient should return for reviews. Patients who are currently in treatment usually see the orthodontist once every four to eight weeks. In special situations where growth needs to be monitored before any treatment, the patient may be seen once or twice a year.

This article was first published in Mind Your Body, The Straits Times.