Dentists are healthcare professionals qualified to practice dentistry after graduating with a degree of either Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD). In most western countries, to become a qualified dentist one must usually complete at least 4 years of postgraduate study. Generally, 2 years of clinical experience working with patients in an educational setting are required. While in most countries, dentists neither earn a Doctorate degree, or medical degree, they are afforded the honorary title "Doctor." Contrary to popular belief, most dentists do not regularly clean teeth, and instead delegate this task to their support staff (e.g. dental hygienists).
General practitioners of dentistry prevent, evaluate, diagnose, and treat diseases of the oral cavity and associated structures, as well as maintain the functionality and esthetics of the teeth and associated tissues and structures. Dentists can further their training in one or more speciality areas - such as surgery, endodontics, and orthodontics. Hence, there can be a great deal of variation between the level of skill in different disciplines from dentist to dentist, however all dentists must achieve a certain degree of skill in various disciplines in order to graduate from dental school and earn licensure. It is important to note that most dentists in general practice perform restorative, prosthetic, routine endodontic therapy, routine periodontal therapy, and simple exodontia, as well as performing dental examinations of a patient's teeth and gums.
The Baltimore College of Dental Surgery, the first dental school in the world, opened in Baltimore, Maryland in 1840, and in 1867 Harvard Dental School became the first dental school affiliated with a university. To become a specialist requires one to train in a residency or advanced graduate training program. Other dental education exists where no post-graduate formal university training is required: cosmetic dentistry, dental implant, temporo-mandibular joint therapy. Specialists in these fields are designated registrable and warrant exclusive titles such as orthodontist, pediatric dentist, oral and maxillofacial surgeon, endodontist, periodontist, and prosthodontist.
Spokane is the largest city and county seat of Spokane County, and is the metropolitan center of the Inland Northwest. According to 2006 census estimates, Spokane has a population of 198,081, making it the second most populous city in the State of Washington, and the third largest in the Pacific Northwest, after Seattle, Washington and Portland, Oregon.
Much of Spokane is reflected in its large variety of neighborhoods. Neighborhoods range from the late Victorian-era style Browne's Addition, to the Davenport Arts District of Downtown, to the more contemporary neighborhoods of North Spokane. The new Kendall Yards development on the northside of Downtown Spokane along the Spokane River will become one of the largest construction projects in the city's history. Spokane is home to many higher education institutions including Gonzaga and Whitworth, and the public Community Colleges of Spokane system.
The region's healthcare needs are served primarily by Seattle-based Providence Health & Services and Spokane-based Empire Health Services, two non-profit organizations who run the two biggest hospitals in Spokane, Sacred Heart Medical Center, and Deaconess Medical Center, respectively. Downtown Spokane has undergone a major rebirth in recent years after the completion of RiverPark Square mall.