I know the topic of money has been discused before, but I don't think that my question has been discused before. My question is, can you make a substantial amount of money in omfs in a large metropolis doing the big cases ie:cancer, trauma, reconstruction and craniofacial.


Any input would be great.

Honestly, you'd make more money going into plastics as an MD. That's my suggestion if the paycheck is of great concern to you.

The richest OMFS are the ones that pull teeth like an assembly line.... every patient.... every day.... I know a few of them that say they just flat out don't do the hospital based surgeries cause it just doesn't pay enough for the time it takes. The say they do some trauma every once in a while for sh!ts and giggles.

Honestly, you'd make more money going into plastics as an MD. That's my suggestion if the paycheck is of great concern to you.

The paycheck isn't that important to me, i'm interested in those types of cases and was curious on how much i'd be taking home.

I once knew a guy who claimed to gross close to seven figures in a 3 chair strip mall office pulling teeth from medicaid patients.

That's what he claimed anyway??

I know the topic of money has been discused before, but I don't think that my question has been discused before. My question is, can you make a substantial amount of money in omfs in a large metropolis doing the big cases ie:cancer, trauma, reconstruction and craniofacial.


Any input would be great.

The simple answer is no.

It doesn't matter if you are a Plastics MD, an ENT, or an OMFS, these procedures tend not to pay and usually are very time consuming. They take time away from more profitable procedures (cosmetic surgery for Plastics and ENTs, dentoalveolar and implants for most OMFS).

There are some areas in the country where you can get paid quite well for trauma coverage, but these places are few and far between.

If you're planning on going into OMFS looking for $$$, you'd be well-advised to reconsider your motivations. I believe that in the future dentoalveolar surgery will not be the cash cow it is right now (read: declining insurance reimbursements for third molar removal). Broad-based insurance coverage for implants is right around the corner - once this happens, reimbursements for implants will fall (exactly as they did for orthognathic surgery in the mid 1980s).

Strangely enough, orthognathic surgery may become profitable again, as new minimally invasive techniques become more mainstream and computer based 3-D treatment planning becomes more efficient.

Look at it this way: You can either shuck 4 wisdom teeth in less than 30 minutes for about $1500. And you do it in your own office where things go quicker.

You can do an orthognathic case in the hospital for about the same fee. The surgery takes several hours, you spend many hours doing pre-op tracings, treatment planning, consults with the orthodontist, and model surgery. Then you have to round on them in the hospital and have several post-op appointments. This is all included in the same fee.

Look at it this way: You can either shuck 4 wisdom teeth in less than 30 minutes for about $1500. And you do it in your own office where things go quicker.

You can do an orthognathic case in the hospital for about the same fee. The surgery takes several hours, you spend many hours doing pre-op tracings, treatment planning, consults with the orthodontist, and model surgery. Then you have to round on them in the hospital and have several post-op appointments. This is all included in the same fee.

.....and then you have inevitable post-op complications!

Oh boy, orthodontics is looking better all the time.



I'm joking of course.

Oh boy, orthodontics is looking better all the time.
That same thought as crossed my mind many nights. It's usually around 3am with arch bars in one hand and some broke-jaw-mullet in the other...

I'll trade you that broke jaw mullet and arch bar any day. You just have to come and be the nurses' bitch and have to deal with whiny COPD patients who want ANOTHER breathing treatment at 2:45 am. I find myself standing in the hall going "I went through a year of school to do this? I can't find any benefit to what I am doing? Say does that stairwell go all the way to the roof?"

Only having a year of school dealing with that stuff hardly compares to someone with a DDS/DMD doing it. (Hence, an OMS resident. :eek: )

I know, but at least he can see some benefit in what he is up at some ungodly hour of the night doing, unlike me. That was the point of my comment.

I was reading one previous post about the changing landscape of OMS in the future and it got me thinking about implants, specifically whether or not GPs will actually be placing a significant amount of these. I'm not sure that'll happen. I don't know if it would be an effective use of a GP's time (because they would take longer than a surgeon). Are the start up costs prohibitively expensive? Would doing occasional implants reduce hourly billing and increase risk to the practice? I'd like to hear what you all think about this.

Don't be too hard on yourself. Just last night I had to nicely ask the RT to stick an ABG on a 290 lb. patient. I coudn't find the radial artery to save my life.

Cool.....ABG's can be a real pain sometimes. If you would like I can PM with some tricks I've learned about doing them.

But seriously, so many of my patients are terminal- either CA pts or COPD'ers, whom we have no hope of curing, or even in many cases even delaying their death, that it makes it very hard to drag oneself out of bed at some ungodly hour of the morning to go to work on a Saturday or to be there at "WTF am I doing awake" hours of of the morning. I don't see much in the way of hard and fast, tangible benefits to what I do for a living now.

That's why dentistry is appealing to me from what I have seen observing so far - you find the problem and you correct it. There's no wondering (at least not nearly on the scale I now experience) about whether my patient might do just as well being given a placebo than the medication I am giving them. You can see the problem and you can see when you fixed it- the decayed material is gone, the patient is no longer in pain, etc. That's great feedback which is exactly what I am looking for.

Sorry....didn't mean to get up on my soapbox- I just had a really ****ty night two days ago...needed to vent.... :barf:

...needed to vent.... :barf:
no pun intended....right?

I would love to hear any tricks of the trade for art sticks. A lot of people around here will stab all the way through both walls of the vessel and then pull back. Send me whatever ya got.

I was reading one previous post about the changing landscape of OMS in the future and it got me thinking about implants, specifically whether or not GPs will actually be placing a significant amount of these. I'm not sure that'll happen. I don't know if it would be an effective use of a GP's time (because they would take longer than a surgeon). Are the start up costs prohibitively expensive? Would doing occasional implants reduce hourly billing and increase risk to the practice? I'd like to hear what you all think about this.

start up costs are not expensive at all. residents price - 2k for drill kit 2k for motor and pros kit. 9k for that plus 30 implants. say each implant is 1500 it will soon pay for itself. there are monthly payment plans too. lets say you place 2 or 4 for an overdenture even in 2hrs which is slow thats not bad money.

say each implant is 1500 it will soon pay for itself.

Once everyone starts placing implants (OMFS, perio, prosth, endo, GPs), you can bet that the cost for each implant is going to fall quite drastically. I highly doubt that implants will remain the cash cow that they are right now.

Can't they all do implants now?
Once everyone starts placing implants (OMFS, perio, prosth, endo, GPs), you can bet that the cost for each implant is going to fall quite drastically. I highly doubt that implants will remain the cash cow that they are right now.

Once everyone starts placing implants (OMFS, perio, prosth, endo, GPs), you can bet that the cost for each implant is going to fall quite drastically. I highly doubt that implants will remain the cash cow that they are right now.

Technology will allow more implants to be done easier and quicker. Hence, if the bone is still decent or other medical complications do not present, implants will become cheap and cusotmers will show up for the treatment by the truck loads (especially the unmotivated present orientated masses who will continue to loose teeth due to lack of basic oral hygiene). In fact, I can see the day soon coming when it will often be quicker and cheaper to pull and plug (implant + prosthetic) rather than restore.

I don't think implants will ever be cheap. In fact, I think $1500 is pretty reasonable. Crowns have been around for a long time and they are only getting more expensive. I don't see why implants would be different. Surely there will be chop shop dentists placing implants for $750, but they're also going to blow a lot of them. Similarly, there are guys doing $600 crowns that are pieces of crap. I think if you do quality dentistry (in any specialty) you can receive good compensation, even if the guy down across town does it for half your fee.

I was reading one previous post about the changing landscape of OMS in the future and it got me thinking about implants, specifically whether or not GPs will actually be placing a significant amount of these. I'm not sure that'll happen. I don't know if it would be an effective use of a GP's time (because they would take longer than a surgeon). Are the start up costs prohibitively expensive? Would doing occasional implants reduce hourly billing and increase risk to the practice? I'd like to hear what you all think about this.

First of all, its not going to happen overnight. For years and years to come OMFS will place the majority of implants. True more general dentists will be doing implants but right now its only a small percentage because most don't do them for the reasons you stated regarding time and liability.

I think in time, you'll see implantology become a recognized ADA specialty, but not in the next 5 years.

My best friend was an oral surgeon. He did 37 third molar extractions a week and would only net $27,802 a year. He would have to go out and hustle fake rolexes at night just to feed his family. He said something about HMO's, WIC, and reimbursements aren't what they used to be. I used to go to his house and snack on his government cheese.
That's some funny ****...I think I bought a Rolex from him...

My best friend was an oral surgeon. He did 37 third molar extractions a week and would only net $27,802 a year. He would have to go out and hustle fake rolexes at night just to feed his family. He said something about HMO's, WIC, and reimbursements aren't what they used to be. I used to go to his house and snack on his government cheese.
Sounds like a resident to me.