Jan 13, 2020
2
0
Status
Dentist
Hello everyone,

I'm a gp, been in practice for a few years. I'm young, and I want to go to residency to specialize and "become an expert in dentoalveolar surgery" (implants, grafting, thirds, alveoloplasty, etc.). I've been debating between omfs and perio. Based on what I know, there are drastic differences in the two residencies. OMFS obviously steps way outside of "just dentistry" and is very hospital based, takes a lot of facial trauma call, head and neck infections, cancer, etc. I'll be honest, I don't really want to do that; it's not for everyone. I like the idea of a perio residency more. My fear, however, is that I'll spend way more time than I'd like measuring perio pockets and scaling than doing actual involved dentoalveolar surgery (I mean no offense to anyone, seriously).
So, my question is, are there perio programs in the US that have a much heavier focus on dentoalveolar and complex implant surgery? Such as you place hundreds of implants, sinus lifts, involved grafting, even thirds experience. Or I am wasting my time and should just apply to omfs? Yes I know I can go do externships, but before I start down that path, I am just trying to get honest feedback before I commit one way or the other. Like which perio programs do you guys recommend I look at? Do they exist?
Thank you!
 
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Svart Aske

Dental Padawan
10+ Year Member
Jun 7, 2008
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My 2 cents before all the OS guys see this thread and jump down your throat... Don't even think about OMFS if all you are interested in is dentoalveolar surgery. OMFS scope and lifestyle is completely different from the other dental specialties.

All perio residencies involve a significant amount of literature review and seminars so be prepared for that. You will spend a lot of time at least initially doing the traditional perio procedures (S/RP, maintenance, osseous, pocket reduction, crown lengthening, gingivectomy etc.) which still forms the clinical foundation of the specialty. I think you are unlikely to take out many thirds in any perio program. I would look into the few VA residencies (tons of implant placement) and programs that fosters perio and prosth collaboration.
 
OP
A
Jan 13, 2020
2
0
Status
Dentist
My 2 cents before all the OS guys see this thread and jump down your throat... Don't even think about OMFS if all you are interested in is dentoalveolar surgery. OMFS scope and lifestyle is completely different from the other dental specialties.

All perio residencies involve a significant amount of literature review and seminars so be prepared for that. You will spend a lot of time at least initially doing the traditional perio procedures (S/RP, maintenance, osseous, pocket reduction, crown lengthening, gingivectomy etc.) which still forms the clinical foundation of the specialty. I think you are unlikely to take out many thirds in any perio program. I would look into the few VA residencies (tons of implant placement) and programs that fosters perio and prosth collaboration.
Thank you for the reply. By VA residency, do you mean GPR/AEGD?
 

charlestweed

Gold Donor
10+ Year Member
Jul 10, 2007
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Dentist
The question is do you have high enough class rank and CBSE score for OS residency? If yes, then apply for OS. And another question is will you be willing to go door to door to meet the referring GPs? If no, then you shouldn’t specialize in either specialty. I know some periodontists, who perform all the things that you listed in their practices: implants, sinus lift, chin/ramus grafts, and 3rd molar extractions etc. If you want to know where these periodontists did their residency, send me a PM. However, it’ll be much easier to convince the GPs to refer their patients to your office for you to perform these procedures if you are an OS. It’s much harder for periodontists to get referrals from the GPs. If you can’t get the GPs to refer patients to you, then all the procedures that you learn from your residency go down the drain….and that’d be a waste of your time and money.
 
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Combine33

7+ Year Member
Dec 3, 2012
215
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Resident [Any Field]
My 2 cents before all the OS guys see this thread and jump down your throat... Don't even think about OMFS if all you are interested in is dentoalveolar surgery. OMFS scope and lifestyle is completely different from the other dental specialties.

All perio residencies involve a significant amount of literature review and seminars so be prepared for that. You will spend a lot of time at least initially doing the traditional perio procedures (S/RP, maintenance, osseous, pocket reduction, crown lengthening, gingivectomy etc.) which still forms the clinical foundation of the specialty. I think you are unlikely to take out many thirds in any perio program. I would look into the few VA residencies (tons of implant placement) and programs that fosters perio and prosth collaboration.
Agreed. UT San Antonio and UW have a strong relationship with the prosth departments
 
Jun 1, 2018
17
64
My 2 cents before all the OS guys see this thread and jump down your throat... Don't even think about OMFS if all you are interested in is dentoalveolar surgery. OMFS scope and lifestyle is completely different from the other dental specialties.

All perio residencies involve a significant amount of literature review and seminars so be prepared for that. You will spend a lot of time at least initially doing the traditional perio procedures (S/RP, maintenance, osseous, pocket reduction, crown lengthening, gingivectomy etc.) which still forms the clinical foundation of the specialty. I think you are unlikely to take out many thirds in any perio program. I would look into the few VA residencies (tons of implant placement) and programs that fosters perio and prosth collaboration.
Nobody’s jumping down anybody’s throat.

As long as you’re comfortable managing your own complications you can do anything you want. That’s your license on the line. Not mine. Most of the OMFS guys I know think the same way. That’s how we can rationalize moonlighting during residency.

However, if you’re not giving your patients the option of referral for higher-level anesthesia (different story if you’re bringing in an anesthesiologist), or if you’re punting your complications to one of us on a regular basis, or you’re taking out uppers and sending us the lowers, then you’re acting irresponsibly.

I’m sure there are some GPs who are referring thirds to periodontists, but I have to think they’re not all that common. OP is a GP, so he or she knows who he or she refers to for thirds. Residency is on your time and you have every right to choose how you spend it. And you get to spend it on things that are typically referred to that specialty, or maybe you’ll spend it on things that aren’t, and you’ll miss out on the skills that turned out to be more important.
I’ve done apicoectomies and crown lengthening and all sorts of stupid stuff during omfs residency that we are either not GPs’ first choice for or not really thought of as doing at all. But i had fun and knew full well I could handle and had access to the resources for any complications including anything all the way up to a big neck infection.

I, and most other OMFS residents/attendings, am not satisfied with not being the best option around for doing anything I do. And if other people don’t think that way, then that’s okay with me.
 
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