Best Residency program for Periodontics
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Harvard is more research oriented yes. I am also trying to learn more.
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UTHSCSA in San Antonio has the "hands down" best Periodontics residency in the country.
Good patient pool, all Board Certified staff, cutting edge technology, academics to prepare you for the Perio Boards--they have it all.
Good patient pool, all Board Certified staff, cutting edge technology, academics to prepare you for the Perio Boards--they have it all.
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I've heard good things about San Antonio as well
If one is going to seriously consider specializing in Periodontics, then I highly recommend a program with a strong research subprogram. The reason -- periodontics is becoming a "junior oral surgeon" with the increasing emphasis on implantology. I recommend to my students that 1) if you want to perform surgery as your clinical mainstay, apply for an OMS residency and 2) if you want to become a Periodontist, then go for a PhD and aim for an academic/research career.
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I think we have one of those "teachable moments" here. First, without research, Periodontics would still be where Oral Surgery is now, doing surgical techniques established in the 188o's by some German or Austrian surgeons and spending your life shucking wisdom teeth or getting some trauma surgery from the local hospital on a non-paying welfare patient. OK, enough said about that--however, the crack aboiut Periodontists becoming "junior oral surgeons" because they are doing implants--what baloney as well! You ask any general dentist if they would rather have an implant placed by an OS or a Peroidontist and I'll bet you a dinner they say Perio. If I need my jaw moved around--give me an OS but don't dis the Perio brotherhood about being Junior Oral Surgeons--really, how insulting. Periodontics is a clinical speciality with a great and innovative research base. OS uses alot of the same research for their techniques, but they do different things. Both do implants and grafting, both take out teeth and they have other areas that are separate but equally important--but Periodontists are clinical--just like Oral Surgeons. So if YOUR Periodontists go into research--who does the perio--Oral Surgeons--good luck! And a career in academia--hey, get out and taste the real world, that's what it is all about!
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This is an interesting comment and another teachable point - you are criticizing someone for saying something that is obviously not true about periodontists by making claims that are absolutely not true about oral surgeons.
True, the first facial osteotomies that were performed were in the 1880s, but to suggest that those techniques have not been refined and that clinical research practice in OMFS has lagged behind in the past 130 years is dishonest and, frankly, absurd. This would suggest that you have never heard of distraction osteogenesis, curvilinear distaction, endoscopic approaches to the facial skeleton, tissue engineered ramus-condyle units for mandibular reconstruction, or many of the other surgical advents that were brought into the mainstream of dentistry via OMFS.
Don't get me wrong, as a periodontist I do resent the implications that perio is analogous to "oral surgery lite", but your comments certainly do not paint a picture of professionalism that would encourage dental students to become periodontists.
Here are some observations:
1. There are good oral surgeons and bad periodontists and vice versa - neither specialty is better at placing implants and certainly neither specialty holds the monopoly on being a "soft tissue" expert.
2. I don't know where everyone gets the idea that perio is the research specialty. Is it because perio has more journals than any other specialty? I would suggest that dental students look not only at the quantity of the work that is being published, but also the quality. Speaking as a former perio resident, yes, we all did research, but doing research does not make you an expert. I'll go one step further to suggest that a lot of periodontists (and dentists in general) have a real inability to critically analyze and interpret research articles and often, in my experience, make their conclusions based on statistical significance (p < 0.05) rather than clinical significance. For example, a lot of the research focuses on bone heights and modulated effects of different interventions on alveolar crest height. The results are statistically significant (p < 0.0001), but the difference in crest height is often observed to be less than what would be clinically relevant.
3. Perception is everything - periodontists are surgeons and OMFS are surgeons. However, if asked what I did for a living, I wouldn't say "I'm a periodontal surgeon". If you are happy with what you do and satisfied with your choices, you will have no need to rag on another specialty just to get your kicks. In the "real world" - nobody cares whether you are a periodontist or oral surgeon. They care about whether you do good work for their patients. My practice has an implant study club with general dentists and oral surgeons in the area. We are colleagues and share ideas, common pitfalls and success strategies. If I have a patient who needs more than a minimal bone graft, third molar removal or biopsy of a significant lesion, I refer to my friendly OMFS colleagues down the street, just as they would refer to me for a patient who requires management of significant periodontal defects or local soft tissue grafting. I do implants and so do they and the results are fairly comparable (though I am always in bed at 3 AM, not fixing some orbital fracture - the same cannot be said of them!). In the real world, no good comes from bad-mouthing another specialist - you can be 100% certain of that.
4. The take home point, I think, is the following: if you want to treat periodontal disease and replace supporting tooth structures with natural or artifical means, and would be happy with the skill sets required to do this, then become a periodontist. If you want to have a broader medical and surgical knowledge base/skill set that can necessarily be contracted to focus on extractions, implants and the like, then become an oral surgeon. As far as skill sets go, pinnacle of periodontal practice is, to a certain extent, the contracted form of oral and maxillofacial surgical practice. The contention occurs because where the specialties meet is where the $$$ is.
I'll get off my soapbox now.
To the OP, I agree with the assessments from prior posters that UTHSC-SA is a terriffic program. I think that Iowa is strong as well, as is Michigan. I was not impressed at all with any of the Boston or New York programs. Very few teach IV sedation, there are many OMFS/perio programs and practitioners in those cities and the experience is somewhat diluted by this fact.
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There is some truth to the idea linking periodontics to research as a long-term relationship. Periodontics is taking us deeper into the physiology of the immune response and mechanics of bone and soft tissue maintenance, the epithelial attachment and the effects of systemic modifiers to oral health.
So where does periodontics fit into private practice? Public demand drives everything (unfortunately) and the traditional periodontal procedures have probably suffered because of the implant alternative and also a lack of understanding/ patient education in the private practice model.
Where do I believe the future is? Implant maintenance and salvaging cases which probably were not adequately treatment planned. Another huge area is referrals from orthodontists before they wire up adult patients.
Oral surgeons due remarkable work- I saw this first hand on my three month anesthesia rotation. They are closer to being orthopedic surgeons than dentists by the time they finish their residencies. The fact someone would even label a dentist with a specialty certificate in Periodontics as a "junior oral surgeon" is remarkably inane- and that is being polite to the author of that statement. I know nothing about nerve lateralization, Leforts, BSSOs and tibia harvests. As well, I doubt an OMFS would be too interested in deciding whether a recession defect is more predictably handled with a pedicle flap vs coronally positioned flap in combination with a subepithelial connective tissue graft. Nor do I believe an OMFS would be too keen on managing a diabetic who comes in with a chief complaint "my gums hurt doc and they are always bleeding". The two specialities are far different from each other.
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