Dentists=Physicians?

[Fowl_Language]

I'm going to have to call out toofache32 on this one. This sounds rather pompous from an oral surgery resident. You may have intubated 200 tracheas in a controlled setting in ideal patients on your anesthesia rotation but are you still doing it routinely? Oral Surgery residents are not called to evaluate an emergent airway, its anesthesia and ENT. Of course anesthesia has the most experience in intubation as they do it daily. However, ENTs perform laryngoscopies all the times in difficult patients and once finding the vocals cords, its just a matter of passing the tube. ENTs take airway call for both pediatric and adults patients during there residency. Next thing you are going to tell me is that an oral surgeon does more trachs than anyone else. While oral surgeons are highly trained, the training is just one year of general surgery where you get scutted out and not operating and the other 3 years of oral surgery. This is less than any surgical specialty. Why do dentists feel the need that they have to prove themselves better than physicians? Its an inferiority complex ..... Comparing a dentist and a residency trained physician is comparing apples and oranges, there is no comparison. The only thing in dentistry that comes close to a physician is an oral surgeon.

1) What residency program are you in?
2) What program are you at?

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[Fowl_Language]

I'm going to have to call out toofache32 on this one. This sounds rather pompous from an oral surgery resident. You may have intubated 200 tracheas in a controlled setting in ideal patients on your anesthesia rotation but are you still doing it routinely? Oral Surgery residents are not called to evaluate an emergent airway, its anesthesia and ENT. Of course anesthesia has the most experience in intubation as they do it daily. However, ENTs perform laryngoscopies all the times in difficult patients and once finding the vocals cords, its just a matter of passing the tube. ENTs take airway call for both pediatric and adults patients during there residency. Next thing you are going to tell me is that an oral surgeon does more trachs than anyone else. While oral surgeons are highly trained, the training is just one year of general surgery where you get scutted out and not operating and the other 3 years of oral surgery. This is less than any surgical specialty. Why do dentists feel the need that they have to prove themselves better than physicians? Its an inferiority complex ..... Comparing a dentist and a residency trained physician is comparing apples and oranges, there is no comparison. The only thing in dentistry that comes close to a physician is an oral surgeon.

The double-post... yeah!

 

[OMFSCardsFan]

That only leaves 2 1/2 years of actual oral surgery.

My program:

Year 1: 10 months OMFS, 2 months ER
Year 2: 1 month OMFS, 11 months MS3
Year 3: 8 months OMFS, 4 months MS4
Year 4: 2 months OMFS, 5 months GenSurg, 5 months Anesthesia
Year 5: 12 months OMFS
Year 6: 12 months OMFS

Total: 45 months OMFS

Compare that to an ENT residency, and the time spent is pretty similar. Our third year on service (PGY-2) last month logged over 35 cases as primary surgeon, and we don't count "tooth" procedures (thirds and extraction cases) into that.

What do I know, though, I'm just a dentist.

1) What residency program are you in?
2) What program are you at?

I'm also curious. ENT? Plastics? GenSurg?

 

[esclavo]

I'm going to have to call out toofache32 on this one. This sounds rather pompous from an oral surgery resident. You may have intubated 200 tracheas in a controlled setting in ideal patients on your anesthesia rotation but are you still doing it routinely? Oral Surgery residents are not called to evaluate an emergent airway, its anesthesia and ENT. Of course anesthesia has the most experience in intubation as they do it daily. However, ENTs perform laryngoscopies all the times in difficult patients and once finding the vocals cords, its just a matter of passing the tube. ENTs take airway call for both pediatric and adults patients during there residency. Next thing you are going to tell me is that an oral surgeon does more trachs than anyone else. While oral surgeons are highly trained, the training is just one year of general surgery where you get scutted out and not operating and the other 3 years of oral surgery. This is less than any surgical specialty. Why do dentists feel the need that they have to prove themselves better than physicians? Its an inferiority complex ..... Comparing a dentist and a residency trained physician is comparing apples and oranges, there is no comparison. The only thing in dentistry that comes close to a physician is an oral surgeon.

We do 95% of the trachs in our hospital. We take all the head and neck trauma-all of it. The only thing I've consulted an ENT on was a laryngeal fracture or tracheal injury. People try to send our ENT's trauma transfers and they call me up to take care of it for them. We will do 10-15 main OR cases a week and then 40- 60 clinical cases a week. We get referred pan facials (or just mandibles) from ENT residencies which need subsequent orthognathic surgery because of the failure to understand anatomy. Plus we can take them to final reconstruction down to the precise color of the teeth! Since we have more anesthesia skills than an ENT (not just intubating but pharmacology) the spectrum from a local anesthetic to a full blown general is done right here in our office. Dentists have the longest history with using general anesthesia as well as the safest history with anesthesia. Toofache grossly underestimated intubations, in our residency we are doing over 500 and that is from the OR to the floor (the actual floor) of the ICU . From someone wide awake in the ED to someone in a halo. We are trained not just to stick a tube between the chords but we are trained in pharmacologically how to get a patient to the point of sticking that tube between the chords. I agree that ENTs are far better at fiberoptics that OMFSs. I think this is where we lag behind in skill when it comes to airway.

We are dentists and some are physicians and dentists. The physician part isn't that helpful to be truthful to you. Medical school puts alot of things in your brain but it didn't do jack for your actual surgical skills. You couldn't do jack with that MD when you were done... but a dentist with his measly DDS or DMD can walk right out on the street after his 4 years and do something valuable for society and be sought after for his services. I see a 3rd year dental student come here and do an externship and watch him suture and their actual surgical skills destroy a 4th year medical student and many of the first year residents fumbling around like they have 10 thumbs and a seizure disorder. Now procedural MD's will be just fine but it will take another 4-5 years of training to get them there...

Now the peace offering... we as dentists do appreciate doctors, they do great things for society and their knowledge and skills make life better and saves lives...but they aren't the apex preditor in all the situations that they think they are....

 

[omfsres]

My program:

Year 1: 10 months OMFS, 2 months ER
Year 2: 1 month OMFS, 11 months MS3
Year 3: 8 months OMFS, 4 months MS4
Year 4: 2 months OMFS, 5 months GenSurg, 5 months Anesthesia
Year 5: 12 months OMFS
Year 6: 12 months OMFS

Total: 45 months OMFS

Compare that to an ENT residency, and the time spent is pretty similar. Our third year on service (PGY-2) last month logged over 35 cases as primary surgeon, and we don't count "tooth" procedures (thirds and extraction cases) into that.

What do I know, though, I'm just a dentist.


I'm also curious. ENT? Plastics? GenSurg?

... and the intern at my program did 35 H and P's last month to get those cases to the OR. 🙂 .

I love it, Bobby6 would have you believe that an ENT is doing bilat radical necks on a daily basis from day 1 of PGY2 when in reality the biggest procedure they see is T&A's which pale in comparison to impacted 3M extractions in complexity. But that's me presuming I know everything that goes on during each year of training in an ENT residency. I bet that is real irritating.

OMS's log just as many OR cases as any other surgical speciality, and much more if you want to count all our clinic procedures done under IVCS.
I can compare johnson size too. When it comes to head and neck pathology(except maybe for SCCA) there is no MD in any specialty that can compete with OMS. We get 2 years of the stuff in dental school and then constant exposure thoughout our residency. I have heard numerous cases of mismanaged lesions like an MD diagnosing a V3 parathesia as a Bells palsy for 3 months when the poor girl actually had a fibrosarcoma in the mandible. Or the Surgeon who did and parotidectomy or hyperplasia secondary to chronic alcoholism. The list goes on and on. You ask an ENT for a differential for a posterior mandibular radiolucency and you're lucky if you here OKC. Dont even get me started on facial trauma.

I don't like comparing our specialties because for the most part they are completely different. If I went to med school first, I wouldn't even consider doing ENT. But what's wrong with two different specialties doing the same procedures if we are trained to do it, and do it to the standard of care? There are plenty of patients to go around. What's wrong is when someone like bobby6 assuming he knows my training and telling me what I can and can't do. Personally I like to think that the only thing that separates me from an ENT is an extra doctorate of knowledge and experience.

Don't get me wrong, I like the ENT guys/girls at my hospital. We are both not hesitant to punt a facial trauma to the other at the stroke of midnight when facial trauma month ends. We agree that we are both competant at managing acute airways and I dont want to have anything to do with temporal bones and they could care less about orthognathics and distraction.

But I digress. This tread is about dentists=physicians. Which they certainly do not(except single degree OMS). Two totally different fields. I can tell you with some exeptions that most dentist's medical knowledge(say five years out of school) fall just short of a experienced Unit nures. However, dentists do have some medical knowledge. Physicians on the other hand have no dental knowledge to speak of, except maybe the Ellis classification of tooth fractures. However, dentist do hold patients lives in their hands every time they do I and D's on malignant neoplasms. I know of at least 3 episodes.

 

[Radpimp]

I am an ENT resident so dentistry/oral pathology is of interest to me. To add, bilateral neck dissections are a senior level case in terms of complexity. Most ENT residents while may dabble, do not play a significant role in the surgery until their 4th or 5th year. I'm not discounting orals surgeons, they have smiliar training and credentials to any physician-surgeon. I doubt the MD really adds that much to their training, its their residency and time spent on call and in the hospital where they learn the real medicine and how to manage a patient. Alot of outside reading is required in residency and essentially you're still a student.

Know that in some other countries, oral and maxillofacial surgery is a specialty within medicine not dentistry, requiring all practioners to obtain an DDS and MD before beginning training, i.e. - England

Reading about something and being the actual person doing is totally different. As I understand it from my father, their is no field in dentistry that has the complexity and length of training as oral surgery.

This thread is turning into an MD vs DDS thread. Both are great but different professions period. 🙂

 

[OMFSCardsFan]

... and the intern at my program did 35 H and P's last month to get those cases to the OR. 🙂

Thanks for reminding me...

 

[esclavo]

The other place that ENT has superior skills for the most part is endoscopic abilities, especially in sinus stuff. I am envious of ENTs for their fiberoptic and endoscopic skills. I know very little of inner ear stuff....Deep neck and thyroid stuff they are also the bomb. They also have some of the best skull base skills when properly trained. I am not an ENT basher which many might think. If I was an MD and couldn't do OMFS, I would think about ENT...

 

[Yah-E]

You know, I've been through some great OMFS externships and I always inquired about the relationships between us (OMFSs) and ENTs. I really enjoy the environment and setting where these two services get along and I believe that's great. Places like Parkland and Cook County, at those two programs the OMFSs and ENTs get along great. All most like brothers.

On the other side of the token, programs like LSU-NO and Minnesota, OMFSs and ENTs just can't seem to get along.

I love the scope of OMFS, but when I bought the Atlas of Head & Neck Surgery (Lore & Medina, 4th Edition) and I browsed through it, I was floored on the type of surgeries that ENTs can perform.

I respect ENTs not because what their scope of practices are, but because I will have to work closely with them due to our blend of services. I will try to amend the relationships between OMFSs and ENTs at LSU-NO (at least with ENT residents in my class, not uppers).

 

[HuyetKiem]

I see a 3rd year dental student come here and do an externship and watch him suture and their actual surgical skills destroy a 4th year medical student and many of the first year residents fumbling around like they have 10 thumbs and a seizure disorder

I bet that dental student was from Case Western 🙂 🙂 🙂 . We are gaining so much experiences up here with extraction and suturing. I've lost count of my number.

 

[bobby6]

...When it comes to head and neck pathology(except maybe for SCCA) there is no MD in any specialty that can compete with OMS. We get 2 years of the stuff in dental school and then constant exposure thoughout our residency. I have heard numerous cases of mismanaged lesions like an MD diagnosing a V3 parathesia as a Bells palsy for 3 months when the poor girl actually had a fibrosarcoma in the mandible. Or the Surgeon who did and parotidectomy or hyperplasia secondary to chronic alcoholism. .

Actually all the top cancer institutions like MD Anderson and Sloan Kettering have ENTs on staff for Head and Neck Cancer not oral surgeons. If no MD in any specialty could not compete with OMS on head and neck pathology, wouldn't these top cancer institutions employ them?

I don't like comparing our specialties because for the most part they are completely different. If I went to med school first, I wouldn't even consider doing ENT. But what's wrong with two different specialties doing the same procedures if we are trained to do it, and do it to the standard of care? There are plenty of patients to go around. What's wrong is when someone like bobby6 assuming he knows my training and telling me what I can and can't do. Personally I like to think that the only thing that separates me from an ENT is an extra doctorate of knowledge and experience.

The only thing that separates you from an ENT is an extra doctorate of knowledge and experience? The extra MD doctorate I doubt adds that much to your training but what does an oral surgeon know about laryngology/diagnosing voice disorders/voice surgery, temporal bone/skull and cranial base surgery/otology/cochlear implantation/hearing disorders, pediatric head and neck surgery - with the exception of craniofacial trained omfs, endoscopic sinus surgery, allergy and immunology. Sure the two specialties involve the same area but to grossly think that what separates you from an ENT is an extra doctorate is a ridiculous overgeneralization.

As an ENT resident I don't assume that I know much about dentoalveolar surgery,Dental implants, and Orthognathic surgery.

 

[OMFSCardsFan]

...but what does an oral surgeon know about laryngology/diagnosing voice disorders/voice surgery, temporal bone/skull and cranial base surgery/otology/cochlear implantation/hearing disorders.

Next to nothing, which is why no OMFS will claim to know anything about it. No one will argue with you that ENT alone is "the man" of the larynx, temporal bone, and the inner ear.

As an ENT resident I don't assume that I know much about dentoalveolar surgery,Dental implants, and Orthognathic surgery.

Knowing a bit about occlusion wouldn't hurt. The patient's occlusion is paramount to correctly reconstructing many types of facial trauma. The ENT department where I am get away with a lot that would be considered damn near malpractice in an educated patient population. Usually the problems are caused by failing to realize the importance of occlusion prior to ORIF procedures. For them, Erich arch bars and MMF became obsolete when IMF screws became available.

I suppose the requirement of an OMFS department for a hospital to be a Level One trauma center is in place for the management of Ellis Class III tooth fractures...

I have as much respect for the ENT specialty as I do for my own, but I have very little respect for people like yourself. You only show how uneducated you are about our training and scope of practice when you make comments such as these. Now, you may be at a program with a worthless OMFS program. This would alter your perception of the specialty if this is the only exposure you get to it. If I had no other experience with ENT other than at my program, I'd have the same feelings about ENT surgeons as you do for OMFS.

 

[toofache32]

Actually all the top cancer institutions like MD Anderson and Sloan Kettering have ENTs on staff for Head and Neck Cancer not oral surgeons. If no MD in any specialty could not compete with OMS on head and neck pathology, wouldn't these top cancer institutions employ them?

Because H&N pathology for ENT's consists of only SCC vs. salivary gland ca. This is the "general surgery" mentality. There's more to pathology than cancer. Way more. When you start med school you'll figure this out.

...what does an oral surgeon know about... pediatric head and neck surgery - with the exception of craniofacial trained omfs...

...which is to say all of them. Craniofacial surgery is a cornerstone of the specialty.

As an ENT resident I don't assume that I know much about dentoalveolar surgery,Dental implants, and Orthognathic surgery...

...nor craniofacial surgery, distraction osteogenesis, facial pain/TMD, bone grafting, preprosthetic surgery, dentofacial deformities, occlusion, maxillomandibular surgery for OSA, or anesthesia (oh wait scratch that...just stick a tube through the cords and now you're an anesthesiologist, right?). Oh....and trauma.

As OMFSRES said, the specialties don't overlap all that much. Now that I think about it, I remember you getting all pissy and high-and-mighty on the dental forums a year or 2 ago.

 

[toofache32]

...Now, you may be at a program with a worthless OMFS program....

....maybe he's in Shreveport.

BOOYAH!!

 

[bobby6]

Whats comments am I making that are grossly wrong? At my institution, oral surgery is a 4 year program without the MD. They spend their first year in oral surgery which includes rotations in infectious disease/cardiology/internal medicine and etc. Their 2nd year consists of a full year of general surgery. Then they go back to oral surgery for their 3rd and 4th year with 6 months of anesthesia built in. Thats about 30-36 months of oral surgery. As I understand, MD trained and non MD trained oral surgeons are the same technically in terms of competency.

You make occlusion sound like rocket science and something an MD can't master, please give me a break, its all the ENTs and Plastics guys screwing up all the mandibles. ENTs and Plastics spend at least four years doing this surgery in residency so occlusion is something that has be learned and mastered. Come on. What have I said to denigrate the field of oral surgery? Nothing. You seem to have this chip on your shoulder with an air of arrogrance that an oral surgeon is better than any MD with trachs and head and neck pathology.

I see that your are in residency at LSU Shreveport, in the middle of nowhere, with one of the worst ENT and General Surgery programs in the country and the same goes for Nebraska. Your oral surgery program may have an expanded scope but that definately isn't the norm around the country.

Reading my comments, there is nothing negative about oral surgery but your comments "no MD in any specialty that can compete with OMS", " If I went to med school first, I wouldn't even consider doing ENT", "the only thing that separates me from an ENT is an extra doctorate of knowledge and experience"

Please, brush that chip off your shoulder.

 

[OMFSCardsFan]

I thought they were keeping the Duke photos out of the press...

 

[GatorDMD]

I see that your are in residency at LSU Shreveport, in the middle of nowhere, with one of the worst ENT and General Surgery programs in the country and the same goes for Nebraska. Your oral surgery program may have an expanded scope but that definately isn't the norm around the country.

dont forget portland, dallas, michigan, alabama, san franscisco, louisville, pittsburgh, maryland and many others... most with respected ENT and surgery programs....

 

[GatorDMD]

....maybe he's in Shreveport.

BOOYAH!!

 

[ajmacgregor]

You make occlusion sound like rocket science and something an MD can't master, please give me a break, its all the ENTs and Plastics guys screwing up all the mandibles. ENTs and Plastics spend at least four years doing this surgery in residency so occlusion is something that has be learned and mastered.

With all due respect, this is just the kind of attitude that makes the OMFS guys react the way they do to your posts. Occlusion is not simple - your saying otherwise is a pretty strong indication that you don't have the grasp of it that you claim to have. Occlusion is certainly not simple enough that it can be learned during residency when you're focusing on learning about the ears, nose, throat, facial cosmetic surgery, head and neck oncology, and whatever else you're learning in ENT. Not everyone should be put in a Class I occlusion (or, more appropriately, Class I Malocclusion). By saying that you can master what you need to know about occlusion in the few hours/week you have devoted to didactic instruction in this area is denigrating to general dentists, OMFS, prosthodontists and orthodontists.

 

[toofache32]

With all due respect, this is just the kind of attitude that makes the OMFS guys react the way they do to your posts. Occlusion is not simple - your saying otherwise is a pretty strong indication that you don't have the grasp of it that you claim to have. Occlusion is certainly not simple enough that it can be learned during residency when you're focusing on learning about the ears, nose, throat, facial cosmetic surgery, head and neck oncology, and whatever else you're learning in ENT. Not everyone should be put in a Class I occlusion (or, more appropriately, Class I Malocclusion). By saying that you can master what you need to know about occlusion in the few hours/week you have devoted to didactic instruction in this area is denigrating to general dentists, OMFS, prosthodontists and orthodontists.

I agree. Dental students take multiple courses over the 4 years on occlusion. The complexity grows immensely when you consider the different occlusal theories and the interactions with the joints. There are entire dental specialties built on occlusion (prosthodontics and orthodontics). The ENTs where I was in dental school were notorious for setting a fractured mandible/maxilla in the wrong occlusion....when the patient complained postoperatively they told them to "go see an orthodontist."

There are some programs where the ENT residents rotate onto oral surgery. These are the residents who see the light and discover how difficult occlusion can be, and they never even knew they were missing the boat. i'm not saying ENT/Plastics can't learn occlusion, but most of them never try. They assume that if they can whack out a T4 squam with a neck dissection and pec flap, then surely they can "make the teeth fit together."

 

[bobby6]

Occlusion may be complex but 4 years of fixing mandibles in residency plus didactics is enough to get a grasp on it. You're making it sound like the ENT and Plastics who are doing these mandibular fixations for at least 4 years of residency training have no clue about occlusion.

No one ever said that you can master what you need to know about occlusion in the few hours/week. ENT and Plastics spend at least 4 years of residency training with countless didactics, taking facial trauma call, and performing fixation of mandles/facial fractures. I'm not suggesting an ENT can do a better ORIF of an mandible or facial fracture than an oral surgeon and vice versa. But to suggest that an ENT or Plastics is clueless about occlusion is denigrating.

 

[toofache32]

Occlusion may be complex but 4 years of fixing mandibles in residency plus didactics is enough to get a grasp on it. You're making it sound like the ENT and Plastics who are doing these mandibular fixations for at least 4 years of residency training have no clue about occlusion.

You summed it up pretty nicely. Someone with a pristine preop class 1 occlusion is simple. The difficulty comes with restoring a malocclusion back to its malocclusion, especially when they only have 6 teeth in their head. As for edentulous mandible fractures, I'm not sure how you can know how to reduce these 3-dimensionally if you've never made a denture before (in dental school).

 

[bobby6]

"Occlusion is not simple - your saying otherwise is a pretty strong indication that you don't have the grasp of it that you claim to have. "

I never said it was simple, its just not rocket science or theoretical physics.

 

[Yah-E]

Gentlemen, you all have one more closing statement post and that's it. Try to get to your points, OK? This thread is getting old.

Bobby6: what is your point?
Toofache: what is your point?
OMFSCard: what is your point?

We want to know the bottom line, this debate is getting old. Haven't you guys receive this type of debate enough in the hospital and you have to bring it to the an internet forum? C'mon!

 

[Rezdawg]

Gentlemen, you all have one more closing statement post and that's it. Try to get to your points, OK?

I'll go first. I learned a new word:

denigrate - to attack the character or reputation of.

My work here is done.

 

[OMFSCardsFan]

Whats comments am I making that are grossly wrong?

1. "While oral surgeons are highly trained, the training is just one year of general surgery where you get scutted out and not operating and the other 3 years of oral surgery. This is less than any surgical specialty."

May be true where you are located, but it's not the case anywhere.

2. "The extra MD doctorate I doubt adds that much to your training but what does an oral surgeon know about laryngology/diagnosing voice disorders/voice surgery, temporal bone/skull and cranial base surgery/otology/cochlear implantation/hearing disorders, pediatric head and neck surgery - with the exception of craniofacial trained omfs, endoscopic sinus surgery, allergy and immunology."

This is as much a part of OMFS as it is Orthopedics (in other words, it's not). No one is saying an OMFS is an ENT surgeon. No OMFS wants to be an ENT surgeon. However, where our specialties do overlap, we are just as qualified to perform the procedures as an ENT surgeon, given that the proper training has been received. Most OMFS programs, not all, will provide sufficient training.

3. "ENTs and Plastics spend at least four years doing this surgery in residency so occlusion is something that has be learned and mastered. Come on....Occlusion may be complex but 4 years of fixing mandibles in residency plus didactics is enough to get a grasp on it."

I got a call from the chief resident of the ENT department a couple weeks ago. He wanted me to evaluate some loose teeth on a patient with a LF I fracture. In talking with him, I recommended that the loose teeth be treated when the patient was placed into Erich arch bars for the reduction of the fracture. At the end of the procedure, after removing the MMF, the upper arch bar would remain in place for two weeks. The patient could then follow-up with our clinic for AB removal. The chief refused, wanting me to place the AB. He said that they were going to open the fracture and ORIF anatomically, without using any kind of MMF. Do you know enough about occlusion to know that this isn't the proper treatment for a dentate patient with a LF I fracture? This chief obviously doesn't, even after his five year residency which, according to you, is adequate training in occlusion.

 

[OMFSCardsFan]

We want to know the bottom line, this debate is getting old. Haven't you guys receive this type of debate enough in the hospital and you have to bring it to the an internet forum? C'mon!

As the person that starts the most threads about the most inconsequential bullsh*t (a.k.a. the DEA thread going right now), I hardly think you should be the one policing other posts for worthiness. I used to feel bad for you when TX would hammer on you, but I've come to realize that you unintentionally encourage it. You're going to be one of the guys that give ENTs the impression that OMFS guys are just dentists...

 

[bobby6]

Anecdotal examples are useless. There are plenty of oral surgeons who screw up occlusions as ENTs and Plastics. Its like this one time at bandcamp, "............." I knew of this one person one time that.......

I highly doubt there is a randomized, double blind, prospective study out there that prove ORIF/MMF outcomes are superior when done by an oral surgeon vs ent vs plastics. Anectodal information is useless. Until that study comes out then what examples you have to say is meaningless. Medicine is evidence based not based on your anectodal "this one time at bandcamp" examples. I haven't said anything negative but I can't pass this one up. The city of Shreveport is a dump. I'm sorry you have to live there OMFSCardsfan. Now Dallas is the bomb. 🙂

My final word which will end all arguments - He Started it First 🙂

 

[bobby6]

 

[Yah-E]

As the person that starts the most threads about the most inconsequential bullsh*t (a.k.a. the DEA thread going right now), I hardly think you should be the one policing other posts for worthiness. I used to feel bad for you when TX would hammer on you, but I've come to realize that you unintentionally encourage it. You're going to be one of the guys that give ENTs the impression that OMFS guys are just dentists...

I'll stand up for OMFS when I need to in person as situations arise, I wouldn't resort to the internet and battle "one" ENT intern. TX hammering me, please, this is an internet forum, you can't take everything personally. The day you get pissed at a post from a guy behind a computer, then that says a lot about you as a person and your character.

I'm proud to be a "dentist", unlike some OMFS I know on here or getting to know.

 

[omfs44]

I'm ashamed to be a dentist, I think I'll go into family practice instead.

 

[Doggie]

Gentlemen, you all have one more closing statement post and that's it. Try to get to your points, OK? This thread is getting old.

Bobby6: what is your point?
Toofache: what is your point?
OMFSCard: what is your point?

We want to know the bottom line, this debate is getting old. Haven't you guys receive this type of debate enough in the hospital and you have to bring it to the an internet forum? C'mon!

I learned something valuable too............toofache is the king of owned/pwned/own3d pictures! Keep it coming.

 

[OMFSCardsFan]

The city of Shreveport is a dump.

This is your most accurate post to date. I'd never live here after residency, but it's a helluva place to train.

 

[Fowl_Language]

Anecdotal examples are useless. There are plenty of oral surgeons who screw up occlusions as ENTs and Plastics. Its like this one time at bandcamp, "............." I knew of this one person one time that.......

I highly doubt there is a randomized, double blind, prospective study out there that prove ORIF/MMF outcomes are superior when done by an oral surgeon vs ent vs plastics. Anectodal information is useless. Until that study comes out then what examples you have to say is meaningless. Medicine is evidence based not based on your anectodal "this one time at bandcamp" examples. I haven't said anything negative but I can't pass this one up. The city of Shreveport is a dump. I'm sorry you have to live there OMFSCardsfan. Now Dallas is the bomb. 🙂

Two things:

#1) Le B, Holmgren E, Holmes JD, Ueeck BA, Dierks EJ.
Referral patterns for the treatment of facial trauma in teaching hospitals in the United States. Journal of Oral and Maxillofacial Surgery.
61(5): 557-60, 2003

#2) Since when was the value of residency training defined by "quality of life?"

 

[Radpimp]

No one is attacking Oral Surgeons. In areas where they overlap with Plastics and ENT, they are as competent and proficient. No one is suggesting otherwise. It is when you suggest that one is better than the other is when you get into these heated debates.. Again oral surgery is one of those specialties that bridges the medicine and dentistry realms.

 

[bobby6]

I'm sorry did I stutter? I guess you need to go back to Statistics 101 or maybe they didn't teach that properly in dental school. The quoted study is not prospective, double blind, randomized or even controlled. The investigators sent a bunch of surveys out to ER/Trauma chiefs to assess the referral patterns of facial trauma in the United States at teaching hospitals
and also questions regarding preferences and opinions regarding the various services.

The study did not assess patient outcomes or even surveyed the patient in terms of complications like infection/bleeding/need for revision procedures, degree of occlusion and etc. The degree of evidence is marginal as it wasn't blinded, controlled, or even prospective, and there is no way to adjust for investigator bias.

Now if theere were a prospective study that randomized each facial trauma patient to either ENT, OMS, or Plastics, blinded the patient to which service performed the repair, and then assess the degree and number of complications along with patient statisfication, all this while blinding both the investigator and the patients, then that study would have a high degree of evidence and power.

 

[aphistis]

...And another inter-specialty urination competition bites the dust.