Future of Perio Specialty?

[Drtrigeminal]

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I will be starting a Perio residency next year and would like to know if anyone has any info in regards to the future and earning potential of the specialty. Are most Perio's across the country quite busy? How does it compare financially to other specialties with lower overhead (ie endo, ortho). What is the scope of practice - are block grafts, zygoma implants, etc in the relm of Perio or more related to OMS? Thanks for any helpful info?[:bigsmile:]

 

[DcS]

I will be starting a Perio residency next year and would like to know if anyone has any info in regards to the future and earning potential of the specialty. Are most Perio's across the country quite busy? How does it compare financially to other specialties with lower overhead (ie endo, ortho). What is the scope of practice - are block grafts, zygoma implants, etc in the relm of Perio or more related to OMS? Thanks for any helpful info?[:bigsmile:]

I don't have the answers to your questions, but moreso am curious as to why you would be starting a Perio residency before you had the answers to these important questions. I would think someone ready to begin their residency would already have found the answers to these questions? 😕

 

[Drtrigeminal]

I am starting perio because I enjoy the surgical nature of the work, and have always been interested in the area. I am inquiring into the financial nature of the specialty for information purposes only. I know I will be comfortable as a GP or in any specialty but specific numbers about perio are hard to come by, hence my questions. As far as scope of practice, there seems to be a great variance and would like to know others options on general scope in private practice.

 

[TX OMFS]

Please refer to my post on this page
http://forums.studentdoctor.net/showthread.php?t=141298&page=2

 

[ip]

I really believe that perio is very misunderstood by some GP's and lots of posters over here on the thread that TX OMFS linked to.

For one, perio is a specialty where it matters a heck of a lot which program you go to. If 90% of what you learn is basic perio, hemisection, SC/RP, etc then that is what you'll do in private practice. There are programs where residents place 15 implants through the 3 years. Ridiculous.

Then there are prograns where residents place 100+ implants, do a dozen or so sinus grafts, and do plenty of ridge aumentations. Ridge augmentation requires learning autogenous grafting techniques (ie: chin, ramus, buccal shelf, tuberosity). To the OMS guy who suggested that OMS can do perio surgery if they wanted to..... well considering that the goal of most practicing OMS is to stick to implants and 3rd molars, do you really believe that perios could not overtake your surgeries if they wanted? Do you really believe that 3rd molar sx is more complex than a chin or ramus graft? Want the severely medically compromised pts, you can have them. Trust me, no practicing OMS wants them.

Perio spends a ton time learning how to avoid/blend gingival scar tissue, learning the fine points of very delicate esthetic cases. OMS does not. Do you think that there is no need for it? To suggest that OMS can do it just as well without the training is the same as the GP saying that they can do 3rd molars just as well as the OMS.

Anyways, I do believe that perio is very financially rewarding but it varies depending on what you do. There are single practitioner old school perio guys with 1 hygienist that make 150k. There are also guys that focus on implants and related surgeries that make 400k. There are group practices that have up to 10 hygienists going at once while the perios do graft after graft after graft and they make around 400k too.

Endo and ortho may be more guaranteed big money but each has their downside. The money is a tough question to answer because there are plenty GP's that earn 300k too. Just being a specialist doesn't necessarily mean more money than a GP. But it does make it much easier to get there.

 

[omsres]

Perio spends a ton time learning how to avoid/blend gingival scar tissue, learning the fine points of very delicate esthetic cases. OMS does not. Do you think that there is no need for it? To suggest that OMS can do it just as well without the training is the same as the GP saying that they can do 3rd molars just as well as the OMS.

What the heck are you blathering about? I've never seen an obvious gingival scar. I have seen scars in the buccal mucosa but those are not noticable at all. I guess that eyelid procedures like blephs and orbital fx access incions don't teach us the fine points about delicate tissue handling. It's only the thinnest skin on the body and much more visible than some gingival scar. We perform vessel anastamosis on vessels with a couple of cell layers with 10-0 suture. It's interesting that lots of people knock the hands of oral surgeons. We have superior surgical and medical training than any dental specialty(not arrogant, but a fact) and perio surgery could easily be accomplished by an oms, much more easily than the inverse.

Perio is legit, execpt when they encroach on more advaced OMS procedures. Of which jp listed none.

 

[omsres]

I will be starting a Perio residency next year and would like to know if anyone has any info in regards to the future and earning potential of the specialty. Are most Perio's across the country quite busy? How does it compare financially to other specialties with lower overhead (ie endo, ortho). What is the scope of practice - are block grafts, zygoma implants, etc in the relm of Perio or more related to OMS? Thanks for any helpful info?[:bigsmile:]

None what you mention is in the scope of perio, unless you consider those mandibular grafts. But perio will not be able to augment a severly atrophic mandible with any reliability. Perio is pretty much isolated to in office procedures confined to the oral cavity.

One question. Are most periodontist certified to administer IV conscious sedation right out of residency?

 

[groundhog]

This is only anecdotal, but I've been referred to a periodontist vs an OMS to get a failing bottom molar removed that had previously been crowned and root canaled and which will later be replaced with an implant. The reason I got was "their training tends to produce folks who have a finer touch in dealing with your type of situation than the OMS types."

 

[TX OMFS]

Hee Hee, I was right! Man, we haven't had a good on-line fight for a while. Glad to see I could help stir the pot.

IP, I found something for you:

Your arguement is easily demolished like the hopes of a ten year old when he finds out there ain't no Santa Claus. How you ask? By the simple fact that if you ever have a complication with any of your new found procedures you will be speed dialing my ass to bail you out. Just the facts, ma'am. On the other hand, I will not be calling you for scar revision. I promise.

 

[ip]

What the heck are you blathering about? I've never seen an obvious gingival scar. I have seen scars in the buccal mucosa but those are not noticable at all. I guess that eyelid procedures like blephs and orbital fx access incions don't teach us the fine points about delicate tissue handling. It's only the thinnest skin on the body and much more visible than some gingival scar. We perform vessel anastamosis on vessels with a couple of cell layers with 10-0 suture. It's interesting that lots of people knock the hands of oral surgeons. We have superior surgical and medical training than any dental specialty(not arrogant, but a fact) and perio surgery could easily be accomplished by an oms, much more easily than the inverse.

Perio is legit, execpt when they encroach on more advaced OMS procedures. Of which jp listed none.

If you've never noticed gingival scar tissue then I guess you prove my point.

I suppose that you're one of those who believe that OMS should be allowed to perform elective plastic surgery. An ability to reconstruct, an ability to make an incision does not make you experts on all things surgical. Plastic surgeons study the art as their one & only goal in life. OMS residents simply do not do it often enough to appreciate the finer aspects of it. Same with perio sx. Not studying the lit, not studying the the finer aspects of gingival contouring and diadnosis and tx of dozens of perio disease classifications makes you unqualified to do a periodontist's job. The fact that you know how to close a facial lac does not qualify you for all things surgical. It's this lack of appreciation for finer details that sends so many GP's to perios for their ridge augmentation/implants.

Go ask Anthony Sclar if he appreciates the periodontist's tissue handling.

BTW, I leaned how to suture blood vessels and nerves under a microscope with 11-0 sutures. Think it makes me qualified to do a bleph?

Drtrigeminal: Block grafts are absolutely within the realm of perio. Is OMSres saying that perios must particulate the graft before they place it? 😀 Of course a perio is not going to go extraoral for a graft but private practice cases that require that large of a graft are few and far between.

 

[ip]

Your arguement is easily demolished like the hopes of a ten year old when he finds out there ain't no Santa Claus. How you ask? By the simple fact that if you ever have a complication with any of your new found procedures you will be speed dialing my ass to bail you out. Just the facts, ma'am. On the other hand, I will not be calling you for scar revision. I promise.

It's actually not about fighting, it's about education. If you don't appreciate what a perio does, you will once you reach private practice and wonder why all the GP's in your area refer to you only the crap which their perio does not want. 😀

New found procedures, huh? I hadn't realized that bone/soft tissue grafting was new-found. Regarding complications, you be very surprised. No question that some guys do not get trained in dealing with complications. Tough crap for them. Other perios do get trained in dealing with all aspects of complications.

You see, this is why OMS guys have their heads grow so large. They only see the work of people who shouldn't be doing a procedure in the first place. The GP who extracts a full bony impaction and severs the nerve. The poorly-trained perio who cannot deal with his sinus graft infection. You don't see the perios who know full well how to deal with complications or the GP who know what not to touch. Your vision is skewed and I don't blame you but I do blame you for having a closed mind. There's room for everyone. There are plenty of ridges to augment, plenty of implants to place. There's work for everyone.

You also (like most OMS residents) don't appreciate the close working relationship that perio residents have with prosth residents. They work together on complex cases and learn to appreciate eachothers skills. Perio residents actually use the surgical templates that prosth gives them. Prosth knows that OMS generally does not use it and it shows. Place it where the bone is, huh? 😀 Who do you they'll continue to refer to after they graduate?

Block your ears to reality but you'll figure it out soon enough once you graduate.

 

[TX OMFS]

It's actually not about fighting, it's about education. If you don't appreciate what a perio does, you will once you reach private practice and wonder why all the GP's in your area refer to you only the crap which their perio does not want. 😀

Reread the post I linked to. Everything you mention is hashed over there. There is a simple reason OMS doesn't get the referrals. A reason I plan to rectify. I love perio guys that tear down OMSs. Your envy of my pee-pee is admirable but not needed.

New found procedures, huh? I hadn't realized that bone/soft tissue grafting was new-found. Regarding complications, you be very surprised. No question that some guys do not get trained in dealing with complications. Tough crap for them. Other perios do get trained in dealing with all aspects of complications.

New found in that gum farmers haven't been doing this for very long. Probably only about as long as their specialty has been on the decline.

You see, this is why OMS guys have their heads grow so large. They only see the work of people who shouldn't be doing a procedure in the first place. The GP who extracts a full bony impaction and severs the nerve. The poorly-trained perio who cannot deal with his sinus graft infection. You don't see the perios who know full well how to deal with complications or the GP who know what not to touch. Your vision is skewed and I don't blame you but I do blame you for having a closed mind. There's room for everyone. There are plenty of ridges to augment, plenty of implants to place. There's work for everyone.

You also (like most OMS residents) don't appreciate the close working relationship that perio residents have with prosth residents. They work together on complex cases and learn to appreciate eachothers skills. Perio residents actually use the surgical templates that prosth gives them. Prosth knows that OMS generally does not use it and it shows. Place it where the bone is, huh? 😀 Who do you they'll continue to refer to after they graduate?

Block your ears to reality but you'll figure it out soon enough once you graduate.

I know I only see the trash. I've also seen the perio staff in my dental school refer their infections, simple infections, to OMS. Now, if your attendings don't know how to handle it how are they going to train their residents? I admit putting a screw into a bone is nothing, but block grafting is a stretch. It will be hard to defend yourself in court when the lawyer says, "So, doc, you were doing surgical procedures in your office when you don't even have hospital privileges?"

 

[TX OMFS]

Dr. Trigeminal,

Good luck in your perio career. There is absolutely a place for perio in this world and I wish you well in your career. I have no hate for periodontists or you. My brethern and I are simply checking IP for his ignorance and b/c he stepped on the land mine.

 

[ip]

TX OMFS: your ability to link to pictures is very impressive. It should take you very far in life.

I'm not a perio and I'm not bashing OMS. I suggest you reread things. I have a feeling that you read this thread from a viewpoint of someone who's had to defend themselves before. All I did is post to the defense of perio which you decided to bash, without any knowledge at all of real world private practice. OMS has a place and I almost went into it myself. OMS guys all wrote my letters of recommendation after school because they are who I knew best. Although they may dig at perio in a joking manner, none have the contempt and utter ignorance of real world that you show. They realize that dental school and hopital dentistry is very far from private practice.

And again, just because you see only one thing does not mean that it is like that everywhere. At your school, the perio dept obviously sucks. Your point of view is skewed but as a seemingly intelligent person in the healthcare field, you need to realize that there is more out there than what you see.

So say what you want about gum farmers not grafting for very long but it doesn't matter that they've only been doing it for 20 years. All it takes is 3 years for them to do it now.

Best of luck to you.

 

[Dr.SpongeBobDDS]

As far as I know there are no perios or residents on this board - at least nobody who posts. You will probably have better luck getting answers to your questions over at www.dentaltown.com There are a number of practicing periodontists who post regularly over there.

I hope you can look past the crap from the previous posters and decide to stick around our forums here. I'm know we would all love for you to keep us updated on your perio experience. That is one area on this board where there is very little good info.

 

[Drtrigeminal]

I would like to thank everyone for there reply. There is obviously some tension on this board between OMS and Perio which I don't understand.... I have always enjoyed surgery and debated whether to go into OMS or Perio. Both are surgical specialties although OMS is much more extensive. I believe Perio offers a better lifestyle for me personally, as I don't have to commit my entire life to my profession and have a 9-5 job.

As for the turf war, I think implants, grafts, sinus lifts, etc should be left to well trained perio's and OMS should concentrate on the more difficult procedures they were trained in, life like removing impacted wizzies, pathology, fractures, cleft lip/palate, and repairing mangled trauma cases. I don't understand after all the training an OMS receives why they would want to through away all their extensive skills and simply concentrate on procedures like 8's and implants ($$) - what a waste of 4-6yrs. I have the utmost respect for all OMS's but I believe the delicate aesthetic surgeries should be left to the perio's and the extensive stuff to OMS so their skills are utilized.

I will also be trained in IV sedation in my residency, we do a rotation at the local hospital and sedate allot of cased for Endo.

Thanks everyone for all the info!

 

[Zurik5]

I hate the trigeminal nerve, like really hate it.....

TX OMFS:
Where did you find those pictures?

 

[drillerNfiller]

I will be starting a Perio residency next year and would like to know if anyone has any info in regards to the future and earning potential of the specialty. [:bigsmile:]

Don't know how reliable these earnings stats are or where they came from but..............

http://www.delta.edu/jobplace/careerprofiles/dentistprofile.html


I also don't really know why so many people think that OMS residents get tons more clinical experience than do perio residents and that OS can do everything the best. Even if you go to a 6 year OMFS program you are gonna get 4 years of clinical experience. As a perio resident sure you will only get 3 years of clinical experience but you are not learning as broad a spectrum of information. 4 years to master the entire head and neck, vs. 3 years to master a smaller more concise area of practice. Yes OS are trained do a greater variety and more complicated procedures than perio peeps and yes they may have a broader medical background which is definitely important especially if complications arise. But, there is no legit reason to think that within the realm of fundamental perio procedures, for example implants, that anyone does them consistently better than perio dudes

 

[omsres]

Don't know how reliable these earnings stats are or where they came from but..............

http://www.delta.edu/jobplace/careerprofiles/dentistprofile.html

That's gotta be a typo, I don't think peri averages $100,000 over the other speciaties.

 

[adamlc18]

Those can't be accurate. From all the practioners I have ever met, I would never believe that Pros brings home $30k more than endo on average, and $45k more than OMFS and Ortho.

 

[TNdentist2005]

Why did TX OMFS get banned? He was the funniest person on these forums. IP and Gavin are big fat weenies.

Here's what happened today. Ip, instead of

had to give his opinion.

I, recognizing that

,had to say

 

[TNdentist2005]

and

and

IP then said

 

[TNdentist2005]

This got the attention of Gavin, the moderator, who said

And

like a

Or something.

 

[TNdentist2005]

Which made me wonder:

Next, Gavin turned to IP and said

Because

That made me think

 

[TNdentist2005]

That is why this is the

So, Ip

And

 

[TNdentist2005]

This situation makes me think,"

"

People, Let's All Realize This Is Just The Internet. You Don't Have To Take It So Serious.

Finally, if you thought this was funny, give me a shout out. Gavin, IP, I hope we can still be friends. I had to do this b/c I'm a
http://img98.exs.cx/img98/3046/******.jpg
without anything better to do. Looks like

So everybody,

I guess I just enjoy stirring the pot too much.

TO ALL MY FANS, THANK YOU. TX OMFS OUT

 

[Zurik5]

Brilliant...

 

[north2southOMFS]

Oh my God I'm still laughing......



Gavin how could you ban him.......this is the funniest stuff on this forum.

 

[omsres]

Gavin, you're the post nazi. Some people on this forum take things way to serious.

 

[omsres]

By the way that was the funniest post of all times.

 

[lnn2]

😀 😀
Man, I couldn't stop laughing!

At least give the guy a fair warning before banning (or is it canning?)

Fairwell to TX OMFS and hello to TNdentist2005 😀

Hey man, I'll refer surgery cases out to ya, maybe even implants if you know what the heck you're doing or promise to be gentle to my patients!

 

[Andrew_Doan]

TO ALL MY FANS, THANK YOU. TX OMFS OUT

Thread closed. Do NOT spam the forum. Do NOT attack other users.