OMFS + Cosmetics AEGD vs. Dental Anesthesia + Implant/OMFS res + Cosmetic AEGD

[cybermech]

So, I feel like I'm in a bit of a dilemma...

I've known that I've wanted to make implant placement a part of my practice for a long time and have considered Perio or OMFS as a means of getting there. However, lately I've considered a different track. Since my dad runs a productive cosmetic practice that I have the opportunity to take over, it'd be a waste to become a specialist due to this fact.

Additionally, I've found that there's a demand for general anesthesia for the general practice in my area. Thus, I've considered something like this:

2 year Dental Anesthesia residency
1 year Implant (or OMFS) residency
1 year Cosmetics GPR/AEGD

Doing this would ultimately bring me closer to the level of my dad and would allow me to fill a vital niche in general anesthesia in the general practice.

However, seeing as it's a 4-year track, I thought about this as an alternative:

4 year OMFS residency
1 year Cosmetics GPR/AEGD

And then "de-limit" my practice and forfeit specialist status.

Obviously all roads can eventually lead to Rome, though i wonder what might be the best option in terms of training, finance, and time?

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[Stroszeck]

Try to finish first year dental school first

 

[cybermech]

Try to finish first year dental school first

I am in the second year and my grades are competitive. And obviously I need to make a serious push for the NBDE I if I need to do OMFS.

 

[charlestweed]

So, I feel like I'm in a bit of a dilemma...
I've known that I've wanted to make implant placement a part of my practice for a long time and have considered Perio or OMFS as a means of getting there. However, lately I've considered a different track. Since my dad runs a productive cosmetic practice that I have the opportunity to take over, it'd be a waste to become a specialist due to this fact.

You are right. It would be a waste of time and $$$ to specialize in OMFS or perio, if you want to do everything in your dad’s practice: implant placement + restorations + sedation + veneers + fillings + dentures etc. No matter how big and how successful your dad’s GP practice is, you will not have as many implant cases as the OS (or perio) who limits his/her practice to OMFS (or perio). If you want to do everything and forfeit your specialist status, none of the GP in the area will refer the patients to you. The OMFS and perio are busy because get patients from different GP offices.

If you want to be an OMFS or perio and want to place a lot of implants, you should hire an associate GP to run your dad’s GP practice and set up a separate OMFS or perio practice.

 

[mmasurf]

4years is a long track, just take over and take courses to get to that certain skill level you want

 

[drhobie7]

Consider just doing a good aegd/gpr and getting a sedation permit, which you may be able to do during the aegd. Conscious sedation should be adequate for most patients seeking dental implants. You'll be ready to roll in 1 year post grad. Look into a GPR at a VA hospital, especially if there is no perio department. They do tons.

 

[cybermech]

Consider just doing a good aegd/gpr and getting a sedation permit, which you may be able to do during the aegd. Conscious sedation should be adequate for most patients seeking dental implants. You'll be ready to roll in 1 year post grad. Look into a GPR at a VA hospital, especially if there is no perio department. They do tons.

I know my dad does PO conscious sedation. Though, does IV sedation usually requires the 2 year anesthesiology res or OMFS status? I'm guessing there's no point in going through all the trouble of the anesthesiology res?

As for learning how to do implants and cosmetics as fast as possible, do you think a 1-year GPR at a VA hospital and maybe a 1-year Cosmetics AEGD might work? It is worthwhile to learn how to do some of the crazier stuff like sinus lifts and bone grafts or are those best left to the specialists?

 

[cybermech]

You are right. It would be a waste of time and $$$ to specialize in OMFS or perio, if you want to do everything in your dad’s practice: implant placement + restorations + sedation + veneers + fillings + dentures etc. No matter how big and how successful your dad’s GP practice is, you will not have as many implant cases as the OS (or perio) who limits his/her practice to OMFS (or perio). If you want to do everything and forfeit your specialist status, none of the GP in the area will refer the patients to you. The OMFS and perio are busy because get patients from different GP offices.

If you want to be an OMFS or perio and want to place a lot of implants, you should hire an associate GP to run your dad’s GP practice and set up a separate OMFS or perio practice.

Haha, i feel like life is so complicated because there are always family expectations to take over the practice. I think what I've always wanted to do was find a way to differentiate myself from my father whom I've always lived in the shadow of.

Having said that though, I think specializing would definitely be a waste of money and effort. I'd have to spend another 1M+ to buy out a specialty practice.

Though, I guess the reason I was asking about OMFS was because I was wondering if it was an "easier" way to get the training necessary to for implants and maxillofacial surgery. However, now that I think about it, it's going about it backwards and a hospital GPR with OMFS/Implant focus seems a better idea.

 

[drhobie7]

I know my dad does PO conscious sedation. Though, does IV sedation usually requires the 2 year anesthesiology res or OMFS status? I'm guessing there's no point in going through all the trouble of the anesthesiology res?

As for learning how to do implants and cosmetics as fast as possible, do you think a 1-year GPR at a VA hospital and maybe a 1-year Cosmetics AEGD might work? It is worthwhile to learn how to do some of the crazier stuff like sinus lifts and bone grafts or are those best left to the specialists?

IV conscious sedation works great, especially for procedures that are not very stimulating, like dental implants. You can take a course or if you do over 20 cases during residency you can be eligible to get certified (that's how it is in CA). I think 1 year post grad, if you pick the right program, would be adequate. I'm sure you'd be able to find a program that would give you experience with sinus lifts and small autogenous grafts like ramus and chin. Honestly, once you do 3 sinus lifts or ramus grafts you probably won't think it's too crazy. There are tons of GPs doing these procedures who learned them from CE courses. It just depends on how aggressive you are. As long as you know what you're doing and can do a good job for the patient that's what matters.

 

[mike3kgt]

Haha, i feel like life is so complicated because there are always family expectations to take over the practice. I think what I've always wanted to do was find a way to differentiate myself from my father whom I've always lived in the shadow of.

Having said that though, I think specializing would definitely be a waste of money and effort. I'd have to spend another 1M+ to buy out a specialty practice.

Though, I guess the reason I was asking about OMFS was because I was wondering if it was an "easier" way to get the training necessary to for implants and maxillofacial surgery. However, now that I think about it, it's going about it backwards and a hospital GPR with OMFS/Implant focus seems a better idea.

Have you considered a prosthodontic residency with a surgically-oriented aspect? Everything you describe would be applicable for prosthodontics, and you can find several residencies that are great for implants for very little (comparatively) total cost compared to what you're proposing.

Then you could walk into your father's practice doing all the high quality restorative care you described and doing implants to add to the practice.

Keep in mind that once you go implants, you have to go all in and do 90% of cases because you risk losing your surgical specialist referrals. You can still refer out major grafting procedures, but at least indirect sinus lifts and IV sedation should be apart of your skill set.

 

[Stroszeck]

I agree with mike3gt. If you really want to do cool stuff and focus on implants and cosmetics as well, NOTHING will prepare you like a great prosthodontics residency. I think prosth has become the best kept secret in dentistry and the one prosthodontist I know not only gets TONS of referrals, but makes lots of $$$ and does fabulous, incredibly complicated (sometimes) cosmetic cases. And I believe the residencies are pretty low key in the sense that you aren't wasting time on call doing trauma and all that but spending time learning all about stuff like implants and roundhouse porcelain bridges and what not. Great idea.

 

[cybermech]

Have you considered a prosthodontic residency with a surgically-oriented aspect? Everything you describe would be applicable for prosthodontics, and you can find several residencies that are great for implants for very little (comparatively) total cost compared to what you're proposing.

Then you could walk into your father's practice doing all the high quality restorative care you described and doing implants to add to the practice.

Keep in mind that once you go implants, you have to go all in and do 90% of cases because you risk losing your surgical specialist referrals. You can still refer out major grafting procedures, but at least indirect sinus lifts and IV sedation should be apart of your skill set.

I agree with mike3gt. If you really want to do cool stuff and focus on implants and cosmetics as well, NOTHING will prepare you like a great prosthodontics residency. I think prosth has become the best kept secret in dentistry and the one prosthodontist I know not only gets TONS of referrals, but makes lots of $$$ and does fabulous, incredibly complicated (sometimes) cosmetic cases. And I believe the residencies are pretty low key in the sense that you aren't wasting time on call doing trauma and all that but spending time learning all about stuff like implants and roundhouse porcelain bridges and what not. Great idea.

I actually hadn't even thought of this option. I had always traditionally thought that Prosthodontics was more about learning the advanced aspects of prosthesis rather than the surgical placement of implants. If I could find a residency that did cover implants, that'd be ideal.

Though I still am wondering if trying to learn it one program (ie. prosth) would be preferable over 2 separate GPRs (ie. implant + esthetics). Though, I'm definitely looking at prosth if I can get it all in one place.