OMFS length of training worth scope of practice?

[fug]

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I just started dental school, and already I've started thinking about the possibility of specializing in OMFS.

From my understanding, the bulk of OMFS private practice work comes from "shucking thirds."

What would the profession look like if people didn't need their wisdom teeth removed anymore? What other procedures do oral surgeons perform on a regular enough basis to justify 4-6 extra years of training?

I know it's an ignorant question on my part, and I'm not trying to bash OMFS. Also, I know that there are vastly more complicated procedures than wisdom tooth extractions that oral surgeons do perform, so please don't list them all for me. My question is not, "what else do oral surgeons do with their time?" but "what else could oral surgeons do to justify 4-6 years of extra training, if everything about the current patient pool remained constant except for the need for wisdom teeth to be removed."

Thanks!

 

[flapaTron]

I just started dental school, and already I've started thinking about the possibility of specializing in OMFS.

From my understanding, the bulk of OMFS private practice work comes from "shucking thirds."

What would the profession look like if people didn't need their wisdom teeth removed anymore? What other procedures do oral surgeons perform on a regular enough basis to justify 4-6 extra years of training?

I know it's an ignorant question on my part, and I'm not trying to bash OMFS. Also, I know that there are vastly more complicated procedures than wisdom tooth extractions that oral surgeons do perform, so please don't list them all for me. My question is not, "what else do oral surgeons do with their time?" but "what else could oral surgeons do to justify 4-6 years of extra training, if everything about the current patient pool remained constant except for the need for wisdom teeth to be removed."

Thanks!

it seems that your interest in oral surgery precedes your knowledge of what the career actually entails.

best solution - go to your OMS clinic at your school (Assuming your institution has one) and shadow the residents. go to the OR and see the cancer resections and craniofacial aspects. see what goes on first hand rather then listening to random ******s on this forum (myself included) tell you.

 

[fug]

best solution - go to your OMS clinic at your school (Assuming your institution has one) and shadow the residents.

The only problem with that is I wouldn't be getting a realistic sense of the procedures performed in private practice.

Like I already said, I'm not looking for someone to tell me what oral surgeons can do. If I were to observe oral surgery residents in training, of course I would see many of the procedures they are required to perform in an academic setting, but that wouldn't tell me anything about the public demand for those procedures in private practice. Maybe I should go talk to an oral surgeon in private practice about this, but I thought I would defer to the infinite wisdom of SDN first 😉.

Again, my question is, if no one needed wisdom teeth extracted anymore, would oral surgeons in private practice have enough other procedures to perform to stay in business?

 

[flapaTron]

Again, my question is, if no one needed wisdom teeth extracted anymore, would oral surgeons in private practice have enough other procedures to perform to stay in business?

Rest assured, third molars aren't going anywhere evolutionarily speaking 😉

It is true that 3rd's can be pulled by periodontists / Gp's who are comfortable with the wide array of complex presentations, but generally speaking, OMS's are (in my opinion) the primary dentists who manage 3rd's.

as far as private practice, it's arguable that 3rd's make up the bulk, but there are a bunch of dentoalveolar (e.g. apicoectomies) procedures and small benign pathologies that are managed in an office. and an obvious big one = implants...but everyone is doing those.

 

[drhobie7]

I know a fair number who do arthroscopy, orthognathic, cosmetics, complex bone grafting (tibia, cranium), complex implants (zygoma and pterygoid), trauma, and non malignant tumor and cyst resection/enucleation. It just depends on what you want to do, were trained to do, feel comfortable doing, and how much $ you want. If you want the most $ with the shortest program endo is the winner.

 

[Regmata]

You asked what else could oral surgeons do if the wisdom tooth market were to dry up...well, any of the procedures that you would see if you were to stroll on down to your school's OMFS program and ask around or observe for awhile. If you wanted to know more about the scope of practice of OMFS, you could always go to the AAOMS site, any number of academic programs websites or you could look for a private practice OMFS that keeps a website. A little bit of effort on your part would open flood gates of knowledge into the subject.

Since the third molar market hasn't dried up and it is most profitable, that is where the vast majority of OMFS's spend their time. There are very few OMFS in private practice who spend the majority of their time doing something other than third molars, who are not also fellowship trained. Thus, you probably won't find much of an answer out there.

There is an incredible amount to learn while becoming an OMFS, believe me...the 4-6 years of training is just the beginning of your learning if you are able to enter a training program and the opportunities to vary your practice are out there. Much of it has to do with how you market yourself.

 

[fug]

You asked what else could oral surgeons do if the wisdom tooth market were to dry up....A little bit of effort on your part would open flood gates of knowledge into the subject.

I agree that I could put a little more effort into figuring this out, but to be fair, a second reading of my question would show that I was asking what oral surgeons in private practice could do if the wisdom tooth market dried up and everything else about the current patient pool remained constant. I stated that part explicitly.

If oral surgeons in private practice aren't currently performing loads of other procedures due to lack of demand for them, then obviously oral surgeons could not simply choose to do those procedures more often to make up for lost income.

That being said, thank you for your response. I'm not concerned that people are suddenly going to stop needing/wanting their wisdom teeth extracted. I do wonder, though, what would happen if public sentiment about preemptive wisdom tooth extraction were to change over time, or if other specialties were to expand their scope of practice to include that procedure.

 

[drhobie7]

I generally feel demand for traditional OMS surgical procedures (joint, jaw, trauma, path, teeth, grafting) will not diminish with time. There has been an effort from some in the public health community to stop prophylactic extraction of wisdom teeth. This didn't seem to gain ground. The types of surgeries OMS do has changed throughout the years, and this was often driven by finances. Orthognathic surgery and TMJ surgery are prime examples. Insurance reimbursement was once much higher and a great many private practice surgeons were doing orthognathic and joint surgery regularly. When reimbursement fell, fewer people were doing it. Dental implants used to pay $2.5-5K per implant and surgeons were reaping huge paydays. Now everyone does implants and some surgeons charge less than $1K per implant. The best defense against this is broad training so you can adjust the surgical composition of your practice if the need should arise. You never know, there may come a day when orthognathic and joint surgery experiences a resurgence in private practice. However, changes like this will likely be market driven. One thing is for sure, the pathology that affects the regions OMS cover will not go away.

 

[Regmata]

I agree that I could put a little more effort into figuring this out, but to be fair, a second reading of my question would show that I was asking what oral surgeons in private practice could do if the wisdom tooth market dried up and everything else about the current patient pool remained constant. I stated that part explicitly.

I explicitly answered that question as well, maybe you need a second reading of my reply.

 

[Sonny881994]

You sounds like the ignorant wanna be dental student who think they can specialize in whatever they want to...just saying. Wisdom teeth is a big portion of an Oral surgeon works but it's certainly not the only thing. Many oral surgeons are employed by hospital and i'm sure people don't go to hospital for wisdom teeth extraction, they go for something else. Therefore, it's safe to say that oral surgeon (especially those who work in clinic setting) can do many things with their time beside wisdom teeth. I'm not gonna list those things because you said you don't want to know. You just started dental school so just slow down a little bit. You may not even make it to the top of your class, let alone thinking about specialize in oral surgery.....time to get back to the reality kid

 

[jeffity]

You sounds like the ignorant wanna be dental student who think they can specialize in whatever they want to...just saying. Wisdom teeth is a big portion of an Oral surgeon works but it's certainly not the only thing. Many oral surgeons are employed by hospital and i'm sure people don't go to hospital for wisdom teeth extraction, they go for something else. Therefore, it's safe to say that oral surgeon (especially those who work in clinic setting) can do many things with their time beside wisdom teeth. I'm not gonna list those things because you said you don't want to know. You just started dental school so just slow down a little bit. You may not even make it to the top of your class, let alone thinking about specialize in oral surgery.....time to get back to the reality kid

Says the high schooler to the dental student...

You kicked up a 5-month old thread just to talk down to the OP? If you were a dentist, resident, or even a dental student that would be one thing, but you're still in high school. Of course you're entitled to opinion and commentary and we're all free to post in any forum we want--that's what drives the site. But you should consider a little more tact and respect in doing so.

 

[fug]

You sounds like the ignorant wanna be dental student who think they can specialize in whatever they want to...just saying.

Haters gonna hate, I suppose.