OMFS Procedures

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Hello all,

First thank you for your time, you must be busy, so I sincerely value it.

I graduated college with my BS in Microbiology spring 2014 and after teaching middle/high science and doing missionary work plus some soul searching I've come to the point where I know dental school is what would satisfy my thirst for learning and helping others, in other words I could really see myself doing it for the long run. But to be more specific not only am I attracted to dentistry but more so than anything OMFS, so that's the end goal. Now with that being said, I kinda wanted to get an idea of how much of the arsenal of procedures OMFS performs REQUIRE you to be standing? Or can pretty much all surgeries and procedures that are referred be performed sitting down? The reason I ask is because I have some lower back problems, I'm talking about more than 30min standing without a break and my back starts aching, and the longer I stand the more it hurts. I could probably tolerate up to 1.5hr before I HAVE to sit and take a break. Due to the nature of the profession which is all facial can an OMFS realistically perform all surgeries/procedures sitting or there are some that are just not practical acceptable to do other than standing? Does that mean then that I would have to just pick and choose the cases that allow to operate sitting down? What is the average length for a procedure that requires an OMFS to operate on their feet?

I'd prefer if maybe we don't go into suggesting ways to fix my back problem instead cause honestly it's just something I've had to live with (making the lines at Universal Studios was the worst) and never impeded me from playing sports, being athletic and in good health, so I don't sweat it. Also I understand the competition and hard work ahead to OMFS, and that it's early for me to even be thinking or asking about this because I am not even accepted into dental school, but fact is I'm going for it so it's just a matter of time. I believe my credentials are good so far, GPA>3.7, honors college, 2 years of research, a patent with some outside interest of licensing, published, and the other shadowing and volunteering so I don't think I am completely crazy or wishfully thinking about getting into dental school, just gotta prep for the DAT and score well.

I didn't mean for my post to get this long, but again thank you all for any input.

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Dentistry is probably the worst profession for someone with back problems before they even start. Sitting or standing, dentistry can and will break you.
 
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You can do clinic sitting down. OR is going to be a huge problem for you if 30 min is your threshold. Procedure wise the time it takes to get stuff done in the OR depends on the variable complexity of the case and skill of the surgeon. I've seen bijaw cases take 3 hours, I've also seen them take 11.
 
If you have to sit down after 1.5 hrs, you won't make it through residency. If you want to go into oral surgery then you have to find a way to be able to stand for long periods during OR procedures.
 
Dentistry is probably the worst profession for someone with back problems before they even start. Sitting or standing, dentistry can and will break you.
You can do clinic sitting down. OR is going to be a huge problem for you if 30 min is your threshold. Procedure wise the time it takes to get stuff done in the OR depends on the variable complexity of the case and skill of the surgeon. I've seen bijaw cases take 3 hours, I've also seen them take 11.
I have low back pain from 5 years of GP practice. In residency now. It hurts, but ibuprofen does wonders
If you have to sit down after 1.5 hrs, you won't make it through residency. If you want to go into oral surgery then you have to find a way to be able to stand for long periods during OR procedures.

Though disappointing, I truly appreciate the feedback. So had another curiosity, as an OMFS resident are left-handed instruments for surgical procedures usually available at programs? or do the same set work for both righties and lefties? If that is the case how big a "hassle" can that be when you go and try to practice out in the real world? I ask cause i'm lefty (very dominantly) and I searched all over the dental forums and everyone was alluding to the fact that being lefty and practicing lefty is at least not an issue during dental school being that accommodations are readily available at most schools in regards to stations/chairs and from what I gathered in the conversations it appeared to me that there wasn't such thing as a righty or lefty instrument (please correct me if I'm wrong here). However, I didn't see anyone specifically referring to this being the case when specializing after dental school (such as in OMFS). My gut tells me there would be designated instruments for lefties and righties at the level of specialization being that from what I read over in the medical forums, once in residency after medical school, left handed surgeons just learn to operate right handed because that is whom the instruments were designed for and left handed instruments are not readily available (if any) in the market with good quality.

Also, in regards to manual skills, I would venture to say (without any dental background) that I am ok/average with my hands. So my other curiosity is, if I were to do well in all of the didactic courses over my 4 years of dental school but similarly over these 4 years I was just average with my manual skills in (labs, pre-clinical, operative, etc) dental manual projects, would that possible hinder or put a stop at getting accepted into OMFS? I just think I can confidently learn and getter better with a set of skills, but I don't think I can necessarily set the bar or hit the bar manually.

Anyways, thanks again in advance for any input.
 
Hand skills can be taught. And you will learn to work from any side.

"Hands kills can be thought" as if I end up having average skills by the time I graduate dental school I can still have a decent shot at OMFS (you know so long I did well on everything else)? And "And you will learn to work from any side" as an just work on the side of the patient that allows you to use the hand you are comfortable with because the same instruments are made for both righty and lefty OMF surgeons? Thanks again for everything.
 
you should just go shadow some dentists and oral surgeons. worrying about right or left handed instruments should be the at the bottom of your list of questions for a future profession.
 
- handedness doesn't matter, there are R / L handed surgeons and you will operate simultaneously with them, the instruments are the same
- sitting down in the OR is not up to you - the attending dictates the pace of a case. If you're 2 hrs in to a Leforte you can't head for the nearest seat as the rest of the team is down fracturing the maxilla. OR cases range from 15 min to 12+ hours.
- clinic is OMFS residency is all about the hustle. 40 patients to see in a day? Leaves very little time to sit.

Try PT to help with your orthopedic issues - i've found it incredibly useful as a residency who suffered from back pain
 
- handedness doesn't matter, there are R / L handed surgeons and you will operate simultaneously with them, the instruments are the same

Thanks Anhedonia. I did find encouraging but also interesting that the instruments are the same for both R/L handed surgeons in OMF surgery, actually specifically what I find interesting is that in all other specialities coming from medical school all instruments are made for R handed surgeons and naturally left handed students will have to practice and learn that way. Do you know why OMF surgery is special in this way? Sorry if I'm bugging, but I am just curious.

- sitting down in the OR is not up to you - the attending dictates the pace of a case. If you're 2 hrs in to a Leforte you can't head for the nearest seat as the rest of the team is down fracturing the maxilla. OR cases range from 15 min to 12+ hours.

From your experience what is the average length of procedures during OMFS residency? Do you see the average length possibly go down once out of residency due to the less academic scope? What would you say is the average length then? Also what would you say is the typical breakdown ratio of OMFS procedures that are done standing vs sitting down both in residency and after residency?
 
- clinic is OMFS residency is all about the hustle. 40 patients to see in a day? Leaves very little time to sit.

Try PT to help with your orthopedic issues - i've found it incredibly useful as a residency who suffered from back pain

The reason I ask is because I'm thinking I can probably find ways to alleviate some strain (like you suggested) and just eat it during residency but then have more autonomy on the cases I do after residency so I can save what would be left of my back lol. Again thank you for your feedback, it is truly helpful for someone like me.
 
The instruments are not an issue for left handed people in OMFS or dentistry in general. The tools are often symmetric. Do screwdrivers, pliers, or hammers give you problems? I should think not. Google some surgery instruments and you will see. The few instruments that do have an asymmetric nature are either double headed (curettes) or come in twos (east/west elevators). That's not for the benefit of left handed people, though, it's because both functions are necessary regardless of handedness of the operator. Forget about being left handed, it couldn't be less of an issue in any medical field.

The standing thing is an issue, mostly in residency. Once you get into practice you'll have a lot more control. I know some OMFS that almost exclusively sit for their office procedures. And the OR would be manageable as an attending, especially if you keep your schedule light and/or work with residents and can take breaks.

You should seriously seek physical therapy though. I had severe lower back pain for many years that made long car trips, and standing and what not very painful after a period of time. I worried about a career in dentistry. Core exercises and stretching have eliminated that problem for me. Don't let it hold you back. Take care of yourself and practice good ergonomics.
 
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Hello all,

First thank you for your time, you must be busy, so I sincerely value it.

I graduated college with my BS in Microbiology spring 2014 and after teaching middle/high science and doing missionary work plus some soul searching I've come to the point where I know dental school is what would satisfy my thirst for learning and helping others, in other words I could really see myself doing it for the long run. But to be more specific not only am I attracted to dentistry but more so than anything OMFS, so that's the end goal. Now with that being said, I kinda wanted to get an idea of how much of the arsenal of procedures OMFS performs REQUIRE you to be standing? Or can pretty much all surgeries and procedures that are referred be performed sitting down? The reason I ask is because I have some lower back problems, I'm talking about more than 30min standing without a break and my back starts aching, and the longer I stand the more it hurts. I could probably tolerate up to 1.5hr before I HAVE to sit and take a break. Due to the nature of the profession which is all facial can an OMFS realistically perform all surgeries/procedures sitting or there are some that are just not practical acceptable to do other than standing? Does that mean then that I would have to just pick and choose the cases that allow to operate sitting down? What is the average length for a procedure that requires an OMFS to operate on their feet?

I'd prefer if maybe we don't go into suggesting ways to fix my back problem instead cause honestly it's just something I've had to live with (making the lines at Universal Studios was the worst) and never impeded me from playing sports, being athletic and in good health, so I don't sweat it. Also I understand the competition and hard work ahead to OMFS, and that it's early for me to even be thinking or asking about this because I am not even accepted into dental school, but fact is I'm going for it so it's just a matter of time. I believe my credentials are good so far, GPA>3.7, honors college, 2 years of research, a patent with some outside interest of licensing, published, and the other shadowing and volunteering so I don't think I am completely crazy or wishfully thinking about getting into dental school, just gotta prep for the DAT and score well.

I didn't mean for my post to get this long, but again thank you all for any input.


Hate to be the bearer of bad news ...

From the time you start residency to the very end, a good portion of your time will be spent in the OR , whether in an assistant capacity or as the primary operating resident. I went to a full scope program, and surgeries - orthognathic, cancer, cleft, etc require you to be on your feet for several hours at a time (2-15+ hours). Even if you don't have any baseline orthopedic/back issues, you will still feel a burn after you have tackled a long case. . I'm not an orthopod, but most causes of LBP are progressive, and OS is a career in which your body is put to the test on a regular basis. I don't know any OS who performs the majority of their procedures from a sitting position. The majority are on their feet for several hours at a time. This is a cold hard fact.

Whats the cause of your back pain? Ankylosis spondylitis? osteoarthritis? herniated intervertebral disc? Perhaps there is a nonsurgical modality that can help you. 4-6 yrs of residency however will worsen any issues you have now. Trust me. Had no LBP issues at the start of residency, now I've taken to yoga, etc to help me along as I shuffle through my week in clinic (50-60 hours work week).
 
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The instruments are not an issue for left handed people in OMFS or dentistry in general. The tools are often symmetric. Do screwdrivers, pliers, or hammers give you problems? I should think not. Google some surgery instruments and you will see. The few instruments that do have an asymmetric nature are either double headed (curettes) or come in twos (east/west elevators). That's not for the benefit of left handed people, though, it's because both functions are necessary regardless of handedness of the operator. Forget about being left handed, it couldn't be less of an issue in any medical field.

The standing thing is an issue, mostly in residency. Once you get into practice you'll have a lot more control. I know some OMFS that almost exclusively sit for their office procedures. And the OR would be manageable as an attending, especially if you keep your schedule light and/or work with residents and can take breaks.

You should seriously seek physical therapy though. I had severe lower back pain for many years that made long car trips, and standing and what not very painful after a period of time. I worried about a career in dentistry. Core exercises and stretching have eliminated that problem for me. Don't let it hold you back. Take care of yourself and practice good ergonomics.

Thank you so much Volfram for your valuable input, I will take your advice. I can handle screwdrivers, pliers and hammers :thumbup:
 
Hate to be the bearer of bad news ...

From the time you start residency to the very end, a good portion of your time will be spent in the OR , whether in an assistant capacity or as the primary operating resident. I went to a full scope program, and surgeries - orthognathic, cancer, cleft, etc require you to be on your feet for several hours at a time (2-15+ hours). Even if you don't have any baseline orthopedic/back issues, you will still feel a burn after you have tackled a long case. . I'm not an orthopod, but most causes of LBP are progressive, and OS is a career in which your body is put to the test on a regular basis. I don't know any OS who performs the majority of their procedures from a sitting position. The majority are on their feet for several hours at a time. This is a cold hard fact.

Whats the cause of your back pain? Ankylosis spondylitis? osteoarthritis? herniated intervertebral disc? Perhaps there is a nonsurgical modality that can help you. 4-6 yrs of residency however will worsen any issues you have now. Trust me. Had no LBP issues at the start of residency, now I've taken to yoga, etc to help me along as I shuffle through my week in clinic (50-60 hours work week).

yeah not exactly sure what is wrong with my back, I will seek some help and live healthier. I would try and get into an OMFS internship before I apply to residency that should give me an idea of what I can handle what I can tweak to alleviate any pain. Thank you so much for your feedback Localnative.
 
Overall, I think I've gotten a better idea now. Thank you all that responded, I sincerely appreciate you taking your time to help me. Hope you're having a good one.
 
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