Oral/Dental Oncology?

[yorkiepoo]

What do you have to do to get into this field? Specialty--which one? Or get an MD?

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[crazy_sherm]

Depends what you want to do. Oral path, oral medicine, omsf are all involved but in different ways.

 

[exmike]

Depends what you want to do. Oral path, oral medicine, omsf are all involved but in different ways.

if you want to do oncology of the oral cavity, the preferred method is ENT --> Head & Neck Oncology

after all, what is the point of removing an oral tumor if you don't have the expertise to reconstruct the defect? (microvascular/head&neck onc)

 

[Dr.Millisevert]

if you want to do oncology of the oral cavity, the preferred method is ENT --> Head & Neck Oncology

after all, what is the point of removing an oral tumor if you don't have the expertise to reconstruct the defect? (microvascular/head&neck onc)

On average, yes there are more ENT H/N surgeons than OMFS H/N surgeons. However, Maxillofacial surgeons are also trained in oncology and are equally eligible to complete fellowships in H/N oncology and microvascular reconstruction. Many OMFS are involved in these types of procedures as well as ENT surgeons.

Examples:

Jonathan S. Bailey, DMD, MD, FACS

Robert A. Ord, MBBCh, BDS, FRCS, FACS

Eric R. Carlson, DMD, MD, FACS

Dr. Ward DDS, MD, FACS

Brian L. Schmidt, DDS, MD, PhD, FACS

Rui P. Fernandes, MD, DMD, FACS

 

[Dr. Dai Phan]

What do you have to do to get into this field? Specialty--which one? Or get an MD?

Hello,

Dental Oncology/Oncologist is not specialty but a so called term for a dentist who is familiar with management for patients with head and neck cancer. These dentists are often consulted to perform pre-radiation or chemotherapy dental exams, fabricate flouride trays, etc... and manage the patients before, during and after radiation/chemotherapy. This tittle sometimes is coined with a maxillofacial prosthodontist who works in a cancer hospital although it is not a recognized specialty. If someone goes around and advertise him/herself as " dental oncologist", that is decieving because there is no such thing. It is along the line of some dentists calling themselves "implantologist". DP

 

[exmike]

On average, yes there are more ENT H/N surgeons than OMFS H/N surgeons. However, Maxillofacial surgeons are also trained in oncology and are equally eligible to complete fellowships in H/N oncology and microvascular reconstruction. Many OMFS are involved in these types of procedures as well as ENT surgeons.

Examples:

Jonathan S. Bailey, DMD, MD, FACS

Robert A. Ord, MBBCh, BDS, FRCS, FACS

Eric R. Carlson, DMD, MD, FACS

Dr. Ward DDS, MD, FACS

Brian L. Schmidt, DDS, MD, PhD, FACS

Rui P. Fernandes, MD, DMD, FACS

I noticed they are all MD/DDS. If I recall correctly, you need an MD to sit for otolaryngology specialty boards, so I suppose if you are considering doing microvascular / H&N, you need a MD/DDS. As for many OMFS being 'involved' in the procedures, I'm sure it happens often, but like i said, being able to create a defect is not the same as being able to repair iit. In fact, though rare, if you are comfortable doing head & neck oncology out of otolaryngology residency, there is no requirement for you do to a fellowship to do the procedures. It really comes down to how much real exposure you get in defect repair in residency.

I think the real question is, if you can make 2-3x yanking teef as a OMFS, why would you take the paycut to do head&neck oncology.

 

[sarah_bellum]

I noticed they are all MD/DDS. If I recall correctly, you need an MD to sit for otolaryngology specialty boards, so I suppose if you are considering doing microvascular / H&N, you need a MD/DDS. As for many OMFS being 'involved' in the procedures, I'm sure it happens often, but like i said, being able to create a defect is not the same as being able to repair iit. In fact, though rare, if you are comfortable doing head & neck oncology out of otolaryngology residency, there is no requirement for you do to a fellowship to do the procedures. It really comes down to how much real exposure you get in defect repair in residency.

I think the real question is, if you can make 2-3x yanking teef as a OMFS, why would you take the paycut to do head&neck oncology.

I asked the same question (is MD required for fellowships) on the residency forums, and the answer was a "no."

 

[armorshell]

I noticed they are all MD/DDS. If I recall correctly, you need an MD to sit for otolaryngology specialty boards, so I suppose if you are considering doing microvascular / H&N, you need a MD/DDS. As for many OMFS being 'involved' in the procedures, I'm sure it happens often, but like i said, being able to create a defect is not the same as being able to repair iit. In fact, though rare, if you are comfortable doing head & neck oncology out of otolaryngology residency, there is no requirement for you do to a fellowship to do the procedures. It really comes down to how much real exposure you get in defect repair in residency.

I think the real question is, if you can make 2-3x yanking teef as a OMFS, why would you take the paycut to do head&neck oncology.

I don't believe an MD is strictly required, but there's certainly some self-selection and probably some academic "discrimination" (for lack of a better word) in there.

 

[rarm1]

I have been doing oral oncology since I graduated in 1972... as part of my Oral Medicine/Oral Pathology and Hospital training.

Treatment of ALL cancer patients (not just head and neck) is best done by a team... and all teams include dental personel.

For chemotherapy, oral lesions/mucositis is possible,
For bisphosphonates, bone lesion are common and need dental pre-eval.
and I can go on and on...

Here all head and neck patients have a dentist on the team to evaluate and treat as part of total treatment plan.

Here, since we started we bis evals... no new cases of osteo necrosis.

Our OMS works with the other surgereons to be sure the jaw will be functioning...

We are a team,

hope this helps.... or call me

 

[aphistis]

At my program (VA GPR) we see all transplants, H&N radiation, and chemo patients for pre-tx clearance as a matter of hospital protocol. We're not the ones primarily managing the patient's disease, but dental management certainly contributes to their overall care and quality of life.

 

[Dr.Millisevert]

I noticed they are all MD/DDS. If I recall correctly, you need an MD to sit for otolaryngology specialty boards, so I suppose if you are considering doing microvascular / H&N, you need a MD/DDS. As for many OMFS being 'involved' in the procedures, I'm sure it happens often, but like i said, being able to create a defect is not the same as being able to repair iit. In fact, though rare, if you are comfortable doing head & neck oncology out of otolaryngology residency, there is no requirement for you do to a fellowship to do the procedures. It really comes down to how much real exposure you get in defect repair in residency.

I think the real question is, if you can make 2-3x yanking teef as a OMFS, why would you take the paycut to do head&neck oncology.

armorshell is correct. an MD is not required for an OMFS to do a H/N oncology/microvascular reconstructive fellowship. There are 1-2 year H/N fellowships at UCSF, Michigan, Jacksonville, Miami, Knoxville, Portland, Maryland, etc. All of which will consider applications from DDS only OMFS residency trained surgeons. (these fellowships are not just ablative, but microvascular reconstructive as well) However, (and again..this is just a trend).. but it is usually the dual degree OMFS guys that "tend" as of late to apply for the H/N fellowships.. so there is some self selection involved. You are correct in suggesting that there is much more money in just setting up your own private surgery practice and yanking teeth and popping in implants... which is why usually only the OMFS guys (as well as ENT for that matter) who are truly passionate about treating H/N patients end up going into the field. 👍


Dental professionals involved in H/N care are:

General dentists: (esp those involved in AEGD or GPR programs): (just as DP stated), "perform pre-radiation or chemotherapy dental exams, fabricate fluoride trays, etc... and dentally manage the patients before, during and after radiation/chemotherapy".

Prosthodontists: Work alongside H/N surgeons to help fabricate maxillofacial prosthesis (eyes, ears, face, etc).

OMFS: Just like ENT surgeons, some finish residency training with adequate case logs of H/N patients to feel comfortable doing some of these cases.. (ablative and reconstructive)... but most who are interested end up completing a 1-2 year fellowship in this area.


Hope that helps to clearify things.