Periodontics Facts - Future of Perio

Discussion in 'Dental Residents and Practicing Dentists' started by P7898, Mar 11, 2018.

  1. P7898

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    Hey everyone! Just an incoming first year shadowing a bunch before school starts..... I have a lot of free time on my hands and I have fallen curious about Perio. It seems like an awesome specialty! I was wondering if there are any residents/students/practicing periodontists that would not mind sharing their thoughts and experiences with the profession! Thank you!
     
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  3. thewingman

    thewingman Probationary Status
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    From a financial aspect, I think Perio will likely slow down in the next decade or so. More general dentist are placing implants and performing simple bone graft procedures. Oral surgeons are performing more complex graft and implant cases. Aside from implants, perio really doesn't have high reimbursement procedures. If I were looking for a surgical speciality, I would opt for OMFS - why limit yourself with perio?
     
  4. P7898

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    I was an OMFS assistant for a year before dental school and I have been thinking about it. My best friends dad is an OMFS and loves it but I was just wondering about Perio. It is cool the kind of surgeries and procedures that they do. It seems like it is pretty good still from the recent ADA numbers.
     
  5. Manic324

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    The ADA numbers are bs propaganda for pre dents who think that making tons of money as a general Dentist is the norm. I wouldn’t believe any of their numbers for any of the specialties.
     
  6. P7898

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    Yeah I figured any online service cannot accurately reflect income. Like for my friends days (3 practices Oral surgeon...that ADA number is way low). however I shadowed a dentist in a very urban area that did not see a lot of patients...that ADA number to high. Anyways your thoughts on perio Manic 324?
     
  7. Manic324

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    I think you should just talk to as many perios as you can I think that’s the only way to get an accurate idea. The ones I’ve interacted with are all doom and gloom about perio dying and discourage it unfortunately. Some have been in practice for a million years so I don’t know if they’re not keeping up or what the problem is (if it’s truly not in demand any more). I think most private practice perios just push implants though and that doesn’t sound like a very appealing lifestyle, to me at least.
     
  8. P7898

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    Yeah when I was shadowing I saw a gum graft, 3 implant cases, and a couple consults. I mean from the looks of it, it looked pretty relaxed. I agree that the bulk is mostly implants and that it maybe harder and harder to get referrals every year. But what is someone just wants to be an implant/soft tissue specialist?
     
  9. PTSD

    PTSD New Member
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    I would not recommend perio as a long term goal. If you read the statistics about periodontal disease and how many people over the age of 50 have at least one pocket greater than 5mm (meaning you can't effectively SRP it) and how many people have dm2 ect you may think perio has potential. However, due to saturation of dentists and student loan debt, it's difficult to find gps who believe in referring periodontal disease/recessions. They keep the patient on perio maintenance and don't even dx recessions because if they refer the wallet, I mean patient, they may lose money. If you check out dentaltown, the general attitude is it's ok to have failure after failure (implants, gbr, sinus lifts) as long as you are just learning. It's better to do surgery after a weekend course + youtube and have the procedure fail then refer it out and lose money. Although the Oregon State Dental Board had to set up and the "Dental Implant Safety Workgroup" because of the dramatic spike in board complaints/malpractice (google the memo) resulting from weekend courses, its not going to change. If you can find 15-20 dentists in your community who don't treat patients like weekend course guinea pigs and believe in treating recessions and pockets greater than 5mm you'll be in good shape. It's just finding dentists who are honest with their patients about their perio needs and not under ethics blurring financial pressure is becoming harder and harder.
     
  10. P7898

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    PTSD great post. I agree with everything you are saying. I am in NC and thank the lord dental school is not crazy expensive here....however the 99% of out of state schools pumping out GPs, I think it will be a hard time to find referrals then. I find it interesting though that a lot of Perios do a bunch of implants. Do you think that will last?
     
  11. 2TH MVR

    2TH MVR Orthodontist
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    I find this humorous. Reading SDN would lead everyone to think that any specialty besides OMFS is dead. 1st ortho is dead. Then endo. Now perio is also dead. There are reports that Pedo is over-saturated or will be. Everyone seems to be heading the OMFS route ... which of course .... in time will be saturated also. Someone should tell all those talented students that are applying to all these specialty programs.
     
  12. lamemrsa

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    Lol don’t worry, plenty on here think OMFS is dying too since GP’s can extract and do implants
     
    #11 lamemrsa, Mar 12, 2018
    Last edited: Mar 12, 2018
  13. Medin2017

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    Hey not to start another omfs vs other debacle but can you explain why you think saturation will occur if no residency positions open up? People in medicine think derm has the best lifestyle balance, but only 400 or so dermatologists graduate per year due to residency positions not opening up, so the field never got saturated despite that belief.

    I'd also like to throw out that due to a few personal reasons, I'm now open to more opinions and am starting to realize that I may not want to pursue a 4-6 year residency after dental school, so I'm not as stubborn as I was in the past. I'm all ears and I apologize for past assertions or conflicts I may have started.
     
  14. 2TH MVR

    2TH MVR Orthodontist
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    You're good. Don't worry about it. You're suffering from PARALYSIS BY ANALYSIS. You get so much information here and most of it is anecdotal. Anecdotal or personal life experiences are fine if you take them with a grain of salt. Most are opinions not based on more than personal experience. But these real life experiences are good to know as long as you view them as individual experiences, not necessarily what everyone experiences.

    Funny. I never had access to this type of information. Probably a good thing since I had no idea how to get into dental school or if my future profession would be good or bad. I still believe that ignorance is bliss. Some success is better than no success.

    I believe the reason for fewer referrals to specialists is mostly a convenience issue with the patients. Patients develop a strong rapport with their GP and if their GP can do the procedure ....why would they want to go see a specialist. On the other hand ... I am biased. I'm currently retreating MANY patients that were treated with aligners thorough their GP. What pisses me off is the patient is the one that loses in these situations. If a GP wants to handle certain specialized treatments ... then it better be more than just handing a patient a bunch of aligners and hoping for the best. Patients unfortunately cannot tell if their treatment was average or could have been better with specialized treatment.

    As for my comment about OMFS becoming saturated in time. Well ... it's just an opinion about the future. When I was in DS .... OMFS and Ortho were the two most sought after specialties that attracted the best, most qualified students. Ortho was less time (2-3 yrs as compared to OS 4-6 yrs) which made ortho more appealing causing more to go into ortho. Now ortho is over-saturated. If the general consensus here is that Ortho, Endo, Perio is dead .... where are all the specialty bound students going to go? OMFS. Private dental schools/hospitals will see an economic opportunity and they will find a way to charge obscene tuition to churn out more OS. It happened to ortho. It could very well happen for OS.

    Conclusion. Nothing is a sure thing. Choose a profession that you will be happy in. Being a dentist or specialist is not a ticket to fame and riches.
     
  15. Medin2017

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    Thanks for the detailed reply. True, we really can't predict the future.
     
  16. P7898

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    Great post! Any specific advice or information on Perio?
     
  17. THS

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    Oral/Maxillofacial Radiology is DEAD as a specialty. Too many dentists are interpreting their own radiographs these days...
     
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  18. 2TH MVR

    2TH MVR Orthodontist
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    Are there any periodontists on this forum? It would be interesting to hear their take although I'm sure it will be a recurring theme.
     
  19. P7898

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    I agree; I would like to hear from practicing Perios! In addition what is a typical class rank to be competitive for Perio?
     
    #18 P7898, Mar 14, 2018
    Last edited: Mar 14, 2018
  20. charlestweed

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    I remember when my wife applied for perio, many of her older GP friends told her not to do it because they rarely referred patients to perio and that perio is a dying specialty etc. She didn’t want to be a GP because there were already too many GPs here in CA. She chose perio through the process of elimination: her GPA and board score were not high enough for ortho and OS, endo programs require GPR or work experience, and prosth...nobody refers to prosth. I don’t think she chose perio because she loved it….nobody likes working. She actually wanted to be an ortho like me.

    When she decided to buy a dying existing perio practice that didn’t do any implants, her upperclassmen and co-residents advised against it. Again, she didn’t listen to them and bought it. When she took over the practice, she started going door to door to meet referring GPs to teach them how to restore implants. She helped the GPs with implant tx planning, making provisional restorations, and educating the patients etc. She got so busy with the implants that she had to refer the time consuming scaling/root planning procedures back to the GPs. Once you are successful and no longer have loans to pay back, you can do whatever you like. That’s the beauty of being a specialist….complete autonomy.

    As our kids got older and need help with the school works, she stopped doing marketing to the GP offices and her schedule became lighter and lighter. Now she only has enough patients to work 3-4 days/month (used to be 12 days/month 5-6 years ago) at her own office. For the other days of the month, she travels to 8-9 different GP offices to place implants for them. Yesterday, she drove 30 miles to a GP office, spent 20 minutes to place 1 implant and the patient wrote her $1200 check and that’s her work day. At 44, she'd much rather travel to different GP offices than running her own office. It’s also much better than doing general dentistry for 8 hours a day, 5 days a week....and have more time for family and kids. She is now studying HS Chemistry and Math with our kids.
     
    #19 charlestweed, Mar 15, 2018
    Last edited: Mar 15, 2018
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  21. Bereno

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    OMS has been remarkably steady in the amount of training programs and the number of OMS they have been training each year. Programs have opened and programs have closed, keeping a relative constant. Also, OMS has always paid its residents a PGY salary as far as I know so charging a resident (other than a med school tuition) would be a really hard sell. That said, I am sure it could happen if the program could find a way for it to happen haha.

    OP: Anecdotally, my dental school mentor was a perio trained general dentist. He went to perio residency but after graduating he found that he was better off practicing as a general dentist who did his own perio. As 2TH MVR noted, this is my anecdotal $0.02. As far as the specialty goes, it seems perio is pushing towards being "implantologists" but this seems like a risky move if you ask me. OMS, pros, perio, endo, and GPs are all doing implants, so it will be hard to advertise as the implant specialist. That said, I think that your financial and business success has more to do with your creativity, business sense, and motivation than it has to do with your chosen specialty.

    All said and done, just go to dental school and keep an open mind when shadowing all the specialties. If you like perio, do perio!
     
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  22. P7898

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    Great reply, thank you for taking time out and writing this! I like Perio after a couple shadowing visits. The Periodontist does very well. M-Thursday about 6-7 surgeries per day (implants and gums - does own IV sedation). The rest of the day are consults. Demographics is definitely key it looks like. I think it is very much alive as a specialty however I am sure others are considered "better". Users' choice.
     
  23. studentdent00

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    That's like saying endo is a dead specialty b/c too many dentists are doing molar endos. Just doing it vs doing it right...huge difference.

    Also, OP I think perio will be the new ortho/OMFS in the next ten years in terms of competitiveness/desirability by dental students. Perios imo rule the academia, and as a specialty has the strongest tie to basic science out of all dental specialties. The specialty will probably see the most dramatic clinical breakthrough in the future.
     
    #22 studentdent00, Mar 16, 2018
    Last edited: Mar 16, 2018
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  24. P7898

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    I could see that. Is IV sedation training a new thing with Periodontists? I see that some residencies offer the training while others do not say. My Perio does IV on his own but his residency had training in it.
     
  25. kingme23

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    Nobody really knows the future and anything is possible, but I would disagree with that prediction. All they have keeping them above water at this point is implants, and implants are becoming commonplace for every specialty nowadays including GPs. Perio is the only specialty I’ve seen where lots of people practice general dentistry after their training, just doing all their own perio stuff.
     
  26. P7898

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    Does anyone know a typical class rank to match into perio? I have seen on the residency lists at least top 50%....is this accurate?
     
    #25 P7898, Mar 17, 2018
    Last edited: Mar 17, 2018

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