Periodontists claiming to be Oral Surgeons...?

[C.elegans]

First of all, this is in no way meant to cause any conflict between the two specialties. I just happened to come across something interesting on the internet and wanted to see what people have to say about this.

So, I was browsing through some websites of dental offices in NY, and found an office claiming they have an associate oral surgeon who is at the forefront of oral surgery and practices the "full scope" of oral surgery. It turns out that this so called oral surgeon is a periodontist and what they meant by full scope oral surgery was third molar extractions, implant surgery, sinus lifts, and minor bone grafting.

So this begs the question... is the title of Oral Surgeon protected or can anyone who practices in-office type minor oral surgery call themselves oral surgeons.... I get that the bread and butter procedures that private practice OMFS and periodontists do these days are pretty much identical. I was, however, under the impression that, like in medicine, a certain type of surgery such as plastic surgery can be used accordingly with the procedure in question regardless of specialty, but the title "Plastic Surgeon" is a protected title. Is it just one office being dishonest and misleading, or is this a common occurrence in other parts of the country where periodontists are referred to as oral surgeons?

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[schmoob]

First of all, this is in no way meant to cause any conflict between the two specialties. I just happened to come across something interesting on the internet and wanted to see what people have to say about this.

So, I was browsing through some websites of dental offices in NY, and found an office claiming they have an associate oral surgeon who is at the forefront of oral surgery and practices the "full scope" of oral surgery. It turns out that this so called oral surgeon is a periodontist and what they meant by full scope oral surgery was third molar extractions, implant surgery, sinus lifts, and minor bone grafting.

So this begs the question... is the title of Oral Surgeon protected or can anyone who practices in-office type minor oral surgery call themselves oral surgeons.... I get that the bread and butter procedures that private practice OMFS and periodontists do these days are pretty much identical. I was, however, under the impression that, like in medicine, a certain type of surgery such as plastic surgery can be used accordingly with the procedure in question regardless of specialty, but the title "Plastic Surgeon" is a protected title. Is it just one office being dishonest and misleading, or is this a common occurrence in other parts of the country where periodontists are referred to as oral surgeons?

From what you are saying, that is completely illegal.

 

[Svart Aske]

I'm ready for this...

Joking aside, I know a few periodontists who were initially trained as "oral surgeons" abroad (understand that the training involved in becoming an oral surgeon differs from country to country). That said, what you described if accurate sounds like a violation of state dental board.

 

[Eli Manning]

Let’s be clear. A periodontist is no more a surgeon than a prosthodontist, endodontist, or general dentist for that matter. Advertising that you practice “full scope oral surgery” is misleading to patients and dangerous. Patients should seek a board certified oral and Maxillofacial surgeon to ensure the best care possible.

 

[PTSD]

A lot of super insecure OMFS guys on here always making sure everyone knows periodontists aren't surgeons. Fine. Cool. Whatever. But, much of the classic lit on sinus lifts, ridge augmentation, GTR, treatment of peri-implantitis, ect has been published by perios. Most of the related names your gp referrals will quote to you are perios. Many, if not the majority, of the biggest names on the implant/bone graft lecture circuit are periodontists. At most grad programs, perio and pros spend three years working closely together on full mouth rehabs while the OMFS guys are occupied at the hospital. At the program I attended, OS residents received zero rehab referrals from pros because they were never around and had little implant experience.

When you finally get out of residency and attend your first study club meeting, make sure to introduce yourself by proclaiming how lame you find a whole class of colleagues your gps have been working, golfing, dining, ect with for years. It will totally boost your referrals.

 

[sam shaar]

Still claiming a title you didn't earn is illegal and if you ask me that's the true insecurity, and i'll spare you a lecture on what literature OS have provided to both dentistry and medicine

 

[PTSD]

Agreed. If a perio advertises as an OMFS its a clear violation of ADA code and should be adressed. No need to spare the lecture, please share, as I’m a sponge for great lit. Much of what I know comes from the seminal publications of countless universally known oral surgeons.

 

[vellnueve]

Advertising as a full-scope oral surgeon is not only unethical, in most states it's also illegal.

A lot of super insecure OMFS guys on here always making sure everyone knows periodontists aren't surgeons. Fine. Cool. Whatever. But, much of the classic lit on sinus lifts, ridge augmentation, GTR, treatment of peri-implantitis, ect has been published by perios. Most of the related names your gp referrals will quote to you are perios. Many, if not the majority, of the biggest names on the implant/bone graft lecture circuit are periodontists. At most grad programs, perio and pros spend three years working closely together on full mouth rehabs while the OMFS guys are occupied at the hospital. At the program I attended, OS residents received zero rehab referrals from pros because they were never around and had little implant experience.

When you finally get out of residency and attend your first study club meeting, make sure to introduce yourself by proclaiming how lame you find a whole class of colleagues your gps have been working, golfing, dining, ect with for years. It will totally boost your referrals.

er

 

[PTSD]

Advertising as a full-scope oral surgeon is not only unethical, in most states it's also illegal.


er

Advertising as a full-scope oral surgeon is not only unethical, in most states it's also illegal.


er

Oh man, it’s illegal. I’m sure the DA woke a judge to issue an arrest warrant.

 

[omfsing]

A lot of super insecure OMFS guys on here always making sure everyone knows periodontists aren't surgeons. Fine. Cool. Whatever. But, much of the classic lit on sinus lifts, ridge augmentation, GTR, treatment of peri-implantitis, ect has been published by perios. Most of the related names your gp referrals will quote to you are perios. Many, if not the majority, of the biggest names on the implant/bone graft lecture circuit are periodontists. At most grad programs, perio and pros spend three years working closely together on full mouth rehabs while the OMFS guys are occupied at the hospital. At the program I attended, OS residents received zero rehab referrals from pros because they were never around and had little implant experience.

When you finally get out of residency and attend your first study club meeting, make sure to introduce yourself by proclaiming how lame you find a whole class of colleagues your gps have been working, golfing, dining, ect with for years. It will totally boost your referrals.

First off, no one is being insecure or bashing periodontists or any other profession in this post. Where is all your hostility coming from? But you go on bashing OMFS and act like you know what our training entails. You did not even address the original poster's question.

 

[PTSD]

Actually, an early poster commented that a periodontist is no more a surgeon than an endodontist or a gp, It’s a typical pattern when perio is discussed on this site and I shouldn’t have taken the bait. Btw, I did mention in an earlier post in this thread I’ve learned a great deal from the literature published by universally admired oral surgeons and a perio advertising as an os should be addressed thru ada rules/dental board along a normal grievance process. Criminal/civil prosecution due to illegality is unlikely.

 

[C.elegans]

Thanks for the input guys! I just hope that whoever owns the practice or in charge of maintaining the website is the one to blame. Not going to report this or anything in the chances that they correct their unethical and false advertisement themselves in the near future.

 

[2TH MVR]

This is interesting. Oral surgery is a broad, general descriptor term. DDS = doctor of dental surgery. Doing anything in the oral cavity can be considered oral surgery. The Periodontist apparently is trained to do those procedures. I'm not agreeing with this tactic because I despise these grey area ads to a misinformed public. OMFS is an accepted specialty title. Not so sure oral surgeon is.

 

[Eli Manning]

A lot of super insecure OMFS guys on here always making sure everyone knows periodontists aren't surgeons. Fine. Cool. Whatever. But, much of the classic lit on sinus lifts, ridge augmentation, GTR, treatment of peri-implantitis, ect has been published by perios. Most of the related names your gp referrals will quote to you are perios. Many, if not the majority, of the biggest names on the implant/bone graft lecture circuit are periodontists. At most grad programs, perio and pros spend three years working closely together on full mouth rehabs while the OMFS guys are occupied at the hospital. At the program I attended, OS residents received zero rehab referrals from pros because they were never around and had little implant experience.

When you finally get out of residency and attend your first study club meeting, make sure to introduce yourself by proclaiming how lame you find a whole class of colleagues your gps have been working, golfing, dining, ect with for years. It will totally boost your referrals.

I agree that perio has contributed a lot to the implant literature. And there are many periodontists who do amazing work. But to go advertise that you practice full scope oral surgery when you are not an oral surgeon is misleading. And it’s also disrespectful to the oral surgeons out there who busted their butt for 4-6 years to become true oral and maxillofacial surgeons. There is so much more to oral surgery than placing implants and extracting teeth. Whether or not one decides to do full scope when they enter private practice is up to that particular person. But how many periodontists are going to take a masticator space abscess to the OR for incision and drainage or treat a mandibular parasymphysis fracture? The answer is they will not because they are not oral surgeons. They are periodontists. And at the end of the day you can give 1000 CE classes about implants and write 1000 journal articles about modified Widmann flaps but if you wanted to truly be a surgeon then you should have either gone to omfs residency or gone to med school and then a surgery residency. Sorry but facts are facts

 

[PTSD]

Never met a perio who claims to be as educated as an oral surgeon. By objective definition your scope exceeds ours. When toof from dental town post a cancer case all reviewers are left in awe of his education and talent. Also, he is remarkably respectful of dental colleagues. If an isolated perio lies to his patients about qualifications, let me know so I can co-sign your complaint letter.

 

[Localnative]

I agree that perio has contributed a lot to the implant literature. And there are many periodontists who do amazing work. But to go advertise that you practice full scope oral surgery when you are not an oral surgeon is misleading. And it’s also disrespectful to the oral surgeons out there who busted their butt for 4-6 years to become true oral and maxillofacial surgeons. There is so much more to oral surgery than placing implants and extracting teeth. Whether or not one decides to do full scope when they enter private practice is up to that particular person. But how many periodontists are going to take a masticator space abscess to the OR for incision and drainage or treat a mandibular parasymphysis fracture? The answer is they will not because they are not oral surgeons. They are periodontists. And at the end of the day you can give 1000 CE classes about implants and write 1000 journal articles about modified Widmann flaps but if you wanted to truly be a surgeon then you should have either gone to omfs residency or gone to med school and then a surgery residency. Sorry but facts are facts

not sure what full scope OS is. I'll take a 'stab'. = placing implants, putting bone putty in sockets, crown lengthening, uncomplicated soft and hard tissue biopsies, tooth extractions, intraoral I and D, and on. Technically if you spend enough on airfare going to CE courses (ie flying to Mexico to work on implant patients, going to a soft tissue course hosted by "el hombre con manos doradas") you can perform a long list of oral surgery procedures. Be forewarned that there are consequences if you are a hack.

now, full scope 'omfs' = all of the above + trachs, ablative/recon surgery, trauma from vertex to clavicle, facial cosmetics (no, not just botox and restylane), orthognathics, and on.

Capisce?

 

[DrReo]

How many oral surgeons actually practice the maxillofacial aspect of surgery?

Very, very few.

What are the actual differences if they oral surgeons and periodontists do implants, thirds and IV sedations?

 

[sgv]

How many oral surgeons actually practice the maxillofacial aspect of surgery?

Very, very few.

What are the actual differences if they oral surgeons and periodontists do implants, thirds and IV sedations?

I would disagree with the i.v. sedation aspect and thirds.

How many periodontists know how to intubate or even bag-mask-ventilate? How many periodontists actually know how to read and interpret an ECG and initiate ACLS without pooping their pants? Do they even know the MOA and adverse effects of even the most common ACLS drugs? If it's standard of care in anesthesia for anesthesiologists to be prepared for the next stage of anesthesia which is general surgical anesthesia if you're administering deep sedation, what can you say about periodontists who've never managed a patient in GA? God forbid, should a patient develop a laryngospasm, how many periodontists are comfortable, let alone even know, to deepen the anesthesia which again is GA if the starting point is deep sedation. Can said periodontist proficiently bag-mask-ventilate in this situation when it matters the most? Does a periodontist even know how many cmH20 it takes to insufflate the stomach and risk aspiration during ventilation?

As a practitioner, should you perform any procedure, you should be able to manage the complications. I don't know of any periodontist who's ever repaired or managed an IAN injury.

 

[schmoob]

As a practitioner, should you perform any procedure, you should be able to manage the complications. I don't know of any periodontist who's ever repaired or managed an IAN injury.

If that's the case, what's the point of a GP? Perforating a robot goes to endo, Root tips left behind during an extraction goes to OS, etc.

 

[sgv]

If that's the case, what's the point of a GP? Perforating a robot goes to endo, Root tips left behind during an extraction goes to OS, etc.

Don't be a GP.

Just kidding. I think the whole idea of a general dentist referring a patient to the specialist is that the case is difficult enough to deserve being managed by a practitioner with the highest degree of training in that particular case (e.g. thirds). It's at the end of the line of the referring chain for which there should be a two-link chain (GP to specialist and not GP to specialist to specialist to specialist).

Your example was a GP referring to a specialist. But in this case, it's a specialist (perio) referring to another specialist (OMFS), implying that the former was referred a patient for whom he/she was not fully prepared to manage. I would say it was an inappropriate referral in the first place.

 

[Pennywisdom]

If that's the case, what's the point of a GP? Perforating a robot goes to endo, Root tips left behind during an extraction goes to OS, etc.

A GP should be able to whatever he/she's capable of, within the scope of practice, but shouldn't do a half-ass job if he/she can't manage the complications. For instance, if you think you're going to break the crown but unable to fish out the root tip, may be you shouldn't even start the process and perhaps refer the patient to someone who knows how to take care of the issue from start to finish. Think about what's best for your patient rather than trying to collect fees on something you aren't really good at.

 

[sgv]

Actually, an early poster commented that a periodontist is no more a surgeon than an endodontist or a gp.

A Guide to Surgical Specialists

I don't see periodontist anywhere on here dude...

 

[schmoob]

Don't be a GP.

Just kidding. I think the whole idea of a general dentist referring a patient to the specialist is that the case is difficult enough to deserve being managed by a practitioner with the highest degree of training in that particular case (e.g. thirds). It's at the end of the line of the referring chain for which there should be a two-link chain (GP to specialist and not GP to specialist to specialist to specialist).

Your example was a GP referring to a specialist. But in this case, it's a specialist (perio) referring to another specialist (OMFS), implying that the former was referred a patient for whom he/she was not fully prepared to manage. I would say it was an inappropriate referral in the first place.

I understand what you're saying. My point was just (respectfully) challenging your point that any procedure performed by a practitioner should be able to handle the complications. A perf or root tips are potential complications of procedures that are generally outside the scope of the GP who performed the procedure.

 

[sgv]

I understand what you're saying. My point was just (respectfully) challenging your point that any procedure performed by a practitioner should be able to handle the complications. A perf or root tips are potential complications of procedures that are generally outside the scope of the GP who performed the procedure.

You know what? Just change the word practitioner to specialist in my previous statement and it all works out.

 

[schmoob]

You know what? Just change the word practitioner to specialist in my previous statement and it all works out.

👍

 

[DocJL]

I would disagree with the i.v. sedation aspect and thirds.

How many periodontists know how to intubate or even bag-mask-ventilate? How many periodontists actually know how to read and interpret an ECG and initiate ACLS without pooping their pants? Do they even know the MOA and adverse effects of even the most common ACLS drugs? If it's standard of care in anesthesia for anesthesiologists to be prepared for the next stage of anesthesia which is general surgical anesthesia if you're administering deep sedation, what can you say about periodontists who've never managed a patient in GA? God forbid, should a patient develop a laryngospasm, how many periodontists are comfortable, let alone even know, to deepen the anesthesia which again is GA if the starting point is deep sedation. Can said periodontist proficiently bag-mask-ventilate in this situation when it matters the most? Does a periodontist even know how many cmH20 it takes to insufflate the stomach and risk aspiration during ventilation?

As a practitioner, should you perform any procedure, you should be able to manage the complications. I don't know of any periodontist who's ever repaired or managed an IAN injury.

Not sure what current training for periodontists entails.

When I did my GPR at a military hospital, we did a 2 week rotation in anesthesia.

I noted that the periodontology residents did a several month rotation, and even completely ran GA (sitting in the same spot as the anesthesiologist - on the other side of the sheet) on several cases, while being supervised by an MD/Anesthesiologist.

Even during my 2-week rotation, I was given a 15-20 opportunities to intubate a patient (it's not that difficult, I think easier so when you are accustomed to working in the oral cavity - I personally found it much more challenging to start IV lines on older pts with tissue thin skin, or obese pts where it was difficult to find a vein), and several opportunities to bag mask ventilate. I am quite certain that the periodontal residents, during their much longer rotation, received much more training and experience in these areas.

I think as with most practitioners, the level of training you receive in any given arena depends mostly on where you get your training/residency.

 

[sgv]

Not sure what current training for periodontists entails.

When I did my GPR at a military hospital, we did a 2 week rotation in anesthesia.

I noted that the periodontology residents did a several month rotation, and even completely ran GA (sitting in the same spot as the anesthesiologist - on the other side of the sheet) on several cases, while being supervised by an MD/Anesthesiologist.

Even during my 2-week rotation, I was given a 15-20 opportunities to intubate a patient (it's not that difficult, I think easier so when you are accustomed to working in the oral cavity - I personally found it much more challenging to start IV lines on older pts with tissue thin skin, or obese pts where it was difficult to find a vein), and several opportunities to bag mask ventilate. I am quite certain that the periodontal residents, during their much longer rotation, received much more training and experience in these areas.

I think as with most practitioners, the level of training you receive in any given arena depends mostly on where you get your training/residency.

If one were to argue for periodontics as a specialty to be considered qualified for deep sedation, one cannot cherry-pick what some outlier residency (although I doubt this one even exists but that's besides the point) can provide for the residents in terms of anesthesia training and then apply those privileges to all periodontists. What you can guarantee is that all graduating OMFS have at a minimum of 5 months of GA anesthesia training where the rotating residents are treated at the same level as anesthesia residents as per CODA. How much training is enough training for administering deep sedation? I don't know. There's no study, no metric, no exam to quantify this. With that said, OMFS is expanding anesthesia rotation length to possibly 9 months.

 

[Wingie]

 

[vellnueve]

I understand what you're saying. My point was just (respectfully) challenging your point that any procedure performed by a practitioner should be able to handle the complications. A perf or root tips are potential complications of procedures that are generally outside the scope of the GP who performed the procedure.

Difference being that a perf or root tip is not immediately life threatening.

 

[Eli Manning]

A Guide to Surgical Specialists

I don't see periodontist anywhere on here dude...

This^^^
Thank you, sgv, for pointing out the ACS website.
My point still stands. A periodontist is not a surgeon anymore than an endodontist or prosthodontist

 

[schmoob]

Difference being that a perf or root tip is not immediately life threatening.

Right. But like I mentioned, at the time my point was if someone performs a procedure they should be able to handle all complications. That's not necessarily the case. I never mentioned anything about life-threatening.

Honestly, OMS makes the most money and everyone knows their training is by far the most rigorous. So the need for all these OMS residents, potential residents, and future attendings to jump in to "defend their honor" with non-applicable arguments is really unnecessary.

 

[vellnueve]

Right. But like I mentioned, at the time my point was if someone performs a procedure they should be able to handle all complications. That's not necessarily the case. I never mentioned anything about life-threatening.

Honestly, OMS makes the most money and everyone knows their training is by far the most rigorous. So the need for all these OMS residents, potential residents, and future attendings to jump in to "defend their honor" with non-applicable arguments is really unnecessary.

Yeah but in this context a sedation complication is far more likely to be life threatening

 

[Pennywisdom]

Right. But like I mentioned, at the time my point was if someone performs a procedure they should be able to handle all complications. That's not necessarily the case. I never mentioned anything about life-threatening.

Honestly, OMS makes the most money and everyone knows their training is by far the most rigorous. So the need for all these OMS residents, potential residents, and future attendings to jump in to "defend their honor" with non-applicable arguments is really unnecessary.

What non-applicable arguments? Are you insinuating that people should do whatever they want, and have specialists deal with the complications? Who cares if it's a non-life threatening situation? Do they truly care for the patient before you start the procedure?

 

[schmoob]

What non-applicable arguments? Are you insinuating that people should do whatever they want, and have specialists deal with the complications? Who cares if it's a non-life threatening situation? Do they truly care for the patient before you start the procedure?

You know what? You're absolutely right. I think ALL dental work in the mandible should go to OS because Bell's is a risk anytime an IAN is administered.

Think of the patients!!

 

[DrReo]

I would disagree with the i.v. sedation aspect and thirds.

How many periodontists know how to intubate or even bag-mask-ventilate? How many periodontists actually know how to read and interpret an ECG and initiate ACLS without pooping their pants? Do they even know the MOA and adverse effects of even the most common ACLS drugs? If it's standard of care in anesthesia for anesthesiologists to be prepared for the next stage of anesthesia which is general surgical anesthesia if you're administering deep sedation, what can you say about periodontists who've never managed a patient in GA? God forbid, should a patient develop a laryngospasm, how many periodontists are comfortable, let alone even know, to deepen the anesthesia which again is GA if the starting point is deep sedation. Can said periodontist proficiently bag-mask-ventilate in this situation when it matters the most? Does a periodontist even know how many cmH20 it takes to insufflate the stomach and risk aspiration during ventilation?

As a practitioner, should you perform any procedure, you should be able to manage the complications. I don't know of any periodontist who's ever repaired or managed an IAN injury.

I hope to god they know how to bag mask. It's a basic skill taught to those who do IV sedations. If an OMFS had to intubate, you' **** your pants, like wise with perio. How often have you intubated past your anesthesia rotation of 4 months? Maybe of placed an oral airway?

Managing a patient in GA... are you serious? I do this weekly as a pediatric dentist with children admitted for bleeding conditions/oncology. Yawn. Is your horse too high?

IAN injuries are sent to the nearest academic center for any repair post managing.

Get off your high horse. Unless you stay in academia, you provide very little service different than a PP perio who is well versed in IV and places 100's of implants. Why? Because medical insurance doesn't pay for a titanium plate at 4 am or a radical neck dissection.

 

[O&MFS]

Get off your high horse. Unless you stay in academia, you provide very little service different than a PP perio who is well versed in IV and places 100's of implants. Why? Because medical insurance doesn't pay for a titanium plate at 4 am or a radical neck dissection.

It seems like there is a power struggle - not only between Perio and OS/OMFS - but also between OS (private practice) and OMFS (academia).

 

[Awarara]

what a ****ty thread. hope this thread gets closed before it keeps going and makes everyone look bad.

 

[2TH MVR]

I agree. This thread is not helping anyone. Turf wars will always exist right or wrong.

 

[schmoob]

what a ****ty thread. hope this thread gets closed before it keeps going and makes everyone look bad.

As of now it's a discussion that is tame and professional, with just a dash of snark. We are all professionals that can respectfully disagree. If things become nasty in here I'm sure a staff member will intervene appropriately.

 

[omfsing]

I hope to god they know how to bag mask. It's a basic skill taught to those who do IV sedations. If an OMFS had to intubate, you' **** your pants, like wise with perio. How often have you intubated past your anesthesia rotation of 4 months? Maybe of placed an oral airway?

Managing a patient in GA... are you serious? I do this weekly as a pediatric dentist with children admitted for bleeding conditions/oncology. Yawn. Is your horse too high?

IAN injuries are sent to the nearest academic center for any repair post managing.

Get off your high horse. Unless you stay in academia, you provide very little service different than a PP perio who is well versed in IV and places 100's of implants. Why? Because medical insurance doesn't pay for a titanium plate at 4 am or a radical neck dissection.

So you’re managing patients under GA? Do you mean you’re working on pediatric patients under GA with an anesthesiologist doing sedation? Also, have your ever had to manage a larygospasm because a bag mask alone doesn’t cut it all the time. Your pediatric dental training must have been very rigorous considering your opinions.

 

[TheDarkSSC]

So you’re managing patients under GA? Do you mean you’re working on pediatric patients under GA with an anesthesiologist doing sedation? Also, have your ever had to manage a larygospasm because a bag mask alone doesn’t cut it all the time. Your pediatric dental training must have been very rigorous considering your opinions.

No way he/she managing the patients while doing cases. To me, thats increasing the chance of having a serious medical emergency and Anesthsia is already dangerous as it is. I only do my cases at surgical centers/children hospitals with the MDs/CRNAs caring for the patient.

Maybe if they are dual trained DentalAnesth/Peds but colleagues who are only do one or the other in a practice day.

I avoid any sedation in office due to very scary, very real complications you described that a month of peds anesthesia rotation during residency would not help me in any way in an emergent situation. I know my airway management limitations

 

[Localnative]

I agree. This thread is not helping anyone. Turf wars will always exist right or wrong.

Ron Jeremy here, stepping in.

I think the guys chiming in who are already in practice have the medico-legal know-how to back up their comments. They know their limitations because in the back of most of our heads the threat of litigation is REAL. Plenty of GPs, Perio AND OS guys have learned the hard way that being unprepared when things go south will invariably lead to consequences that could potentially bleed you DRY. Funny how the turf wars are more heated between dental students on SDN.

 

[shaomfs]

Let's be real. This argument is like saying a dental hygienist is the same as a dentist. Anyone who disagrees needs to go spend a week in both departments.

 

[2TH MVR]

 

[Eli Manning]

Ron Jeremy here, stepping in.

I think the guys chiming in who are already in practice have the medico-legal know-how to back up their comments. They know their limitations because in the back of most of our heads the threat of litigation is REAL. Plenty of GPs, Perio AND OS guys have learned the hard way that being unprepared when things go south will invariably lead to consequences that could potentially bleed you DRY. Funny how the turf wars are more heated between dental students on SDN.

You’re a dental student

 

[schmoob]

You’re a dental student

No he's not.

 

[Big Time Hoosier]

Look, you’re all dentists and dentists aren’t real doctors. End of argument.

Big Hoss

 

[vellnueve]

Look, you’re all dentists and dentists aren’t real doctors. End of argument.

Big Hoss

The 6 year MD guys are...

 

[Localnative]

You’re a dental student

Lol, ok Elle Fanning... good luck with perio residency. I'll give a heads up to Arce, Baur, Waite, Kaban, Ghali, Ward & Company that you're a total douche.

 

[Big Time Hoosier]

The 6 year MD guys are...

No, they had to use the backdoor to get into medical school, so still just dentists. Might as well be a bunch of chiropractors or “naturopathic” doctors.



Big Hoss