Prosthodontics and Maxillofacial Prosthetics Mentoring Thread

[Dr. Dai Phan]

Hi all,

I will be happy to answer any inquiries related to my specialty. Anything from seeking residency training to the nature of the field and anything in between. DP

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[Dr. Dai Phan]

what are some of the better pros programs in the West?

What what I have known, UCLA, USC and USF are pretty good. DP

 

[Dr. Dai Phan]

Is is true that maxillofacial prosthodontists have a hard time getting work fulltime if they work in private practice as opposed to a hospital?

Are the practices of regular prosthodontists busy? (I ask this question because it seems that general dentists now do the work that prosthodontists historically did. Also, I don't know many people who need full mouth dentures anymore.)

I read somewhere that the average income of a prosthodontist is about $230,000. Is this true?

Do you think the future of the specialty is bright?

Besides research, what else should I do in dental school to make myself a strong prosthodontic residency candidate?

As a maxillofacial prosthodontist, your area of specialty will be doing complicated reconstruction cases both intra and extra orally. MP is NOT a speciality but a sub-specialty of prosthodontics. MP's scope of work can be full mouth reconstructions, difficult crown & bridge cases, dificult denture cases, prosthetic eyes, nose ears for patients who had head and neck cancer or fabricating oral appliances for patient with speech problems. A maxillofacial prosthodontist therefore is NOT only limited to extra oral prostheses but can do everything that a regular prosthodontist does. Therefore, a MP does NOT need to be in a hospital setting to practice his specialty. However, if one only wants to practice EXCLUSIVELY in the field of MP, then he/she needs to be near or in a Medical Center that deals with Head and Neck Cancer. If you open your office doing only MP, you will soon be broke! Thanks the Lord that although oral cancer is a very serious disease, it is not common. All MPs I know even in Medical Centers (cancer centers) have their fair share of regular patients too.

It is true that many GPs do the more complicated cases but there are plenty of them who would not want to be bothered with such complicated jobs. Thus, these patients are referred to the prosthodontists. You should also know that prosthodontists don't just sit around and wait till some GPs feed them patients. That is a myth. Prosthodontists advertise and get their patients just like any other restorative dentists do.

The salary of prosthodontists according to the ADA is above 200,000 so yes, that is right to assume. Remember that this is the average figure. I know some who haul in 500K while others barely above 100K mark.

The majority of dentistry procedures are in restorative business so yes, the future is bright for prosthodontists.

If you think about specializing in pros. you need to have above average class rank, board scores and demonstrate ability to excell in restorative procedures. You must also show you have the eyes for details and enjoy tacking difficult restorative challenges. DP

 

[Dr. Dai Phan]

I am a current perio resident and am heavily considering applying for a prostho residency spot a year or so after graduating. I have really begun to enjoy the restorative aspect of dentistry and would like to further my career by supplementing my periodontal education with formal prosthodontic training. I believe this would help me in treatment planning and treating very complex full mouth rehabs. I also intend on teaching later in my career and dual training would, I believe, assist in this goal. Any advice or feelings you have for this somewhat odd situation would be greatly appreciated.

I have seen some pros residents who had completed the perio and wanted to have further training in difficult restorative cases. You will be a very competitive applicant when comes to seeking faculty postion. Complete also a maxillofacial fellowship and you will be golden! Don't worry about being "odd". Specialize in multiple specialties is more common than you think. DP

 

[Dr. Dai Phan]

I know each school is different, but in general what are some ballpark numbers of crown/bridge, implant cases, partials, completes, maxillofacial prosthesis I can expect to do in a 3 year pros program? The more the merrier.

It has been over 10 years since I started my pros. residency so I cannot recall the numbers of cases even in ball park figures. Your best bet is to call the PD and ask them directly. I assure you that you will do plenty to be efficient in all restorative procedures. DP

 

[Dr. Dai Phan]

Do you have any suggestions when it comes to writing a personal statement for prosthodontic residency applications. As I'm working on my applications it seems the Essay is proving to be the most difficult part. Thanks!

Write it up and let me see it. DP

 

[Dr. Dai Phan]

Hi Dr. Phan,

I'm assuming getting a residency in Prosthodontics is similar to that of other dental specialities?

-Good board scores (~90%??)
-Good class rank (Top 10-20%??)
-Research (how important is it?)
-Externship (how important is it?)

(1) What other factors am I missing?

(2) What else is required for one to be successful in getting into a good Prosthodontics program?

(3) How many years is a Prosthodontics residency?

(4) What do you do during your Prostho residency? Are there more exams to be taken after NBDE part II if you want to do Prostho?

(5) As a Prosthodontist, are you allowed to do root canals and all the things GP's do (assuming you don't advertise yourself as a specialist?)

(6) Assuming you are allowed to do all the procedures that a GP does, how common is it for a prosthodontist to be concerned with these procedures? Are you just so busy doing implants and other restorative procedures that you don't worry about these GP procedures?

(7) Is it difficult to establish a patient base if you don't advertise as a specialist? For you personally, do most of your patients come via referrals from GPs or from your own advertising?


Thank You.

Prosthodontic specialty is not as difficult to get in compared to others such as endo, oral surgery and orthodontics. This is because many students do not enjoy doing lab work or tackling complicated reconstruction cases. Therefore, the number of applicants to a certain pros. residency is not as numerous as the above three specialties. International students do find pros. program very appealing since getting the training will allow them to understand the US approach to restorative dentistry that is unavailable in their home countries. So while it is not AS difficult to get in, it still require you to have above average credentials. Pending on the year and the quality of the applicants to a certain program, you may get in with average class rank and Board scores or you may even get rejected at a 90 + NB or first in class. To be competive, you need upper 80s in NB and top 30%. One thing about pros is having excellent hand skill because the residency is doing lots and lots and lots of lab work. If you struggle waxing up a molar at the time of graduation, you will struggle in the residency. Mark my words for it! So in addition to having good rank and board scores, you have to show that you can do EXCELLENT lab work and have completed some difficult cases that others can't. I can't stress enough the importance of having excellent hand skill. Your ability to graduate depend on this factor. Forget about research or externship activities as they can be important but not required.

Prosthodontic residency is a three year long that may lead to a Masters of Science degree. I strongly encourage you to get a Masters if your residency offers it. You will learn the principles of restorative dentistry as well as applying those principles to your patients. There is no National Boards to take in your residency but you must pass the exams set forth by the PD to get the certificate. If you do not advertise as a prosthodontist, you can do anything you wish. However, you will be busy with with other complex cases that most likely you would not want to do GP procedures such as cleaning or simple fillings. Since prosthodontist is a restorative dentist, you will have no problems getting patients. DP

 

[Dr. Dai Phan]

Dear Dr. Phan,
I am currently writing my essay for a prosthodontics residency. I've noticed on a previous post that you offered to read someone's essay.
I could also use a little help if you don't mind...
Thank you,
Joanna

I will be honored to help you. DP

 

[Dr. Dai Phan]

Hi Dr. Phan,
Thank you for your help. I decided to take up on your advice and stay with dentistry for now.
I'd like your opinion on two subjects:
1) the Massad denture technique, http://www.joemassad.com/
My weakness has always been complete dentures. I'm considering taking C.E. from Dr. Massad. Any other suggestions?
2) I notice many dentists prep PFM crowns with knife-edge margins, which was never taught at my school. Would you only resort to knife-edge margin for extremely difficult PFM prep (i.e. the tooth is way back, patient has difficulty opening, strong tongue, severe gag reflex, etc?
Thank you!
Tina

Hello,

Thank you for asking your questions and I apologize for not discovering your inquiries sooner. I am not familiar with Dr. Massad technique but you are not alone when comes to complete dentures construction. Fabrication of dentures is easy but making them work for patients is another story. I have given many CE courses in removable prosthetics and you can look up my name on the Net to know when the next courses are being offered. Regarding knife edge margin, please stay away from them. There are cases where this cannot be avoided due to the assessibility issue and this is done only as last resort. With PFM, you cannot get a margin that is flush with the tooth surface and this will act as a plaque trap. If you faced with KE margin, choose gold restoration instead. This is because gold material can be burnished and casted with thickness that is much less than the metal made for PFM. Hope this helps. DP

 

[Dr. Dai Phan]

Hello Dr Phan. I followed your posts on this forum and they were very informative. I am going to do pros. I want your opinion on 2 programs. Loma Linda's and USC. I heard that USC is so difficult since you have to complete all your cases and patients are not transferrable. People hardly finish in 3.5 to 4 years plus it is very expensive. While Loma Linda patients are transferrable....any input on that I would really appreciate it. Also which areas are in need for pros or they can do well there?

thanks

Greetings,

I do not know much about their programs although I have heard many positive things about them. In my opinion, if the residents routinely have to stay half or additional year to finish the residency then either the program is asking too much or the residents do not plan their cases properly. In either case, this needs to be corrected in my view. You should call and talk to the senior residents directly and ask on their takes. PDs always paint the rosy pictures and they are always in favor for them. This applies to any residency programs you may want to pursue. Being expensive does not always mean quality so choose your program wisely. DP

 

[Dr. Dai Phan]

Dear Dr. Phan,

I am a general dentist in Australia. I have been practicing for 6 years and I have my own surgery with two associates. I have also completed my primary fellowship exams for the Royal Australasian College of Dental Surgeons.

I am interested in applying to do postdoctoral prosthodontics in the US, mainly, Univeristy of Michigan, USC and U Pen. in 2010. I noticed that you have mentioned that you have a particular liking towards UCLA, USC and USF. I am just wonderng what do you based that on? I have not sat my boards and UCLA and I think USF both require board scores.

My 1st preference is U of M as many of the prosthodontics in Western Australia graduate from there in the 80's. I would be grateful if you can advise me of your thoughts, namely strenght and weakness, about different residency programs in the States. In addition, what sort of candidates do the programs look for?

Looking forward to your response.

Hello,

The strengths and weaknesses of each program differ greatly from one program to the other. You should talk to the senior residents on their takes. Only them can give you the true pluses and minuses of the program. I only have heard positive things from USF and others but that is based on word of mouth. PDS look for candidates who have demonstrated excellency in restorative dentistry as well as good GPA,NB scores and letters of recommendation. DP

 

[Dr. Dai Phan]

Hello Dr. Phan,
I was just wondering if you could tell me what you believe is the most intriguing aspect of your speciality, and what is often misunderstood about your speciality as a whole.

Thanks!

Hi there,

What I enjoy most about my specialty is that I am the "quarterback" of the patient's overall dental reconstruction. It is the only specialty where you must take into account in all dental specialties in order to have a successful outcome. It is like an architec who must know about the land foundation, engineering and design to make into a sucessful project. A common misconception is that a maxillofacial prosthodontist is the person who makes prosthetic facial parts. In reality, the person who does this is likely not a maxillofacial prosthodontist but a maxillofacial prosthetist (a technician). However some maxillofacial prosthodontists including me enjoy doing these so I did all of them when ever I have a chance without referring them to the prosthetist. Making INTRA oral prosthesis to correct oral defects is the true duty of the maxillofacial prosthodontist. DP

 

[Dr. Dai Phan]

Dr.Dai Phan,
I am a prosthodontist in India. I will be completing my 3 year residency in prosthodontics in June 2010. Maxillofacial prosthodontics is my area of interest. Is it possible for me to train in MP in the US? Do universities offer fellowships or training programmes in MP for foreign graduates not wishing to practice in the US?Thank you for your time.

Hello,

Yes. There are many programs in the US that accept foreign trained prosthodontists. To be sure contact the programs and inquire directly. DP

 

[Dr. Dai Phan]

Dr. Phan,

Was wondering what the limitations of the prosth specialty. Seeing that prosth seems to be able to do everything that a general does, would this also mean that they technically can do endodontic procedures or does the ACP limits prosthodontics to just doing crown, bridge, etc....?

Greetings,

There are no limitations in prosthodontic specialty if you want to focus entirely in prosthetics or do NOT advertise yourself as a prosthodontist. In other words, if you want to do other procedures such as endodontics, oral surgery, etc... then you should not advertise yourself as a prosthodontist or "Practice Limited to Prosthodontics" in your bussiness. I know many prosthodontists who practice general dentistry along with doing prosthodontics. The only area that I truly enjoy is in prosthetics so I am very content of what I do. The area is so vast that I never see any limitations to it. DP

 

[Dr. Dai Phan]

Greetings,

I open this thread to answer any inquiries about prosthodontics/maxillofacial prosthetics field that dental graduates may have. I am honored to be at your service. DP

 

[Dr. Dai Phan]

Hi Dr. Phan,
I am in the process of working on my PASS application. Lower than average stats from dental school, GPR in the US Navy, experience as general dentist serving in the Navy, a love and passion for prosthodontics! Any information on USC or Loma Linda prosth programs? Do you think its possible to meet with the director to express my interest or find an opportunity to shadow residents? Thanks for your time!

Hello,

You should email the director with your stats and ask him if your situation is competitive enough to apply. If you have documented cases of your work, make sure you mention that too. If he feels you deserve a look, he will no doubt make an effort to audition you. Good luck! DP

 

[flurocore]

Hello,

You should email the director with your stats and ask him if your situation is competitive enough to apply. If you have documented cases of your work, make sure you mention that too. If he feels you deserve a look, he will no doubt make an effort to audition you. Good luck! DP

Thank you!

 

[Dr. Dai Phan]

Hi Dr. Phan,

Thank you for being so open and accessible on this forum! Your posts are very informative and helpful. You were asked similar questions 7 years ago on SDN but I was curious if your opinion has changed since then.

Currently, what are some key areas of concern or importance in prosthodontics?
Do you foresee any changes in prosthodontics in the near future?

I want a program that provides strong background in traditional prostho but also enough surgical experience (ie: implants, sinus lifts, bone grafts etc) to feel comfortable. UM-Baltimore and UIC are 2 programs that provide a good balance of both. I know it's difficult for you to comment but would you happen to know why west coast schools seem to provide less hands-on surgical experience? UCLA residents rarely place implants and UCSF allows their residents place a max of 12 implants over the 3 years.

Also, are you still available to review personal statements and CV's?

Greetings,

At this time I have no concerns whatsoever in the field of prosthodontics. Regarding the changes, I think it will be more toward implants and cosmetic reconstruction. This is no different than how dentistry has shifted toward the cosmetic aspect in the past decades. I do not know the programs you mentioned so your best bet is to contact the schools and find out the curriculum. Yes, I am available to review PS as needed. DP

 

[Dr. Dai Phan]

Can you describe a typical week of a Pros resident?

When I started my program 17 years ago, a work week consisted of literature review, case presentations, classes, patient's care and long long after hours lab work. DP

 

[Dr. Dai Phan]

Greetings,

This is what I do in my specialty. DP

http://www.va.gov/health/newsfeatures/2014/July/The-Other-Side-of-VA-Dentistry.asp

 

[jun531]

Dr. Dai Phan,

I know you have posted in the past about qualifications for acceptance into prosthodontic residency programs, however I think that was before the boards were pass/fail. Now that they are pass/fail do you have any idea if the general competitive GPA has increased? or a ballpark of what is competitive? Also with this change do you feel extra work like research will become more important for applicants? Any insight would be much appreciated from yourself or anyone that has gone through the process recently. Thank you so much for all the time committed to this forum!!

 

[Ndeb2015]

I am preparing for my ndeb exams and find the lower molar full metal crown preparation a bit difficult.
My problem are is the distal proximal margin, I always end up with 1mm margin rather than .5mm.
Can you please suggest some tips to tackle this, also any recommendations on how to avoid nicking the adjacent tooth when going proximal ?
Thanks

 

[dmd12]

Dear Dr. Phan,
What books would you recommend for prostho/esthetic?

Thank you

 

[Odont0]

Hi all,

I will be happy to answer any inquiries related to my specialty. Anything from seeking residency training to the nature of the field and anything in between. DP

Dear Dr Phan,

I am a prosthodontist (> 9 years experience) from Kuala Lumpur, Malaysia with special interest in implant and max fac pros and is keen to have further training in this field. I realized that UCLA does not accept foreign students for the fellowships in this field. (Sent e mail to UCLA but no response).
I have contacted MSKCC and they would only send me application package if I comply with the ADA CODA to whom I have sent e mail as well and still waiting for the reply.

In the meantime is there any chance at all for me to do it in the States?

TQVM

 

[drrobin1982]

Hi Dr. Phan i like reading your posts and its really appreciable how you help the people around. i would like to know few things from you. I completed Master degree in prosthodontics from India and i have around 3 years of academic and clinical experience. i can say that i love practicing prosthodontics. recently i moved to US and i am resident of Indiana now. i was planning to get into Prosthodontic graduate program in US and practice exclusive prosthodontics. Then i met few dds guys and they told me prosthodontics as such is a dead specialty in US and its better to do DDS. So what u suggest? Please guide me on this

 

[oatmeal0322]

I have a patient, about 45yof, recently cemented onlay (with multilink) who has has sensitivity to eating on it " only with crunchy foods, granola, etc. and she points to the occlusal surface as being the sorce of the sensitivity. I have seen her multiple times for adjustment on occlusion with little relief. another doctor in the practice also saw her and adjusted her bite. she also saw endo without significant findings. another doctor in the practice recommended to re-do the onlay. I'm not convinced this will solve the problem. do you have any suggestions?

 

[Aashipiya]

Hi all,

I will be happy to answer any inquiries related to my specialty. Anything from seeking residency training to the nature of the field and anything in between. DP

Hi, need some info with the Pros boards! Kind of questions asked in scenerio and how to prepare?

 

[DerekGatta]

@Aashipiya The following link is a video guide to a mock scenario testing session. I took the scenario section in 2014 and found it very helpful to have a systematic approach. That way, regardless of the kind of case they show, you can just go through your mental checklist. You will most likely see are CAMBRA caries case, wear case, some type of implant case, combination syndrom or denture/partial.

https://www.abpros.org/abp/examvideo.asp

I have some more study materials on my blog
http://www.americanboardofprosthodonticsstudynotes.com/

Feel free to private message me with more questions.

 

[nuk]

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[DerekGatta]

@nuk email me at [email protected] and I'll show you some study materials.

 

[nuk]

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[Mahmoud ebaid]

Hi all,

I will be happy to answer any inquiries related to my specialty. Anything from seeking residency training to the nature of the field and anything in between. DP

what it takes for any dental student to get into this career????