Your Guide to Advanced Postgraduate Study

All dental students at one time will reach a point in there educational career, thinking "what should I choose as my specialty?". It may not be easy, so we are here to help you out with that problem. We will discuss prostodontics, oral and maxillofacial surgery, and orthodontics. Special thanks to Dr. Rashed for his much appreciated contribution to this magazine

Prosthodontics

Prosthodontics is one of the nine dental specialties recognized by the American Dental Association (ADA).

Prosthodontics is the science and art of replacing missing natural teeth and associated structures with fixed or removable substitutes. Prosthodontists specialize in the restoration of oral function by creating prostheses and restorations (i.e. complete dentures, crowns, implant retained/supported restorations). Cosmetic dentistry, implants and joint problems all fall under the field of prosthodontics.

The American College of Prosthodontists (ACP) ensures standards are maintained in the field. Becoming a prosthodontist requires an additional 3-4 years of specialty training after obtaining a dental degree (D.D.S. or D.M.D.) in an ADA approved program or equivalent, which allows the holder to practice as a general dentist. The extra 3-4 years of residency leads to becoming a specialist. This amounts to an immense amount of time spent in clinical and didactic study from 3000 hours over 3 years in a British

program to 7000 hours over the same period in US accredited programs.

Training consists of rigorous preparation in head and neck anatomy, materials

science, esthetics, and occlusion (bite). Due to this extensive training, prosthodontists are frequently called upon to treat cosmetic cases, full mouth implant reconstructions, TMD related disorders, congenital disorders, and sleep disorders by planning and fabricating various prostheses and orthotic appliances. They are the "decision makers" deciding the recommended treatment plan for the patient.

Maxillofacial prosthetics is a sub-specialty of prosthodontics. Maxillofacial prosthodontists treat patients who have acquired and congenital defects of the head and neck (maxillofacial) region due to surgery, trauma, and/or birth defect. It requires an additional year of training after completing an ADA approved prosthodontic training program. Artificial eyes, ears, and maxillary obturators are commonly planned and fabricated by maxillofacial prosthodontists. Other less commonly employed prostheses include mouth devices used by amputees to aid in daily activities, tracheostomy obturators, and cranial implants.

References:

-         www.ada.org

-         en.wikipedia.org/wiki/Wiki

Oral and Maxillofacial Surgery

Oral and Maxillofacial Surgery is surgery to correct a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. It is a recognized international dental specialty, which, in the European Union, requires a minimum length of formation of 5 years for a basic medical training and 4 years for a basic medical and dental training. In the U.S.A., Canada, Australia, and New Zealand it is one of the 9 dental specialties recognized by the American Dental Association, Royal College of Dentists of Canada, and Royal Australasian College of Dental Surgeons.

Area of Specialty

Oral and maxillofacial surgeons are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. They are also trained to administer anesthesia, and provide care in an office setting. The scope of this specialty is extensive and concerns the diagnosis and treatment of diseases affecting the oral (mouth) and maxillofacial (face and neck) regions, including the following:

Oral and Dentoalveolar Surgery (removal of impacted and buried teeth, cysts, etc).

Preprosthetic Surgery.

Dental implant surgery and associated bone grafting (to replace missing teeth or stabilize dentures; rehabilitation of patients having undergone surgery for tumors; to retain facial prostheses).

Orthognathic surgery (dentofacial deformities).

Facial trauma surgery (facial bone fractures and injuries).

Surgery of Odontogenic and non-odontogenic Tumors

Reconstructive surgery

Cleft lip and palate surgery

Congenital craniofacial deformities

Facial plastic surgery (rhinoplasty, rhytidectomy, blepharoplasty, facial implants, etc).

Temporomandibular joint disorder (TMJD).

Head and Neck Oncology

United States, Canada, Australia, and New Zealand

Oral and Maxillofacial Surgery is one of the 9 dental specialties recognized by the American Dental Association, Royal College of Dentists of Canada, and the Royal Australasian College of Dental Surgeons. Oral and Maxillofacial Surgery requires 4-7 years of further formal University training after dental school (DDS,DMD,BDent, or BDS). Four-year residency programs grant a certificate of specialty training in Oral and Maxillofacial Surgery. Six-year residency programs grant the specialty certificate in addition to a medical degree (MD,MBBS,MBChB, etc). Specialists in this field are designated after passing board exam registerable U.S. “Board Diplomate” and warrant exclusive titles.

Approximately 50% of the training programs in the U.S., 100% of the programs in Australia and New Zealand, and 1/5 of Canadian training programs, are dual-degree leading to dual certification in Oral and Maxillofacial Surgery and medicine (MD,MBBS,MBChB, etc).

In addition, graduates of Oral and Maxillofacial Surgery training programs can pursue advanced fellowships, typically 1 - 2 years in length, training in the following areas:

Craniofacial/Pediatric Maxillofacial Surgery (cleft lip and palate repair, surgery for craniosynostoses, etc.)

Head and Neck Surgical Oncology (ablative surgery for cancer and microvascular reconstructive surgery)

Facial Cosmetic Surgery (facelift, rhinoplasty, etc.)

Maxillofacial Trauma Surgery (soft tissue and skeletal injuries to the face and neck)

UK and Europe

The Oral and Maxillofacial Surgeon (OMFS) is a person with a medical (MD: 6 years) and a dental degree (DDS or DMD : 5 years) or equivalent qualifications, examples of which would be a specialist certificate in Stomatology. This training must be a University Course authenticated by a certificate.

This specialty is defined within Europe, including the United Kingdom, under the medical Directive 2001/19/EC (Official Journal of the European Communities L 206, 31.07.2001). It requires 5 years for a basic medical training (MD) or 4 years of further formal University training after a dual qualification in Medicine (MD) and Dentistry (DDS or DMD).

References:

-         www.ada.org

-         en.wikipedia.org/wiki/Wiki

Step by Step from Jabriya to USA

The Road to Orthodontics specialization

Welcome to the second oldest recognized specialty in all Medicine and Dentistry after General Surgery. Orthodontics is the branch of dentistry that specializes in the diagnosis, prevention and treatment of dental and facial irregularities. The technical term for these problems is "malocclusion," which means "bad bite". The practice of orthodontics involves the design, application and control of corrective appliances (braces) to bring teeth, lips and jaws into proper alignment and achieve facial balance. The first professional organization for orthodontists, the American Association of Orthodontists (AAO), was founded in 1900. Admission to orthodontic post-graduate programs is extremely competitive and selective worldwide and it takes lots of organized work and effort to become an Orthodontist. We will try to highlight the important steps that you need to take to join this profession. We will do that in a simple and clear way. We will discuss the process of applying to orthodontic programs in the US only.

The educational requirements are demanding. Most of the orthodontic programs will look mainly at three things in you application. (1) Grade Point Average (GPA) (2) National Board Exam scores (3) Research Experience. It is your job to work on these fronts and make them as good and competitive as you can.

Step #1 (Dental degree and Grade Point Average)

You have to graduate from a dental school that is accredited by the American Dental Association (ADA). The faculty of Dentistry at Kuwait University is accredited by the ADA. As we said earlier it is your work to get a competitive GPA. Those who have an average GPA in their earlier years can still have a chance if they show that their GPA is improving and getting better with time. Remember GPA is one thing but not the whole thing.

Step #2 (TOEFL exam)

If you are planning to study in the US, then you are required to take the TOEFL exam compulsorily. The purpose of the TOEFL exam is to evaluate English proficiency of students whose native language is not English. The Test of English as a Foreign Language TOEFL measures the ability of nonnative speakers of English to use and understand English as it is spoken, written, and heard in college and university settings. It is recommended that you start taking this exam as early as possible and keep trying until you get a good score and make sure you get what you are asked for.

Step #3 (National Dental Board Exam)

It is recommended that you sit for the National Dental Boards Exams which is an exam that all American dental students from deferent dental schools take on the same time. This two parts written examination assesses the ability to understand important information from basic biomedical and dental sciences and also the ability to apply such information in a problem-solving context. The timing of when to sit for these exams is based on your own preference some likes to get done earlier when the information is fresh ,others likes to wait after graduation  to dedicate more time to it. Whatever you choose make sure to get a decent score. You are considered as an outsider and these exams are a good way for them to compare you to the American applicants. For more information on these exams please visit www.ada.org

Step #4 (Postdoctoral Application Support Service)

Start collecting your scores and transcript and get all the official seals and

signatures, after that you are ready to start applying to the programs. This Postdoctoral Application Support Service (PASS) simplifies the application process by providing on standardized format and relieving applicants of the need to complete multiple applications. Dental programs benefit by receiving uniform information on all applicants Most of the orthodontic programs participate in this system very few don’t, so make sure you know who is not participating and apply directly to them. For more information on this you can go to their website at www.adea.org

Step #5 (Postgraduate Dental Matching Program)

You are also required to register with the Postgraduate Dental Matching Program. This Program (the "Match") places applicants into first year residency training positions in dentistry in the United States. For more information on how this complex system works please visit their website at www.natmatch.com/dentres

Remember that you need to apply at least one year before the wishing start date, so collect all the information you need (transcript, exam scores, recommendation letters, personal essays, etc) before that time and check each school deadline.

If let say the orthodontic program you wish to join starts on August, 2009 then you need to apply no later than August, 2008. Most of the programs will start calling for interviews from September, 2008 to December, 2008 and then those who are accepted will be notified by January, 2009.

Once again be organized and optimistic and if you need help please feel free to ask any Orthodontist at our school.

Good Luck

Dr.Rashed Al-Azemi

Department of developmental and Preventive Sciences

Faculty of Dentistry, Kuwait University