A Career as a Dental Specialist

The American Dental Association describes alternative careers in dentistry, requiring the standard four-year dental school education in dental medicine, but not specifically or exclusively engaging in clinical practice. The ADA identifies these as academic dentistry and organized dentistry, including the accreditation of dental schools; dental consulting; a career in the dental benefits industry or a career in the dental products industry, or a career in dental research.

According to the American Dental Association, about 20 percent of the currently practicing 164,000-or so dentists in the U.S. are dental specialists who specifically and in a limited fashion only practice one of the ten specialties recognized by the National Commission on Recognition of Dental Specialties and Certifying Boards. The American Dental Association summarizes all executive personnel and contact information for each of their recognized dental specialties here.

Many, if not most, of these specialties are rarely seen alone in private practice, but remain an essential element in academic dentistry or the provision of highly specialized oral health diagnosis and care and are frequently secondary dental specialties taken on by some graduate dentists. The American Dental Association’s National Commission on Recognition of Dental Specialties and Certifying Boards explicitly defines each recognized dental specialty here.

 

Advanced Education in General Dentistry (AEGD) or General Practice Residency (GPR) Programs

A program that focuses on the advanced study of dental clinical techniques and dental practice issues. Includes instruction in subjects such as the history of dentistry, advanced dental practice management, dental ethics and jurisprudence, social and behavioral science studies of dentistry, advanced restorative dentistry, oral medicine, oral radiology, advanced clinical procedures and technology, and others.

AEGD and GPR programs are perceived inside dental academics as closely akin to a one- to two- (sometimes three) year kind of residency program in the practice of general dentistry. Frequently these residencies are hospital-based, and some dental schools boast more than one, such as an AEGD program affiliated with their dental school and a GPR program affiliated with the dental school’s associated medical center.

The best programs require many hours of hands-on patient care under faculty supervision and sometimes require residents to take hospital emergency room call. Some AEGD and GPR programs require tuition but then offer tuition reimbursement with a modest stipend.

As always, refer to the American Dental Association’s weblink connecting you to the specific program of your interest, and read mindfully what each program offers you

  

Dental Materials Careers in Dentistry

A program that focuses on the scientific study of the biomaterials and inert and active compounds used in dental procedures; the development of dental materials, particularly bioresorbable or biocompatible materials, and the effects of such materials on the living tissues of the oral cavity and systemic bodily health. Includes instruction in materials science, dental bioengineering, biocompatibility of materials, physics and mechanics of dental materials, elastic and plastic deformation, surface bonding, and applications to fixed and removable prostheses and restorative procedures. One currently very active area of development in the scientific study of dental biomaterials is the 3D printing of dental crowns, dental implants, dental veneers, and even full upper and lower dentures.

See this article for a discussion of the ways 3D printing technology is revolutionizing the dental biomaterials industry.

 The study and practice of dental biomaterials and bioprocessing methodologies is an important and emerging field allied to the clinical practice of dentistry. One does not however have to be a dentist to study or research in this field. Likewise even one who is an expert or who has had doctorate-level education in this field cannot engage in the clinical practice of dentistry or even sit for a licensing examination.

The American Dental Association does not tabulate or vet the many undergraduate, programs in dental biomaterials. As always, research, research, research the options available for the expense of your tuition dollars, and buyer beware.

 

Oral Biology, Oral and Maxillofacial Pathology, Oral and Maxillofacial Radiology Careers in Dentistry

A program that focuses on the scientific study of the growth, development, diseases, healing properties, and neurological components of the oral cavity, related tissues and organs, and associated craniofacial areas. Includes instruction in oral microbiology, microanatomy, craniofacial pain, the humoral aspects of disease, the etiology and histology of caries, plaque ecology, wound healing, oral disease epidemiology, oral manifestations of systemic disease, lesions, normal and pathologic physiology, and related molecular and physical studies.

The American Dental Association uses the terminology ‘oral medicine’ and ‘oral and maxillofacial pathology’ and links to the dental specialty organizations for these advanced dental practice areas here.

The American Academy of Oral Medicine discusses its residency programs and requirements here and provides links to the nine residency programs it certifies.

These are

Carolinas Medical Center, Charlotte, North Carolina

The Harvard School of Dental Medicine at the Brigham and Women’s Hospital, Boston, Massachusetts

The Tufts University School of Dental Medicine Advanced Education in Oral Medicine program (Boston)

The University of California at San Francisco

The University of Pennsylvania

The University of Washington

The University of Alberta

The University of British Columbia

The University of Toronto

 

Oral and Maxillofacial Pathology.  The dental specialty of oral and maxillofacial pathology concerns itself with the causes and effects of diseases of the head and neck regions, the mouth, the face, and the jaws. As the American Dental Association describes the combination specialty of dentistry and pathology, the nature, identification and management of diseases of the head and neck and the causes, processes, and effects of those diseases, are the interest of oral and maxillofacial pathologists.

The American Dental Education Association (ADEA) provides a strong synopsis of advanced training in the specialty of oral and maxillofacial pathology. The American Academy of Oral and Maxillofacial Pathology (www.aaomp.org) sets the standards for and supervises the activities of dentists who have the additional advanced training and residency certification in oral and maxillofacial pathology.

Oral and Maxillofacial Radiology. The dental specialty of oral and maxillofacial radiology combines dentistry with the discipline of radiology to take and interpret images in all modalities of radiant energy, such as two-dimensional radiographic and three-dimensional other imagining modalities, among them cone bean computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound, in order to diagnose and manage the diseases, conditions, and disorders of the head and neck region.

The American Association of Oral and Maxillofacial Radiology maintains standards and practices for the dental specialty of oral and maxillofacial radiology (https://www.aaomr.org/)

Related to the specialties of oral and maxillofacial pathology and oral and maxillofacial radiology, the American Dental Association recognizes these associated dental specialty organizations, the American Academy of Oral Medicine https://www.aaom.com/ and the American Academy of Orofacial Pain www.aaop.org

 

Dental Public Health and Education Careers in Dentistry

A program that focuses on the scientific study of dental disease prevention and control, community dental health promotion, and prepares dentists and public health professionals to function as dental health specialists. Includes instruction in preventive dentistry, the relationship of oral disease to health and quality of life, patient and practitioner behavior, dental epidemiology, nutrition and dental health, dental care policy and delivery, oral health program planning and administration, biostatistics, and research methods.

Dental Public Health. The ADA defines dental public health as the segment of dentistry that leads in the responsibility of maintaining the dental safety net, that is, providing quality dental care to the materially poor. The organization charged with promoting and preserving the integrity of the specialty is the American Board of Dental Public Health (www.aaphd.org/abdph). The ADA further conceives dental public health as the dental practice that treats the community as the patient. The dental specialty of dental public health targets areas of population-based dentistry and oral health surveillance (as in the academic or policy examination of dental health disparities among specific populations, and the reporting and recording of trends in dental health, like increases in the prevalence of dental caries); dental policy-setting in organized dentistry; community-based dental and other disease prevention, and the promotion of good oral health as the gateway to good general health. The organization charged with residency programs and dental specialty training in dental public health is the American Association of Public Health Dentistry.

 

 Orthodontics/Orthodontology Careers in Dentistry

A program that focuses on the advanced study of the guidance of growing dental structures and the correction of misalignments, disproportionate growth, and traumas caused by genetics, disease, injuries, and dysfunctional behaviors. Includes instruction in craniofacial growth and development, malocclusion, design and fabrication of orthodontic appliances, craniofacial alignment, physiological function and analysis, cephalometrics, model analysis, space analysis, surgical orthodontics, cleft lip and palate, and treatment planning and management.

The American Association of Orthodontists (www.mylifemysmile.org) is the regulatory and governing body for the dental specialty. To practice as an orthodontist in the United States requires an acceptable degree from a U.S. or Canadian accredited dental school (four years) and then an advanced certificate in the study of orthodontics (usually three years: or 3700 hours of advanced specialized training, according to the AAO website) from an American Dental Association-approved program. Should you choose to seek board-certification as an orthodontist, those examinations are offered by the American Association of Orthodontists.

As the AAO website points out, one hundred percent of the job of the orthodontist is focused on aligning the teeth and the jaws. The orthodontist’s tool for doing that is braces.

As always, when doing your research, refer to the American Dental Association’s current list of accredited programs in the United States or Canada in any field.  Because of the American Dental Association’s Commission on Dental Accreditation’s (CODA) very strong program-sanctioning standards, it is possible almost to say that every orthodontics program is pretty much the same. But every program is very different.

This 2009 study of the satisfaction of orthodontics residents in the then 65 orthodontics programs in the United States (335 respondents from 37 programs) concluded that three-quarters were satisfied with their program. Two downsides the authors identified from the survey responses were the residents perceived a lack of interdisciplinary teaching and not enough cases started and completed before graduation.

The U.S. Bureau of Labor Statistics cites the annual salary of orthodontists (and oral and maxillofacial surgeons) as above the maximum cited by the BLS. As a prospective student of orthodontics, know that those two programs are the most competitive to get into and survive in, and at the same time academically and clinically the most rigorous, of the advanced dental specialties.

 

Endodontics/Endodontology Dental Careers

A program that focuses on the advanced study of the morphology, physiology, and pathology of human dental pulp and periradicular tissues, and prepares dentists to diagnose and treat internal diseases and injuries of teeth. Includes instruction in theory and practice of endodontics; pulpal disease; relationship of endodontic conditions to other dental/oral health issues; endodontic operative technique; and patient care and management.

Endodontics. Fewer than three percent of U.S. dentists are endodontists. Additional training as an endodontist pivots on diagnosing tooth pain, and providing root canal treatment and other procedures related to the interior (dentin, pulp, cementum, and roots) of the tooth. Such procedures frequently save the tooth. The organization responsible for setting policy and enforcing procedures among endodontists is the American Association of Endodontists (www.aae.org), who provide an excellent overview of their specialty here.

As always, when doing your research, refer to the American Dental Association’s current list of accredited programs in the United States or Canada in any field.  Because of the American Dental Association’s Commission on Dental Accreditation’s (CODA) very strong program-sanctioning standards, it is possible almost to say that, as is the situation with every dental specialty program, every endodontics program is the same. But every program is very different. Buyer beware

The ADA website currently links to 55 programs in endodontics

Visit the U.S. Bureau of Labor Statistics website for the occupational outlook for endodontists.

 

Oral and Maxillofacial Surgery Dentistry Careers

A program that focuses on the advanced study of the diagnosis and intrusive and adjunctive treatment of diseases, injuries, and defects of the oral and maxillofacial regions, including functional and aesthetic aspects. Includes instruction in pharmacology, analgesia, anesthesia, anxiety control, surgical procedures and techniques, surgical instrumentation, exodontia, oral diseases and malfunctions, soft and hard tissue pathology, dentoalveolar surgery, infection management, and prosthetic implantation.

Oral and Maxillofacial Surgery. Oral and maxillofacial surgeons specialize in the diagnosis and treatment of diseases, disorders and conditions of the head and neck. The American Association of Oral and Maxillofacial Surgeons (www.aaoms.org) is the governing body for the specialty. Oral and maxillofacial surgery is one of the most broad-ranging, yet specific in its procedures and domain, among the dental specialties. In some, but not all, residency training programs, in order to receive certification, residents in oral and maxillofacial surgery are required to be graduates of both medical and dental schools affiliated with the program. Oral and maxillofacial surgeons are specifically well-qualified in dental implant surgery, wisdom tooth management and extraction, and the treatment and surgical reconstruction of facial trauma, such as broken facial bones, facial lacerations, or broken eye sockets.

Oral surgeons, some with still additional advanced medical specialty training in plastic surgery, perform facial cosmetic surgical reconstructions, such as rhinoplasty, blepharoplasty, and many others. Oral surgeons are also called upon to perform orthognathic (jaw) advancements to correct an over- or under-bite; cleft lip and cleft palate surgical reconstructions; surgical reconstruction of congenital craniofacial malformations; orthodontic oral surgery to improve the alignment of the jaw during or prior to orthodontic procedures, as in the placement of orthodontic braces; endodontic microsurgery; and surgical bone or soft-tissue grafting to ensure jawbone support before dental implant placement or other prosthetic tooth replacement.

Oral and maxillofacial surgeons also perform complicated soft-tissue reconstructive procedures, such as an airway correction (called an uvulopalatoplasty) for people suffering from obstructive sleep apnea; soft tissue surgeries in the lip, tongue, gum, palate, or airway; treatments to alleviate temporomandibular joint (TMJ) dysfunction and relieve facial pain; and dentoalveolar surgery, in a range of tissue repair, shaping, and grafting procedures. Of course, oral and maxillofacial surgeons are a definitive diagnostic source, for the diagnosis and treatment of any chronic or acute disease or infection in the head and neck region, and for cancer diagnosis and surgical removal of head, neck, throat, and oral cancers, and then the reconstruction and repair of the remaining head and neck anatomy, guiding the construction and placement of any prosthetic devices. Finally, and again deriving from the oral and maxillofacial surgeon’s pivotal position as a facial trauma reconstructive surgeon, the OMS is the dental emergency specialist, for knocked-out or broken teeth, jaws, noses, eye sockets, or cheeks.

Refer to the American Dental Association list of accredited oral and maxillofacial surgery programs in the United States or Canada to research the oral and maxillofacial surgery programs of your choice.  Be aware that because many of these programs offer a medical doctor (MD) degree in oral and maxillofacial surgery, acceptance into these programs requires participation in the medical school selection process known as Match.

The U.S. Bureau of Labor Statistics cites the annual salary of oral and maxillofacial surgeons as above the maximum cited by the BLS.

The Student Doctor Network, in their online applicant forum conversations, offer several intriguing lists of programs ranked in a host of ways (best six-year medical school program with MD residency, best four-year non-MD residency program) and a robust discussion of what exactly does ‘best’ mean anyway, when you’re training in a complicated surgical specialty like this?  Repeatedly in the threads one hears the extremely practical advice of those who have already chosen and are now out there practicing: chose your oral/maxillofacial surgery residency based on what you want to do after you get all the education, clinical training, and the degrees and get on with your life. And be honest with yourself about your capabilities and expectations, and be realistic.

 

Prosthodontics/Prosthodontology Careers in Dentistry

A program that focuses on the advanced study of the restoration and maintenance of teeth, oral function, and aesthetic form through the use of single or compound materials, structures, and artificial devices. Includes instruction in implant dentistry, surgical procedures, denture design and fabrication, fixed and removable prosthodontics, restorative techniques, occlusion therapy and devices, geriatric dentistry, cosmetic dentistry, and tempromandibular joint dysfunction.

The American College of Prosthodontists www.gotoapro.org

says this about the specialty.  The American College of Prosthodontists is the organization of dentists with advanced specialty training who create optimal oral health, both in function and appearance, including dental implants, dentures, veneers, crowns, and teeth whitening.

Informally, prosthodontists are the dental specialty that focuses on restorative dentistry --- that is, the making of the traditional appliances of ‘false teeth’: fixed and removable bridges, caps and crowns, full or partial upper, lower, or complete dentures, bonding, and veneers.

Like the other dental specialties, prosthodontists are staking their claim as the dental specialty best trained --- technically, clinically, and philosophically --- to place dental implants.

Within the past twenty years, the market for teeth whitening has exploded. Professional dental teeth whitening is a specialty service best handled by a dental practice limited to the practice of prosthodontics.

 

Help researching graduate dental school or hospital-based programs for the study of prosthodontics, refer to the American Dental Association’s weblink connecting you to the specific program of your interest, and read mindfully what each program offers you

The ADA website currently links to 47 programs in prosthodontics. The ADA website also links to eight programs in maxillofacial prosthetics

 

What is maxillofacial prosthetics?

Maxillofacial prosthetics is the specialty branch within conventional prosthodontics that extends to greater reconstruction of the entire face, head, and neck region (as opposed to the reconstruction of individual teeth, the traditional purview of prosthodontists). Patients of maxillofacial prosthodontists often require reconstruction of congenital defects (a very common situation is prosthetic rehabilitation of cleft lip and palate), or facial structures damaged by disease (such as oral or head and cancers), or trauma.

Maxillofacial prostheses restore function --- swallowing, speech, or chewing --- or esthetics. Maxillofacial prostheses can restore either soft tissue areas --- cheeks, upper or lower palate, tongue --- or areas of bone --- the jaw, the orbital rim. Prostheses or prosthetic devices are frequently part of the package in the treatment of oral or head and neck and cancers, being necessary to position or shield facial structures during radiation therapy, for instance, or to contain treatment devices such as an electrolarynx, a medical device essentially a mechanical voicebox, used in the treatment of cancer of the larynx.

Maxillofacial prosthodontics is one of the most interdisciplinary and cooperative of the dental specialties. The practice of maxillofacial prosthodontics, although it varies, is frequently within a hospital clinical environment, where the great variety of other medical specialists required would be in close clinical proximity. Maxillofacial prosthodontists must collaborate and become accustomed to clinical integration with otolaryngologists (ENTs), oral and maxillofacial surgeons, other specialty dentists for the reconstruction or treatment of specific tooth structures, plastic surgeons, neurologists, radiation oncologists, speech pathologists, the medical artists who create the individual specific facial prostheses, and the entire team of ancillary dental personnel  --- assistants, techs, and hygienists --- who are part of carrying out oral care treatment.

Inside this model is at least one such stellar interdisciplinary program in maxillofacial prosthetics, the maxillofacial prosthetics program at the Wilford Hall Ambulatory Surgical Center-of the 59th Medical Wing (WHASC) of the U.S. Air Force at Lackland Air Force Base outside San Antonio, Texas, part of the U.S. Air Force Medical Service.

 

Pediatric Dentistry/Pedodontics Dental Careers

A program that focuses on the advanced study of the therapeutic and preventive care of the oral health of children from birth through adolescence, and the care of adults with physical, mental, and emotional disabilities. Includes instruction in developmental oral biology, preventive medicine, diet therapy and counseling, patient management, pediatric restorative procedures, pulp therapy, trauma management, anesthesia, treatment planning, patient management, and the treatment of handicapped patients.

Pediatric dentistry is that specialty branch of dental medicine that serves the oral health of the developing human body, that is, children from birth through adolescence, and at the same time is the specialty devoted to the oral health care of adults with special needs and physical, mental, and emotional disabilities, sometimes profound ones. Pediatric dentists work with children up to the point of putting on braces, at which point the adolescent patient is referred out to a fulltime practice limited to orthodontics. Some programs do provide basic, elementary training in orthodontics although orthodontics is not within the scope of the practice of pediatric dentistry.

The clearinghouse for all things related to the practice of pediatric dentistry is the American Academy of Pediatric Dentistry (AAPD) https://www.aapd.org/

Founded in 1947 and established on the same model as the other not-for profit membership organizations governing and representing the various dental specialties, the American Academy of Pediatric Dentistry represents at current count some 10,800 members. And their mission is among the simplest of all the specialties: to provide outstanding dental care to the nation’s children.

At the same time, the specialty of pediatric dentistry has taken onto itself the mission to care for the oral health of the country’s special needs adults, a vast number of physically, mentally, or emotionally-challenged adults. No other dental specialty specifically embraces that population within their mission, philosophy, or practice area.

The residency in pediatric dentistry, like the residency in oral and maxillofacial surgery, can be either hospital-based or dental school-based. Like the residency in oral and maxillofacial surgery, residency programs in pediatric dentistry often participate in the Match program, which is not necessarily the norm in other dental specialties. A program that is dental school-based will likely still charge tuition while offering a nominal stipend. Likewise a hospital-based program may offer only a certificate, but the university-based program may have an option to receive a degree credential in addition to a certificate.

The point being? Know what you want from your residency experience, based on your goals for your practice life after the residency is over

As always, the American Dental Association’s weblink to all dental school and dental residency programs is one of the definitive sources connecting you to the specific program of your interest

The ADA website currently links to 82 programs in pediatric dentistry. Twenty-six of those are identified by the ADA as hospital-based programs

The American Academy of Pediatric Dentistry (AAPD) provides the same kind of resource, with extremely in-depth and detailed similar information for all residency programs sanctioned by the AAPD

For comparison purposes, pick a hospital-based program and related dental school-based program, possibly both from the same dental school and its affiliated medical center, and compare.

One such example is the pediatric dental residency at the University of Pittsburgh versus the affiliated but independent pediatric dental residency at the University of Pittsburgh Medical Center’s Children’s Hospital of Pittsburgh

For another, compare two programs in the city of Richmond, Virginia: the pediatric dental residency at Bon Secours St. Mary’s Hospital of Richmond versus the pediatric dentistry residency at Virginia Commonwealth University, also in Richmond

And yet, a similar, but still very different, situation exists in the two-year combined hospital and university-based pediatric dentistry residency at the Medical University of South Carolina at Charleston.

The point being? Research, research, research. Read and comprehend all the fine print before you apply. Know what you want before you interview

 

Periodontics/Periodontology Careers in Dentistry

A program that focuses on the advanced study of the etiology and treatment of diseases of the gingivae (gum tissue) and supporting bone, nerve, and vascular structures. Includes instruction in periodontium pathology, diagnostic procedures and equipment, occulsion, nutritional aspects of periodontology, surgical treatments, and patient care and management.

Periodontists take as their specialty focus the prevention, diagnosis, and treatment of diseases affecting the gums and the supporting structures of the teeth --- in technical terms, the cementum, the periodontal ligaments, the alveolar (jaw) bone, and the gingiva.

Periodontists also claim the placement of dental implants squarely within their specialty scope of practice.

The organization that certifies the education and training of residents in periodontics, and that regulates the activities of certified periodontists practicing the specialty is the American Academy of Periodontology (www.perio.org)

Periodontists train up to an additional three years after dental school and specialize in non-surgical treatment and periodontal plastic surgery. The AAP has characterized periodontists as the ‘plastic surgeons of dentistry’ --- this from the infinitesimally-small micro-surgeries that re-shape the gum around each individual surface of each individual tooth, toward the goal of shaping the perfect smile within the existing biological structures of the individual patient.

Periodontists are specialists in gum graft surgery, laser treatment for gum surgery, gum regeneration surgeries, surgeries to build up gum that has been lost around individual teeth (pocket reduction) due to infection and inflammation, and periodontal plastic surgery procedures that simply improve the look of your smile.  Among these are gum replacement surgeries that take away the look of a gummy smile (reshaping and cutting away excess gum and bone tissue to expose more of the natural tooth, surgeries that replace gum to cover roots that have become exposed, or surgeries that replace gum to repair an area where jawbone has receded.

More than any other dental specialty, periodontists are dentistry’s clinical specialists in oral --- and systemic --- inflammation. Periodontists have pioneered the oral-systemic health link, being the dental specialty that identified the link between oral health and cardiovascular health, established the bi-directional link between diabetes and periodontal disease, and are moving forward aggressively to establish other links between oral health and systemic health by rigorous evidence-based dentistry.

In every procedure, the periodontist works to combat the further oral --- and then systemic --- spread of infection and inflammation. For instance, in the bread-and-butter periodontal pocket reduction procedure, the periodontist folds back inflamed gum tissue and removes the disease-causing bacteria, then secures the gum tissue back into place. If damaged bone is involved, the periodontist further smooths the area to reduce the number and size of areas where disease-causing bacteria can hide.

Regular maintenance such as this --- all within the regular practice of periodontics --- are the procedures that halt the progression of periodontal disease and help you maintain a healthy smile.

As always, when researching graduate residency programs to specialize in the study of periodontics, refer to the American Dental Association’s weblink of programs

The ADA website currently links to 56 programs in periodontics.

On its website, the American Academy of Periodontology lists a comprehensive guide to postdoctoral periodontal programs, with links to all U.S. and Canadian programs in periodontics, their official guide to periodontal externships and an important form, postdoctoral periodontal admission information and important forms, and information about periodontal programs participating in the Postdoctoral Dental Matching Program through the National Matching Services (NMS)

The U.S. Bureau of Labor Statistics cites salary and career outlook information for the specialty of periodontics as among ‘other dental specialties’

 

Dental Anesthesiology Careers in Dentistry

Dental Anesthesiology. Dental anesthesiology combines the practice of dentistry and the discipline of anesthesiology to manage pain, anxiety, and patient health during dental, oral, maxillofacial, or any supportive surgical or diagnostic procedures at any point during the surgical period. The American Society of Dental Anesthesiologists is the governing body of the dental anesthesiology specialty (www.asdahq.org). The American Dental Board of Anesthesiology undertakes responsibility for the training and certifying of graduate dentists as residents in the specialty and then dental anesthesiologists.