Careers in Dentistry - Introduction

Careers in dental medicine promote the health and well-being of other people through the gateway of good oral health.

When considering a career in dentistry, it is very important to recognize that is a career in medicine.  You will be involved daily with blood and bodily fluids, infection and germs, the acute pain of your patients, and simultaneously the tiniest reconstruction or drainage of infected teeth.

Ask yourself why you are interested in a career in dental medicine. Then ask yourself if you possess enough of the subjective qualities dental school admissions committees seek, that people in the dental chair really deserve, and that are necessary for long-term success in the career.

Be aware that dental school admissions committees not only want the individuals they agree to train as dentists to possess these qualities, they will require prior demonstration of the qualities, by volunteer, academic, and service experiences recounted on paper, in recommendations, and by their own examination of your personality and competence in the admissions interview.

Basic skills you will need to possess

  • Outstanding people skills. The personal ability to remain calm and proactive in the face of other peoples’ pain and extreme distress;
  • Demonstrated manual dexterity;
  • Demonstrated strong eye-hand coordination;
  • The intellectual ability to grasp complex and increasingly specific medical concepts, and then implement the concepts into demonstrated clinical skill.
  • At the dentist-graduate threshold, an individual needs specific and abundant business acumen to succeed in private practice. One aspect of this is the acceptance and management of additional business debt on top of potentially already significant personal student tuition and other debt.

Except for the potentially special cases of academic, military or public and international health dentistry, or hospital-based traumatic maxillofacial surgical reconstructive dental medicine, the hours and lifestyle of even a dentist in a specialty practice can be predictable and potentially financially lucrative

Article Link – Dentistry Career Options

 The American Dental Association (ADA) numbers about 164,000 current dentists in clinical practice, most of them general dentists. The American Dental Association statement on careers in dentistry.

In addition, another interesting article is the American Dental Association article on 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.

  

Careers in Dentistry (Dental Clinical Sciences)

Dental School is a program of dental medical education that prepares individuals enrolled to become dentists.  Accredited dental medical education in the oral sciences and clinical dental medicine practice, prepares the individual, upon graduation and licensing, to practice as a general dentist or to enter one or more of the advanced graduate dentistry specialties.

Getting in to Dental School – The Application Process

The American Dental Association publishes a background and instructions page on applying to dental school.  Make yourself familiar with all the information listed here about the American Association of Dental Schools Application Service (AADSAS), as the Association’s Dental Schools Application Service is used by dental schools everywhere in the United States and Canada. The application service is a program of the American Dental Education Association, the regulatory umbrella of academic dentistry. Within the Association’s Dental Schools Application Service is the Postdoctoral Application Support Service (PASS).

PASS simplifies the application process by providing a standardized format, including portals for your college to upload transcripts and letters of recommendation, the format then submitted to all the schools to which you’ll choose to send applications. The dental schools benefit by receiving uniform, standardized, information regarding applicants --- many of whom will be international applicants from offshore educational institutions. When you are ready to apply --- the best timing for applying being during the college junior year --- go here to the actual general application portal.

Apply early. Apply to as many as you can afford. Many people hoping for admission to dental school apply to as many as twenty programs, and more. Dental school interviews begin at least as soon as the fall semester does, and a first round of acceptances can be offered about early December or earlier for some dental schools. As a norm, acceptances continue on a rolling basis until a given program’s next-season incoming class is full.

When you actually to identify the schools to which you are going to apply, the American Dental Association provides a sophisticated and irreplaceable dental school search tool here that filters programs by predoctoral (DDS/DMD) dental education programs (dental schools) or allied dental education programs (programs teaching dental assisting or dental hygiene careers) or advanced dental education programs (only for graduate dentists, an extra one- or two-year program of additional mostly clinical, patient hands-on training) and includes a United States (including Puerto Rico) and Canadian programs search function.

Keep in mind that acceptance to dental school requires an extreme commitment to one’s personal academic performance long before one even ever applies.

Dental schools routinely receive many applications from the highest-achieving college undergraduates possible, students with straight 4.0 averages overall and especially 4.0 averages in the dental school prerequisites (typically eight hours of biology with lab, eight hours of inorganic chemistry with lab, eight hours of organic chemistry with lab, eight hours of physics, eight hours of English).

If acceptance to dental school is what you want, you must first succeed in all that academic achievement yourself, and then distinguish yourself in an applicant pool where outstanding academic achievement is already the norm.

A word about prerequisites: the American Dental Association cites the subjects and hours listed here as a baseline and admonishes college undergraduates to contact (via the application pages on their websites) individual dental schools for specific prerequisite information. Majoring in a science field is not necessary but many people frequently do. Just as frequently non-science majors are accepted into dental school. What is non-negotiable is general academic success, success in the prerequisites, and a high score on the Dental Admission Test (DAT).

The DAT is taken at least a year before applying, and after completing the college biology, inorganic, and organic chemistry prerequisites (for many students, the timing to take this test is the summer after sophomore year, and certainly no later than during the junior year). The DAT is a computerized test (not necessarily taken at a testing site) measuring general academic ability, science knowledge in biology, chemistry, and physics, and perceptual ability.

The American Student Dental Association provides a similar roster of 66 dental schools in the United States and Puerto Rico, with links here to each program.

Because the American Student Dental Association (ASDA) is managed by dental students for dental students, the links on the right sidebar are essential.

Topics covered include resources available to accepted dental students, advice on getting into dental school, what to know before applying, how to do the shadowing required by most dental programs, how to pay for dental school (ASDA current average debt carried by a graduating dentist: $285,184) and how to prepare for the Dental Admission Test (DAT), the key qualifying standard examination, similar to the SAT.  Also included are posts about the real-world life of being a dental student, how to finesse the dental school interview, and how to survive the waiting period until you are accepted.

Dental school admission committees do factor in overall college undergraduate achievement and prioritize applicants who can operationally demonstrate highly subjective interpersonal and character attributes such as intellectual and career motivation, commitment to the dental medical ideal, volunteerism in service to society and the profession, prior experience in an allied dental medical career (transitioning from training as a dental hygienist or dental assistant, as long as one possesses also the required baccalaureate degree, is a frequently-seen path to dental school), or even education and full prior other careers in fields such as law, engineering, or the military. And ultimately the successful dental school applicant must also demonstrate a genuine yet intangible likeability that convinces admissions committees to extend the opportunity to spend the next four years among them. One can only wish you well.

A word about paying for it all. It is possible to say that nothing about the making of a dentist comes cheap. As the American Student Dental Association calculations point out, their estimated average dental school debt ($285,184) is only an average, is a four-times increase in the past thirty years, and is not declining any time soon.

Being accepted into dental school is not the time to begin trading on the substantial amounts of credit banks and lenders are willing to offer the new dental student. Investing in a condo over renting the university’s graduate student housing may be a sound financial investment, taking a hefty car loan on the vehicle of your dreams is probably not.

Consult a reputable financial adviser with your best interests in mind early and often. Make a budget and stick to it. Pay off credit card debt as you incur it. Attempt to save. With the help and advice of that financial adviser, make a plan for paying off your undergraduate and dental school tuition debt. Scholarships and tuition repayment programs do exist, where the graduate dentist trades tuition reimbursement in exchange for years of service.

The Affordable Care Act had a public-health dentistry tuition reimbursement proviso. Military service and a career as a dentist in the military is a frequent option, as is a career as a graduate dentist in the Indian Health Service. Understand whatever loan payment plan you do make.

The bottom line is, conscious decisions and actions must be taken to cope with and pay back the enormous student debt created by attending dental school. Exactly as has been every other issue on the road toward becoming a good dentist, debt repayment is your personal responsibility as well.

 

Getting in to Dental School - What you need to know before you apply

First, be clear that careers in dentistry are professional working opportunities in medicine. Careers in dental medicine promote the health and well-being of other people through the gateway of good oral health.

The American Dental Association numbers about 164,000 current dentists in clinical practice, most of them general dentists. Check out the general American Dental Association statement on careers in dentistry.

When considering a career in dentistry, it is very important to ask yourself why you are interested in a career in dental medicine. Then ask yourself if you possess enough of the subjective qualities dental school admissions committees keep top-of-mind, that people in the dental chair really deserve, and that are necessary for long-term success in the career.

Be aware that dental school admissions committees not only want the individuals they agree to train as dentists to possess these qualities, they will require prior demonstration of the qualities, by volunteer, academic, and service experiences recounted on paper, in recommendations, and by their own examination of your personality and competence in the admissions interview.

Basic skills you will need to possess

  • Outstanding people skills. The personal ability to remain calm and proactive in the face of other peoples’ pain and extreme distress;
  • Demonstrated manual dexterity;
  • Demonstrated strong eye-hand coordination;
  • The intellectual ability to grasp complex and increasingly specific medical concepts, and then implement the concepts into demonstrated clinical skill.
  • At the dentist-graduate threshold, an individual needs specific and abundant business acumen to succeed in private practice. One aspect of this is the acceptance and management of additional business debt on top of potentially already significant personal student tuition and other debt.

Except for the potentially special cases of academic, military or public and international health dentistry, or hospital-based traumatic maxillofacial surgical reconstructive dental medicine, the hours and lifestyle of even a dentist in a specialty practice can be predictable and potentially financially lucrative.

Finally, consider here what the United States Bureau of Labor Statistics says about careers in oral care, factoring in employment, wages, and training; wages and hours; getting started in the career; and the outlook for the future of a particular career pathway in oral healthcare.

The U.S. Bureau of Labor Statistics also links the reader to its generalized online Occupational Outlook Handbook. (The Bureau cites the fastest growth, much faster than average, in the period 2018-2028, in the allied dental health careers of dental assisting, dental hygiene, and dental laboratory technician. This is a logical situation, considering that these are low-education threshold, low-specialty, not high-wage occupations easily accessible to a broad population. In the highly-educated, high-wage dental occupations, somewhat accelerated growth is seen among general dentists and the highly popular specialties of oral and maxillofacial surgery, orthodontists, and prosthodontists. About average growth is forecasted for all the other dental specialties.)

 

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.

 

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.

 

 

Dental Assisting/Assistant Careers in Dentistry

A program that prepares individuals to provide patient care, take dental radiographs (x-ray photographs), prepare patients and equipment for dental procedures, and discharge office administrative functions under the supervision of dentists and dental hygienists. Includes instruction in medical record-keeping, general office duties, reception and patient intake, scheduling, equipment maintenance and sterilization, basic radiography, pre- and post-operative patient care and instruction, chairside assisting, taking tooth and mouth impressions, and supervised practice.

 

Four-Handed Dentistry

The dental assistant is a key role inside nearly every dental office in the real world, essential to the concept of four-handed dentistry dominating dental practice offices everywhere.

When practicing four-handed dentistry, the dental assistant's two hands complement the dentist's two hands through every stage of every procedure. It’s like a ballet

Four-handed dentistry turns on repeatable, sustainable principles of positioning and seating, the use of a minimum number of ergonomically-designed pieces of equipment laid out in pre-set trays in their sequence of use, in order (left to right or top to bottom, depending on office preference), and all equipment, instruments, and materials prepared in advance and ready to go before the assistant seats the patient. (Most often prepared the night before.) Once the dentist begins the procedure, motion economy takes over, and the assistant anticipates and predicts the dentist’s every next move, passing him each instrument, piece of material, or piece of equipment he’ll need next, before the dentist asks for it.

The steps of each patient’s treatment is planned logically in advance, and likewise discussed with each patient in advance, before the treatment starts and as the procedure unfolds. The dentist and the assistant work in an interaction of trust and synchronicity. Every day in every procedure, the dentist and the assistant work together to establish and follow a safe, standardized, and predictable instrument transfer protocol. Inside the office, the dentist delegates to the qualified dental assistant any and all duties legally possible to delegate.

The practice of dentistry is rigorously physical, with an endless every-day stretch of repetitive micro-motions. The objective of motion economy is to minimize the number and magnitude of motions and conserve everybody’s energy while working.

For a really thorough instruction in the principles of four-handed dentistry, read this continuing education course posted by dental care materials manufacturers Crest and Oral-B.

The American Dental Association identifies 243 ADA-accredited training programs for dental assisting, located largely in regional community colleges and technical colleges. Many kinds of dental assisting training programs are available, but only these are accredited by the American Dental Association.

The same ADA search tool for predoctoral (DDS/DMD) dental education programs or residency programs can be used to search for allied dental education programs (programs in dental assisting).

There are two national professional associations for dental assistants, the nearly 100-year old American Dental Assistants Association https://www.adaausa.org/ (founded in 1921 by Juliette A. Southard, a dedicated young assistant working in New York City for dentist Dr. Henry Folwer), and the National Dental Assistants Association.

The Dental Assisting National Board is the nonprofit national certification board for the nation’s 37,000 currently certified dental assistants

The key job of the dental assistant is the practice of four-handed dentistry, helping to provide direct patient care in all dental specialties, whatever is the specialty practice employing the assistant

On the job the dental assistant can be expected take and develop dental x-rays; take impressions of patients' teeth for study casts (models of teeth); confirm the patient’s medical history and take blood pressure and pulse; greet the patient from the reception area and seat the patient; and make the patient feel comfortable before, during, and after the dental procedure. The assistant communicates post-op oral care instructions, and teaches appropriate oral hygiene strategies (tooth brushing, flossing, and nutritional counseling). Inside the office practice, the assistant participates in office management, and acts as the practice’s infection control officer, developing infection control protocols, and preparing and sterilizing instruments and equipment

 

 

Dental Hygiene/Hygienist Careers in Dentistry

A program that prepares individuals to clean teeth and apply preventive materials, provide oral health education and treatment counseling to patients, identify oral pathologies and injuries, and manage dental hygiene practices. Includes instruction in dental anatomy, microbiology, and pathology; dental hygiene theory and techniques; cleaning equipment operation and maintenance; dental materials; radiology; patient education and counseling; office management; supervised clinical training; and professional standards.

 

Day-to-Day Work Life

Career prospects for dental hygienists are currently excellent

On the job, dental hygienists professionally clean teeth with dental instruments --- every one of the six surfaces of the thirty-two teeth --- a procedure called a dental prophylaxis. Patients are logically scheduled one every hour. Dental hygiene is a career that easily accommodates part-time and flex-time, as well as full-time, working.

Clinical dental hygiene is not a career that can at all be performed remotely. Like dentistry, clinical dental hygiene is on the front-lines of patient care, and rigorous infection-control practices are essential. Dentistry learned many lessons about infection control during the 1980s AIDS epidemic and remains one of the medical professions with the most practical knowledge and rigorous application of infection control protocols already in place prior to the Covid-19 pandemic

Oral health is the gateway to good systemic health. Dental hygienists practice in general dentistry offices, and in the offices of all the dental specialties. The limits of dental hygiene practice are established by the various state dental boards, and vary from state to state but include, for instance, under the direction of the supervising dentist in the practice, patient screening procedures --- assessing the oral health condition, reviewing the health history, assessing patient vital signs, and taking and developing dental x-rays. Depending on the practice, the hygienist (or the assistant) makes impressions of patients' teeth as models to be used by the dentist doing the patient’s treatment

The actual dental prophylaxis (prophy) procedure removes plaque and calculus from all surfaces of all the teeth. The hygienist then commonly polishes the teeth and applies sealants and fluorides (preventive materials) to the teeth. The hygienist counsels good nutrition and instructs the proper dental hygiene home care regimen

Consider this article in Registered Dental Hygienist magazine about another side of the reality of being a dental hygienist: working in a highly stressful dental office where the work could be better allocated between the dental hygienist and the dental assistant

And, read this other first-person account from Dental Products magazine

As the American Dental Association points out, dental hygiene is a career with many benefits: the flexibility in hours --- the abundance of part-time and flex-time work, and the ability to leave the career for an amount of time and then return, picking up easily where one has left off --- job security and prestige as a stable healthcare profession, and the variety, creativity, and personal satisfaction of the work

 

Where to study and learn to be a dental hygienist

The American Dental Hygienists Association is the umbrella membership organization for trained and licensed dental hygienists, providing government and professional advocacy, continuing education opportunities, and career guidance, acting as a forum and clearinghouse for dental hygiene research and education opportunities, and providing support to the dental hygiene practice community

Keep in mind that only the American Dental Association’s Commission on Dental Accreditation (CODA) accredits programs in dental hygiene. To find an accredited program in dental hygiene, use this weblink from the American Dental Association.

The ADA’s Commission on Dental Accreditation currently certifies 351 dental hygiene programs, in institutes of higher education ranging from regional technical schools to community college to universities.

The American Dental Hygienists Association offers a link here to programs, breaking down the programs it knows about into categories: those best suited for entry-level learners; degree completion programs --- meaning programs that offer a bachelor’s degree (BS/BA) to individuals already possessing a certificate as a registered dental hygienist (RDH); programs ideally positioned to accommodate re-entry or mid-/second-career learners; programs that offer master’s degrees in dental hygiene (MSDH) or related disciplines; and programs accommodating online/distance education.

The ADHA discusses in this online fact sheet an issue facing American higher education, the proliferation of non-accredited programs in for-profit schools (some schools and programs are accredited by the ADA, and some aren’t). The ADHA says it welcomes student and faculty members from accredited programs in for-profit institutions, and makes statements of its concern for the proliferation of such programs damaging the (currently excellent) employment prospects of dental hygienists generally

In this article, the ADHA states that it is the conventions of state practice laws that really decide in a general way what kind of school is necessary to qualify for a license as a dental hygienist. Like dentists, dental hygienists require licensure from state dental boards, continuing education, and a clean criminal record in order to obtain and maintain a license to practice their career.

The American Dental Hygiene Association offers this fact-sheet of tips to help you determine the best dental hygiene program for your particular situation

The fact sheet points out important questions to ask of any program seeking your tuition dollars in exchange for education.

For instance, ask

What are the relevant numbers of students who, once enrolled, actually finish your program (attrition rate)?

What percentage of graduates pass the national board exam on the first attempt?

What percentage of graduates pass the clinical licensing exam on the first try?

What percentage of graduates find full-time employment as a clinical hygienist within several months of graduation?

More than ever, when choosing a place to study and learn, research your options.

 

 

Dental Laboratory Technology/Technician Careers in Dentistry

A program that prepares individuals, under the supervision of dentists, to design and construct dental prostheses such as caps, crowns, bridges, dentures, splints, and orthodontic appliances. Includes instruction in dental anatomy, dental materials, ceramics technology, impressions, complete dentures, partial dentures, orthodontics, crowns and bridges, sculpture, bonding and assembly techniques, and equipment operation.

In short, the dental technician makes the prostheses and devices --- the caps, crowns, bridges, dentures, splints, and braces --- the particular practicing general dentist or specialist orthodontist, prosthodontist/maxillofacial prosthodontist, or oral and maxillofacial surgeon --- will place

Manual dexterity and a high school diploma are essential prerequisites for training and a career in dental technology

The Commission on Dental Accreditation of the American Dental Association accredits instructional programs in dental technology, in institutes of higher education like technical colleges, community colleges, vocational schools, universities, and dental schools. You can search for an accredited program in dental technology via the weblink at the American Dental Association

The American Dental Association currently accredits 24 programs in dental technology

According to the ADA, certification as a dental laboratory technician [Certified Dental Technician (CDT)] is possible by passing an examination administered by the National Board for Certification in Dental Laboratory Technology. According to the ADA, certified dental technicians specialize in one or more of six dental device areas: implants, complete dentures, removable partial dentures, crown and bridge, ceramics, or orthodontics.

The National Board for Certification in Dental Laboratory Technology posts details regarding certification here.

The American Dental Association says this about a career as a dental laboratory technician.

The ADA points to the flexibility, independence, and job security of being a dental technician as positives to the career. There is a routinely high level of creativity and personal fulfillment involved in being a dental technician as well

Inside Dental Technology, the respected trade publication of the profession, talks here about the evolving role of both the dental technician and technology in the dental practice.