Dental

Decision in a Sea of Dental Residencies

Over the holidays, dental school students all over the nation put down the books, hung up the scrubs, and went home to spend time with family. Despite every effort to forget about school for a few days, the memories came flooding back with every conversation with a relative asking about school. In the first couple years of dental school the interrogation usually includes questions about how school is going and if you’ve made some new friends. For the third and fourth year students, however, the conversations likely started with “Do you know what you’re doing after school yet?”

For some, the question about life after graduation is a no-brainer. For the rest of us, this question might have prompted turning the Christmas music up a couple decibels or pouring another glass of eggnog. The truth is that the options after dental school can be overwhelming. Dental school differs from medical school in that a residency is not necessary to practice. For those wanting to join the workforce, there are opportunities to start a new practice, associate with an existing dentist, work for a dental school, or work for a corporate group directly out of school. For those who won’t go straight into practice, the options are even more numerous. This is where the dental residency comes into play.

According to the ADA, somewhere between 35 and 40% of dental students pursue advanced education in a residency program. Considering many dentists enter residency programs years after graduation, this estimate may even be on the low side. With over 700 residency programs across the country, the options feel endless.

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There are 9 specialties recognized by the ADA, each with their own residency program. When people think of residencies, they usually think about those residencies associated with a specialty. In addition to specialist residencies, residency programs exist for practitioners looking to hone their skills in general dentistry. For the sake of brevity, this article will cover some of the more popular residency types among graduating dentists. For an introduction to these programs, let’s review the three D’s of residency: a Description, the Duration, and the Degree earned.

Advanced Education in General Dentistry (AEGD)
Description: The AEGD program is a residency which is not affiliated with a specialty. Rather, the AEGD program is intended to supplement the dental education received in dental school and prepare students to be more competent and confident dentists. The focus is on clinical dentistry, rather than medical management.
Duration: Almost all programs last one year.
Degree: A certificate is earned.

General Practice Residency (GPR)
Description: The GPR program is another residency not tied to a specialty. It is similar to an AEGD program, but with more of a focus on treating patients in a hospital setting.
Duration: The majority of GPR programs are one year in duration, but some span two years.
Degree: A certificate is earned.

Endodontics
Description: Endodontics is the dental specialty concerned with the pulp and periradicular tissues. The most common treatment associated with endodontics is root canal treatment. The majority of patients are seen on an emergency basis.
Duration: Most programs are 2-3 years long.
Degree: Graduates receive either a certificate or Master of Science in Endodontics.

Oral and Maxillofacial Surgery
Description: Oral and maxillofacial surgery is unique in that it is a recognized specialty of dentistry as well as medicine. It is a branch of surgery focusing on the hard and soft tissues of the head and neck. The most common treatment associated with oral surgery is extraction of wisdom teeth, but the specialty is so much more than this.
Duration: The minimum requirement is four years. If earning an MD or PhD, programs may last 6 years. Students may enter a program from either medical or dental school.
Degree: If completing a 6-year program, residents may earn an MD or PhD.

Orthodontics
Description: Orthodontics is the dental specialty that aims to correct both dental and skeletal relationships. The end goal is the proper positioning of teeth and jaws. The most common treatment associated with orthodontics involves the alignment of teeth using braces.
Duration: Programs vary between two and three years in length.
Degree: Residents may earn either a certificate or a combined MS/PhD option.

Pediatrics
Description: Pediatric dentistry is an age-defined specialty. Pediatric dentists work with children, adolescents, and special needs patients to prevent and correct disease of the oral cavity.
Duration: Programs must last a minimum of 24 months.
Degree: About half offer a certificate and half offer a master’s degree.

Periodontics
Description: Periodontics is the dental specialty concerned with the supporting and surrounding tissues of the teeth or implants. Periodontists work with patients to achieve and maintain the health of the gingiva, bone, and attachment apparatus. Implants and tissue grafts are among the more common procedures performed in periodontics.
Duration: Most programs last three years. There is a required minimum 30 months of instruction.
Degree: Most programs offer a certificate upon graduation.

Prosthodontics
Description: Prosthodontics is the dental specialty, which involves the replacement of missing or damaged teeth or other oral structures with prosthetics. Prosthodontists perform many of the same procedures as general dentists, but often handle more complexes cases including full mouth rehabilitation.
Duration: Prosthodontics programs last a minimum of 33 months.
Degree: Graduates receive either a certificate or a Master of Science degree.

These synopses are not intended to be a complete summation of all the questions related to residencies. Rather, they should provide a framework to start to understand what distinguishes one type of residency from another. There are plenty of variables within each residency type. One of the biggest variables is the cost component. The cost of a residency can vary greatly, even within seemingly similar programs. It is not unheard of to pay upwards of $90,000 per year for some programs. Meanwhile, other schools give residents a yearly stipend that more than covers the entire cost of tuition. In general, private schools tend to offer the more expensive residencies.

With all these residency options and all the variability between them, how is a student to decide? A few small steps can make a big dent in your decision to pursue a residency.

  1. The first and best step is to shadow a graduate or current resident of the programs you’re interested in.

    Many programs offer externships that allow interested and qualified students to spend a day or a week alongside the residents. In fact, for oral surgery residencies an externship is almost an unspoken requirement for candidates. Shadowing a graduate out in practice is usually even easier. Most practitioners are more than happy to have students come shadow in their practice. It’s often as simple as contacting their office manager and giving them your availability.

  2. Do your homework.

    The Internet is a wealth of knowledge. There are great resources online through the ADA and various dental blogs. Almost all residency programs also have websites filled with valuable information and contacts. Dental residencies are not as intimidating as students often make them out to be. One of the biggest mistakes students make is becoming paralyzed by options. Since there is so much to understand about residencies, it is easy to avoid the topic altogether. The earlier students can start exploring the options, the easier it will be to make an informed decision in those later years of dental school.

  3. Do your actual homework.

    Residencies are competitive. Your grades won’t always get you into a residency, but they sure can keep you out of a residency. Good luck finding an admissions committee that will disclose what their class rank or percentile cutoff is for applicants, but those numbers do matter. For those students who will pursue a specialist residency, it’s tempting to focus so much on courses and clinic grades related to this specialty that you neglect excellence in the rest of the curriculum. Avoid this pitfall. No matter what your ambition is for residency, your performance in dental school is crucial. The better you do in dental school, the more options you will have available to you when you walk across that stage and receive a DMD or DDS.

Following these simple tips will offer a surprising amount of confidence in your ability to decide on a dental residency. Hopefully the next time you have a family member or friend ask about your plans after dental school, you’ll be able to tell them confidently about your options and the steps you’re taking to get there.

For more information regarding dental residency programs, refer to the ADA links below.
Specialty Definitions
Advance Education Program Options and Descriptions

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Colson Smith is a third year dental student at the University of Alabama Birmingham School of Dentistry. He is an avid outdoorsman and enjoys spending time outside with his friends, family, and three-year-old black lab. Colson Smith is a third year dental student at the University of Alabama Birmingham School of Dentistry. He is an avid outdoorsman and enjoys spending...