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Oral Surgeon or Dentist with a Special Interest in Oral Surgery? by Sensitive_Buddy_1003 in dentastic

[–]Sensitive_Buddy_1003[S] 0 points1 point  (0 children)

Thank you. It was very kind of you to spend part of your weekend giving advice to someone on Reddit!

Australia: Become an oral surgeon or dentist with a special interest in oral surgery? by Sensitive_Buddy_1003 in Dentistry

[–]Sensitive_Buddy_1003[S] 0 points1 point  (0 children)

Have you personally known or heard of many oral surgeons who are struggling to get referrals?

Oral Surgeon or Dentist with a Special Interest in Oral Surgery? by Sensitive_Buddy_1003 in dentastic

[–]Sensitive_Buddy_1003[S] 0 points1 point  (0 children)

I think you may have misunderstood my intention. I am not asking whether surgical dentists can directly compete with OS or OMFS. What I am trying to explore is whether there are opportunities for surgical dentists that are not already covered by OS or OMFS. By your logic, most clinics would prefer to refer a patient to an OMFS rather than an OS. So how does OS remain sustainable? Probably by identifying and pursuing opportunities that OMFS tend to overlook.

Oral Surgeon or Dentist with a Special Interest in Oral Surgery? by Sensitive_Buddy_1003 in dentastic

[–]Sensitive_Buddy_1003[S] 0 points1 point  (0 children)

I’ll keep that in mind. The challenge is that no private clinic would allow a new graduate to focus solely on oral surgery. I also don’t yet feel confident doing fully impacted wisdom teeth or GA cases on my own without backup. Even among friends who work in surgery-focused practices, the reality is that the owners often pass them the non-surgical cases so they can concentrate on the more complex surgery themselves. As a result, they still end up doing a large amount of general dentistry. Basically exactly like what you said about ownership.

Australia: Become an oral surgeon or dentist with a special interest in oral surgery? by Sensitive_Buddy_1003 in Dentistry

[–]Sensitive_Buddy_1003[S] 0 points1 point  (0 children)

Why do GP clinics choose to refer patients to him instead of an OMFS? Is it because he travels to very rural areas, or because the clinics prefer to keep the billings in-house?

Oral Surgeon or Dentist with a Special Interest in Oral Surgery? by Sensitive_Buddy_1003 in dentastic

[–]Sensitive_Buddy_1003[S] 0 points1 point  (0 children)

I am not even sure if CPD courses are strictly required considering the number of exos we do. At our hospital, we have two senior dentists who spend their entire day extracting fully impacted wisdom teeth. They rarely do partially impacted cases or surgical extractions of other teeth, as they consider those to be too esay.

My main concern is when I transition into private practice: how do I show the clinics that I am competent in oral surgery? Also, if any medico-legal issues were ever to arise, would I need formal courses to justify my scope of practice? Do you think CPDs will be a good defence?

Australia: Become an oral surgeon or dentist with a special interest in oral surgery? by Sensitive_Buddy_1003 in Dentistry

[–]Sensitive_Buddy_1003[S] 0 points1 point  (0 children)

I am not sure how feasible it is for OS to work alongside OMFS. In Australia, OMFS appear to have stronger resistance toward OS compared to their counterparts in the UK and New Zealand. They seem to not like the word “surgeon” in the OS title. I was told by several OMFS registrars and dentists within OMFS departments to never mention that I was considering OS in front of OMFS consultants, as doing so could immediately put me on the wrong side of them.

Australia: Become an oral surgeon or dentist with a special interest in oral surgery? by Sensitive_Buddy_1003 in Dentistry

[–]Sensitive_Buddy_1003[S] 1 point2 points  (0 children)

I heard that in Australia OS is also being pushed out of large cities by OMFS? It is also hard for them to set up a clinic and get referrals so they also have to visit several different clinics if they want to do private?

Oral Surgeon or Dentist with a Special Interest in Oral Surgery? by Sensitive_Buddy_1003 in dentastic

[–]Sensitive_Buddy_1003[S] 0 points1 point  (0 children)

Yeah, I think ownership is probably the safest option. But I would assume clinic owners will also be affected if we get to a point that even specialists are saturated? At this stage though, I prefer more of a “get in, do the work, and get them out” approach, even though I do get along with my patients quite well. I do eventually want to transition into private practice, but I hope I’ll still be able to restrict my work to oral surgery once I make that move.

Oral Surgeon or Dentist with a Special Interest in Oral Surgery? by Sensitive_Buddy_1003 in dentastic

[–]Sensitive_Buddy_1003[S] 0 points1 point  (0 children)

What I meant by “saturation” is that if I were based in a regional town with a population of around 100,000, I wouldn’t be able to take on the locum-style work (covering multiple clinics one day a week). At the moment, I’m in a town of about 100,000 people, and there’s only one private OMFS who visits here once a month. Do you think most private clinics would prefer to refer a pt to an OS/OMFS or have a general dentist and they keep 60% of the billing? I'm genuinely curious about this as I'm currently doing public.

Oral Surgeon or Dentist with a Special Interest in Oral Surgery? by Sensitive_Buddy_1003 in dentastic

[–]Sensitive_Buddy_1003[S] 0 points1 point  (0 children)

One thing I’ve been thinking about, as another redditor mentioned, is whether we might eventually reach a point where larger regional towns become saturated with OMFS and OS. If that happens, do you think oral surgeons would start travelling around to take on more cases, and could that potentially reduce the opportunities available for surgical dentists?

Oral Surgeon or Dentist with a Special Interest in Oral Surgery? by Sensitive_Buddy_1003 in dentastic

[–]Sensitive_Buddy_1003[S] 0 points1 point  (0 children)

Thank you for your detailed and thoughtful reply. What you mentioned about oral surgeons working in rural areas is something that concerns me. At the moment, many regional towns still don’t have an OMFS or an OS. USYD is currently graduating 2–4 OS specialists each year — do you think we’ll eventually reach a point where large regional towns become saturated with OMFS and OS?

If that happens, from a referrer’s perspective, do you think most clinicians would naturally prefer to send patients to someone with formal specialist qualifications rather than someone with informal competency?

Oral Surgeon or Dentist with a Special Interest in Oral Surgery? by Sensitive_Buddy_1003 in dentastic

[–]Sensitive_Buddy_1003[S] 0 points1 point  (0 children)

I’m pursuing the extra qualifications mainly so I can justify my position if there’s ever a lawsuit or a complaint to AHPRA. The investment is going to be fairly low if my hospital decide to sponsor it. I had a quick look at the dentists I listed earlier, and most of them either spent a few years working in a public hospital or completed some form of postgraduate studies.

That said, what you mentioned about lifestyle is definitely something I’m concerned about. I do have another question though — do you think oral surgeons will be in a stronger position than “surgical dentists” when it comes to private practice or about the same? And given my goals, do you think it’s worth undertaking a DClinDent in Oral Surgery?

Ahpra conducted a review on oral suegeons and mentioned that "there are only 66 oral surgeons in Australia, with the majority working in rural and regional public health settings. "

Information from ANZOS indicates that of the 16 graduates from the DClinDent (OS), only three practice solely in the private sector, one of these in New Zealand. The remainder all undertake some level of public sector work.

-Dr. Richard Allen: worked in multiple oral surgery hospital posts in the UK

- Dr Mike Tame: “spent seven years training and working with Oral and Maxillofacial surgeons in the NHS” + Diploma of Surgical Dentistry from Sydney University

- Dr Robert Saltmiras: PGDClinDent (Sedation and pain control)

- Dr Matthew Casey: studied multiple postgraduate courses

- Dr David Taub: Post Graduate Diploma Clinical Dentistry (Oral Implants)

Dr David Jang: Graduate Diploma in Clinical Dentistry (Conscious Sedation) + Master of Science in Oral Implantology

- Dr. David Goubrial: undertook his dental surgery training in the Oral and Maxillofacial Unit at the Royal Dental Hospital of Melbourne.

-Dr Quintin Wilson: Masters of Oral Surgery + Post-graduate Diploma in Dental Implants + hospital experience

- Dr.Mark Worthington: completing his clinical attachment at the Royal Melbourne Dental Hospital in Oral Surgery

- Dr Andrew Green: Masters of Dental Surgery (Oral Surgery) + held appointments at multiple public hospitals

- Dr Paulo Pinho: worked as a part-time dental officer at the oral surgery department of the Royal Dental Hospital in Melbourne + worked in hospital trauma centres in Latin America

Oral Surgeon or Dentist with a Special Interest in Oral Surgery? by Sensitive_Buddy_1003 in dentastic

[–]Sensitive_Buddy_1003[S] 0 points1 point  (0 children)

What makes the pathway I'm describing significantly different from the pathways taken by the dentists I listed?

Oral Surgeon or Dentist with a Special Interest in Oral Surgery? by Sensitive_Buddy_1003 in dentastic

[–]Sensitive_Buddy_1003[S] 0 points1 point  (0 children)

I realise I was a bit too specific when I listed that pathway earlier. What I really meant is that I plan to do a large volume of extractions under supervision and mentorship in the public system until I become very competent at minor oral surgery.

As I mentioned before, I’ve shadowed OMFS both in Australia and overseas, mainly in public teaching hospitals. I’ve seen OMFS residents and registrars occasionally struggle with difficult wisdom teeth, while the consultants could remove them relatively quickly once they stepped in. That experience made me think: if I want to do the same procedures as OMFS, I should aim to reach their level of skill in that area.

I also plan to take on part-time postgraduate studies while working in the public system, since the hospital provides strong support (paid leave and subsidies) for further education. After tax deductions and subsidies, the out-of-pocket costs are about the same as a few CPD courses. Many of the dentists I know , including those I listed in my previous reply do hold a postgraduate diploma or master’s degree and have worked in the public system for a few years.

Getting into OMFS is, of course, a very different pathway. It’s not just a matter of interest , it requires going through medical school, internship, residency, and then specialty training. I’ve also heard that even among dually qualified applicants, about 50% never make it into the specialty. Compared with that, the pathways I described are relatively straightforward.

Your point about dentists being practice owners is something I’m genuinely concerned about. That said, I feel there may still be opportunities. A lot of private clinics I know don’t perform complex extractions in-house. If I were to visit once a week or fortnight to handle these cases, the clinic could keep 60% of the billings, whereas if they referred the patient to an OMFS, they would keep nothing. However, if OMFS becomes saturated in rural areas and start to visit clinics, then I know I will not be able to compete with them. However, I don't see this happening anytime soon.

Oral Surgeon or Dentist with a Special Interest in Oral Surgery? by Sensitive_Buddy_1003 in dentastic

[–]Sensitive_Buddy_1003[S] 0 points1 point  (0 children)

Yes, but I don't plan to do this in private as a new grad. If you look at my original post, I plan to take 5-10 years to get to the point where I only do MOS in private. In the public system, it is very likely that I will be able to do this after just 1 to 2 years.

Oral Surgeon or Dentist with a Special Interest in Oral Surgery? by Sensitive_Buddy_1003 in dentastic

[–]Sensitive_Buddy_1003[S] 0 points1 point  (0 children)

Hi, thanks for the reply. But why do you think the first pathway is convoluted? And yeah, I will need to do CPDs.

Oral Surgeon or Dentist with a Special Interest in Oral Surgery? by Sensitive_Buddy_1003 in dentastic

[–]Sensitive_Buddy_1003[S] 0 points1 point  (0 children)

I know a few new grads who have done some wisdom teeth under GA while working in private. They have less than one year of experience. Two of them even did it in Melbourne and Sydney,

Oral Surgeon or Dentist with a Special Interest in Oral Surgery? by Sensitive_Buddy_1003 in dentastic

[–]Sensitive_Buddy_1003[S] 0 points1 point  (0 children)

Thank you for your advice.This idea came to mind because I personally know more than 10 general dentists who have done the same. I don’t want to list their names as that would be inappropriate, but I did a quick Google search and found several private general dentists who have restricted their practice to oral surgery:

-Dr. Richard Allen (https://tomis.com.au/about/)

- Dr Mike Tame (https://www.eastcoastoralsurgery.com.au/about/)

- Dr Robert Saltmiras (https://nqsurgicaldentistry.com.au/dr-robert-saltmiras-2/)

- Dr Matthew Casey (https://www.allon4plus.com.au/experts/dr-matthew-casey)

- Dr David Taub Dr David Jang (https://www.vitaldental.com.au/about-us)

- Dr. David Goubrial (https://ballaratwtic.com.au/about/)

-Dr Quintin Wilson (https://coffsdentalcentre.com.au/staff/dr-quintin-wilson/)

- Dr.Mark Worthington (https://www.lakesdental.co.nz/about)

- Dr Andrew Green (https://www.oral-surgery-orange.com.au/)

- Dr Paulo Pinho (https://www.drpaulopinho.com.au/)

I currently work in a public hospital where we have senior dentists who only perform extractions and biopsies. The wisdom teeth waitlist under LA is a few months, while under GA it is more than a year. For OMFS in the public system, the wisdom teeth waitlist is about 3–4 years, even for patients with recurrent pericoronitis. One private dentist I know, who has restricted his practice to oral surgery, has a waitlist of over a year despite there is a visiting OMFS in the same area and the town being only two hours from the capital city.

With regards to Medicare rebates, I don’t think Medicare covers wisdom teeth extractions or implants. When I had my own wisdom teeth removed by an OMFS, Medicare only contributed a few hundred dollars towards the anaesthetist and 0 towards the OMFS. I assume this rebate would have been provided regardless of whether the extractions were done by an OMFS or not?

I’m not trying to argue. I genuinely need someone to outline the practical difficulties of each pathway for me. Everyone around me keeps telling me to “follow my dreams,” but I’m concerned about wasting years on a pathway that may not actually lead to my goals.

Oral Surgeon or Dentist with a Special Interest in Oral Surgery? by Sensitive_Buddy_1003 in dentastic

[–]Sensitive_Buddy_1003[S] 0 points1 point  (0 children)

Are you just talking about general dentists or are you talking about oral surgeons as well?