08 • Career
SURGICAL SOLUTIONS
Oral surgery promises a varied, challenging career that takes advantage of the latest technological developments
T
HE specialty of oral surgery is a dynamic one that has developed and evolved at a rapid pace in recent years. It has a key role to play in oral healthcare provision, particularly as dentists face growing challenges in treating an ageing population, with increasing numbers of patients retaining teeth later in life.
As the name suggests, oral surgery focuses on surgical
interventions to address problems with the jaw and mouth. These range from the extraction of broken and decayed teeth to the removal of non-cancerous lumps and cysts, and the placing of implants. Career paths are broad-ranging and practitioners can work as specialists, or with a special interest in the field, basing themselves across both primary and secondary care. It has close ties with the specialty of oral and maxillofacial surgery but does not require a medical degree. Technology has played a big part in advances in oral surgery and clinicians are increasingly able to use minimally invasive techniques. They can now take advantage of state-of-the-art innovations such as 3D cone beam imaging, digital impressions and other specialised computer programs.
Entry and training Dentists interested in a career as a specialist in oral surgery are expected to have completed two years dental foundation training, or equivalent, with a minimum of two years dental core training in relevant posts. Following this, specialty training lasts three years (whole time equivalent), during the last six months of which dentists must successfully pass the specialty membership exam in oral surgery (M Oral Surg) of the Royal Surgical Colleges of Great Britain. Once they have completed training and passed the exam, they will then be recommended for a certificate of completion of specialist training (CCST). Trainees working towards a CCST can gain experience in various
settings, including a dental teaching hospital with relevant attachments in oral surgery or oral and maxillofacial surgery in district general hospitals, or specialist centres. They may also undertake formal postgraduate training, such as a Masters (MClinDent) in oral surgery offered by the likes of the University of Edinburgh and UCL Eastman Dental Institute, or the MSc/PGDip oral surgery programme offered by the University of Central Lancashire. Once dentists have been awarded the CCST, they can choose to work
as a specialist or pursue a two-year post-CCST development programme. This would also lead to an intercollegiate specialty fellowship examination and from there the dentist can work as an NHS consultant. Dentists can also pursue an academic training pathway after
completion of two years foundation training. This may initially be via an academic clinical fellowship post, followed by research training fellowship (PhD) and subsequent clinical lectureship, before leading back into the three-year core competency specialty training and postdoctoral studies. Ultimately this training can lead to honorary
The job The GDC defines oral surgery as dealing with “the treatment and ongoing management of irregularities and pathology of the jaw and mouth that require surgical intervention. This includes the specialty previously called surgical dentistry.” Specialists spend much of their time dealing with the surgical
aspects of patient care that go beyond the competence of general dental practitioners. Work can be based both in primary and secondary care with common procedures including:
• complex dental extractions • apical surgery • implant placement
• dealing with minor trauma, carried out under local anaesthetic with or without sedation in a primary care setting
• dealing with more complex patients or major surgery requiring general anaesthetic in the hospital service.
Practitioners can take advantage of the latest techniques which
allow jaw surgeries to be planned in 3D with the use of CT scans and specialist computer programs. Detailed digital reconstructions of the face and skull can be made easily, which has improved the way implant surgeries are carried out. Procedures can also be carried out virtually on a computer, allowing the oral surgeon to practise skills to assist in hands-on patient care. The British Association of Oral Surgeons provides useful resources
and professional networking/educational opportunities for practitioners, from those with a special interest to specialists and academic oral surgeons. Annual membership costs £125 and includes access to their Oral Surgery journal.
Sources • Royal College of Surgeons of England, Faculty of Dental Surgery. Specialty training curriculum: Oral surgery –
http://tinyurl.com/ zrap39y
• British Association of Oral Surgeons:
www.baos.org.uk
consultant and combined academic (research and teaching) roles. Dentists who plan to use the title of “oral surgeon” or “specialist”
must successfully apply to join the General Dental Council’s (GDC) oral surgery specialist list. This is not compulsory for working within the specialty. Many practitioners are not on the list and would generally be described as having a “special interest in oral surgery”.
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