Public perception of the dental profession has changed significantly over the last decade. Thanks to TV shows like "Extreme Makeover" and "The Swan", and new technology such as invisible braces and veneers, consumers are flocking to the dentist's chair in hopes of a new smile.
According to the US Department of Labor, Bureau of Labor Statistics, the demand for dental care should grow substantially through the year 2012. This is due in large part to the aging of the baby-boomer generation, as well as the fact that the elderly are more likely than ever before to retain their own teeth. Both of these circumstances are leading to a greater need of care. In addition, the field of cosmetic dentistry has blossomed over the last few years. According to an independent study performed by the American Academy of Cosmetic Dentistry (AACD) the number of consumers whitening their teeth increased 300% from 1995 to 2000, and the number of patients requesting veneers grew 250% over the same time period.
In an age of medical malpractice suits and negative media attention on medical professionals, dental professionals are being revered as one of the most trustworthy and generous in the medical profession. Gallup polls consistently rank dentistry among the top ten professions for honesty and ethical standards, and the American Dental Association (ADA) reports that in 1997 private practice dentists donated $1.7 billion in free dental care.
Dentists also are consistently one of the highest paid professions. According to the ADA, in 2001, the average earnings for a general practitioner who owns his/her practice was $173,000; the average earnings for a dental specialist was $275,000, which puts the average dentist in the highest 5% U.S. family income bracket. The average annual salary for dental hygienists in 2002 was about $55,000, however, hygienist salaries were reported to be as much as $81,000 in that same year.
With the many opportunities the field provides, the growing need for dental care, and the new and evolving technology, a career in dentistry can be both personally and financially rewarding. It's never been a better time to think about entering the dental profession.
When thinking about the dental profession, the first job that comes to mind is the Doctor of Dentistry. Afterall, it's usually the doctors who are featured on reality shows and in advertisements. However, the field of dentistry offers several career options, including Dental Hygienist, Dental Technician and Dental Assistant. In fact, according to the Bureau of Labor Statistics of the above mentioned professions, dentists are actually expected to see the smallest increase in jobs over the next seven years - three to nine percent. Whereas a 36% or higher increase is expected for dental hygienist and dental assistant positions over the next seven years. In fact dental hygienist is reported to be one of the fastest growing occupations today.
Helena Gallant Tripp, president of the American Dental Hygienists' Association (ADHA) explains what makes the dental hygiene profession desirable. "Dental hygiene is a healthcare profession with an attraction to people who are interested in providing benefits to the general population. It's a very flexible profession and is great for people who wish to work part-time. The majority of hygienist work today is in private practice, so it can be fulltime or part-time. It's also a fairly well paying job."
Tripp also states that new options are being opened to dental hygienists. "The majority of hygienist work is in private practice providing clinical services to patients. However, there are also career opportunities in public health, healthcare policy; corporate opportunities in research, sales, and management; educational opportunities in dental school and dental hygiene education, and some even in public school systems.
"Up until the 1950's most hygienists were public health professionals and worked in schools, then the focus on dentistry became prevention and hygienists moved into the private practice. Now we're looking to become more involved in public health again. There is a major aspect of the population in this country that does not receive proper dental care. Hygienists are looking to become more involved in the public setting, become increasingly aggressive in our efforts to prevent disease rather than to treat."
It's not just the hygienists that have an array of career options, either. There are many options for individuals having attended dental school.
"Within dentistry there are many different career opportunities. Eighty percent of dentists fall into private practice, while the remaining 20% fall into one of nine specialty areas," says Dr. Christopher Arena, vice president for students at the American Dental Education Association (ADEA). These specialty areas include: periodontics, orthodontics and dentofacial orthopedics, pediatric dentistry, endodontics, oral and maxillofacial pathology, oral and maxillofacial radiology, oral and maxillofacial surgery, prosthodontics, and dental public health. For detailed information about what each of these specialties are, visit the American Dental Associations "Dental Definitions" page.
Another area of the dental field growing in popularity is oral medicine. "Oral medicine is a non-recognized specialty by the ADA, but does have its own board," says Dr. Arena. "People in oral medicine are experts in diagnosis and treatment of oral diseases. Typically oral medicine professionals work in hospitals or on academic faculties, they don't generally practice dentistry."
Dr. Arena goes on to mention some other opportunities in the field of dentistry. "Another option is to work with a dental insurance company -- to look at patient information and dental claims to help determine if treatment is warranted. You can also go into research, such as microbiology and clinical research, testing pharmaceuticals or restorative materials." But perhaps the area closest to Dr. Arena's heart, one he says is in very high demand, is academic dentistry.
"Currently there is a shortage of dental educators -- approximately 300 faculty positions available nationwide. We need people to come into the profession and become educators in the dental schools."
So with all of the options, how does one choose? "It depends on your interests," says Dr. Arena. "If you're interested in public policy you might want to consider public health." Likewise, if you enjoy working in a lab environment, research might be the right choice. Of course, you may want to wait until you've spent some time in dental school or the clinical setting before choosing a particular specialty, as many of them do require additional education.
"Within the different specialty areas there is a bit of range as far as the education it takes to get there. The minimum is a two year program, needed for endodotics or periodontics, the maximum is a 6 year program, which you need for something like oral surgery which requires an MD degree," reports Dr. Craig Yarborough, associate dean of institutional advancement, the University of the Pacific, Arthur A. Dugoni School of Dentistry.
Of course if you're not sure that the dental profession is for you, or you're hesitant to jump into years of schoolwork, you might want to consider starting as a dental assistant. Most assistants learn their skills on the job, although an increasing number of dental assistant training programs are being offered and most of these take less than a year to complete. Dental assistants assume a variety of tasks, often working side-by-side with the dentists and dental hygienists. For many, being a dental assistant serves as a steppingstone, providing basic training and experience within the dental profession.
Whether you've known since you were 12 that you wanted to be an orthodontist, or you've spent a few years as a dental assistant an now want to be a hygienist, the next step is finding the right dental school.
According to the ADEA, in 2004 there were 56 dental schools in 34 states, D.C. and Puerto Rico. Of these, 36 were public institutions, 15 were private, and 5 were state-related. Fifty-five of the 56 schools offer four-year programs, with the University of the Pacific offering a three year degree program. All of these dental education programs are standardized by accreditation from the ADA's Commission on Dental Accreditation.
The same ADEA report showed that there are 265 dental hygiene programs in the United States and Puerto Rico, 259 dental assisting programs and 24 dental laboratory technology programs.
So how do you choose the right school? And does your choice of school matter?
"It is absolutely important to choose the right school," says Dr. Qais Musmar, who works in a shared private practice in Northern Virginia. "Not all dental schools are created equal. There are huge differences among schools in requirements for graduation as well as clinical requirements." So Dr. Musmar recommends doing your homework on a school and their requirements before applying.
Dr. Yarborough agrees, and offers this advice when researching schools: "Find out what their mission is, clinical vs. research. Also, how they treat students is important, as well as the length of the program, the location, facilities, and the technology within the school." Dental programs also vary in their admission requirements. While some programs only require that two years of undergraduate course work has been completed, others require a Bachelor's Degree.
"Each school has a list of prerequisites that they want the incoming class to have, generally that includes biology, chemistry, and possibly biochemistry," says Dr. Arena. "The ADEA publishes an official guide to dental schools, which lists the prerequisites for each school." One thing all dental schools require, however is that applicants take the Dental Admissions Test (DAT). The DAT is administered by the ADA and test scores can range from 1-30, with 17 or 18 signifying an average score.
In addition to reviewing a school's programs, offerings, and admission requirements, a key concern for many students in choosing the right school can be cost. "Dental education is probably the most expensive post-graduation training education," says Dr. Yarborough. "The average student probably borrows $125-130 thousand." According to the ADA, at least 91% of dental students graduate with debt-owing an average of more than $115,000.
Dr. Yarborough goes on to say, "the cost of tuition for dental school ranges from about $150,000 - $300,000 (this includes tuition and living expenses)." The ADA has estimated that tuition for pre-doctoral dental education rose 62.5% from 1994 to 2003.
If you're looking to attend school to become a dental hygienist, however, the cost is much less, with programs starting at around $10,000. This is due in part to the fact that dental hygiene programs range from 2-year certificate or Associate Degree programs to four year baccalaureate programs. However, Tripp encourages students to seek out the Bachelor's Degree before entering the profession. "ADHA feels very strongly that the baccalaureate degree be the entrance into the profession. Although there is no difference in the clinical training between the two degrees, the baccalaureate degree gives you a more well-rounded education," says Tripp.
As with almost any educational degree there are means to help a student cover the costs. There are scholarships and grants available from individual schools, as well as organizations like the ADA and ADHA Institute for Oral Health, as well as from private companies like Proctor & Gamble (the makers of Crest products), but the majority of students tap federal and private loans to pay for their education.
Dr. Arena says that there are financial options available and although the cost of dental education is significant, it should not prohibit anyone from pursuing their dream. "There are plenty of loans out there to help students pay for school. Cost shouldn't be something that prevents someone from going into dentistry because it is possible to pay back."
Once you've selected which school(s) you wish to apply to and completed any pre-requisites, the ADEA has simplified the application process by offering a centralized application service known as the American Association of Dental Schools Application Service (AADSAS). AADSAS simplifies the application by allowing applicants to complete one application form. Information is then sent in a standardized format to dental schools requested by the applicant.
Licensure
Like other medical professions, the dental profession is governed by state licensing boards. If you've successfully completed dental school then you've graduated with either a Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD) degree (depending on the school), but before you can start practicing you must be licensed. Each state has its own requirements for licensure, however most require satisfactory degree completion from an accredited institute and the passing of written and practical examinations. Most states allow candidates to fulfill the written part of their licensing requirements by passing the National Board Dental Examination II. However, for detailed requirements for licensure you should contact the individual state's licensing board.
To become a practicing dental hygienist you must also complete state licensing requirements. Again, these requirements vary from state to state, however they usually include successful completion of an accredited dental hygiene program, completion of the written National Board Dental Hygiene Examination, and completion of a regional or state clinical board examination.
Individual states have adopted different standards for dental assistants, however, not all states require licensure or registration to work as a dental assistant.
The National Board for Certification (NBC), an independent board established by the National Association of Dental Laboratories (NADL), offers certification in dental laboratory technology, however certification is voluntary and not required. There are no state regulations for dental laboratory technicians.
Continuing Education
To maintain licensure as a dentist or dental hygienist there is usually a state-mandated amount of continuing education (CE) credits that must be obtained on an on-going basis. "The requirements vary from each state, but after a dentist is licensed they have to renew every two years, and usually this requires approximately 40 credits of continuing education," explains Dr. Arena.
"Continuing education is offered by dental schools, professional organizations, such as the ADA, state dental associations, and companies that have products related to dentistry. The subject matter can range from practice management skills to implant placement, advanced restorative to surgical techniques." Dr. Arena also states that there are no requirements on the subject matter of these CE credits. Dental professionals are able to choose subject matter that interests them.
Employment
So you've been in school for the last 3-7 years, you've taken the exams and gotten your licensure, now what? For many dental students they view this as the time to jump right in and start their own practice. Dr. Musmar doesn't agree.
"The amount of clinical exposure you get in dental school is very limited. You get the principles down, but coming out of school you know very little beyond that, so once you start private practice it can be very overwhelming."
Dr. Musmar goes on to say "there are lots of continuing education options for learning about running a business, but it's difficult to take advantage of these once you've opened your own practice. You can't take time off once you've opened up the business to go learn business."
So how does one truly prepare to run their own practice? Dr. Musmar recommends two things to graduates to help them ease into the profession. The first is to do a residency. "One of the most important things you can do is a residency program, which will give you good clinical skills. There are several types of residencies, such as the General Practice Residency (GPR), the AGD, or the NDO."
The other big piece of advice Dr. Musmar gives is educate yourself on small business practices. "Dental schools don't teach you the business aspect of running a practice. A lot of dentists get frustrated with the management of an office and the day to day business. If I could recommend one thing for a dental student: don't open up shop right away. Go work for an associate and learn the rules for running a business, otherwise you won't know what you've gotten into. The worst thing a dental graduate can do is come out of dental school right away and open up shop without any business management training."
"Dental school is very challenging," concludes Dr. Arena. "There's a lot of studying that goes into it, you learn a lot of sciences, and the preclinical training is challenging as well. If one chooses to go into dental education they need to be very serious of what they are undertaking and be prepared to work very hard -- but it will be well worth it in the end."
Want to know more? Both the ADA and the American Student Dental Association (ASDA) provide excellent resources for dental students or prospective dental students.
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