In the next couple of weeks I have a head and neck anatomy exam coming up. I have to admit, I am a bit nervous about it. As always I am amazed by the number of different structures that are in the body. I am doubly impressed by how many structures are in the head and neck region as compared with the rest of the body. The next couple of weeks will involve some pure memorization and constantly reviewing material… over and over and over again.
At this point it has been officially one month since I started reading and writing reports. Considering my personality type, this is absolutely the best career path I can imagine for myself. Low key, clean, minimal human contact (if any) and eventually being able to practice on my own time and schedule. I can’t wait.
Finally! LOL, I’ve been patiently waiting for your next post! Good luck on the exam!!!! It’s really great to hear you are happy with your choice.
^ Likewise. I would just like to mention that I have been silently following your blog for awhile. If anything I feel like I am your Canadian counterpart; I finished a H. BSc at the University of Toronto downtown campus, and then applied to and graduated from the University of Toronto, Faculty of Dentistry, and have since worked full-time in a very successful private general practice in Toronto. I have a very serious passion for photography and digital imaging, and naturally this specialty had always piqued my interest. After lots of research (including this blog) and much interaction with both residents and practicing private OMFR’s in Toronto, I had made the decision to apply to the University of Toronto’s OMFR specialty program (the only one that exists in Canada, actually). I am very pleased to say that I have been accepted, and that I will be starting in August of this year. I hope you can continue to blog about your experiences in this relatively fresh and undiscovered field, and when appropriate, I hope to be able to contribute my experiences as well!
Best regards,
Edwin
As a follow-up to the previous comment, here’s a video we made as a spoof of the Inception movie trailer which you may enjoy; it was submitted for the annual talent/variety show held at the Faculty of Dentistry called Dentantics. It’s basically a comical ad for the private OMFR imaging clinic that sponsored of this year’s show.
Hope this provided you some comical relief from your anatomy cram jam. 🙂
Edwin
Thanks all.
Edwin,
Welcome to the profession and I hope you end up enjoying it as much as I have. You are more than welcome to contribute your experiences as well. This specialty is under represented in every facet possible. This spoof was great. I will post this to my Twitter account. I know some people following will get a kick out of it.
OMFR,
I had a question for you. With small volume CBCT, how imperative is it for a general dentist to seek interpretation by by an OMFR? Does a small volume CBCT, by limiting the field of view to essentially the teeth eliminate the extra liability that might incline a generalist to seek out professional radiographic interpretation?
Your thoughts would be greatly appreciated.
Thanks!
Great question. From what I’ve seen so far, small or large volume really doesn’t make a different. The liability is the same, if you miss something and someone sues, it’s the same as if you miss something on a large volume and someone sues. That being said, a small volume will have less information. When I first started I thought that this would make a difference and there would be less to report. As part of my residency I like to keep a log of each report I have done and mark if there is an incidental finding or not. To give you an idea, so far I have a 56.5% incidental finding for all the reports I have written, this includes small and large volume. Incidental findings are anything that the previous dentist has missed that could affect treatment. This includes radicular cysts, tumors, TMD, systemic diseases, endos that looks great on a 2D picture but are really not, fibro-osseous dysplasia and so forth. So far I have not run into any malignancies, but seeing as how high my incidental finding is, the day that I do I won’t be surprised. With an incidental finding as high as I’ve come across, I would say it is imperative. It all comes down to each dentist though, if they’re comfortable reading their own CBCT scans (small or large) then they’re ok. I just remember my training in dental school and it really doesn’t cover everything that could happen in the head and neck region.
The issue from reading CBCT volumes isn’t lack of education necessarily, although I admit there is a lot I didn’t know as a general dentist, but for any reasonably busy office, the time it takes to thoroughly go through each scan. Currently we have offices that send everything to us and some offices that send us scans for a specific area that they noticed. It just depends on how comfortable you are in the scans that you have.
I have another question for you Mr. OMFR. I just read a piece in this months issue of dentistry today from Dr. Stephen Buchanan who talks about emerging trends in Endo. He says that cbct is the biggest technological game changer in Endo in the last decade. He mentions Pre-treatment scans to show definitively the number of canals in the tooth. I’m surprised to hear this from a prominent endodontist. Thoughts?
My thoughts really are of practicality. I’m not surprised to hear an endodontist using CBCT to pre-op for an endodontic treatment, it is very effective and very accurate. We read plenty of scans for endodontists. I do stand by the AAOMR-AAE position paper on utilizing CBCT for endodontic treatment. It is not necessary for every case, but just as any tool, CBCT can be vastly useful whenever dealing with two dimensional images isn’t providing enough information. For example, I wouldn’t get a CBCT on straight forward endo cases, however if I suspect an accessory canal and conventional radiographs just aren’t enough, then CBCT is the logical step. If a tooth is severely dilacerated and the 3D root morphology makes a difference in treatment, I will order a CBCT. This rule really applies to any practice and any specialty. If I run across an anterior tooth that needs endo, I will generally stay with conventional imaging. If I’m retreating a tooth that looks completely filled then I would consider a small volume CBCT scan to see if there is another reason that the treatment is failing.
This conversation brings me to another thought. For as much as I can tell, dentists always deal in three dimensional space but we stress an incredible amount over radiation, so we choose to stick with 2D imaging modalities. I doubt this will change any time soon, however, I do believe that when necessary, it is reasonable to get a CBCT if you think it will affect treatment. I believe overall practitioners need to be less afraid of doing what is necessary to improve treatment outcome.
Yet another question for you dear friend. On the AAOMR website, I’ve noticed only one joint position paper regarding the use of CBCT in Endo. Do you know of any such similar joint position papers in other specialties, or even in General Dentistry. Thanks!
I don’t think they currently do, although I know they are actively working on a whole bunch. These things take a while to do usually.
How did the anatomy exam end up going?
Still waiting to find out, but I think it went OK. Now on to the next challenge.