The Department of Dentistry/Oral and Maxillofacial Surgery is headed by a chairman, director and full-time program director for the division of General Dentistry and the Division of Oral and Maxillofacial Surgery. The division of General Dentistry includes board certified/board eligible attending staff in pediatric dentistry, orthodontics and oral Surgery.
The department serves a large and diverse population in a newly constructed dental facility. We provide comprehensive care in all areas of dentistry including periodontics, orthodontics prosthetics, endodontics, cosmetic and implant surgery and specialized dental care for the medically compromised and physically challenged patient.
The outpatient dental clinic, located on the Downtown Brooklyn campus of The Brooklyn Hospital Center (TBHC), is adjacent to the Oral and Maxillofacial Surgery Clinic and contains a conference center, a computerized charting and registration area and a completely equipped outpatient facility for providing general dentistry with sedation.
TBHC’s main campus has 15 operating suites that include a complete facility for general dentistry under general anesthesia. The Department of Dentistry/Oral and Maxillofacial Surgery provides approximately 8,000 ambulatory visits per year with 350 admissions.
The department has a fully accredited four-year Oral & Maxillofacial Surgery (OMS) Residency Program that accepts three residents per year. The hospital also has fully accredited one- and two-year General Practice Residency (GPR) Programs.
Education Resources:The Department of Dentistry maintains a library of specialized literature. TBHC also has a Health Sciences Library, which is directed by a full-time medical librarian, and subscribes to 135 journals, has 1,325 books and each year acquires about 350 new medical titles. The library also maintains a collection of audio and video tapes. Audio-visual equipment is available upon request.
TBHC also participates in an inter-library loan program. A powerful computer gives TBHC users access to the vast national network of medical library facilities. Literature searches using CD-ROM are also available for material dating 1996 to the present.
The hospital produces several publications including a bi-weekly calendar of events and medical education programs, and TBHC sponsors a wide variety of programs that are approved for Category I credit by the Accreditation Council for Continuing Medical Education.
House Staff Office coordinates credentialing, benefit and resident activities and can provide information about housing opportunities and other community resources. The office acts as a liaison between the House Staff Association and the Hospital Center’s Administration.
ORAL AND MAXILLOFACIAL SURGERY (OMS) RESIDENCY PROGRAM
Our OMS program boasts a curriculum that meets all the requirements of the Commission on Dental Accreditation (CODA) for our approved OMS Residency Program.
Our residents experience multiple hospitals and learn under many different attendings, which allows them exposure to a variety of surgical techniques. We partner with the following hospitals to help educate our residents:
The Brooklyn VA Medical Center is a first- and second-year rotation with each OMS Resident spending four to six months over the four years under the supervision of the hospital’s Chief of Oral & Maxillofacial Surgery.
Geisinger Medical Center, located in rural Pennsylvania, is a two-hospital consortium (Danville and Wyoming Valley) with a level I trauma designation. During each year of residency, our OMS residents are assigned to a full-time rotation under the supervision of the Chair of Oral & Maxillofacial Surgery at the Geisinger Medical Center. The TBHC residents are assigned exclusively to rotate through the Wyoming Valley site, which has three full-time equivalent OMFS attendings. The TBHC chief residents rotate through this hospital with one other junior resident in three- to four-month intervals.
Bronx Lebanon Hospital Center, located in the Bronx, New York City, is a high-volume, urban hospital with approximately 100,000 outpatient dental and OMS visits seen per year. It is a state-of-the-art institution with five full-time OMS attendings. OMS residents will be assigned to full-time rotations at this facility throughout their four years of training.
These external programmatic hospital affiliations help assure that our residents receive significant clinical exposure to all aspects of advanced Oral & Maxillofacial Surgery procedures under direct supervision of Board Certified Oral & Maxillofacial Surgeons.
The remainder of the time is spent at The Brooklyn Hospital Center (TBHC), including the following off-service rotations:
- 4-month rotation in General Surgery
- 5-month rotation in the Department of Anesthesia
- 2-month rotation in the Department of Medicine
- 1-month rotation in the Surgical Intensive Care Unit
- 1-month rotation in ENT
Residents are also exposed to a strong didactic program with both onsite and offsite lecture programs.
OMS Residency Program Goals
- To prepare the OMS residents to be qualified in the special skills and expertise necessary to practice the full scope of Oral and Maxillofacial Surgery in their community.
- To be trained to perform history and physical examinations in order to properly evaluate patients prior to any surgical or anesthetic procedure.
- To be in compliance with the ADA’s standard on Advanced Oral and Maxillofacial Surgery residency programs.
- To incorporate and integrate the biomedical sciences along with essential non-clinical information (infection control, risk management, quality assurance, among others) into effective clinical patient management.
- To prepare residents to be clinically capable with sufficient knowledge to sit for certification by the American Board of Oral and Maxillofacial Surgery.
- To be competent and knowledgeable in the applied clinical sciences of anesthesia, surgery, and medicine and their direct impact on quality patient care.
- To be competent and knowledgeable in pain assessment and pain control.
- To instill in the residents a spirit of continuous lifelong educational commitment and scholarly activity in order to advance and enhance their Oral and Maxillofacial Surgery knowledge base.
OMS Resident Competencies
- History and physical examinations
- Placement of IV lines
- Pre-op, post-op, daily orders
- Consultation appropriately completed
- Chart documentation per departmental policies
- Simple and surgical extractions
- Biopsies (hard and soft tissue)
- Simple laceration repair
- Simple intra-oral incision and drainage
- Placement of arch bars and IVY loops
- Treatment of avulsed teeth and alveolar fractures
- Case presentation at weekly conferences
- Prep and drape patient for surgical procedures
- Use of nitrous oxide
- Socket grafting and site preservation techniques
- Use of oral and nasal airways
- Endo-tracheal intubation
- Placement of Foley catheters
- Placement of nasogastric tube
- Removal of impacted wisdom teeth
- Simple implant placement
- ICU orders
- Complex laceration repair
- Periodontal soft tissue surgery
- Extra-oral incision and drainage
- Ability to draw arterial blood for analysis
- Biopsy techniques
- PRF use and techniques
- Maxillary sinus lifts
- Intra-oral bone harvesting techniques
- Complex implant placement
- IV sedation/general anesthesia
- Evaluation of the TMD patient
- TMJ arthocentesis
- Intra-oral open reduction of mandibular fractures
- Closure of oral-antral communications
- Orthognathic treatment planning and surgical model work-up
- Ridge splitting for implant placement
- Repair of complex facial lacerations
- Scar revision
- Mandibular and palatal tori removal
- Calwell-luc sinus procedures
- Closed reduction nasal bone fracture
- Open reduction of zygomatic arch fractures
- Cephlometric training
- Onlay bone grafting
- Soft tissue harvesting of mucosal grafts — hard palate, buccal mucosa
- Botox injections for treatment of TMD
PGY IV—Chief Resident
- IV sedation
- Saggital split osteotomies of mandibular ramus
- Le Fort I osteotomy
- Open reduction of ZMC fractures
- Open reduction of orbital floor fractures and reconstruction
- Ilium autologous bone harvest
- Mandibular/maxillary segmental osteotomies
- Arthroscopy of TM joint
- Vertical ramus osteotomies
- Facial cosmetic procedure Botox, collagen fillers
- Open TM joint surgery
- Cleft lip and palate surgery
- Complex removal of large cysts and benign tumors of the jaws
- Management of the Ludwig angina patient
- Management of the complex benign soft tissue neoplasm in the face
- Genioplasty procedures
- Alloplastic grafting for cosmetic treatment
GENERAL PRACTICE RESIDENCY (GPR) PROGRAM
TBHC’s one-year general practice residency program was inaugurated July 1, 1993. The residents are exposed to the entire scope of general dentistry with concentration placed in the areas of management of the medically compromised patient, prosthetic reconstruction of the physically challenged patient, pain control, surgical and non-surgical periodontal therapy, implant dentistry, and evaluation and treatment of TMJ disorders.
Our CODA-approved GPR Program is 12 months in duration. Residents are exposed to all facets of general dentistry with an opportunity to spend more concentrated time performing oral surgery. Our GPR residents spend a good deal of time restoring implants and dentures with medically compromised patients. Our GPR program is headed by a fellowship-trained oral medicine specialist, Dr. Ricardo Boyce.
An integral part of the training of the GRP residents includes rotations through the following clinical areas of TBHC:
- One month rotation in the Department of Anesthesia
- One month rotation in the Department of Emergency Medicine
A complete and full didactic program is offered with a special lecture series in pain control, physical diagnosis, oral pathology, implantology and periodontology. Weekly planning conferences are held where comprehensive treatment planning is reviewed with the residents and the attending staff.
Goals & Objectives
To provide each GPR resident:
- A didactic and clinical experience on a postgraduate level in all dental specialties.
- Preparation to develop the skills to act as a primary oral healthcare providers for a wide variety of diverse patients including those patients with special physical, mental and emotional needs.
- Advanced clinical training and education in pain and anxiety control management and an overview of sedation techniques.
- Instruction on how to function effectively within the hospital and other healthcare settings, as well as how to function effectively on an interdisciplinary healthcare team.
- Didactic and clinical training to become competent in physical and medical assessment, as well as the recognition and management of dental and medical emergencies.
- Training in the fundamentals of infection control, risk management, practice management, professional ethics continuous quality assessment, and improvement and acceptance of cultural diversity in professional practice.
- Education in understanding the oral healthcare needs of communities and engage them in community service.
- Training to apply scientific principles to learning, including critical thinking in regards to journal review and the use of evidenced-based medicine and dentistry when developing clinical decisions.
GPR Resident Progression of Responsibilities
The GPR resident is responsible:
- For all reasonable duties and assignments requested by his/her superiors.
- To the director of the particular service to which he/she is on rotation
- When on call, to be available at all times to the operator and must respond immediately to the Emergency Room when summoned.
- To not make admissions or discharges of inpatients without the approval of the OMS Chief Resident and/or the Chief of OMS or the attending of record.
- To attend all morning inpatient rounds; lateness will not be tolerated.
- For maintaining all necessary data regarding Emergency Room visits and inpatient consultations, and making certain that the Director of OMS receives all necessary documentation.
- For making certain that he/she attends all assignments, rotations, conferences and lectures as assigned by the Program Director.
- For writing clearly and legibly on all hospital official records.
- To conduct literature searches on various topics as assigned by the Program Director.
- For notifying the Department of Dentistry’s executive assistant if he/she will be out sick or unavailable for clinical attendance due to personal reasons.
- For acting, dressing and behaving in a professional manner at all times.
- To fully complete the 405 Compliance Form in a timely manner.
- To complete the Credentialing Book in a timely manner.
- Make certain that patients are making timely payments when doing prosthetic work.
- For logging all case work done into computer-based record system.
- For notifying his/her attending if any untoward or adverse patient outcomes occur.
- To notify the senior oral surgery resident of any order he/she writes in an inpatient chart when on call.
- For completing all necessary documentation in both inpatient and outpatient charts.