Overview

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 oral surgery with sedation.

The hospital has 80 to 100 admissions per year and does approximately 14,000 outpatient clinic ambulatory visits and approximately 150 same-day surgeries in the operating room.

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.

Anne Arundel Medical Center in Annapolis, Maryland. Our senior residents rotate through this institution where they are actively involved in the diagnosis, virtual surgical treatment planning and operating room experience in the treatment of complex orthognathic surgical cases and associated cosmetic facial surgical procedures. Senior residents spend approximately six total days per month at this hospital rotation.

St. Barnabas Hospital, located in Bronx, New York, is a high-volume urban hospital with an active oral surgical and general dental outpatient clinic. It is a designated Level One Trauma Center and has an Orthodontic Residency Training Program. It has an active and involved oral surgical attending staff who, alongside our residents, treat major complex multiple facial trauma cases as well as pathology and orthognathic cases. The outpatient oral surgery clinic performs approximately 900 to 1,000 ambulatory sedation/anesthesia cases per year. Two OMFS residents plus one chief OMS resident cover the program at all times.

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
1-month rotation in Plastic Surgery

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

PGY I—Intern

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

PGY II

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
Apicoectomies
Periodontal soft tissue surgery
Extra-oral incision and drainage
Ability to draw arterial blood for analysis
Biopsy techniques
PRF use and techniques

PGY III

Maxillary sinus lifts
Intra-oral bone harvesting techniques
Complex implant placement
IV sedation/general anesthesia
Evaluation of the TMD patient
TMJ arthrocentesis
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
Cephalometric 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
Sagittal 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
Vestibuloplasties
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 Dr. Ricardo Boyce.

Teaching Program

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
Two-week 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 the first year General Practice Resident a didactic and clinical experience on a postgraduate level in all dental specialties.
Prepare our General Practice Residents to develop the skills to act as a primary oral health care provider for a wide variety of diverse patients including those patients with special physical, mental and emotional needs.
To provide our General Practice Residents with advanced clinical training and education in pain and anxiety control management and an overview of sedation techniques.
To teach our General Practice Residents how to function effectively within the hospital and other healthcare settings as well as functioning effectively in an interdisciplinary healthcare team.
To provide didactic and clinical training to allow our General Practice Residents to be competent in physical and medical assessment as well as the recognition and management of dental and medical emergencies.
To train our General Practice Residents 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.
To educate our General Practice Residents in understanding the oral healthcare needs of communities and engage them in community service.
To train our General Practice Residents 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.
To encourage the residents to elevate their knowledge and improve their proficiency level.
To maintain performance evaluations on the residents that will serve as an instrument of growth.
To provide our General Practice Residents with advanced clinical training in Fixed and Removable Restorative Implantology as well as Treatment Planning.

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.