Sop Oral Surgeons AMA

AMA
Scope of
Practice
Data Series
A resource compendium for
state medical associations and
national medical specialty societies

Oral and Maxillofacial
Surgeons
American Medical Association
September 2009

Disclaimer: This module is intended for informational purposes only, may not be used in credentialing decisions of individual
practitioners, and does not constitute a limitation or expansion of the lawful scope of practice applicable to practitioners in
any state. The only content that the AMA endorses within this module is its policies. All information gathered from outside
sources does not refect the offcial policy of the AMA.
demographics
education and training
licensure and regulation
professional organization
current literature
2 Scope of Practice Data Series: Oral and Maxillofacial Surgeons Table of contents
Return to table of contents
Table of contents
I. Overview ................................................................................................................. 4
II. Introduction ........................................................................................................... 5
III. Oral and maxillofacial surgery as a profession ........................................................... 7
Defnition(s) ........................................................................................................................................................ 7
Specialization ....................................................................................................................................................... 7
General duties and responsibilities ...................................................................................................................... 8
Employment types and locales ............................................................................................................................. 8
Brief history of the profession .............................................................................................................................. 9
Demographics of the profession ........................................................................................................................... 9
Number of dentists and oral and maxillofacial surgeons in the workforce ................................................. 9
Salary data ..................................................................................................................................................... 9
IV. Billing for services................................................................................................ 11
Medicare ............................................................................................................................................................ 11
Medicaid ............................................................................................................................................................ 11
V. Education and training of oral and maxillofacial surgeons ......................................... 15
Dental school ..................................................................................................................................................... 15
Dental school admission criteria ................................................................................................................. 15
Dental Admission Test ......................................................................................................................... 16
Dental school curriculum requirements ...................................................................................................... 16
Dental school curriculum ............................................................................................................................ 17
First and second years ............................................................................................................................ 17
Third and fourth years ........................................................................................................................... 18
Dental school graduates .............................................................................................................................. 18
OMS training programs ..................................................................................................................................... 18
Admission requirements for OMS training programs ................................................................................. 18
Categories of OMS training programs ........................................................................................................ 18
CODA curriculum accreditation standards for OMS training programs ................................................... 20
OMS training program curriculum: didactic program ................................................................................ 21
OMS training program curriculum: clinical experiences ........................................................................... 22
OMS fellowships ......................................................................................................................................... 23
3 Scope of Practice Data Series: Oral and Maxillofacial Surgeons Table of contents
VI. Oral and maxillofacial surgeon licensing and board certication ............................... 24
Dental licensing ................................................................................................................................................. 24
Board certifcation for oral and maxillofacial surgeons ..................................................................................... 24
National board certifcation exam .............................................................................................................. 25
OMS board recertifcation .......................................................................................................................... 26
VII. Education and training of plastic surgeons and otolaryngologists ............................. 27
Plastic surgeons .................................................................................................................................................. 27
Otolaryngologists ............................................................................................................................................... 29
VIII. Professional organization .................................................................................... 30
IX. Professional journals of interest ............................................................................. 31
Appendix
Roster of state dental boards ........................................................................................................................................... 32
Roster of state dental and oral and maxillofacial surgery associations ........................................................................... 32
National association policy concerning oral and maxillofacial surgeon scope of practice ............................................ 39
Literature and resources .................................................................................................................................................. 41
Comparison of the education and training of physicians and oral surgeons ................................................................. 44
Figures
Figure 1: State licensure requirements for oral and maxillofacial surgeons
Figure 2: State scope of practice regulations for oral and maxillofacial surgeons
Figure 3: State dentistry board operating information
Acknowledgments
Many people have contributed to the compilation of information contained within this module. The American Medical Association gratefully acknowledges the
contributions of the California Medical Association, the Medical Society of the State of New York, The American Academy of OtolaryngologyHead and Neck
Surgeons and the American Society of Plastic Surgeons.
4 Scope of Practice Data Series: Oral and Maxillofacial Surgeons I. Overview
I. Overview
The American Medical Association (AMA) Advocacy
Resource Center has created this information module
on oral and maxillofacial surgeons to serve as a resource
for state medical associations, national medical specialty
societies and policymakers. This guide is one of 10
separate modules collectively comprising the AMA
Scope of Practice Data Series, each covering a specifc
non-physician health care profession.
Without a doubt, limited licensure health care provid-
ers play an integral role in the delivery of health care
in the United States. Effcient delivery of care, by all
accounts, requires a team-based approach, which cannot
exist without inter-professional collaboration between
physicians, nurses and other non-physician health care
providers. With the appropriate education, training and
licensing, these providers can and do provide safe and
essential health care to patients. The health and safety
of patients are threatened, however, when non-
physician providers are permitted to perform services
that are not commensurate with their education or
training.
Each year, in nearly every state and at times on the
federal level, non-physician health care providers
lobby state legislatures, their own state regulatory
boards or federal regulators for expansions of their
scopes of practice. While some scope expansions may
be appropriate, others defnitely are not. It is important,
therefore, to be able to explain to legislators and
regulators the limitations in the education and/or
training of non-physician health care providers that
may result in the substandard or potentially harmful
care of patients. Those limitations are brought clearly
into focus when compared with the comprehensiveness
and depth of the medical education and training of
physicians.
Issues of access to qualifed physicians in rural or under-
served areas provide these providers with what, at frst
glance, seems to be a legitimate rationale for lobbying
for expanded scope of practice. However, solutions to
actual or perceived work force shortages simply can-
not justify practice expansions that expose patients to
unnecessary health risks.
In November 2005, the AMA House of Delegates
approved Resolution 814, which called for the study of
the qualifcations, education, academic requirements,
licensure, certifcation, independent governance, ethi-
cal standards, disciplinary processes and peer review
of non-physician health care providers. By surveying
the type and frequency of bills introduced in state leg-
islatures, and in consultation with state medical asso-
ciations and national medical specialty societies, the
AMA identifed 10 distinct non-physician professions
that are currently seeking scope-of- practice expansions
that may be potentially harmful to the public.
Each module in the AMA Scope of Practice Data Series
is intended to assist in educating policymakers on the
qualifcations of a particular non-physician health care
profession, as well as on the qualifcations physicians
possess that prepare them to accept the responsibility
for full, unrestricted licensure to practice medicine in
all its branches. It is within the framework of educa-
tion and training that health care professionals are best
prepared to deliver safe, quality care under legislatively
authorized state scopes of practice.
It is the AMAs intention that these Scope of Practice
Data Series modules provide background information
for state- and federal-based advocacy campaigns where
the health and safety of patients may be threatened as
a result of unwarranted scope- of -practice expansions
sought by non-physician health care providers.
Michael D. Maves, MD, MBA
Executive Vice President, Chief Executive Offcer
Disclaimer
This module is intended for informational purposes only, may not be used
in credentialing decisions of individual practitioners, and does not constitute
a limitation or expansion of the lawful scope of practice applicable to
practitioners in any state. The only content that the AMA endorses within
this module is its policies. All information gathered from outside sources
does not refect the offcial policy of the AMA.
5 Scope of Practice Data Series: Oral and Maxillofacial Surgeons II. Introduction
The American Medical Association (AMA) is pleased
to offer this informative module on oral and maxillofacial
surgery (OMS) with the intention of aiding physicians
in countering the advocacy efforts of oral and
maxillofacial surgeons (also known as oral surgeons)
to expand their scopes of practice to include elective
cosmetic surgical procedures outside the oral and
maxillofacial region and other procedures involving the
soft tissues of the oral and maxillofacial region, head and
neck region. This module examines the education and
training of oral and maxillofacial surgeons, as well as
board certifcation information, licensure requirements
and current scope of practice for oral and maxillofacial
surgeons in all 50 states. Also included are resources
related to state oral and maxillofacial surgery board
operation and a bibliography of medical and dental
journal articles. This information will assist state medical
associations and national medical specialty societies in
educating legislators and regulators to evaluate oral and
maxillofacial surgeons attempts to expand their scopes
of practice beyond that which their education and
training have prepared them to safely perform.
While all oral and maxillofacial surgeons attend dental
school, some additionally pursue a medical degree.
In fact, a signifcant proportion of accredited training
programs in oral and maxillofacial surgery require their
trainees to attend medical school after graduating
from dental school. This module focuses on those oral
surgeons who do not pursue the medical degree.
The scope of practice for oral surgeons has been
legislatively expanded in several states to include cosmetic
surgery. State statutory defnitions of the practice of
dentistry are frequently used as the basis for determin-
ing the scope of OMS practice.
1
The American Dental
Association (ADA) and the American Association of
Oral and Maxillofacial Surgeons lobby for an extraor-
dinarily broad defnition of dentistry which grants state
dental boards signifcant leeway in interpreting which
procedures a dentist and/or an oral and maxillofacial
surgeon may legally perform. In 1997 the ADA adopted
the current model defnition of the practice of dentistry:
1. Web. American Association of Oral and Maxillofacial Surgeons
(AAOMS). www.aaoms.org/gov_affairs.php?id=20.
Retrieved May 24, 2008.
II. Introduction
The evaluation, diagnosis, prevention and/or
treatment (non-surgical, surgical or related proce-
dures) of diseases, disorders, and/or conditions of
the oral cavity, maxillofacial area and/or the adjacent
and associated structures and their impact on the human
body; provided by a dentist, within the scope of his
or her education, training and experience, in
accordance with the ethics of the profession and
applicable law.
2
(emphasis added)
It is not under contention in this module that oral
surgeons are qualifed to perform surgical procedures
treating or correcting dental conditions within the
maxillofacial (oral cavity) area. However, the surgical
or medical treatment of any condition of the skin, eyelids,
eyes, ears, nose or other structures in the head and neck
region is clearly beyond the scope of dental training and
practice. Patient safety is best protected when a licensed
and trained physician provides medical and surgical
care for areas outside of the maxillofacial area.
It is the AMAs position that education and training
best prepare health care professionals to provide safe,
high-quality care to patients. The quality of medical
school training in the surgical and medical care of
patients is far more encompassing than that of dental
school, exposing medical students to numerous aspects
of surgical care, including the pre-, peri-, and post-
operative medical care of patients. Indeed, the
comprehensive education a medical student receives
provides the core foundation of medical knowledge
upon which the new physician builds by choosing a
residency in which he or she obtains advanced
surgical preparation and training.
Physicians receive comprehensive medical and surgical
training in the provision of aesthetic and reconstructive
facial surgery through different accredited residency
programs. Under the supervision of licensed physicians,
residents in these surgical training programs assess
patients medical conditions and histories to evaluate
their suitability for undergoing plastic or reconstructive
surgery. Common to all surgical residency programs is
not only advanced training in the techniques of surgery,
but also in medical assessment, operative management
2. Web. American Dental Association (ADA). Current Policies.
www.ada.org/prof/resources/positions/doc_policies.pdf.
Retrieved November 4, 2008.
6 Scope of Practice Data Series: Oral and Maxillofacial Surgeons II. Introduction
and monitoring of patients, and post-operative and
follow-up medical care. Patients seeking facial plastic
surgery may include trauma and burn victims, individu-
als born with congenital conditions, as well as patients
seeking to improve their appearance through elective
surgery.
Physicians pursuing residency training in plastic surgery
devote an initial three years to learning the fundamentals
of general surgery. After this broad exposure to surgery,
the plastic surgery resident then progresses to three
more years studying the sophisticated art of improving
the human forms appearance and function through
reconstructive and aesthetic surgery. Plastic surgeons are
trained to provide reconstructive and aesthetic surgery
on the entire body, including the facial region.
Otolaryngologists are physicians trained in the medical
and surgical management and treatment of patients
with diseases and disorders of the ear, nose, throat,
and related structures of the head and neck. Residents
in otolaryngology spend one year in a general surgery
internship, also learning the principles of the care and
management of surgical patients. The otolaryngology
resident then devotes an additional four years to the
medical and surgical care of the head and neck area.,
improving the function and/or appearance of anatomical
structures through corrective, reconstructive, and
aesthetic surgical procedures.
Oral and maxillofacial training programs for dentists
simply cannot duplicate the medical education that
physicians receive, which prepares the physician to
assess and respond to unexpected medical complications
observed during surgery, manage the post-operative
recovery and follow-up care of patients, and fully address
the systemic needs of surgical patients who may have
chronic health conditions that can exacerbate their
risks for adverse events during surgery.
The OMS training programs provide oral surgeons-
in-training broad exposure to the principles of oral and
maxillofacial surgery. However, the training a dentist
receives in facial cosmetic and head and neck surgery is
minimal. In fact, accreditation standards of the ADAs
Commission on Dental Accreditation, the body that
accredits OMS training programs, requires that OMS
trainees perform (or act as frst assistants) on only 75
major OMS surgeries. Furthermore, only a minimum
of 10 surgeries need be accrued in the category of
reconstructive and cosmetic surgery, with no experience
required for any single cosmetic procedure, including
but not limited to, procedures such as rhinoplasty
(plastic surgery on the nose), blepharoplasty (plastic
surgery on eyelid), or rhytidectomy (facelift).
Nonetheless, oral surgeons frequently incorporate these
procedures into the elective cosmetic surgery services
offered by their practices.
The AMA stands ready to assist state and specialty
medical societies in their efforts to preserve the highest
quality of care and protect the safety of patients. The
American Society of Plastic Surgeons and the American
Academy of Otolaryngology-Head and Neck Surgery
similarly welcome inquiries and requests for assistance
with OMS scope-of-practice issues.
The AMA holds patient safety in the highest regard,
and opposes the practice of medicine by those oral
surgeons who have not obtained a medical degree.
We hope that the information contained in this module
will provide the tools necessary to allow physicians to
present relevant facts in response to non-physician oral
and maxillofacial surgeons efforts to increase their scope
of practice to include the provision of elective cosmetic
surgery on areas other than the oral cavity.
Advocacy Resource Center
AMA Scope of Practice Data Series module
distribution policy
The modules are advocacy tools used to educate legisla-
tors, regulatory bodies and other governmental decision
makers on the education and training of physician and
non-physician health care providers. As such, the AMA
will distribute the modules to the following parties:
(1) State medical associations
(2) State medical boards
(3) National medical specialty societies
(4) National medical organizations
In line with the express purpose of the modules being
governmentally directed advocacy, it will not be the
policy of the AMA to provide the modules to individual
physicians.
Organizations supplied with the modules shall
mirror the intent, purpose and standards of the AMA
distribution guidelines.
7 Scope of Practice Data Series: Oral and Maxillofacial Surgeons III. Oral and maxillofacial surgery as a profession
Denition(s)
Oral and maxillofacial surgery (OMS), commonly
known to the general public simply as oral surgery,
is the practice of dentistry that includes the diagnosis
and treatment of disease, injuries, and defects involving
the oral and maxillofacial region. According to the
American Association of Oral and Maxillofacial
Surgeons (AAOMS), the professional association
representing oral and maxillofacial surgeons, these
providers treat conditions, defects, injuries and esthetic
aspects of the mouth, teeth, jaws and face. Their
training includes a four-year graduate degree in dentistry
and the completion of a four-year specialty postgraduate
training program in OMS.
3

OMS is listed as a dental specialty in the nationally
recognized Occupational Outlook Handbook of the U.S.
Department of Labor. That reference describes the role
of an oral and maxillofacial surgeon as follows: to per-
form surgery on mouth, jaws and related head and neck
structure to execute diffcult and multiple extractions of
teeth; to remove tumors and other abnormal growths;
to correct abnormal jaw relations by mandibular or
maxillary revision; to prepare mouth for insertion of
dental prosthesis; or to treat fractures of the jaws.
4
Specialization
Most dentists practice general dentistry while some
choose to specialize. There are nine dental specialties
recognized by the American Dental Association
(ADA).
5
The ADA reports that 80 percent of U.S.
dentists are general practitioners, while the remaining
3. Web. American Association of Oral and Maxillofacial Surgeons
(AAOMS). Public Information. www.aaoms.org/oms.php.
4. Web. Bureau of Labor Statistics (BLS), U.S. Department of Labor.
Occupational Outlook Handbook 2008-09 Edition.
www.bls.gov/oco/ocos072.htm. Retrieved May 24, 2008.
5. Web. American Dental Association (ADA).
www.ada.org/prof/ed/specialties/defnitions.asp. Retrieved June 4, 2008.
20 percent specialize in one of the nine specialty areas.
6

Orthodontists make up the largest group of specialists,
while oral and maxillofacial surgeons constitute the
second largest group.
7
The nine ADA-recognized dental
specialty areas include:
Oral and maxillofacial surgeons operate on the mouth
and jaws. They diagnose and treat diseases, injuries
and defects involving the hard and soft
tissues of the oral and maxillofacial region.
Orthodontists straighten teeth by applying braces
or retainers. They diagnose, prevent, and correct
malocclusion and abnormalities of orofacial structures
Prosthodontists treat patients with missing or
defcient teeth. They offer rehabilitation and main-
tenance of the oral function by using permanent
fxtures, such as crowns and bridges, or removable
fxtures such as dentures.
Endodontists perform root canals. They diagnose,
prevent and treat diseases and injuries of the pulp
and associated conditions.
Periodontists prevent, diagnose and treat diseases of
the gums and bone that support the teeth.
Oral and maxillofacial pathologists study oral diseases.
They research and diagnose diseases affecting
the oral and maxillofacial regions using clinical,
radiographic, microscopic, biochemical or other
examinations.
Oral and maxillofacial radiologists diagnose diseases in
the oral and maxillofacial region through the use of
imaging technologies.
Public health dentists promote dental health in the
community through education and research. They
administer dental care programs for the prevention
and control of dental diseases.
Pediatric dentists focus on dentistry for children.
8

6. Web. American Dental Association (ADA). Infopak: Careers in Dentistry.
www.ada.org/prof/ed/careers/infopaks/careers.pdf.
7. Web. American Dental Association (ADA).
www.ada.org/prof/ed/specialties/defnitions.asp. Retrieved June 4, 2008.
8. Id.
III. Oral and maxillofacial surgery as a profession
General duties and responsibilities
Oral and maxillofacial surgeons examine patients to
determine the nature and extent of abnormalities and
injuries of jaws and adjacent bones and tissues. They
perform oral surgical operations to remove infected,
impacted, or malposed teeth; prepare jaws for prosth-
odontic appliances; and remove abnormal growths,
cysts, and foreign bodies from jaws and oral structures.
9

Dental implants and extraction of wisdom teeth are
the most common procedures performed by oral and
maxillofacial surgeons. The AAOMS notes that major
areas of OMS practice include:
Administration of anesthesia in dental offces and
ambulatory care settings
Dentoalveolar surgery (extraction of diseased or
impacted teeth, preparation of the mouth for
dentures, treatment of oral infections and biopsy
of suspicious lesions of the hard and soft tissue)
Surgical correction of maxillofacial deformities of
the jaw, facial skeleton and associated soft tissues
Orthognathic surgery to correct developmental
growth abnormalities of the jaws and facial bones
Cleft and craniofacial surgery to correct congenital
and acquired defects of the maxillofacial region
(this includes participating on multidisciplinary
teams to correct cleft lip and palate)
Maxillofacial trauma (repair facial injuries, set
fractured jaw and facial bones, reconnect severed
nerves and ducts, and treat other injuries of the
face and neck region)
Surgical and non-surgical management of
temporomandibular joint disorders
Management of pathological conditions of the oral
and maxillofacial region, including cysts, benign
and malignant tumors, severe infections of the oral
cavity and salivary glands and reconstruction of the
mouth and face following tumor removal
Reconstructive and cosmetic surgery of the jaw,
facial bone and facial soft tissues
10

9. Web. Bureau of Labor Statistics (BLS), U.S. Department of Labor.
Occupational Outlook Handbook 2008-09 Edition.
10. Web. AAOMS.
www.aaoms.org/credential_resources.php.
While these are major areas of practice identifed by
AAOMS, there has been signifcant debate in the states
between OMSs and the medical community concerning
the adequacy of the training OMSs receive to prepare
them to safely provide care to patients with some of the
conditions listed.
Employment types and locales
While some dentists work as partners or associates to
other dentists, most dentists own their own practices,
operating as sole practitioners with a small staff.
11
Of
those dentists in private practice, 78 percent are sole
proprietors.
12
Those dentists who are not in private
practice are often employed in hospitals or offces of
physicians, as well as public health agencies and the
military.
13 14
Of those dentists specializing in oral and
maxillofacial surgery, 30 percent are reported to be self-
employed while the remaining 70 percent work in part-
nerships or other health care settings.
15

In the care of patients with injuries or lesions that
involve complicated dental surgical problems, oral sur-
geons may be part of the surgical team or may act inde-
pendently in the area of their competence to provide
needed care. In the hospital setting, oral surgeons may
be included as members of the department of surgery,
16

and may work alongside physicians, including radiolo-
gists, anesthesiologists, pathologists, oncologists, otolar-
yngologists-head and neck surgeons, neurosurgeons and
plastic surgeons, as well as other dental specialists, such
as orthodontists and/or prosthodontists.
11. Web. BLS, U.S. Department of Labor.
www.bls.gov/oes/current/oes291022.htm . Retrieved May 24, 2008.
12. Id.
13. Id.
14. Web. ADA. Infopak: Careers in Dentistry.
www.ada.org/prof/ed/careers/infopaks/careers.pdf.
www.bls.gov/oes/current/oes291022.htm. Retrieved May 24, 2008.
16. Web. American College of Surgeons (ACS). Statement on Principles.
www.facs.org/fellows info/statements/stonprin.html.
Retrieved June 28, 2008.
Brief history of the profession
The early years of the 18th century marked the emergence
of the father of modern dentistry, Pierre Fauchard. His
revolutionary book, The Surgeon Dentist, A Treatise on
Teeth (Le Chirurgien Dentiste), was the frst to describe
a comprehensive system for the practice of dentistry. In
1760 John Baker, an immigrant from England, was the
frst trained dentist to practice in America.
17

By the mid-19th century, the frst American dental
journal was published, the frst dental school and
national dental organization were formed, and the frst
act regulating dentistry was adopted. By the end of
the century, toothpaste was invented and there was
widespread adoption of oral hygiene.
18

The dental specialty of oral and maxillofacial surgery
was developed in the U.S. military. Prior to World War
I, no formal training programs existed for the treatment
of maxillofacial injuries. In July of 1917, then Surgeon
General William Gorgas organized a working group
called the Section of Plastic and Oral Surgery. The
groups task was to train general surgeons and dentists
to work together to treat soldiers maxillofacial wounds.
Approximately 164 physicians and 123 dentists were
trained in 36 week courses, and then were assigned in
teams, composed of one physician and one dentist, to
each unit overseas. The program continued to educate
both physicians and dentists in the treatment of
maxillofacial injuries; graduates of these courses
continued to be sent overseas, and also served in feld
and base hospitals during WWI.
19

The U.S. military currently continues its tradition
of preparing oral and maxillofacial surgeons, offering
10 accredited OMS programs in 2008: two Air Force
programs (Wilford Hall Medical Center at Lackland
AFB in Texas; and David Grant USAF Medical Cen-
ter at Travis AFB in California); two Navy programs
(Portsmouth Naval Medical Center in Virginia; and
The Naval Medical Center in San Diego); and six U.S.
17. Web. ADA. History of Dentistry.
www.ada.org/public/resources/history/timeline_ancient.asp.
18. Id.
19. Strother M. Maxillofacial surgery in WWI: the role of dentists and
surgeons. Journal of Oral and Maxillofacial Surgery. August 2003,
p 493.
Army training programs (Walter Reed Army Medical
Center in Washington; Madigan Army Medical Center
in Tacoma, Washington; Brooke Army Medical Center
in Houston; Womack Army Medical Center at Fort
Bragg, North Carolina; Tripler Army Medical Center
in Honolulu; and Eisenhower Army Medical Center at
Fort Gordon, Georgia.
20

Demographics of the profession
Number of dentists and oral and maxillofacial
surgeons in the work force
According to the Bureau of Labor Statistics (BLS),
dentists held approximately 161,000 jobs in 2006.
21
Oral
and maxillofacial surgeons held 7,700 jobs that year as
well.
22

Salary data
The BLS reports that the median annual earnings of
salaried dentists in 2007 were $141,010.
23
Salaried
dentists tend to earn less than their counterparts who
are self-employed in private practice.
24
Also, dental
specialists historically earn signifcantly more than that
of general dental practitioners.
25
In 2004 CNNs Money magazine reported that the
average pay for an oral and maxillofacial surgeon was
$211,766 with an anticipated 10-year growth rate
around 16 percent
26
According to the BLS, the mean
annual wage for oral and maxillofacial surgeons in 2007
was $178, 440.
27

20. Web. AAOMS. www.aaoms.org/docs/residency/program_list.pdf.
21. Web. BLS, U.S. Department of Labor. www.bls.gov/oco/ocos072.htm.
22. Id.
www.bls.gov/oes/currentoes291021 .htm. Retrieved August 16, 2008.
24. Id.
25. Web. ADA. Dentistry Fact Sheet.
www.ada.org/public/careers/team/dentistry_fact.pdf.
Retrieved August 16, 2008.
26. Web. CNN Money. Money Magazines Best Jobs.
money.cnn.com/magazines/moneymag/bestjobs/snapshots/102.html.
www.bls.gov/oes/current/oes291022.htm. Retrieved May 27, 2008.
The BLS forecasts that employment of dentists will
grow at the average rate (an increase of 9 percent) for
all occupations through 2016. Most jobs available to
dentists and dental specialists will result from the
retirement of a large number of baby boomer dentists.
28

The BLS projects that as the baby-boom generation
ages, the need for specialty services, such as oral surgery,
will increase. Todays elderly are more likely to retain
their natural teeth, and will consequently require more
specialized dental care than in the past.
11 Scope of Practice Data Series: Oral and Maxillofacial Surgeons IV. Billing for services
Medicare
Medicare does not include a dental plan. However,
Medicare will pay for dental services that are an integral
part either of a covered procedure (e.g., reconstruction
of the jaw following accidental injury), or for extractions
done in preparation for the radiation treatment of
neoplastic diseases involving the jaw. Coverage is not
determined by the value or the necessity of the dental
care but rather by the type of service provided and
the anatomical structure on which the procedure is
performed.
29
There is an exception which allows for
Medicare coverage when the dental procedure itself is
so severe as to require hospitalization.
30
Medicaid
State Medicaid agencies administer their own plans
but must meet federal guidelines set by the Centers for
Medicare and Medicaid Services.
29. Web. Centers for Medicare and Medicaid Services (CMS).
Medicare Dental Coverage.
www.cms.hhs.gov/MedicareDentalCoverage/. Retrieved August 20, 2008.
30. Id.
IV. Billing for services
While states are not required to include dental services
for adults (individuals 21 and older) in their Medicaid
plans, Medicaids comprehensive child health program,
Early and Periodic Screening, Diagnostic and Treatment,
requires dental services that focus on the prevention,
early diagnosis and treatment of medical conditions.
31
Medical and surgical services of a dentist are those
services that if furnished by a physician, would be
considered physicians services. They are services that,
in accordance with state law, may be performed by
either a physician or a dentist. The predominant
reimbursement methodology used by states for
medical/surgical services of a dentist is fee for service.
This means that the state has established a maximum
payment amount for a particular service, or uses the
maximum applicable to the Medicare program for the
service, and pays the lesser of the providers charge or
this amount.
32
31. Web. Centers for Medicare and Medicaid Services Medicaid Dental
Coverage. www.cms.hhs.gov/MedicaidDentalCoverage/.
32. Web. The Kaiser Commission on Medicaid and the Uninsured.
www.kff.org/medicaid/benefts/service.jsp Retrieved August 20, 2008.
The Kaiser Commission gathered its information from Medicaid State
Plans and State Plan amendments submitted to and approved by the
Department of Health and Human Services Center for Medicare and
Medicaid Services (CMS).
Medicaid coverage of medical/surgical services of a dentist for adults
State Coverage
Alabama Fee-for-service reimbursement.
Alaska Fee-for-service reimbursement.
Arizona Fee-for-service reimbursement.
Arkansas Coverage limited to 12 visits per year irrespective
of setting included in limits for other specifed
practitioners. Fee-for-service reimbursement.
California $1 per visit copayment requirement. Prior approval
required for specifed services. Fee-for-service
reimbursement.
Colorado Fee-for- service reimbursement.
Connecticut Fee-for-service reimbursement.
Delaware Fee-for- service reimbursement.
District of Columbia Coverage limited to trauma care. Fee-for-service
reimbursement.
Florida $2 per day copayment requirement for oral surgery.
Fee-for-service reimbursement.
Georgia $2 per day copayment requirement for oral and
maxillofacial surgery. Prior approval required for
specifed services. Fee-for-service reimbursement.
Hawaii Coverage limited to emergency treatment for relief of
pain and infection, frequency of X-rays limited by type.
Idaho Prior approval required for specifed services. Coverage
limited to preventive and restorative services.
Illinois Fee-for-service reimbursement.
Indiana Prior approval required for specifed services including
non-emergency services provided on an inpatient
hospital basis and oral surgery. Second opinions required
for specifed procedures, ambulatory services limited.
Iowa $2 per day copayment required. Services limited
to what a physician would provide. Fee-for-service
reimbursement.
Maine Prior approval required for non-emergency services.
Maryland Prior approval required for specifed services.Services
for non-pregnant adults limited to trauma care and
emergency treatment rendered in a hospital emergency
department. Fee-for-service reimbursement.
Massachusetts Fee-for-service reimbursement.
Michigan Prior approval required for specifed services. Coverage
limited to emergency treatment for relief of pain and
infection. Fee-for-service using physician fee schedule
reimbursement.
Minnesota Prior approval required for specifed services.
Mississippi $3 per visit copayment requirement. Limited to trauma
care and emergency treatment for relief of pain and
infection. Fee-for-service reimbursement with annual
maximum for specifed services.
Missouri $0.50$3 per service depending on copayment
requirement. Fee-for-service reimbursement.
Montana $3 per visit copayment requirement. Prior approval
required for oral surgery. Fee-for-service or percentage
of charge reimbursement.
Nebraska $2 per visit copayment requirement for specialists.
Prior approval required for services provided on an
inpatient hospital basis. Services limited to what a
physician would provide. Fee-for-service reimbursement.
Nevada Fee-for-service reimbursement.
New Hampshire Prior approval required for services provided on an
inpatient hospital basis. Fee-for-service reimbursement.
New Jersey Prior approval required for specifed services, and x-ray
services costing more than $35. Specifed procedures
require a second opinion. Fee-for-service reimbursement.
New Mexico $5$7 copayment requirement. Prior approval required
for services provided on an inpatient hospital basis.
New York Fee-for-service reimbursement.
North Carolina $3 per episode of treatment copayment requirement.
Prior approval required for specifed services including
complex oral surgeries. Fee-for-service reimbursement.
North Dakota $2 per visit copayment requirement. Fee-for-service
reimbursement.
Ohio Services limited to extractions, surgical excisions and
incisions. Fee-for-service reimbursement.
Oklahoma Services limited to what a physician would provide.
Oregon $3 per visit copayment requirement for Group A
individuals. Prior approval required for specifed services.
Specifed services require a second opinion for Group A
individuals. Coverage is limited to emergency treatment
for pain and infection for Group B individuals. Fee-for-
service reimbursement.
Pennsylvania $0.50$3 per service depending on copayment
requirement. Fee-for-service reimbursement.
Rhode Island Prior approval required for specifed services.
South Carolina Fee-for-service reimbursement.
South Dakota Cosmetic surgery limited to post-trauma conditions.
Fee-for-service, or percentage of charge for unlisted
services reimbursement.
Tennessee $15 per visit copayment requirement for Group B1
individuals. $25 per visit copayment requirement.
Note: Rule 1200-13-13-.04 states that Dental Services
are not covered for persons aged 21 and older.
Additionally Rule 1200-13-13-.10(b) 23 states that
dental services are specifcally excluded from coverage
under the TennCare program.
Texas Prior approval required for specifed surgical procedures
and services. Fee-for-service or global reimbursement.
Utah 10% of copayment required for Group C individuals.
Coverage limited to trauma care and emergency
treatment for relief of pain and infection for Group B &
C individuals. Fee-for-service reimbursement.
Vermont Coverage limited to 1 inpatient hospital visit per day.
Virginia Coverage limited to trauma care and oral surgery.
Washington Fee-for-service reimbursement.
West Virginia Coverage limited to trauma care including maxillofacial
surgery and emergency treatment for relief of pain and
infection. Fee-for-service reimbursement.
Wisconsin $0.50$3 per service copayment requirement depending
on payment. Prior approval required for specifed
services. Fee-for-service reimbursement.
Wyoming Fee-for-service reimbursement.
15 Scope of Practice Data Series: Oral and Maxillofacial Surgeons V. Education and training of oral and maxillofacial surgeons
Dental school
Prior to acceptance into a post-graduate training program
which prepares the dentist to specialize in oral and
maxillofacial surgery, oral and maxillofacial surgeons
(OMSs) frst obtain a dental degree through an accred-
ited dental school. Colleges of dentistry offer a four-year
graduate program. Most graduates receive the degree of
Doctor of Dental Surgery (DDS). Some dental schools
award the alternate Doctor of Dental Medicine (DMD)
degree.
33
There is no difference, however, between the
two degrees. Dentists who hold a DDS or DMD receive
the same education. While individual universities
determine which degree is awarded, both degree pro-
grams adhere to the same curriculum standards as set by
the American Dental Association (ADA) Commission
on Dental Accreditation (CODA).
34

Interestingly, a 2000 editorial in the Journal of Oral and
Maxillofacial Surgery discussed the confusion among the
public regarding the existence of two different degrees
in dentistry. The article references a 1999 survey, the
fndings of which the author notes, clearly indicate
that there is considerable confusion on the part of the
public about the training and scope of those who have a
DDS and those who have a DMD degree.
35
The author
suggests adopting a single degree within the profession,
and notes that the 1999 survey found that many of the
respondents commented at the end of the interview that
the DMD sounds more like a medical doctor because of
the MD part of the abbreviation, and therefore those
with this degree were able to perform more complex
procedures.
36
Not surprisingly, the author concluded,
33. Web. American Dental Education Association (ADEA). ADEA Offcial
Guide to Dental Schools.
www.adea.org/dental_education_pathways/aadsas/Documents/OG08_
1-77_r4.pdf. Retrieved June 28, 2008.
34. Web. ADA. Dentistry Defnitions.
www.ada.org/prof/ed/specialties/defnitions.asp#dds.
35. Laskin DM. Public Perception of the Dental Degree. J Oral Maxillofac
Surg 58:591-592, 2000. Referencing a survey published in the Journal of
American Colleges of Dentistry, J Am Coll Dent 66:29, 1999.
36. Id.
it is time to eliminate ambiguity, maximize public
understanding, and adopt the degree that engenders
the greatest public confdence. This is defnitely
the DMD degree.
37
According to the ADA Web site, in 2005 there were
10,731 applicants and 4,688 frst-year enrollees to U.S.
dental schools.
38
The average annual tuition at dental
schools in 2005 was $24,286.
39

Dental school admission criteria
The American Dental Education Association (ADEA)
is the professional organization representing the interests
of dental schools and post-doctoral dental education/
training programs in North America. The ADEA has
developed dental school admission standards. The ADEA
encourages dental schools to accept only students who
have completed at least two years of undergraduate
education and have taken the Dental Admission Test.
40

The ADEA suggests that dental schools encourage
applicants to earn their baccalaureate degrees before
entering dental school. Most frst year dental stu-
dents have obtained a bachelors degree, but some are
accepted to dental school after two or three years of
undergraduate study and may fnish their bachelors
degree while in dental school.
41

37. Id.
38. Web. ADA. Applicants and Enrollees. Referencing Chmar JE et al,
US Dental school applicants and enrollees: 2005 entering class. J Dent
Educ 2007; 71:1098-1123. Retrieved September 5, 2008.
www.adea.org/publications/adeadentaledataglance/Pages/
ApplicantsandEnrollees.aspx
39. Web. ADA. Tuition.
www.adea.org/publications/adeadentaledataglance/Pages/Tuition.aspx.
Retrieved September 5, 2008.
40. Web. American Dental Education Association (ADEA). ADEA Offcial
Guide to Dental Schools.
www.adea.org/dental_education_pathways/aadsas/Documents/OG08_
1-77_r4.pdf. Retrieved June 28, 2008.
41. Web. National Institute of Health; Offce of Science Education. Oral
and Maxillofacial Surgeon. science-education.nih.gov/LifeWorks.nsf/
Alphabetical+List/Oral+and+Maxillofacial+Surgeon.
V. Education and training of oral and
maxillofacial surgeons
Dental Admission Test (DAT)
The DAT consists of 180 multiple-choice test items and
requires four hours and 15 minutes for administration.
There are four topic areas covered in the DAT. Exam
content and weight are as follows:
DAT topics Number of questions
Natural sciences 100
Biology 40
General chemistry 30
Organic chemistry 30
Perceptual ability 90
Reading comprehension 50
Quantitative reasoning 40
DAT scores are reported as a standard score rather
than a percentage or raw score. Scores range from
1 to 30 with the score of 17 usually signifying average
performance on a national basis.
42

Each accredited dental school has its own application
process and set of admission requirements; however,
common college-level course requirements include:
43
Course Undergraduate
prerequisite hours
Biology with lab 8
General/Inorganic
chemistry with lab
8
Organic chemistry 8
Physics 8
English 68
Math 6
42. Web. ADA. Dental Admission Testing Examinee Guide.
www.ada.org/prof/ed/testing/dat/dat_examinee_guide_2008.pdf.
43. Web. Based on information from the University of Pennsylvania School
of Dental Medicine: www.dental.upenn.edu. Columbia University College
of Dental Medicine: cpmcnet.columbia.edu/dept/dental. University
of Michigan School of Dentistry: www.dent.umich.edu. University of
California at San Francisco School of Dentistry: dentistry.ucsf.edu/.
General requirements for admission into a doctoral
program in dentistry are: overall DAT score of
approximately 20; an average GPA of 3.5; and
undergraduate coursework in biology, chemistry,
English, math and physics.
44
Dental school curriculum requirements
Since 1973 the ADAs CODA has been continuously
recognized by the U.S. Department of Education as
the specialized accrediting agency in dental education.
45

CODA accredits dental schools, advanced dental
training programs and allied dental education programs.
The mission of CODA is to serve the public by estab-
lishing, maintaining and applying standards that ensure
the quality and continuous improvement of dental
and dental-related education and refect the evolving
practice of dentistry. Activities for CODA include:
formulating and approving accreditation standards by
which programs are evaluated; establishing policies and
procedures for conducting the accreditation program;
determining and publicizing program accreditation
status; and appointing consultants and site visitors to
assist in accreditation activities.
46
CODA reviews and
recommends the accreditation status of OMS training
programs at least every fve years.
47

CODA has developed standards related to the
following topics for accreditation purposes: institutional
commitment and program effectiveness; program
director and teaching staff; facility and resources; and
curriculum and program duration.
44. Id.
45. In 1973 the House of Delegates for the American Dental Association
approved the establishment of a Commission on Accreditation of Dental
and Dental Auxiliary Educational Programs. In 1979 this name was
changed to Commission on Dental Accreditation. ADA. Commission
on Dental Accreditation (CODA).
www.ada.org/prof/ed/accred/commission/epp.asp.
46. Web. ADA. www.ada.org/prof/ed/accred/commission/index.asp.
47. Web. AAOMS. Dental Students Selecting a Program.
www.aaoms.org/dental_students.php#2. Retrieved May 27, 2008.
There are currently 57 CODA-accredited dental schools
in the United States and 10 in Canada.
48 49
Below are
the pertinent accreditation standards related to dental
school biomedical and clinical sciences curriculum.
50

Biomedical science instruction in dental education
must ensure an in-depth understanding of basic
biological principles, consisting of a core of informa-
tion on the fundamental structures, functions and
interrelationships of the body systems.
The biomedical knowledge base must emphasize the
orofacial complex as an important anatomical area
existing in a complex biological interrelationship
with the entire body.
Information on abnormal biological conditions must
be provided to support a high-level understanding
of the etiology, epidemiology, differential diagnosis,
pathogenesis, prevention, treatment and prognosis
of oral and oral-related disorders.
Biomedical science knowledge must be of suffcient
depth and scope for graduates to apply advances in
modern biology to clinical practice and to integrate
new medical knowledge and therapies relevant to
oral health care.
At a minimum, graduates must be competent in
providing oral health care within the scope of gen-
eral dentistry as defned by the school, for the child,
adolescent, adult and geriatric patient, including:
Patient assessment and diagnosis
Comprehensive treatment planning
Health promotion and disease prevention
Informed consent
Anesthesia and pain and anxiety control
Restoration of teeth
Replacement of teeth
Periodontal therapy
48. Web. ADA. www.ada.org/prof/ed/programs/search_ddsdmd_us.asp.
49. Web. Canadian Dental Association. Accredited Education Programs.
www.cda-adc.ca/en/cda/cdac/search_aep/search1.asp?lstProvince=0&op
tProgram=1. Retrieved August 11, 2008.
50. Web. ADA. Commission on Dental Accreditation (CODA)
Accreditation Standards for Dental Education Programs, p. 12-16.
www.ada.org/prof/ed/accred/standards/predoc.pdf. Note that not all
standards related to the dental school curriculum are listed here.
Pulpal therapy
Oral mucosal disorders
Hard and soft tissue surgery
Dental emergencies
Malocclusion and space management
Evaluation of the outcomes of treatment
Graduates must be competent in providing
appropriate life support measures for medical
emergencies that may be encountered in
dental practice.
Graduates must be competent in the use of
critical thinking and problem solving related to
the comprehensive care of patients.
Dental school curriculum
First and second years
Dental students spend the majority of their frst two
years studying biological sciences and learning the struc-
ture, function and diseases of the human body. During
this time, dental students take basic sciences courses
such as anatomy, physiology, biochemistry, microbiology
and pharmacology. Classes also include dental-specifc
biology sciences such as oral anatomy, oral pathology
and oral histology. In many dental schools, frst- and
second- year dental students take courses in providing
care to diverse populations and principles of oral
diagnosis and treatment. Dental procedures are initially
practiced on models of the mouth and teeth. In some
schools, dental students begin interacting with patients
and providing basic oral health care during their frst or
second year.
51
Also during the frst or second year of dental school,
students typically take a gross anatomy course with
cadaver lab that allows dental students to study human
anatomy with a focus limited to the head and neck.
Students may also take a practical course focused on
obtaining a medical history for application in later
dental clinic settings.
52
51. Web. American Dental Education Association (ADEA).
www.adea.org/dental_education_pathways/educational_resourses/
Documents/OG_ch2.pdf. Retrieved August 12, 2008.
52. Web. Tufts University School of Medicine. dental.tufts.
edu/1186142167927/TUSDM-Page-dental2w_1186142327816.html#med2.
Third and fourth years
The third and fourth years of dental school focus
primarily on clinical study designed to provide
competence in prevention, diagnosis and treatment of
oral diseases and disorders within the scope of general
dentistry. Dental students apply basic principles and
techniques related to oral diagnosis, treatment planning,
restorative dentistry, periodontics, oral surgery,
orthodontics, pediatric dentistry, prosthodontics and
endodontics. Students learn to provide direct patient
care to chronically ill, disabled, geriatric and pediatric
patients. Dental students rotate through various
dental clinics to treat patients under the supervision
of a licensed dentist.
53

Dental school graduates
In 2007 there were 4,714 graduates of U.S. dental
schools.
54
Of those graduates, the ADA reports that
approximately 12 percent enrolled in postgraduate
training programs in one of the nine recognized dental
specialties, including OMS.
55

OMS training programs
According to the American Association of Oral and
Maxillofacial Surgeons (AAOMS), the professional
organization representing oral and maxillofacial surgeons,
there are 99 CODA-accredited OMS training programs
in the United States.
56
During the 20072008
academic year, 990 dentists were enrolled in OMS
training programs.
57
According to the Advanced
Education and Professional Affairs department of the
AAOMS, approximately 180190 trainees complete
OMS training annually.
58

Some OMS training programs have affliations with
dental schools and medical schools. Other programs
53. Web. American Dental Education Association (ADEA). www.adea.org/
dental_education_pathways/educational_resourses/Documents/OG_ch2.
pdf. Retrieved August 12, 2008.
54. Web. American Dental Education Association (ADEA).
www5.adea.org/tde/2_1_3.htm. Retrieved August 5, 2008.
55. Web. National Institute of Health; Offce of Science Education Oral
and Maxillofacial Surgeon. science-education.nih.gov/LifeWorks.nsf/
Alphabetical+List/Oral+and+Maxillofacial+Surgeon?OpenDocument&
ShowTab=All&. Retrieved May 27, 2008.
www.aaoms.org/dental_students.php#2 Retrieved May 27, 2008.
57. Id.
58. E-mail message from AAOMS. Dated September 25, 2006.
are based primarily in hospitals. Although many OMS
trainees receive a stipend from federal Graduate Medical
Education (GME) funds, the ADA reports that many
postgraduate dental programs charge tuition and/or fees
to its trainees.
59
For example, in the 2005 2006 academic
year, tuition and fees for the following postdoctoral
dental specialty programs were:
Oral and maxillofacial surgery $12,200
Endodontics $23,743
Pediatric dentistry $16,737
Prosthodontics (all types) $21,405
It is not noted whether these post-doctoral specialty
programs result in the award of an academic degree,
or are simply clinical training programs for dental
graduates. However, it is also noted that Many
postdoctoral programs provide stipends that cover
tuition and fees for frst-year students.
60
Admission requirements for OMS training programs
Post-doctoral OMS training programs have less uniform
admissions standards than do dental schools. Common
admissions requirements are: a DDS or DMD degree
from an accredited U.S. or Canadian dental school,
National Dental Board Examination scores (90 percent
or higher average on Part 1), satisfactory academic
records, letters of recommendation and references. In
addition to these requirements, some OMS programs
may require dual admission to medical school or PhD
programs.
61
Categories of OMS training programs
As mentioned previously, upon completion of dental
school, approximately 12 percent of new graduates
enroll in advanced dental specialty education training
programs. Those dentists who choose the OMS specialty
have three different training pathways to consider:
62

The traditional method is to enter a four-year OMS
certifcate training program, which awards the trainee
a certifcate of completion in OMS and qualifes the
59. Web. ADA. Tuition.
www.adea.org/publications/adeadentaledataglance/Pages/Tuition.aspx.
Retrieved September 5, 2008.
60. Id.
61. Web. Baylor College of Dentistry: www.tambcd.edu; University of
Alabama: main.uab.edu/ofs/; University of Texas Southwestern Medical
Center: www.utsouthwestern.edu/; University of Texas Health Science
Center: www.uthscsa.edu/. Retrieved May 28, 2008.
www.aaoms.org/dental_students.php#2 Retrieved May 27, 2008.
trainee to sit for the OMS certifcation examination.
No additional degrees are awarded through this
training route.
In the second option, a candidate can attend a
57 year program in which the trainee is accepted into
a four-year OMS certifcate program, and also receives
advance standing as a second- or third-year student
in medical school upon completion of the OMS
training. In these programs, the trainee will be awarded
an OMS certifcate and may optionally complete a
medical degree following OMS training, if the trainee
qualifes for admission into the medical school. Upon
successful completion of both the OMS training and
medical school, the trainee obtains a certifcate of
completion in OMS and a medical degree.
In the third option, the applicant enters a dual degree
OMS training program. These programs combine either
an MD or PhD with the OMS certifcate program. The
student is guaranteed a place in either medical school or
a PhD program in addition to his or her placement in
the OMS program. The MD/OMS dual degree programs
integrate mandatory medical training and 30 months
of OMS training. Upon completion, the resident is
awarded an OMS certifcate and an MD degree.
Typically, in the PhD dual degree programs, students
spend their frst three years obtaining a PhD before
completing the OMS certifcate requirements. Most
students take 78 years to complete the PhD/OMS
certifcate programs.
Of the 99 OMS training programs, 10 are military/
federal programs that offer trainees the single OMS
certifcate upon completion. Of the remaining 89 OMS
training programs, 47 offer the single OMS certifcate,
while the remaining 42 offer the dual MD/OMS or PhD/
OMS degrees upon completion.
63
The OMS training programs offered through the Baylor
College of Dentistry provide an illustration of the struc-
ture of the varied pathways to receive OMS training:
64
63. Web. AAOMS. Accredited Advanced Training Programs in Oral and
Maxillofacial Surgery. www.aaoms.org/docs/residency/program_list.pdf.
64. Web. Baylor College of Dentistry.
www.bcd.tamhsc.edu/oralsurgery/postdoc/postdoc.htlm.
Four-year OMS certicate program
The 48-month certifcate-only program in OMS is made
available primarily for U.S. military service trainees.
The frst 12 months of the program include time on the
OMS service, and also rotations on the general surgery,
medicine and anesthesia services at Baylor University
Medical Center, functioning at the resident level. The
remaining three years of the program are primarily spent
on the OMS service, with intermittent rotations of one
month each to the oral pathology, head and neck
surgery, and oculoplastic surgery services.
MD/OMS dual degree program
The MD/OMS dual degree program is a combined pro-
gram leading to a certifcate in OMS and an MD degree.
The minimum duration of study is 72 months. After
completion of dental school, the trainee attends
Texas Tech University Medical School in Lubbock as
a full-time medical student with advanced standing in
the second-year medical class. Six months of the
fourth- year medical school program are spent on the
oral and maxillofacial surgery service. After completion
of medical school, the resident completes a one-year
general surgery internship at Baylor University Medical
Center. The remaining 24 months of the program are
spent on the OMS service at Baylor College of Dentistry
and Baylor University Medical Center.
Year 1 Advanced placement as
a second-year medical
student at the Texas Tech
University School of
Medicine
Year 2 Medical school, year 3
Year 3 Medical school, year 4;
6 months rotation spent
on the OMS service; after
completion, awarded MD
degree
Year 4 1-year general surgery
internship at Baylor
University Medical
Center
Year 5 OMS service/training
Year 6 OMS service/training
PhD/OMS dual degree certicate program
The OMS and PhD program in craniofacial biology is
a sequential post-dental school program with the PhD
study and dissertation completed frst, followed by the
OMS training. The PhD program is jointly conducted
through Baylor College of Dentistry. This course of
study requires courses and research leading to prepara-
tion and defense of the students PhD dissertation. The
program design requires completion of the PhD degree,
including dissertation and defense, prior to entering
the OMS clinical training program.
CODA curriculum accreditation standards for
OMS training programs
CODA, the accrediting body of the American Dental
Association, has developed the following standards
related to curriculum that are required for accreditation
of all OMS certifcate and dual degree MD/OMS or
PhD/OMS programs:
65

OMS training program must be a minimum of
48 months of full-time study.
Each OMS student must devote a minimum of
30 months to clinical oral and maxillofacial surgery.
Twelve months of training on the oral and
maxillofacial service must be at a senior level,
of which 6 months training must occur in the
fnal year.
Training in a private practice facility must be no
longer than two months of the 30-month require-
ment.
Didactic and clinical courses regarding medical
history and physical evaluation must be initiated in
the frst year of OMS training. This is required in
order to ensure that students apply the principles of
physical diagnosis to adults and pediatric patients
throughout the training program.
The OMS training program must include integrated
training in basic and clinical sciences.
Introduction in the basic biomedical sciences
at a level beyond that of pre-doctoral dental
school. Curriculum must include courses in
anatomy, physiology, pharmacology, microbiol-
65. Web. ADA. CODA. All OMS training programs awarding the certifcate
of completion must adhere to these standards, whether they are stand-
alone training programs or dual degree programs. Accreditation
standards for advanced specialty education programs in oral and
maxillofacial surgery. ada.org/prof/ed/accred/standards/oms.pdf.
ogy, and pathology. Instruction may be provided
through formal courses, seminars, conferences or
rotations to other services of the hospital.
Integrated clinical science curriculum must
include rotations off the OMS service, lectures
and seminars given during the OMS training
program by OMS trainees and staff.
The OMS training program must include the
following rotations:
30 months of clinical oral and maxillofacial
surgery
4 months of anesthesia rotation functioning at
a level commensurate to an anesthesia resident,
including regular on-call responsibilities
4 months of general surgery rotation functioning
at a level commensurate to a surgery resident,
including regular on-call responsibilities
2 months of clinical medicine rotation to
gain the highest level of educational opportu-
nity available, even if trainee does not have
complete management authority over patients
(this experience may be at medical student
level or higher)
6 months of expanded clinical or research
opportunities
2 months of additional clinical or medical
education rotations
The OMS training program must include rotations
in outpatient OMS procedures, ambulatory
anesthesia, and emergency care.
OMS students must administer anesthesia to a
minimum of 100 ambulatory OMS patients per
year, 10 of which must be general anesthesia.
In the fnal year, OMS students must perform major
oral and maxillofacial surgery on 75 patients.
For the surgery to be counted, the OMS student
must be the operating surgeon or frst assistant
to an OMS attending staff member and the
patient must be on the OMS service.
The OMS student must play a signifcant role
in determining the diagnosis, providing
preoperative care, selecting and performing the
appropriate operative procedure and managing
the postoperative course.
Surgery performed by OMS students while
rotating on or assisting with other services
cannot be counted toward this requirement.
Of the 75 major surgical patients required in
the fnal year of OMS training, there must be at
least 10 patients in each category of surgery.
The categories of major surgery are defned as:
Trauma
Trauma management includes, but is not
limited to, tracheostomies, open and closed
reductions of fractures of the mandible,
maxilla, zygomatico-maxillary, nose, naso-
frontal-orbital-ethmoidal and midface region
and repair of facial, oral, soft tissue injuries and
injuries to specialized structures.
Pathology
Pathology management includes, but is not
limited to, major maxillary sinus procedures,
treatment of temporomandibular joint
pathology, cystectomy of bone and soft tissue,
sialolithotomy (removal of calculus from a sali-
vary gland or duct
66
), sialoadenectomy (exci-
sion of salivary gland
67
), management of head
and neck infections, including incision and
drainage procedures, ffth nerve surgery and sur-
gical management of benign and
malignant neoplasms.
Orthognathic surgery
Orthognathic surgery includes correction of
deformities in the mandible and the middle
third of the facial skeleton. This includes, but
is not limited to, deformities of the mandible,
maxilla, zygoma and other facial bones.
Reconstructive and cosmetic surgery
Reconstructive surgery includes both bone
grafting and soft tissue grafting procedures, aug-
mentation procedures, temporomandibular joint
reconstruction, facial cleft repair and inser-
tion of craniofacial implants. Cosmetic surgery
includes, but is not limited to,
rhinoplasty (plastic surgery on the nose
68
),
blepharoplasty (plastic surgery on eyelid
69
),
66. Web. Dental Dictionary (online). www.dentaldictionary.net.
67. Id.
68. Web. Merriam-Websters Medical Dictionary (online).
www.medical.merriam-webster.com. Retrieved August 17, 2008.
69. Id.
rhytidectomy (facelift
70
), genioplasty (plastic
surgery of the chin
71
), lipectomy (the excision
of subcutaneous fatty tissue especially as a cos-
metic surgical procedure
72
), otoplasty (plastic
surgery of the external ear
73
) and scar revision.
While these CODA standards provide detailed require-
ments for the structure of the OMS training program,
they fail to establish specifc requirements in certain
critical areas. The standards do not establish a minimal
requirement of cases to perform for outpatient OMS
procedures. Similarly, while the emergency care standard
specifes that the OMS student must assume major
responsibility for the care of oral and maxillofacial
injuries, it does not establish a minimum number of
cases or minimum length of rotation. Limited experience
in these critical areas raises valid concerns for patient
safety, especially for those trainees who lack the
additional clinical education and training obtained
through the medical training in the dual degree
MD/OMS programs.
Also of concern is the fact that these standards provide
only a maximum of six months of general surgery
experience; four months if the OMS trainee does not
opt for two additional months of general surgery
training. Furthermore, the training an OMS receives in
cosmetic and reconstructive surgery is minimal. Under
the standards, an OMS trainee need act as frst assistant
or surgeon on a minimum of only 10 cosmetic or
reconstructive surgeries.
OMS training program curriculum: didactic program
OMS training programs are primarily clinically based.
Nonetheless, the programs do have didactic requirements
that are usually met in the early years of the program.
In the case of an MD/OMS dual-degree program, some
didactic courses may have been completed in the
medical school program.
Topics covered in didactic courses often include specialty
areas of dentistry, physical diagnosis, hospital dentistry,
treatment planning, medical emergencies, conscious
70. Id.
71. Id.
72. Id.
73. Id.
sedation, oral pathology/medicine, pharmacology, infec-
tion control, surgical implants, head and neck anatomy,
literature reviews, and practice management.
74

OMS training program curriculum: clinical
experiences
All OMS trainees participate in clinical rotations as the
major focus of their training. While all OMS training
programs have the common goal of preparing the trainee
for OMS board certifcation, the clinical rotations of the
many programs vary. Trainees in dual-degree programs
may count some of their medical rotation experience
toward the curriculum standard requirements listed in
the previous section. Clinical rotations may include the
following medical and dental services:
75
Oral and maxillofacial surgery
Surgical intensive care unit
Anesthesiology
General surgery
Plastic and reconstructive surgery
Emergency medicine
Neurosurgery
Otolaryngology
Cleft lip and palate
Trauma surgery
Pathology
Although OMS programs may vary in the sequence
in which students take their rotations, all have similar
74. Web. UCLA School of Dentistry.
www.uclasod.dent.ucla.edu/admissions/index.asp?id=362.
University of Alabama School of Dentistry Oral and Maxillofacial
Surgery OFS Residency Program.
www.main.uab.edu/ofs/Templates/Inner.aspx?pid=92166.
Medical College of Wisconsin.
www.mcw.edu/display/router.asp?docid=2770. U.S. Army Southeast
Regional Dental Command and Dental Activity Oral and Maxillofacial
Surgery Training Program. www.serdc.amedd.army.mil/oral_max.htm.
University of Iowa.
www.dentistry.uiowa.edu/public/clinics/oralsurg/oralmagp.html.
University of Southern California.
www.usc.edu/hsc/dental/academic_programs/oral_maxillofacial/
program_overview.htm. Virginia Commonwealth University Oral and
Maxillofacial surgery.
www.dentistry.vcu.edu/omfs/residency/curriculum.html#frst. Retrieved
August 12, 2008.
75. Id.(excerpted from all)
rotation lengths (approximately four weeks each).
The following curriculum is representative of four-year
OMS certifcate training programs. Note that the OMS
trainee typically gains exposure to medical and surgical
specialties during his or her frst year of training, and
then spends the majority of the remaining three years on
the oral and maxillofacial surgery service.
Virginia Commonwealth University OMS training
program
76
First year
The frst year of a Virginia Commonwealth University
(VCU) OMS program, the trainee focuses primarily
on inpatient care responsibilities in the pre-and post-
operative periods, as well as the hospital outpatient
minor surgery clinic. Rotations include:
Physical diagnosis (eight weeks)
OMS hospital clinic (six months)
General surgery (one month)
Surgical oncology (one month)
Trauma surgery (two months)
Internal medicine (one month)
Emergency medicine (one month)
Second year
The second year is similar to the frst, with the addition
of clinical rotations structured to nurture the increasing
autonomy of the trainee while he or she participates on
the OMS service under the direct supervision of OMS
service faculty.
OMS service: in hospital, operating room or school
clinic settings (six months)
Anesthesia (four months)
Cardiology (one month)
Surgical ICU (one month)
76. Web. Virginia Commonwealth University Oral and Maxillofacial Surgery.
www.dentistry.vcu.edu/omfs/residency/curriculum.html#frst.
Third year
In the VCU OMS program trainees third year, his
or her participation and responsibility in patient
management increases. Still under the supervision
of the attending OMS staff, the trainee assumes
responsibility for the day-to-day consultative and
administrative details of the service. Third-year
rotations include:
OMS hospital operating room (three months)
Private OMS service at local hospitals with local
surgeons or in the faculty practice at VCU
(six months)
OMS school clinic (three months)
Fourth year
The fourth-year trainee assumes total responsibility for
the organization and operation of the service and assists
in the organization of the academic program and teaches
junior trainees and dental students on the OMS service.
In addition, the fourth-year trainees, known as chief
residents at VCU, staff all major OMS operating room
cases, where, according to CODA standards, they must
complete at least 75 major OMS surgeries.
OMS fellowships
A fellowship in oral and maxillofacial surgery is defned
by the ADA as a planned post-residency program that
contains education and training in a focused area of the
specialty. The focused areas include: esthetic oral and
maxillofacial surgery, oral and maxillofacial oncology,
pediatric oral and maxillofacial surgery, maxillofacial
trauma and craniofacial surgery.
77
Like OMS training
programs, these OMS fellowships are accredited by
CODA. Information regarding the frequency with
which OMS trainees pursue fellowship training is not
available on the CODA Web site.
Accreditation requirements include: a duration of no
less than one year, and the inclusion of both didactic
and clinical educational components. Each OMS
specialty fellowship is required to meet certain clinical
requirements that are documented in CODAs
Accreditation Standards for Clinical Fellowship Training
Programs in Oral and Maxillofacial Surgery.
78
For
example, CODA requires that the surgical experience
for the fellowship in esthetic OMS includes a minimum
of 125 maxillofacial esthetic cases. These procedures
include, but are not limited to, blepharoplasty, brow
lifts, treatment of skin lesions, cheiloplasty, genioplasty,
otoplasty, rhinoplasty and rhytidectomy.
77. Web. ADA. Fellowship Accreditation Standards.
www.ada.org/prof/ed/accred/standards/omsf.pdf. Retrieved July 8, 2008.
78. Id.
24 Scope of Practice Data Series: Oral and Maxillofacial Surgeons VI. Oral and maxillofacial surgeon licensing and board certication
Dental licensing
State boards of dentistry are created by state legislatures
to govern the qualifcations and practice of dentistry. To
qualify for licensure as a dentist in all 50 states and the
District of Columbia, candidates must graduate from an
ADA-accredited dental school, and pass written and
practical examinations.
79

The written examination requirement is fulflled by the
National Board Dental Examination (NBDE).
80
This
test consists of two parts. Part I is usually taken after
students have completed their second year of dental
school. It is a computer-based, comprehensive test that
is administered in one day. Part I of the NBDE consists
of 400 multiple-choice items with even distribution of
the following topics: anatomic sciences, biochemistry,
physiology, microbiology, pathology, and dental anatomy
and occlusion.
81
Students must successfully complete
Part I in order to become eligible to take Part II of the
examination. Part II of the NBDE consists of 500
multiple-choice items and is administered over one
and a half days. Part II tests nine dental discipline areas:
endodontics, operative dentistry, oral and maxillofacial
surgery, oral diagnosis, orthodontics-pediatric dentistry,
patient management, periodontics, pharmacology and
prosthodontics.
82

States often grant licensure by recognition. Specifcally,
where an applicant for licensure has already obtained
a license in another state, he or she is granted a license
in the new state based on the applicants having
successfully met the licensure requirements in the other
state/jurisdiction.
83

79. Web. National Institute of Health; Offce of Science Education. science.
education.nih.gov/LifeWorks.nsf/Alphabetical+List/Oral+and+Maxillofa
cial+Surgeon?OpenDocument&ShowTab=3&. Retrieved May 28, 2008.
80. Web. ADA. www.ada.org/prof/ed/testing/index.asp.
81. Web. ADA. National Board Dental Examination Part I: Candidates Guide
www.ada.org/prof/ed/testing/nbde01/nbde01_candidate_guide_2008.pdf.
82. Web. ADA. National Board Dental Examination Part II:
Candidates Guide.
www.ada.org/prof/ed/testing/nbde02/nbde02_candidate_guide_2008.pdf.
83. Web. ADA. www.ada.org/prof/prac/licensure/information.asp.
All states require licensure as a dentist in order for a
candidate to practice and specialize as an oral and max-
illofacial surgeon. Other state requirements for practice
as an oral and maxillofacial surgeon vary. Nevertheless,
in general, states require that oral and maxillofacial
surgeons practicing in their respective states either com-
plete an accredited educational OMS program or hold
diplomate status in the specialty, signifed by board cer-
tifcation in OMS. Some state dental boards also require
oral and maxillofacial surgical specialty examinations.
84

Board certication for oral and maxillofacial
surgeons
The American Board of Oral and Maxillofacial
Surgery (ABOMS) is the certifying board for oral and
maxillofacial surgery in the United States, and is
recognized and approved by the Council on Dental
Education of the ADA. The ABOMS is responsible for
reviewing all applicants for board certifcation, as well
as administering the examinations involved in the cer-
tifcation process. Those individuals who demonstrate
achievement of the requisite training, experience and
knowledge are granted diplomate certifcates.
85
Board
certifcation is not a requirement for OMS practice but
is often a criterion for gaining surgical privileges
in many hospitals, surgery centers or managed care
organizations.
86
There are two pathways for ABOMS board certifcation:
Candidates for board certifcation must have
graduated from an accredited dental school and
must be licensed in the state in which they practice.
In addition, a candidate must have completed an
OMS training program approved by CODA; or
84. Id.
85. Web. American Board of Oral and Maxillofacial Surgery (ABOMS).
www.aboms.org/General_information/CertifcationProcess.htm.
86. Web. AAOMS. www.aaoms.org/dental_students.php#9.
VI. Oral and maxillofacial surgeon licensing
and board certifcation
Candidates who have received training in programs
not accredited by CODA must provide verifcation
of their OMS training having provided equivalent
educational backgrounds. In addition, these
applicants must have:
Completed at least 12 months of oral and
maxillofacial surgery training at the senior
resident level, or
Completed an accredited fellowship that is a
minimum of 12 months in duration, or
Served 12 consecutive months as a full-time
faculty member in an accredited OMS training
program during the past two years and have an
active state license.
87
Applicants for board certifcation in oral and
maxillofacial surgery must provide evidence of their
educational and training qualifcations. In addition,
letters of recommendation from board-certifed oral
and maxillofacial surgeons attesting to the applicants
acceptable ethical and moral standing are also required
as part of the certifcation procedure.
88
In 2007 ABOMS received 458 applications and
certifed 153 candidates. While 6,666 total ABOMS
board certifcations have been granted, 4,620
certifcations are considered active.
89
National board certication exam
The ABOMS board certifcation process consists of two
examinations: the qualifying (written) examination and
the oral certifying examination. A candidate must pass
the qualifying exam before being permitted to sit for
the oral certifying examination.
90
Once certifed, the
candidate becomes a diplomate of the board.
91
87. Web. American Board of Oral and Maxillofacial Surgery (ABOMS).
88. Web. ABOMS.
89. These fgures are through December 31, 2007. Web. ADA.
Report of the ADA Recognized dental specialty certifcation boards.
www.ada.org/prof/ed/specialties/specialty_certifying_report.pdf.
90. Web. ABOMS. Candidates.
www.aboms.org/Candidates/Candidates.htm. Retrieved August 3, 2008
91. Web. ABOMS. www.aboms.org/Candidates/Candidates.cfm.
The qualifying exam is a seven-hour computer-based
exam given every January, and must be taken after the
completion of OMS training.
92
It contains 300 or more
multiple-choice questions in the following subject areas:
Medical assessment and management
Anesthesia
Dentoalveolar
Trauma
Orthognathic/cleft/craniofacial
Cosmetic
Temporomandibular/facial pain
Pathology
Reconstruction
In January 2008, a total of 253 candidates sat for the
qualifying exam. The success rate for the 210 frst
time-takers was 80.8 percent. The success rate for the
43 repeat takers was 55.8 percent. The 198 total
successful candidates constituted an overall pass rate
of 78.3 percent.
93
The oral certifying exam consists of four 45-minute
sessions given in one day each February. Candidates
have three opportunities to take the oral examination
after passing the qualifying exam. The oral exam
evaluates skills in the following three areas:
Data gathering/diagnosis/treatment plan
Management
Treatment variations/complications.
Four surgery topics are covered in the oral
examination:
94
Dentoalveolar, implants, temporomandibular (TMJ)
joint disorders, facial pain, infections
Trauma, orthognathic surgery, esthetic surgery
92. Id.
93. Web. ABOMS. Study Resource for the 2009 Qualifying
Certifcation Examinations.
www.aboms.org/Candidates/StudyResources/StudyResources.htm.
94. Id.
Pathology, reconstruction, clefts, obstructive
sleep apnea
Anesthesia, perioperative medical care.
In February 2008, 81 percent of 183 frst-time candidates
and 66.6 percent of 18 repeat candidates were successful
for an overall pass rate of 80 percent.
95
OMS board recertication
As of 1990, recertifcation is required every 10 years,
and involves successful completion of a computerized
examination. The recertifcation exam emphasizes
clinical OMS practice, and consists of eight topic
modules: core (75-minute time limit); implants
(35 minutes); trauma (35 minutes); orthognathic
(35 minutes); cosmetic (35 minutes); TMJ (35 minutes);
pathology (35 minutes); and reconstruction
(35 minutes).
96
The test material is taken from current
publications and literature in oral and maxillofacial
surgery. Individuals who were issued certifcation prior
to 1990 are not required, but are encouraged, to
participate in the recertifcation process.
97
In 2007
158 candidates recertifed, though 912 applicants have
recertifed since 1990.
98
95. Id.
96. Web. Pearson Education, Inc. ABOMS exam details. www.vue.com/
servlet/vue.web2.core.Dispatcher?wsid=1219342250265&HasXSes=Y
&wscid=62688046&webViewID=10010296&examCode=ABOMS-RE.
97. Web. ABOMS. www.aboms.org/General_Information/reCertifcation.htm.
98. Web. ADA. Report of the ADA Recognized dental specialty
certifcation boards.
www.ada.org/prof/ed/specialties/specialty_certifying_report.pdf.
27 Scope of Practice Data Series: Oral and Maxillofacial Surgeons VII. Education and training of plastic surgeons and otolaryngologists
Physician specialty certifcation in plastic surgery or
otolaryngology is obtained only through rigorous post-
graduate training in an accredited medical residency
program and by passing a specialty board certifcation
examination. A physician enters residency training after
graduating from a four-year medical school, where the
frst and second years are spent learning the scientifc
principles of human anatomy and physiology, biochemis-
try, pharmacology, genetics, microbiology, immunology,
pathology of disease states, and similar courses in both
the natural and behavioral sciences, as well as in
introductory clinical experiences. The third and fourth
years of medical school are devoted to full-time clinical
rotations and clerkships where the medical student
is introduced to the comprehensive clinical care of
patients, primarily in the hospital inpatient setting.

Medical students who attend schools accredited by the
Liaison Committee on Medical Education are required
to care for patients in both inpatient and outpatient
settings in the following clinical rotations: family
medicine, internal medicine, obstetrics and gynecology,
pediatrics, psychiatry and surgery.
99
Similarly, students at
colleges of osteopathic medicine that are accredited by
the American Osteopathic Associations Commission on
Osteopathic College Accreditation must receive educa-
tion in the following clinical disciplines: internal medi-
cine, family medicine, pediatrics, geriatrics,
obstetrics and gynecology, preventive medicine and
public health, psychiatry, surgery and radiology.
100
All medical students must also select a number of
specialty elective rotations to round out their exposure
to the branches of medicine, ensuring a broad and
comprehensive medical knowledge base upon which he
or she builds by choosing an area of practice specializa-
tion for graduate medical education, commonly known
as residency. Medical students considering careers as
surgeons typically select elective rotations in surgery
99. Web. Liaison Committee on Medical Education (LCME). LCME
Accreditation Standards with annotations.
www.lcme.org/functionslist.htm#curriculum%20management.
Retrieved July 21, 2008.
100. Web. American Osteopathic Association (AOA). College of Medicine
Accreditation Standards and Procedures.
www.osteopathic.org/pdf/SB03-Standards%20of%20Accreditation%20Ju
ly%202008.pdf. Retrieved September 22, 2008.
or its specialties in order to gain more exposure to the
aspects and techniques of the surgical care of patients.
Established in 1981, the Accreditation Council for
Graduate Medical Education (ACGME) is a private,
non-proft council that evaluates and accredits medical
residency programs in the United States. The mission of
the ACGME is to improve health care by assessing and
advancing the quality of resident physicians education
through accreditation. Each of the 26 medical special-
ties has ACGME program requirements for graduate
medical (residency and fellowship) education.
101
Both
plastic surgery and otolaryngology are recognized as
medical specialties by the American Board of Medical
Specialties. In addition to residency training, which
encompasses facial and head and neck cosmetic surgical
training, training and specialization opportunities are
available to medically-trained surgeons wishing to refne
their skills in facial cosmetic and reconstructive surgery.
Plastic surgeons
There are two approved educational training models for
plastic surgeons: the independent model and the inte-
grated model. Several additional organizations involved
in the medical education of plastic surgeons provide
governance over these models. The Residency Review
Committee for Plastic Surgery of the ACGME sets
educational standards and accredits plastic surgery
residencies. The American Board of Plastic Surgery sets
educational requirements, examines and certifes
graduates of the plastic surgery residency programs.
In both the independent and integrated models, plastic
surgery is divided into two parts: prerequisite training
and requisite training. Prerequisite training is the
acquisition of a basic surgical science knowledge base
and experience with basic principles of surgery. Requisite
101. Web. Accreditation Council on Graduate Medical Education (ACGME).
ACGME at a Glance.
www.acgme.org/acWebsite/newsRoom/newsRm_acGlance.asp.
VII. Education and training of plastic surgeons
and otolaryngologists
training consists of plastic surgery principles and
practice, including advanced knowledge in specifc
plastic surgery techniques.
102
In the independent model, residents complete their
prerequisite training outside of the plastic surgery
residency, whereas in the integrated model, residents
complete both their prerequisite and requisite training
within one single plastic surgery residency training
program. For example, a new medical school graduate
wishing to pursue plastic surgery as a career may choose
to spend three years in a general surgery residency (for
his or her prerequisite training), then enter a three-year
plastic surgery residency program (for requisite training).
Moreover, some academic medical centers offer a
combined or coordinated 3+3-year program, which
allows residents to complete their prerequisite general
surgery training and plastic surgery residency in the
same facility or institution.
103

The independent model also permits physicians in
other surgical specialty training programs, such as otolar-
yngology, neurosurgery, orthopedic surgery or urology, to
enter a plastic surgery residency program after successful
completion of the initial prerequisite surgical residency.
Oral surgeons who have obtained an MD degree can
enter an ACGME-accredited plastic surgery residency
program so long as their prerequisite trainingthe OMS
training program is accredited by the ADA and con-
tains at least 24 months of general surgery training.
104
There are 20 integrated model plastic surgery residency
training programs in the United States. Training in the
integrated model, where the resident completes a single
training program, requires six years of ACGME-
accredited plastic surgery residency. No less than two
years of this program must be concentrated in plastic
surgery, and the fnal 12 months must entail senior-level
clinical plastic surgery responsibility.
105
Plastic Surgery Residency Review Committee. Pathways into Plastic
Surgery. www.acgme.org/acWebsite/RRC_360/360_pathways.pdf.
103. Id.
104. Id. However, most ADA-accredited OMS training programs offer
far less general surgery training (a minimum of 4 months) than do
ACGME-accredited prerequisite surgical training programs.
Plastic Surgery Residency Review Committee. Pathways into Plastic
Surgery. www.acgme.org/acWebsite/RRC_360/360_pathways.pdf.
ACGME educational standards for plastic surgery
residencies require that plastic surgery residents obtain
specifc clinical competencies in the following areas:
Congenital defects of the head and neck, including
clefts of the lip and palate, and craniofacial surgery
Neoplasms of the head and neck surgery,
including neoplasms of the head and neck, and
the oropharynx
Cranio-maxillofacial trauma, including fractures
Aesthetic (cosmetic) surgery of the head and neck,
trunk, and extremities
Plastic surgery of the breast
Surgery of the hand/upper extremities
Plastic surgery of the lower extremities
Plastic surgery of the trunk and genitalia
Burn reconstruction
Microsurgical techniques applicable to plastic
surgery
Reconstruction by tissue transfer, including faps
and grafts
Surgery of benign and malignant lesions of the
skin and soft tissues
106

Moreover, plastic surgery residency programs are
strongly suggested to have specifc clinical experience
in the following areas:
Acute burn management
Anesthesia
Oral and maxillofacial surgery
Dermatology
Oculoplastic surgery or ophthalmology
Orthopaedic surgery
107
In addition, residents in ACGME-accredited plastic
surgery training programs must demonstrate knowledge
of established and evolving biomedical, clinical, epi-
106. Web. Accreditation Council for Graduate Medical Education (ACGME).
ACGME Program Requirements for Graduate Medical Education
in Plastic Surgery. www.acgme.org/acWebsite/downloads/RRC_
progReq/360_plastic_surgery_07012009.pdf. November 5, 2008.
107. Id.
demiological and social-behavioral sciences, as well as
the application of this knowledge to patient care. These
requirements are met by mandatory scholarly activities
including conferences that include pertinent basic
science subjects, such as anatomy, physiology, pathology,
embryology, radiation biology, genetics, microbiology,
pharmacology, as well as practice management, ethics
and medico-legal topics. Plastic surgery residents must
also participate in, and present educational material at,
conferences; and must be exposed to the concepts of
surgical design, surgical diagnosis, embryology, surgical
and artistic anatomy, surgical physiology and
pharmacology, wound healing, surgical pathology and
microbiology, adjunctive oncological therapy, biome-
chanics, rehabilitation and surgical instrumentation.
108

Otolaryngologists
Residency training in otolaryngology requires fve years
of supervised medical and surgical training, where the
otolaryngology resident acquires the knowledge and
experience necessary to provide the comprehensive
evaluation, as well as medical and surgical management,
of patients of all ages having diseases and disorders of
the ears, upper respiratory and upper alimentary systems
and related structures, and the head and neck. The
residency should include instruction in the clinical
aspects of the diagnosis, medical and/or surgical therapy,
and the prevention of and rehabilitation from diseases,
neoplasms, deformities, disorders and/or injuries of the
ears, upper respiratory and upper alimentary systems, the
face, the jaws, and other head and neck systems; head
and neck oncology; and facial plastic and reconstructive
surgery.
109

108. Id.
109. Web. ACGME. ACGME Program Requirements for Graduate
Medical Education in Otolaryngology.
www.acgme.org/acWebsite/downloads/RRC_progReq/280otopr707.pdf.
The initial year of residency training in otolaryngology
provides broad exposure to the care of patients with all
types of medical and surgical conditions, including rota-
tions in emergency medicine, anesthesia, critical care,
and neurological surgery. Additional experiences in the
frst year typically include general surgery, pediatric sur-
gery, vascular surgery, thoracic surgery, surgical oncology
or plastic surgery.
110
The four subsequent years of otolaryngology-specifc
medical and surgical training provide the resident
with experience in direct and progressively responsible
patient management, culminating in suffcient
independent responsibility for clinical decision-making
to evidence the fact that the graduating resident has
developed sound clinical judgment and possesses the
ability to formulate and carry out appropriate
management plans. ACGME standards for otolaryngol-
ogy residency training require that the resident must
manage the pre-, peri-, and post-operative/procedural
care for patients requiring surgery or invasive procedures
in the following categories:
General otolaryngology, including pediatric
otolaryngology, rhinology, bronchoesophagology
and laryngology
Head and neck oncologic surgery
Facial plastic and reconstructive surgery of the
head and neck
Otology and neurotology
111

Otolaryngology residents should perform a suffcient
number and variety of surgical procedures to ensure
education in the entire scope of the specialty. There
must be adequate distribution and suffcient complexity
of cases within the principal categories of the specialty.
112

110. Id.
111. Id.
112. Id.
30 Scope of Practice Data Series: Oral and Maxillofacial Surgeons VIII. Professional organization
American Association of Oral and Maxillofacial
Surgeons (AAOMS) is the not-for-proft professional
association serving the specialty of oral and
maxillofacial surgery.
American Association of Oral and Maxillofacial Surgeons
9700 W. Bryn Mawr Ave.
Rosemont, IL 60018-5701
(800) 822-6637
The AAOMS currently has an affliation base of more
than 7,000 fellows, members and residents in the United
States. Membership requirements vary depending on
what membership category for which an individual is
applying. The membership categories that the AAOMS
recognizes are: resident member; candidate status; com-
ponent OMS society membership; fellow; member;
federal service fellow and member; faculty fellow and
member; affliate member; and provisional fellow/
member. A little more than half of the members fall
into the Fellow category. For a complete listing of
membership requirements for each membership
category, refer to the AAOMS Web site.
113

American Dental Association (ADA) is the
professional association of dentists committed to the
publics oral health, ethics, science and professional
advancement.
American Dental Association
211 E. Chicago Ave.
Chicago, IL 60611-2678
(312) 440-2500
113. Web. AAOMS. Retrieved September 12, 2006.
www.aaoms.org/aboutus.cfm.
VIII. Professional organization
There are more than 153,000 members of the ADA.
Membership requirements of the association vary greatly
depending on the types of membership, which are:
affliate membership; associate membership; ASDA/
ADA predoctoral membership; charitable organization
practitioner membership; federal dental service
membership; graduate student membership; life
members membership; non-practicing dentists
membership; provisional membership; retired life mem-
bers; retired member membership; and tripartite mem-
bership.
114

Related professional organizations
American Dental Education Association (ADEA) is
the leading national organization for dental education
with its membership composed of all US and Canadian
dental schools, advanced dental education programs,
hospital dental education programs, allied dental
education programs, corporations, faculty, and students.
American Dental Education Association
1400 K Street, N.W., Suite 1100
Washington, DC 20005
114. Web. ADA. Retrieved September 12, 2006. www.ada.org/.
31 Scope of Practice Data Series: Oral and Maxillofacial Surgeons IX. Professional journals of interest
The Journal of the American Dental Association (JADA)
www.jada.ada.org
Journal of Oral and Maxillofacial Surgery (JOMS)
www2.joms.org
Journal of Dental Education
www.jdentaled.org
IX. Professional journals of interest
32 Scope of Practice Data Series: Oral and Maxillofacial Surgeons Appendix
Roster of state dental boards
Alabama Board of Dental Examiners
5346 Stadium Trace Parkway, Ste. 112
Hoover, AL 35244
Phone: (205) 985-7267
Web site: www.dentalboard.org
Alaska Board of Dental Examiners
P.O. Box 110806
Juneau, AK 99811-0806
Phone: (907) 465-2542
Web site: www.dced.state.ak.us/occ/pden.htm
Arizona State Board of Dental Examiners
5060 N.19th Ave., Ste. 406
Phoenix, AZ 85015
Phone: (602) 242-1492
Web site: www.azdentalboard.org
Arkansas State Board of Dental Examiners
101 E. Capitol Ave., Ste. 111
Little Rock, AK 72201
Phone: (501) 682-2085
Web site: www.asbde.org
Dental Board of California
1432 Howe Ave., Ste. 85
Sacramento, CA 95825
Phone: (916) 263-2300
Web site: www.dbc.ca.gov
Colorado Board of Dental Examiners
1560 Broadway, Ste. 1350
Denver, CO 80202
Phone: (303) 894-7800
Web site: www.dora.state.co.us/dental
Connecticut Department of Public Health
Dental Licensure
410 Capitol Ave.
MS# 12APP
P.O. Box 340308
Hartford, CT 06134-0308
Phone: (860) 509-7603
Web site: www.ct-clic.com/detail.asp?code=1688
Appendix
Delaware Board of Dental Examiners
Cannon Building, Ste. 203
861 Silver Lake Blvd.
Dover, DE 19904
Phone: (302) 744-4533
Web site: www.professionallicensing.state.de.us/boards/
dental/index.shtml
Florida Board of Dentistry
4052 Bald Cypress Way
Tallahassee, FL 32399-3257
Phone: (850) 245-4474
Web site: www.doh.state.f.us/mqa/dentistry/index.html
Georgia Board of Dentistry
237 Coliseum Drive
Macon, GA 31217-3858
Phone: (478) 207-2440
Web site: www.sos.state.ga.us/plb/dentistry
Hawaii Board of Dental Examiners
DCCA-PVL
Attn: DENTAL
P.O. Box 3469
Honolulu, HI 96801
Phone: (808) 586-2702
Web site: www.hawaii.gov/dcca/areas/pvl/boards/dentist
Idaho State Board of Dentistry
P.O. Box 83720
Boise, ID 83720-0021
Phone: (208) 334-2369
Web site: www2.state.id.us/isbd/index.htm
Illinois Division of Professional Regulation
320 W. Washington St.
Springfeld, IL 62786
Phone: (217) 785-0800
Web site: www.idfpr.com/dpr/WHO/dent.asp
Indiana Professional Licensing Agency
Attn: State Board of Dentistry
402 W. Washington St., Room W072
Indianapolis, IN 46204
Phone: (317) 234-2057
Web site: www.in.gov/pla/bandc/isbd
Iowa Board of Dental Examiners
400 S.W. Eighth St., Ste. D
Des Moines, IA 50309-4687
Phone: (515) 281-5157
Web site: www.state.ia.us/dentalboard
Kansas Dental Board
900 S.W. Jackson, Room 564-S
Topeka, KS 66612-1230
Phone: (785) 296-6400
Web site: www.accesskansas.org/kdb
Kentucky Board of Dentistry
10101 Linn Station Road, Ste. 540
Louisville, KY 40223
Phone: (502) 429-7280
Web site: www.dentistry.ky.gov
Louisiana State Board of Dentistry
365 Canal St., Ste. 2680
New Orleans, LA 70130
Phone: (504) 568-8574
Web site: www.lsbd.org
Maine Board of Dental Examiners
143 State House Station
161 Capitol St.
Augusta, ME 04333-0143
Phone: (207) 287-3333
Web site: www.mainedental.org
Maryland State Board of Dental Examiners
Spring Grove Hospital Center
Benjamin Rush Building
55 Wade Ave.
Catonsville, MD 21228
Phone: (410) 402-8500
Web site: http://dhmh.state.md.us/dental
Massachusetts Board of Registration in Dentistry
Division of Health Profession Licensure
239 Causeway St., Second Floor, Ste. 200
Boston, MA 02114
Phone: (617) 973-0971
Web site: www.mass.gov/dph/boards
Michigan Board of Dentistry
Capitol View Building
201 Townsend St.
Lansing, MI 48913
Phone: (517) 373-3740
Web site: www.michigan.gov/mdch/0,1607,7-132-27417_
27529_27533---,00.html
Minnesota Board of Dentistry
University Park Plaza
2829 University Ave., S.E., Ste. 450
Minneapolis, MN 55414-3246
Phone: (612) 617-2250
Web site: www.dentalboard.state.mn.us
Mississippi State Board of Dental Examiners
600 E. Amite St., Ste. 100
Jackson, MS 39201-2801
Phone: (601) 944-9622
Web site: www.msbde.state.ms.us/mainpg.htm
Missouri State Dental Board
3605 Missouri Blvd.
P.O. Box 1367
Jefferson City, MO 65102-1367
Phone: (573) 751-0040
Web site: www.pr.mo.gov/dental.asp
Montana Board of Dentistry
301 South Park, Fourth Floor
P.O. Box 200513
Helena, MT 59620-0513
Phone: (406) 841-2390
Web site: www.mt.gov/dli/bsd/license/bsd_boards/den_
board/board_page.asp
Nebraska Department of Health and Human Services
Regulation & Licensure
P.O. Box 95007
Lincoln, NE 68509-5007
Phone: (402) 471-2133
Web site: www.hhs.state.ne.us/reg/regindex.htm
Nevada State Board of Dental Examiners
6010 S. Rainbow Blvd., Ste. A-1
Las Vegas, NV 89118
Phone: (702) 486-7044
Web site: www.nvdentalboard.org
New Hampshire Board of Dental Examiners
2 Industrial Park Drive
Concord, NH 03301-8520
Phone: (603) 271-4561
Web site: www.state.nh.us/dental
New Jersey State Board of Dentistry
124 Halsey St.
Newark, NJ 07102
Phone: (973) 504-6200
Web site: www.state.nj.us/lps/ca/medical/dentistry.htm
New Mexico Board of Dental Health Care
P.O. Box 25101
Santa Fe, NM 87504-5101
Phone: (505) 476-4680
Web site: www.rld.state.nm.us/b&c/dental/index.htm
New York State Offce of the Professions Dentistry
Offce of the Professions
State Education Building, Second Floor
Albany, NY 12234
Phone: (518) 474-3817
Web site: www.op.nysed.gov/dent.htm
North Carolina State Board of Dental Examiners
15100 Weston Parkway, Ste. 101
Cary, NC 27513
Phone: (919) 678-8223
Web site: www.ncdentalboard.org/default.asp
North Dakota State Board of Dental Examiners
P.O. Box 7246
Bismarck, ND 58507-7246
Phone: (701) 258-8600
Web site: www.nddentalboard.org
Ohio State Dental Board
Riffe Center
77 S. High St., 18th Floor
Columbus, OH 43215-6135
Phone: (614) 466-2580
Web site: www.dental.ohio.gov
Oklahoma Board of Dentistry
201 N.E. 38th Terrace, #2
Oklahoma City, OK 73105
Phone: (405) 524-9037
Web site: www.state.ok.us/~dentist
Oregon Board of Dentistry
1600 S.W. Fourth Ave., Ste. 770
Portland, OR 97201
Phone: (503) 229-5520
Web site: www.oregon.gov/Dentistry
Pennsylvania State Board of Dentistry
P.O. Box 2649
Harrisburg, PA 17105-2649
Phone: (717) 783-7162
Web site: www.dos.state.pa.us/bpoa/cwp/view.
asp?a=1104&q=432687
Rhode Island Board of Examiners in Dentistry
Department of Health
3 Capitol Hill, Room 105
Providence, RI 02908
Phone: (401) 222-2827
Web site: www.health.ri.gov/hsr/professions/dental.php
South Carolina Board of Dentistry
Synergy Business Park
Kingstree Building
110 Centerview Drive
Columbia, SC 29210
Phone: (803) 896-4599
Web site: www.llr.state.sc.us/POL/Dentistry
South Dakota State Board of Dentistry
P.O. Box 1037
Pierre, SD 57501-1037
Phone: (605) 224-1282
Web site: www.state.sd.us/doh/dentistry
Tennessee Board of Dentistry
227 French Landing, Ste. 300
Nashville, TN 37243
Phone: (615) 532-3202
Web site: www2.state.tn.us/health/Boards/Dentistry/
index.htm
Texas State Board of Dental Examiners
William P. Hobby Building
333 Guadalupe St.
Tower 3, Suite 800
Austin, TX 78701
Phone: (512) 463-6400
Web site: www.tsbde.state.tx.us
Utah Dentist and Dental Hygienist Licensing Board
Division of Occupational and Professional Licensing
Attn: Dental Board
160 E.300 South
Salt Lake City, UT 84111
Phone: (801) 530-6628
Web site: www.dopl.utah.gov/licensing/dental.html
Vermont Board of Dental Examiners
26 Terrace St., Drawer 09
Montpelier, VT 05609-1101
Phone: (802) 828-2390
Web site: www.vtprofessionals.org/opr1/dentists
Virginia Board of Dentistry
6603 W. Broad St., Fifth Floor
Richmond, VA 23230-1712
Phone: (804) 662-9906
Web site: www.dhp.state.va.us/dentistry/default.htm
Washington State Dental Quality Assurance
Washington State Department of Health
Health Professions Quality Assurance
P.O. Box 47865
Phone: (360) 236-4700
Web site: www.fortress.wa.gov/doh/hpqa1/HPS3/Dental/
default.htm
West Virginia Board of Dental Examiners
207 S. Heber St.
Beckley, WV 25801
Phone: (877) 914-8266
Web site: www.wvdentalboard.org
Wisconsin Professional Licensing Dentistry Examining
Board
P.O. Box 8935
Madison, WI 53708-8935
Phone: (608) 266-2112
Web site: www.drl.wi.gov/boards/den/index.htm
Wyoming Board of Dental Examiners
Occupational Licensing Administrator
1800 Carey Ave., Fourth Floor
Cheyenne, WY 82002
Phone: (307) 777-6529
Web site: www.plboards.state.wy.us/dental/index.asp
Roster of state dental and oral and
maxillofacial surgery associations
Alabama Dental Association
836 Washington Ave.
Montgomery, AL 36104-3839
Phone: (334) 265-1684
Web site: www.aldaonline.org
Alaska Dental Association
9170 Jewel Lake Road, Ste. 203
Anchorage, AK 99502-5381
Phone: (907) 563-3003
Web site: www.akdental.org
Arizona Dental Association
3193 N. Drinkwater Blvd.
Scottsdale, AZ 85251-6491
Phone: (480) 344-5777
Web site: www.azda.org
Arkansas State Dental Association
7480 Highway 107
Sherwood, AR 72120
Phone: (501) 834-7650
Web site: www.dental-asda.org
California Dental Association
1201 K St.
Sacramento, CA 95814
Phone: (916) 443-0505
Web site: www.cda.org
Colorado Dental Association
3690 S. Yosemite, Ste. 100
Denver, CO 80237-1808
Phone: (303) 740-6900
Web site: www.cdaonline.org
Connecticut State Dental Association
835 W. Queen St.
Southington, CT 06489
Phone: (860) 378-1800
Web site: www.csda.com
Delaware State Dental Society
The Christiana Executive Campus
200 Continental Drive, Ste. 111
Newark, DE 19713
Phone: (302) 368-7634
Web site: www.delawarestatedentalsociety.org
District of Columbia Dental Society
502 C St., N.E.
Washington, DC 20002-5810
Phone: (202) 547-7613
Web site: www.dcdental.org
Florida Dental Association
1111 E. Tennessee St., Ste. 102
Tallahassee, FL 32308-6913
Phone: (850) 681-3629
Web site: www.foridadental.org
Florida Society of Oral and Maxillofacial Surgeons
4850 Golden Parkway, Ste. B-417
Buford, GA 30518
Phone: (877) 831-2500
Web site: www.fsoms.org
Georgia Dental Association
7000 Peachtree Dunwoody Road, N.E.
Suite 200, Building 17
Atlanta, GA 30328-1655
Phone: (404) 636-7553
Web site: www.gadental.org
Georgia Society of Oral and Maxillofacial Surgeons
4850 Golden Parkway, Ste. B-417
Buford, GA 30518
Phone: (770) 271-0453
Web site: www.ga-oms.org
Hawaii Dental Association
1345 S. Beretania St., Ste. 301
Honolulu, HI, 96814-1821
Phone: (808) 593-7956
Web site: www.hawaiidentalassociation.net
Idaho State Dental Association
1220 W. Hays St.
Boise, ID 83702-5315
Phone: (208) 343-7543
Web site: www.isdaweb.com
Illinois State Dental Society
1010 S. Second St.
P.O. Box 376
Springfeld, IL 62705
Phone: (217) 525-1406
Web site: www.isds.org
Illinois Society of Oral and Maxillofacial Surgeons
222 E. Wisconsin Ave., Ste. 214
Lake Forest, IL 60045
Phone: (847) 482-0222
Web site: www.isoms.net/
Indiana Dental Association
P. O. Box 2467
Indianapolis, IN 46206-2467
Phone: (317) 634-2610
Web site: www.indental.org
Iowa Dental Association
5530 W. Parkway, Ste. 100
Johnston, IA 50131
Phone: (515) 986-5605
Web site: www.iowadental.org
Kansas Dental Association
5200 S.W. Huntoon St.
Topeka, KS 66604-2398
Phone: (785) 272-7360
Web site: www.ksdental.org
Kentucky Dental Association
1920 Nelson Miller Parkway
Louisville, KY 40223-2164
Phone: (502) 489-9121
Web site: www.kyda.org
Louisiana Dental Association
7833 Offce Park Blvd.
P. O. Box 261173
Baton Rouge, LA 70809-7604
Phone: (225) 926-1986
Web site: www.ladental.org
Maine Dental Association
P. O. Box 215
Manchester, ME 04351-0215
Phone: (207) 622-7900
Web site: www.medental.org
Maryland State Dental Association
6410 Dobbin Road, Ste. F
Columbia, MD 21045-4774
Phone: (410) 964-2880
Web site: www.msda.com
Massachusetts Dental Society
2 Willow St., Ste. 200
Southborough, MA 01745-1027
Phone: (508) 480-9797
Web site: www.massdental.org
Michigan Dental Association
230 Washington Square, North, Ste. 208
Lansing, MI 48933-1312
Phone: (517) 372-9070
Web site: www.smilemichigan.com
Minnesota Dental Association
2236 Marshall Ave.
Saint Paul, MN 55104-5758
Phone: (651) 646-7454
Web site: www.mndental.org
Mississippi Dental Association
2630 Ridgewood Road, Ste. C
Jackson, MS 39216-4903
Phone: (601) 982-0442
Web site: www.msdental.org/cms/
Missouri Dental Association
3340 American Ave.
Jefferson City, MO 65109
Phone: (573) 634-3436
Web site: www.modental.org
Montana Dental Association
P. O. Box 1154
17 1/2 S. Last Chance Gulch
Helena, MT 59624
Phone: (406) 443-2061
Web site: www.mtdental.com
Nebraska Dental Association
3120 O St.
Lincoln, NE 68510-1533
Phone: (402) 476-1704
Web site: www.nedental.org
Nevada Dental Association
8863 W. Flamingo Road, Ste. 102
Las Vegas, NV 89147-8718
Phone: (702) 255-4211
Web site: www.nvda.org
New Hampshire Dental Society
23 South State St.
Concord, NH 03301
Phone: (603) 225-5961
Web site: www.nhds.org
New Jersey Dental Association
One Dental Plaza
P.O. Box 6020
North Brunswick, NJ 08902-6020
Phone: (732) 821-9400
Web site: www.njda.org
New Mexico Dental Association
9201 Montgomery Blvd, N.E., Ste. 601
Albuquerque, NM 87111
Phone: (505) 294-1368
Web site: www.nmdental.org
New York State Dental Association
121 State St., Fourth Floor
Albany, NY 12207-1622
Phone: (518) 465-0044
Web site: www.nysdental.org
North Carolina Dental Society
P. O. Box 4099
Cary, NC 27519-4099
Phone: (919) 677-1396
Web site: www.ncdental.org
North Dakota Dental Association
P. O. Box 1332
Bismarck, ND 58502-1332
Phone: (701) 223-8870
Web site: www.nddental.com
Ohio Dental Association
1370 Dublin Road
Columbus, OH 43215-1009
Phone: (614) 486-2700
Web site: www.oda.org
Oklahoma Dental Association
317 N.E. 13th St.
Oklahoma City, OK 73104
Phone: (405) 848-8873
Web site: www.okda.org
Oregon Dental Association
P.O. Box 3710
Wilsonville, OR 97070-3710
Phone: (503) 218-2010
Web site: www.oregondental.org
Pennsylvania Dental Association
P. O. Box 3341
Harrisburg, PA 17105-3341
Phone: (717) 234-5941
Web site: www.padental.org
Rhode Island Dental Association
200 Centerville Road, Suite 7
Warwick, RI 02886-4339
Phone: (401) 732-6833
Web site: www.ridental.com
South Carolina Dental Association
120 Stonemark Lane
Columbia, SC 29210-3841
Phone: (803) 750-2277
Web site: www.scda.org
South Dakota Dental Association
804 N. Euclid, Suite 103
Pierre, SD 57501-1194
Phone: (605) 224-9133
Web site: www.sddental.org
Tennessee Dental Association
660 Bakers Bridge Ave., Suite 300
Franklin, TN 37067
Phone: (615) 628-0208
Web site: www.tenndental.org
Texas Dental Association
1946 S. IH-35, Suite 400
Austin, TX 78704
Phone: (512) 443-3675
Web site: www.tda.org
Utah Dental Association
1151 E. 3900 South, Suite 160
Salt Lake City, UT 84124-1216
Phone: (801) 261-5315
Web site: www.uda.org
Vermont State Dental Society
100 Dorset St., Suite 18
South Burlington, VT 05403-6241
Phone: (802) 864-0115
Web site: www.vsds.org
Virginia Dental Association
7525 Staples Mill Road
Richmond, VA 23228
Phone: (804) 261-1610
Web site: www.vadental.org
Washington State Dental Association
1001 Fourth Ave., Suite 3800
Seattle, WA 98154
Phone: (206) 448-1914
Web site: www.wsda.org
West Virginia Dental Association
2016 1/2 Kanawha Blvd. E.
Charleston, WV 25311-2204
Phone: (304) 344-5246
Web site: www.wvdental.org
Wisconsin Dental Association
6737 W. Washington St., Suite 2360
West Allis, WI 53214
Phone: (414) 276-4520
Web site: www.wda.org
Wyoming Dental Association
P.O. Box 40019
Casper, WY 82604
Phone: (307) 237-1186
Web site: www.wyda.org
National association policy concerning oral
and maxillofacial surgeon scope of practice
H-475.983 Defnition of Surgery
Our AMA adopts the following defnition of surgery
from American College of Surgeons (Statement ST-11):
Surgery is performed for the purpose of structurally alter-
ing the human body by the incision or destruction of
tissues and is part of the practice of medicine. Surgery
also is the diagnostic or therapeutic treatment of condi-
tions or disease processes by any instruments causing
localized alteration or transposition of live human tissue
which include lasers, ultrasound, ionizing radiation, scal-
pels, probes, and needles. The tissue can be cut, burned,
vaporized, frozen, sutured, probed, or manipulated by
closed reductions for major dislocations or fractures, or
otherwise altered by mechanical, thermal, light-based,
electromagnetic, or chemical means. Injection of diag-
nostic or therapeutic substances into body cavities,
internal organs, joints, sensory organs, and the central
nervous system also is considered to be surgery (this does
not include the administration by nursing personnel
of some injections, subcutaneous, intramuscular, and
intravenous, when ordered by a physician). All of these
surgical procedures are invasive, including those that are
performed with lasers, and the risks of any surgical pro-
cedure are not eliminated by using a light knife or laser
in place of a metal knife, or scalpel. Patient safety and
quality of care are paramount and, therefore, patients
should be assured that individuals who perform these
types of surgery are licensed physicians (defned as doc-
tors of medicine or osteopathy) who meet appropriate
professional standards. (Res. 212; A-07)
H-475.992 Defnitions of Cosmetic and
Reconstructive Surgery
(1) Our AMA supports the following defnitions of
cosmetic and reconstructive surgery: Cosmetic sur-
gery is performed to reshape normal structures of the
body in order to improve the patients appearance and
self-esteem. Reconstructive surgery is performed on
abnormal structures of the body, caused by congenital
defects, developmental abnormalities, trauma, infection,
tumors or disease. It is generally performed to improve
function, but may also be done to approximate a normal
appearance. (2) Our AMA encourages third-party
payers to use these defnitions in determining services
eligible for coverage under the plans they offer or
administer. (CMS Rep. F, A-89; Reaffrmed: Sunset
Report, A-00; Reaffrmed, A-03)
H-35.990 Non-Physician Measurement of
Body Functions
In the public interest, the AMA recommends that
non-physicians who perform tests such as blood pres-
sure or blood sugar measurements advise the examinee
to communicate these fndings to a licensed physician.
(Sub. Res. 59, I-80; CLRPD Rep. B, I-90; Reaffrmed:
Sunset Report, I-00)
H-160.936 Comprehensive Physical Examinations
by Appropriate Practitioners
AMA policy supports the position that performance of
comprehensive physical examinations to diagnose medi-
cal conditions be limited to licensed MDs/DOs or those
practitioners who are directly supervised by licensed
MDs/DOs; and the AMA will actively work with state
medical societies and medical specialty associations,
both in the courts and in the legislative and regulatory
spheres, to oppose any proposed or adopted law or
policy that would inappropriately expand the scope of
practice of practitioners other than MDs/DOs. (Sub.
Res. 210, I-96)
H-160.949 Practicing Medicine by Non-Physicians
Our AMA: (1) urges all people, including physicians
and patients, to consider the consequences of any health
care plan that places any patient care at risk by substi-
tution of a non-physician in the diagnosis, treatment,
education, direction and medical procedures where
clear-cut documentation of assured quality has not been
carried out, and where such alters the traditional pattern
of practice in which the physician directs and supervises
the care given; (2) continues to work with constituent
societies to educate the public regarding the differences
in the scopes of practice and education of physicians
and non-physician health care workers; (3) continues
to actively oppose legislation allowing non-physician
groups to engage in the practice of medicine without
physician (MD, DO) training or appropriate physician
(MD, DO) supervision; (4) continues to encourage state
medical societies to oppose state legislation allowing
non-physician groups to engage in the practice of
medicine without physician (MD, DO) training or
appropriate physician (MD, DO) supervision; and
(5) through legislative and regulatory efforts, vigorously
supports and advocates for the requirement of appropri-
ate physician supervision of non-physician clinical staff
in all areas of medicine. (Res. 317, I-94; Modifed by
Res. 501, A-97; Appended: Res. 321, I-98; Reaffrma-
tion A-99; Appended: Res. 240, Reaffrmed: Res. 708
and Reaffrmation A-00; Reaffrmed: CME Rep. 1, I-00)
H-215.995 Hospital Admission Histories
and Physicals
Our AMA believes that the best interests of hospitalized
patients are served when admission history and physical
exams are performed by a physician, recognizing that
portions of the histories and physical exams may be
delegated by the physician to others whose credentials
are accepted by the medical staff. (I-81; Reaffrmed:
CLRPD Rep. F, I-91; Reaffrmed: Sunset Report, I-01)
American Society of Plastic Surgeons
Dental Scope of Practice: Issue Brief
In 1997 the American Dental Association (ADA)
approved a change to the organizations defnition of the
practice of dentistry. According to the ADA, dentistry is
defned as:
The evaluation, diagnosis, prevention and/or
treatment (nonsurgical, surgical or related procedures)
of the diseases, disorders and/or conditions of the oral
cavity, maxillofacial area and/or the adjacent and
associated structures and their impact on the human body.
(emphasis added)
Since that time, the dental lobby has approached a large
number of state legislatures with proposals to revise
their states legal defnition of dentistry according to the
ADAs updated defnition. For states that have adopted
this broad and ambiguous language in their dental
practice law, the consequence has been an opportunity
for dentists to argue that the legal scope of their pro-
fession includes cosmetic surgical procedures, such as
rhinoplasty (nose reshaping), blepharoplasty (eyelid
surgery), rhytidectomy (face lift), otoplasty (ear surgery)
and liposuction.
Unfortunately, plastic surgery and organized medicine
have generally not been effective at countering the
highly organized and motivated dental offensive. Each
year more state legislatures are approving legislation
based on the ADA defnition, and more non-physician
oral surgeons are getting the green light to do the same
procedures plastic surgeons spend years in medical and
surgical training to perform.
However, there is proof that a successful campaign
against the dental professions attempts to encroach into
the practice of medicine is possible, if physicians com-
mit to waging a sustained and organized advocacy effort.
The work of a coalition of surgical specialties and the
Medical Society of the State of New York was pivotal
to the passage of legislation in November 2001 which
could serve as a model in other states. The language
in the New York law specifes that dentistry includes
treatment, diagnosis, operating, prescribing, etc., of
the oral and maxillofacial area related to restoring and
maintaining dental health, thereby narrowing and
clarifying the states legal defnition of dentistry.
To support grassroots advocacy of the dental scope
of practice issue, the ASPS has developed tools to
communicate plastic surgerys opposition to state
dental scope expansion proposals. Please contact an
ASPS government affairs associate at 847/228-9900
for more information.
Literature and resources
The dual degree: does it change the scope of practice
for oral and maxillofacial surgery?
Byrne RP. Tex Dent J. 2004 Apr;121(4):304-9.

The scope of practice for OMS is not, nor should it ever
be, an issue of single or dual degree but must be related
to the surgeon being trained to competence in the
procedures performed. Future evolution will be based
on continual advancements in the specialty and related
areas as well as the development of new techniques.
While the medical education may improve a core fund
of general knowledge, the surgical residency and/or
fellowship is the determinant of surgical competence
and scope of practice.
PMID: 15150890 [PubMed - indexed for MEDLINE]
The consequences of expanded oral surgery scope of
practice in Richmond, Virginia.
Ladocsi LT, Zinsser JW. Plast Reconstr Surg. 2007
Jan;119(1):387-400.
BACKGROUND: On March 25, 2001, the Common-
wealth of Virginia changed the defnition of dentistry
and expanded the scope of practice of single-degree
oral surgeons to include cosmetic procedures previously
restricted to physicians. The Board of Dentistry
established standards for practice under the new scope.
Suggestions made by the Board of Medicine regarding
these standards were disregarded. The authors reviewed
the events and consequences surrounding the redefni-
tion of dentistry. METHODS: Events between January
1, 2000, and January 1, 2005, were reviewed. Data
were gathered from public records and Internet sites,
reports of physicians practicing cosmetic surgery in the
Richmond metropolitan area, hospital staff committees,
and medical societies. RESULTS: Physicians in Virginia
were ill prepared to participate in the legislative process.
Physicians treating patients unhappy with the results
of cosmetic procedures by local oral surgeons described
errors in preoperative diagnosis, failure to perform the
appropriate surgical procedure, or inability to perform
the appropriate procedure properly. A survey of cosmetic
surgeons showed that 50 percent had cared for similar
patients. There was no evidence to demonstrate a
signifcant economic effect from increased competition
by oral surgeons. The authors were unable to show that
oral surgeons practicing in the Richmond metropolitan
area are able to match the community standard for
providing care. CONCLUSIONS: The authors continue
to regard scope of practice as an educational issue. On
the basis of their review, it is not clear that standards
promulgated by the Virginia Board of Dentistry have
thus far produced surgeons capable of matching the
Richmond community standard for cosmetic surgery.
Cosmetic blepharoplasty.
Niamtu J 3rd. Atlas Oral Maxillofac Surg Clin North Am.
2004 Mar;12(1):91-130.

Cosmetic blepharoplasty is the hallmark of facial
rejuvenation and is rewarding for the surgeon and
patient. No other cosmetic procedure is more common
in the 40- to 65-year age group. This procedure carries
a steep learning curve, but the training of an oral and
maxillofacial surgeon is adequate to begin learning this
procedure. Proper diagnosis and adherence to strict
preoperative, intraoperative, and postoperative proto-
cols are paramount to avoiding complications that may
be serious. The author, like many surgeons, enjoys
this procedure and believes that its place in the
contemporary scope of oral and maxillofacial surgery
is well established.

Carotid artery-cavernous sinus stula.
Harris AE, McMenamin PG. Arch Otolaryngol. 1984
Sep;110(9):618-23

Carotid artery-cavernous sinus fstula is a lesion most
often associated with massive head trauma. The maxil-
lofacial surgeon must be able to diagnose this major
complication of head trauma, use proper diagnostic
techniques, and initiate appropriate therapeutic regi-
mens. The symptoms of pulsatile headache, bruit, and
visual change accompany the physical fndings of bruit,
conjunctival engorgement, chemosis, proptosis, and
ophthalmoplegia. A number of procedures have been
devised to correct this diffcult lesion, ranging from cer-
vical ligation to balloon occlusion. Two cases of carotid
artery-cavernous sinus fstula are reported in detail,
documenting clinical fndings, treatment, and long-term
sequelae. Although surgical treatment is not within
the scope of this specialty, the otolaryngologist must
understand the vascular dynamics and surgical
procedures related to this traumatic lesion.
Patients perceptions of the scope of oral and
maxillofacial surgery.
Dubois DD, Chinnis RJ, Pizer ME. J Oral Surg. 1981
Jul;39(7):518-21.
The primary purpose of this study was to determine a
measure of selected patients perceptions of the scope
of services provided by the oral and maxillofacial
surgeon. Data were collected from 403 patients by a
questionnaire and were combined with data from the
participating patients charts. Analysis and interpreta-
tion of the data disclosed two trends: patients perceived
that problems of odontogenic origin should be treated
by dentists or oral surgeons, and patients perceived that
problems of nonodontogenic origin should be treated
by medical professionals rather than by oral and maxillo-
facial surgeons. If these patients are representative of the
general population, then these trends strongly suggest
a need for greater public and professional dental educa-
tional opportunities about the scope of services rendered
by the oral and maxillofacial surgeon. It is recommended
that dental societies and dental schools assume the lead
in offering these opportunities.

Perception of oral maxillofacial surgery by health-care
professionals.
Rocha NS, Laureano Filho JR, Silva ED, Almeida RC.
Int J Oral Maxillofac Surg. 2008 Jan;37(1):41-6.

Oral and Maxillofacial Surgery (OMFS), a dentistry
specialty recognized by the Federal Dentistry Board
in the mid-1960s, is responsible for the diagnosis, and
clinical and surgical treatment of traumatic, congenital,
developmental and iatrogenic lesions in the maxillofa-
cial complex. Even today, diffculties are experienced
owing to the lack of knowledge of the general public
and health professionals concerning the scope of OMFS.
To investigate recognition of the scope of OMFS, 400
questionnaires were sent to dentistry students, medical
students, dentists and doctors, in 4 equal groups. The
questionnaire covered 26 clinical situations in four
different specialties (OMFS, Plastic Surgery, Ear Nose
and Throat Surgery, Head and Neck Surgery) and an
option with no specialty specifed. Each interviewee
had to correlate the clinical situation with the respec-
tive specialist. For facial trauma, dento-facial deformi-
ties, mandibular reconstruction and temporomandibular
joint surgery, most respondents would consult the OMF
surgeon for treatment (mean, 90%). In cases of oral
biopsy and treatment of benign mandibular tumours
the mean referral rate to OMFS was low (48%). On
the basis of the questionnaire responses, a good level
of knowledge of the scope of OMFS was found. In order
to ensure the correct referral of all patients, the specialty
needs to broaden its horizons.
Oral and maxillofacial surgery residency education.
Felsenfeld AL, Casagrande A. J Calif Dent Assoc.
2004 Oct;32(10):817-22.
Oral and maxillofacial surgery is the recognized specialty
of dentistry that is responsible for the diagnosis and
surgical and adjunctive treatment of diseases, injuries
and defects involving both the functional and esthetic
aspects of the bone and soft tissues of the oral and max-
illofacial region. This article will present a review of
the educational process for residents in oral and maxil-
lofacial surgery as it has evolved and current training
standards.
Overview of facial cosmetic surgery.
Arcan SC. J Calif Dent Assoc. 2004 Oct;32(10):849-53.
Dentists routinely refer patients to oral and maxillofacial
surgeons for dentoalveolar surgery, however few of these
dentists are fully informed as to the full scope of surgical
practice. Appropriately trained oral and maxillofacial
surgeons may also offer cosmetic facial surgery to their
patients under certain circumstances. This paper will
provide an overview of cosmetic facial surgery.
Non-surgical treatment modalities of facial photodam-
age: practical knowledge for the oral and maxillofacial
professional.
Hegedus F, Diecidue R, Taub D, Nyirady J. Int J Oral
Maxillofac Surg. 2006 May;35(5):389-98.
With the increasing interest in cosmetic procedures, oral
and maxillofacial surgeons are being asked not only to
improve oral health and aesthetics but to extend their
expertise to provide advice on improving the overall
appearance of the face. For the discerning patient,
improving overall facial skin appearance is becoming
an integral part of the process of surgical cosmetic
procedures. Here, some of the non-surgical options
available for the treatment of photodamaged skin are
reviewed and an overview of the specifc treatments
in this category provided. Sun avoidance and protec-
tion from harmful rays with appropriate sunscreens are
primary to maintaining healthy skin and appearance.
Among treatment options, topical treatments with
preparations such as retinoids, alpha-hydroxy acids and
antioxidants have been shown to provide some beneft
and are relatively easy to use albeit with appropriate
precautions and professional guidance. As a second-level
option, facial rejuvenation procedures such as botulinum
toxin injection, soft tissue augmentation with collagen
or hyaluronic acid gel, skin resurfacing, use of chemical
peels, dermabrasion and laser resurfacing procedures
can be used but require administration by qualifed
practitioners. Overall, these treatments may be used to
complement rehabilitative, reconstructive, or cosmetic
oral and maxillofacial surgery to further improve and
complement surgical results.
PMID: 16352420 [PubMed - indexed for MEDLINE
Comparison of the Education and Training of Physicians and Oral Surgeons
MD-Surgeon
(Physician with medical degree)
DDS or DMD
(Single-degree oral surgeon)
Physician Surgical Specialists:
5-6 years of clinical surgical education:
(general surgery, otolaryngology-head and neck surgery,
plastic surgery, neurosurgery, critical care medicine,
ophthalmology, trauma management)
Training Includes:
Advanced surgical planning and diagnosis, surgical
physiology and pharmacology, wound healing, surgical
pathology, management of surgical complications
Progressive responsibility in an accredited program
recognized by the Accreditation Council on Graduate
Medical Education
Oral Surgery Residents:
4-year program, only
18 months medical/surgical rotations
30 months clinical oral health
Oral Surgeons total post-graduate residency
experience is less than a medical student earns before
obtaining their MD
Senior OMS residents are required to complete only 10
total aesthetic and reconstructive surgical cases
Post-
Graduate/
Residency
Training
4 Years Medical School
Third Year: Clinical Rotations in Medicine, Surgery,
Pediatrics, Psychiatry, Obstetrics/Gynecology, Family
Medicine
Fourth Year: Acute Care, Ambulatory Care, Internal
Medicine, and Neurology Clerkships; Clinical Electives;
Advanced Cardiac Life Support
24 months devoted to learning diagnosis and
management of the whole patient
4 Years Dental School
Third Year: Restorative Dentistry, Pediatric Dentistry,
Advanced Dental Surgery, and Outcomes of Treatment
Fourth Year: 10 months required externships and clinical
rotations in dentistry/oral health-related service
Focus on oral health, not management of
the whole patient
Graduate
Training
American Society of Plastic Surgeons, 2003
Figure 1. State licensure requirements for oral and maxillofacial surgeons
State Workforce
License as a
specialist required
Specialty education required
Specialty examination
required
Certification
Reciprocity/
licensure by
credentials
Continuing
education
Alabama 90 (as of
5/2007)**
No. Completion of a specialty
education program approved by the
American Dental Association and
the Commission on Dental
Accreditation required. (Code of
Ala. 34-9-19)
Must be eligible to sit for
the specialty exam or
possess diplomate status
required to advertise as
specialist. (Code of Ala.
34-9-19)
Must be eligible to sit for
the specialty exam or
possess diplomate status
required to advertise as
specialist. (Code of Ala.
34-9-19)
Yes. (Code of
Ala. 34-9-10)
Required. 20 hours
annually. (Ala.
Admin. Code r. 270-
X-4-.04)
Alaska N/A* Yes. (Alaska Stat.
08.36.244)
Complete as many academic years
of advanced education in the
specialty as are required by the
appropriate specialty board in a
program accredited by the
Commission on Accreditation of
the American Dental Association
or its successor agency. (Alaska
Stat. 08.36.246)
Pass a specialty
examination given by the
Central Regional
Examining Board OR be
board certified. (Alaska
Stat. 08.36.246)
Pass exam OR be board
certified by a specialty
certification board
recognized by the
American Dental
Association. (Alaska Stat.
08.36.246)
Yes. (Alaska
Stat.
08.36.234)
Required. 28 contact
hours and CPR
certification. (12
Alaska Admin. Code
28.400)
Arizona N/A* No. Completion of educational program
of two or more years in a specialty
area accredited by the Commission
on Dental Accreditation of the
required for advertising specialty
services OR Board eligible OR
Board certified. (A.A.C. R4-11-
1102)
No./Optional. (A.A.C.
R4-11-1102)
State statute allows for
specialty practice by Board
eligible/Board certified
specialists, but also allows
educationally qualified
specialists to advertise as
specialists. (A.A.C. R4-
11-1102)
Yes. (A.A.C.
R4-11-202)
Required. 72 hours
per renewal period.
(A.A.C. R4-11-1203)
Arkansas N/A* No. Board issues
certificates to
specialists who
meet requirements.
(A.C.A. 17-82-
305)
Complied with requirements as
specified by the American Dental
Association Council on Dental
Education in a specialty branch of
dentistry. (A.C.A. 17-82-305)
Specialty Examinations
may be oral or written, or
both, and the applicant
may be required to
demonstrate his
knowledge and
proficiency in the
specialty in which he
desires to be certified.
Not required if certified.
(A.C.A. 17-82-305)
Required for advertising as
specialist. (A.C.A. 17-
82-305)
Yes. (A.C.A.
17-82-308)
Required. 50 credit
units every two years.
(038 00 CARR 001,
ARTICLE XIV)
State Workforce
License as a
specialist required
required
Certification
Reciprocity/
licensure by
credentials
Continuing
education
California 1010 (as of
5/2007)
No. Board issues
permits to
individuals who
meet requirements.
(Cal Bus & Prof
Code 1638)
Requires individual to be certified
in the specialty by specialty board
of ADA. (Cal Bus & Prof Code
1638). A qualified oral surgeon
shall be a dentist who meets the
requirements of (1) and either (2)
or (3). (1) Confines his practice to
the specialty of oral surgery; (2)
Has successfully completed a
course of advanced study in oral
surgery of three years or more in
programs recognized by the
Council on Dental Education of the
ADA; (3) Has completed advanced
training in oral surgery and meets
both of the following requirements:
(A) Has had advanced study and
hospital experience in performing
oral surgery in maxillofacial
deformities and temporo-
mandibular joint dysfunction. (B)
Is listed in the Directory of the
ADA with the Specialty Code of
10. (22 CCR 51223)
State requires individual to
be certified in the specialty
by specialty board of ADA
or to be eligible to sit for
specialty certification
exam. (Cal Bus & Prof
Code 1638, 1640)
Yes. (Cal Bus &
Prof Code
1638; 16 CCR
1040)
Required. 50 hours
per renewal period.
Effective J an. 1,
2006, licensees are
required to complete
cue units on infection
control and the
California Dental
Practice Act. (16 CCR
1017)
State Workforce
License as a
specialist required
required
Certification
Reciprocity/
licensure by
credentials
Continuing
education
Colorado 47 (as of
2005)**
No. A licensed
dentist has the legal
authority to practice
in any and all areas
of dentistry and
also the authority to
confine the areas in
which he or she
chooses to practice.
(3 CCR 709-1,
Rule XXVI)
Practitioners who have successfully
completed an ADA accredited
specialty program may advertise
the practice of that specialty. (3
CCR 709-1, Rule XXVI)
Silent. Silent. Yes. (C.R.S. 12-
35-120; 3 CCR
709-1, Rule IV)
Silent.
Connecticut N/A* No. Completed two years of advanced
or postgraduate education in the
area of such specialty. (Conn. Gen.
Stat. 20-106a)
Silent. Silent. Yes. (Conn.
Gen. Stat. 20-
110)
Required. 25 contact
hours every 2 years.
(Conn. Gen. Stat.
20-126c)
Delaware N/A* No. Silent. Silent. Silent. Yes. (24 Del. C.
1124)
Required. 50 hours
every 2 years as well
as a CPR course.
(CDR 24-1100,
Section 6)
D.C. N/A* No. Silent. Silent. Silent. Yes. (C.D.C.R.
17-4209.1)
Required. 25 hours
every 2 years, which
includes CPR and
infection control.
(C.D.C.R. 17-4206.4)
Florida 270 (as of
5/2007)
No. Completed a specialty education
program approved by the American
Dental Association and the
Commission on Dental
Accreditation. (Fla. Stat.
466.0282)
Individual must be
eligible for examination
OR already be a
diplomate. (Fla. Stat.
466.0282)
Be a diplomate of a
national specialty board
recognized by the
American Dental
Association. (Fla. Stat.
466.0282)
No. Required. 30 hours
biennially. (Fla. Stat.
466.0135)
State Workforce
License as a
specialist required
required
Certification
Reciprocity/
licensure by
credentials
Continuing
education
Georgia 110 (as of
5/2007)
No. Complete the educational
requirements stated in the
American Dental Association's
specialty practice guidelines. (Ga.
Comp. R. & Regs. r. 150-11-.01 )
Silent. Silent. Yes. ( O.C.G.A.
43-11-41,
O.C.G.A. 43-11-
42, Ga. Comp. R.
& Regs. r. 150-7-
.04)
Required. 40 hours
per biennium.
(O.C.G.A. 43-11-
46.1)
Hawaii N/A* No. Silent. Silent. Silent. No. Required. 32 hours
every two years and
basic life support.
(WCHR 16-79-144)
Idaho N/A* License as Dental
Specialist required.
(Idaho Code 54-
916)
Must be a graduate of and hold a
certificate from both a dental
school and a Graduate Training
Program that are accredited by the
Accreditation of the American
Dental Association. (IDAPA
19.01.01.045)
An examination covering
the applicants chosen
field may be required
and, if so, will be given
by the Idaho State Board
of Dentistry or its agent.
Individuals practicing
specialty prior to 1992
may not be required to
take exam. (IDAPA
19.01.01.045)
Candidates who are
certified by the American
Board of that particular
specialty, and who meet
the qualifications set forth
in the Board's Rules, may
be granted specialty
licensure by Board
approval. (IDAPA
19.01.01.045)
Yes. (Idaho Code
54-916B)
Required. 30 hours
per each biennial
renewal period. All
dentists must hold
current CPR card.
(IDAPA
19.01.01.050)
State Workforce
License as a
specialist required
required
Certification
Reciprocity/
licensure by
credentials
Continuing
education
Illinois 30 (as of
5/2007)
Required. (225
ILCS 25/11)
Successful completion of a 4 year
(48 months) period of training in
oral and maxillofacial surgery in a
school and/or hospital approved by
the Department. A minimum of 30
months shall be in clinical oral and
maxillofacial surgery. The
schedule shall include 24 months
of full-time hospital training in an
acceptable oral and maxillofacial
surgery residency program. Not
less than 4 months of this period
must be devoted to training in
anesthesiology. (68 Ill. Adm. Code
1220.310)
Examination as a
specialist in Oral and
Maxillofacial Surgery.
(68 Ill. Adm. Code
1220.320)
Individual who is certified
as an American Board
Diplomate in the specialty
for which application for
licensure is made shall not
be required to take the
examination for dental
specialist licensure. (68 Ill.
Adm. Code 1220.335)
Yes. (225 ILCS
25/19).
Required. 48 hours
per three year
licensing period. (225
ILCS 25/16.1)
Indiana 210 (as of
5/2007)
No. Graduation from an accredited
advanced dental educational
program. (828 IAC 1-1-18)
Silent. Silent. Yes. (Burns Ind.
Code Ann. 25-
14-1-16)
Required. 20 credit
hours every two years.
(Burns Ind. Code
Ann. 25-14-3-8)
Iowa 100 (as of
5/2007)
No. Successfully completed a formal
graduate or residency training
program in oral surgery accredited
by the Commission on Dental
Dental Association OR have
limited practice to this area prior to
J anuary 1, 1965, and have been
permitted to continue to do so
pursuant to resolution of the ADA
House of Delegates. (650 IAC
28.5(153))
Silent. Silent. Yes. (650 IAC
11.2 (147,153))
Required. 30 hours
every 2 years. (650
IAC 25.2(153))
State Workforce
License as a
specialist required
required
Certification
Reciprocity/
licensure by
credentials
Continuing
education
Kansas 50 (as of
5/2007)
No. Board certifies
specialists. (K.A.R.
71-2-5)
Each applicant shall have
successfully completed a graduate
program in the specialty for which
certification is sought in a dental
school, college, or other dental
specialty training program that is
approved by the board and that the
board determines has standards of
education not less than those
required for accreditation by the
Dental Association equivalent,
applicable for the year in which the
training was completed. (K.A.R.
71-2-5)
Kansas specialty
examination. (K.A.R.
71-2-7); Waiver of
examination (K.A.R.
71-2-5).
Each applicant for a
specialist certificate shall
meet the following
requirements: (a) Submit a
transcript of all graduate-
level dental education
completed and a letter of
reference from a practicing
dentist who has personal
knowledge of the
applicant's experience and
qualifications in the
specialty for which a
specialist certificate is
sought; and (b) pass a
board-approved specialist
examination for the
specialty sought.
(K.A.R. 71-2-7)
Yes. (K.S.A.
65-1434)
Required. 60 hours
every 2 years.
Specialist dentist is
required to take 40 of
the 60 hours on cue
courses relevant to the
specialty. (K.A.R.
71-4-1)
Kentucky N/A* Required. (KRS
313.410)
Education of not less than two (2)
years study in graduate or
postgraduate courses, after
graduation from a dental school.
(201 KAR 8:345)
State specialty
examination required.
(201 KAR 8:340) The
passing grade shall be
seventy-five (75) percent.
Failure to attain this
passing mark shall
disqualify the candidate
for licensure in a dental
specialty. (201 KAR
8:350)
Silent. Yes. (KRS
313.420)
Required. 30 hours
every 2 years.
State Workforce
License as a
specialist required
required
Certification
Reciprocity/
licensure by
credentials
Continuing
education
Louisiana N/A* State recognizes
specialists. (LAC
46:XXXIII.122)
The licensed dentist seeking
specialty recognition must have
successfully completed an ADA
accredited post-doctoral program
for each specialty. (LAC
46:XXXIII.122)
Silent. Silent. Yes for licensure
by credentials.
Licensure by
reciprocity is
prohibited. (La.
R.S. 37:768)
Required. 40 hours
per renewal period.
(LAC
46:XXXIII.1611)
Maine N/A* No. Silent. Silent. Silent. Yes. (32 M.R.S.
1085, CMR 02-
313-012)
Required. 40 hours
every 2 years with
CPR certification
required. (32 M.R.S.
1084-A, CMR 02-
313-013)
Maryland 90 (as of
5/2007)
Board will identify
specialists. (Md.
HEALTH
OCCUPATIONS
Code Ann. 4-
504)
Qualifications may include:
requirements established by various
specialty certifying boards of the
American Dental Association;
education and experience. (Md.
HEALTH OCCUPATIONS Code
Ann. 4-504)
Qualifications may
include: requirements
established by various
specialty certifying
boards of the American
Dental Association;
education and experience.
(Md. HEALTH
OCCUPATIONS Code
Ann. 4-504)
Qualifications may
include: requirements
established by various
specialty certifying boards
of the American Dental
Association; education and
experience. (Md. HEALTH
OCCUPATIONS Code
Ann. 4-504)
Yes. (Md.
HEALTH
OCCUPATIONS
Code Ann. 4-
306)
Required. 30 hours
per renewal period,
including 2 hours of
infection control and
CPR certification.
(COMAR
10.44.22.04)
Massachusetts 230 (as of
5/2007)
No. Silent. Yes. (234 CMR 2.02) Silent. Yes. (ALM GL
ch. 112, 48)
Required. 40 hours
biennially. (234 CMR
5.01)
State Workforce
License as a
specialist required
required
Certification
Reciprocity/
licensure by
credentials
Continuing
education
Michigan 40 (as of
5/2007)
Yes. (MCL
333.16608)
Graduation from an accredited
program in the specific specialty.
(R 338.11267)
Specialty exam required.
(MICH. ADMIN. CODE
R 338.11267, MICH.
ADMIN. CODE R
338.11513)
No. For purposes of the
administration of the
general rules of the board
of dentistry in the
Michigan administrative
code, a reference to
specialty certification is a
reference to a health
profession specialty field
license. (MCL
333.16608)
Yes. (R
338.11267)
Required. 60 hours
every 3 years. Dental
specialists shall have
completed 20 hours of
the 60 required board-
approved continuing
education hours in the
dental specialty
field in which they are
certified.
At least 1 cue credit
in pain and symptom
management (R
338.11701)
Minnesota 190 (as of
5/2007)
No. In the case of
oral and
maxillofacial
surgeons only, have
a Minnesota
medical license in
good standing.
(Minn. Stat.
150A.06, Subd. 1c)
Successfully completed a
postdoctoral course approved by
the Commission on Accreditation
in one of the specialty areas OR
approval of specialty examining
board. (Minn. R. 3100.7000)
Approval by one of the
specialty examining
boards OR educationally
qualified. (Minn. R.
3100.7000 )
Approval by one of the
specialty examining boards
OR educationally
qualified. (Minn. R.
3100.7000 )
Yes. (Minn. Stat.
150A.06,
Subd. 4)
Required. 50 credit
hours every biennial
cycle. CPR
certification required.
(Minn. R. 3100.5100)
State Workforce
License as a
specialist required
required
Certification
Reciprocity/
licensure by
credentials
Continuing
education
Mississippi 50 (as of
5/2007)
Board certifies
specialists. (Miss.
Code Ann. 73-9-
29)
Individual must comply with the
requirements specified by the
American Dental Association in a
specialty branch of dentistry OR be
certified as a diplomate of a
specialty Board. (Miss. Code Ann.
73-9-29)
Mississippi State Board
of Dental Examiners
specialty examination.
(Miss. Code Ann. 73-9-
29)
A diplomate of a specialty
board approved by the
American Dental
Association may announce
specialty. (Miss. Code
Ann. 73-9-29)
Yes. (Miss. Code
Ann. 73-9-24)
Required. 40 hours
every 2 years. (CMSR
50-010-001, Board
Rule No. 41)
Missouri 70 (as of
5/2007)
Yes. ( 332.171
R.S.Mo)
Completed a dental specialty
program accredited by the Council
on Dental Accreditation. (
332.171 R.S.Mo.)
Silent. Recognized in the state,
but not required. (
332.171 R.S.Mo)
Yes. ( 332.171
R.S.Mo.)
Required. 50 hours
per renewal period.
(20 CSR 110-2.240)
Montana N/A* No. Dentists who announce as
specialists must have successfully
completed an educational program
accredited by the Commission on
Dental Accreditation, two or more
years in length, as specified by the
Council on Dental Education or be
diplomates of a nationally-
recognized certifying board.
(MONT. ADMIN. R. 24.138.3101)
Silent. Dentists who announce as
specialists must have
successfully completed an
educational program
accredited by the
commission on dental
accreditation, two or more
years in length, as
specified by the council on
dental education or be
diplomates of a nationally-
recognized certifying
board. (MONT. ADMIN.
R. 24.138.3101)
Yes. (MONT.
ADMIN. R.
24.138.507)
Required. 60 credit
(MONT. ADMIN. R.
24.138.2104)
State Workforce
License as a
specialist required
required
Certification
Reciprocity/
licensure by
credentials
Continuing
education
Nebraska 50 (as of
5/2007)
No. Individual must have current
certification from, or eligibility for
current certification from, a
specialty board, recognized by the
appropriate to that area of dental
practice to advertise as a specialist.
(Nebraska Admin. Code Title 172,
Ch. 54)
Silent. Individual must have
current certification from,
or eligibility for current
certification from, a
specialty board, recognized
by the American Dental
Association appropriate to
that area of dental practice
to advertise as a specialist.
(Nebraska Admin. Code
Title 172, Ch. 54)
Yes. (R.R.S.
Neb. 71-144)
Required. 30 hours
every 2 years.
(Nebraska Admin.
Code Title 172, Ch.
56-004.01)
Nevada N/A* Required. (Nev.
Rev. Stat. Ann.
631.250)
Successfully completed the
educational requirements currently
specified for qualification in the
special area by the certifying board.
(NRS 631.250)
Examination not required
for specialty licensure.
(Nev. Rev. Stat. Ann.
631.250)
Certification not required
for specialty licensure.
(Nev. Rev. Stat. Ann.
631.250)
Yes. (Nev. Rev.
Stat. Ann.
631.255)
Required. 20 hours
per year. CPR
certification must be
current. (NAC
631.173)
New Hampshire N/A* No. Dentists announcing specialization
and limitation of practice shall
adhere to section 5-H of the 2005
edition of the American Dental
Association Code of Ethics, as
provided in Den 500. (N.H. Admin.
Rules, Den 302.04)
Dentists announcing
specialization and
limitation of practice
shall adhere to section 5-
H of the 2005 edition of
the American Dental
Association Code of
Ethics, as provided in
Den 500. (N.H. Admin.
Rules, Den 302.04)
Dentists may announce
diplomate status granted by
a bona fide national
organization. (N.H.
Admin. Rules, Den
302.04)
Yes. (RSA 317-
A:24)
Required. 40 hours
per biennium,
including a basic life
support course. (N.H.
Admin. Rules, Den
403.03)
State Workforce
License as a
specialist required
required
Certification
Reciprocity/
licensure by
credentials
Continuing
education
New Jersey 360 (as of
5/2007)
Board issues
specialty permits.
(N.J .A.C. 13:30-
6.1)
Successfully completed a post-
doctoral education, accredited by
the American Dental Association
Council on Dental Education, of
two or more years in duration in
one or more of the specialty areas
OR have certification to advertise
as specialist. (N.J .A.C. 13:30-6.1)
Silent. A licensed dentist who is
certified or eligible for
certification by a specialty
board recognized by the
American Dental
Association appropriate to
that area of dental practice
listed OR educationally
qualified required to
advertise as specialist.
(N.J .A.C. 13:30-6.1)
Yes. (N.J . Stat.
45:6-6)
Required. 40 hours
every 2 years. (N.J .
Stat. 45:6-10.1)
New Mexico N/A* Yes. (N.M. Stat.
Ann. 61-5A-12)
Applicant shall have a postgraduate
degree or certificate from an
accredited dental college, school of
dentistry of a university or other
residency program. (N.M. Stat.
Ann. 61-5A-12)
Clinical and written
examination given by the
board or its examining
agents that covers the
applicant's specialty.
(N.M. Stat. Ann. 61-
5A-12)
Successfully completed an
examination for diplomat
status or a specialty
licensure examination
comparable to the specialty
exam. (16.5.8.9 NMAC)
Yes. (N.M. Stat.
Ann. 61-5A-
12)
Required. 60 hours
every triennial cycle.
(16.5.8.9 NMAC)
State Workforce
License as a
specialist required
required
Certification
Reciprocity/
licensure by
credentials
Continuing
education
New York 360 (as of
5/2007)
No. Completion of a graduate level
program in oral and maxillofacial
surgery acceptable to the
department. Required for dental
anesthesia certificate. (8 NYCRR
61.10)
Silent. Silent. Yes. (8 NYCRR
61.4)
Required. 60 hours
per triennial
registration period. (8
NYCRR 61.15)
Beginning J anuary 1,
2009, each dentist
shall become certified
in CPR by a provider
approved by the
department.
Coursework will be
included in the
mandatory hours of
continuing education.
(8 NYCRR 61.19)
North Carolina 220 (as of
5/2007)
No. Completion of a postdoctoral
course approved by the ADA
Commission on Accreditation in a
specialty or approved by one of the
specialty examining Boards
required for advertisement as
specialist. (21 N.C.A.C. 16P.0105)
Silent. Silent. Yes. (N.C. Gen.
Stat. 90-36)
Required. The Board
shall determine the
number of hours of
study within a
particular period and
the nature of course
work required. (N.C.
Gen. Stat. 90-31.1,
21 N.C.A.C.
16R.0103)
State Workforce
License as a
specialist required
required
Certification
Reciprocity/
licensure by
credentials
Continuing
education
North Dakota N/A* Yes. A dentist
shall practice
within the scope of
that dentist's
education,
advanced training
as recognized by
the board, and any
specialty practice
recognized by the
American dental
association or other
professional entity
recognized by the
board. (N.D. Cent.
Code, 43-28-10)
Successfully completed an
educational program accredited by
the Commission on Accreditation
of Dental and Dental Auxiliary
Educational Programs, two or more
years in length, as specied by the
Dental Association required OR
may have certification to advertise
as a specialist. (N.D. Admin. Code
20-02-01-01)
Silent. Individual must be a
diplomate of a nationally
recognized certifying
board OR educationally
qualified to advertise as
specialist. (N.D. Admin.
Code 20-02-01-01)
Yes. (N.D. Cent.
Code, 43-28-
15)
Required. 32 hours
every two years. The
infection control cue
requirement is 2
hours. CPR
certification must be
current. (N.D. Cent.
Code, 43-28-12.2,
N.D. Admin. Code 20-
02-01-06)
Ohio 180 (as of
5/2007)
State Board
"recognizes"
specialists. (OAC
Ann. 4715-5-04)
Successfully completed a post-
doctoral education program for the
specialty which is accredited by the
Accreditation OR certification.
(OAC Ann. 4715-5-04)
Silent. Be a diplomate of the
national certifying board of
a specialty recognized by
the American dental
association OR
educationally qualified.
(OAC Ann. 4715-5-04)
Yes. (ORC Ann.
4715.10)
Required. 40 hours
biennially. (ORC
Ann. 4715.141)
State Workforce
License as a
specialist required
required
Certification
Reciprocity/
licensure by
credentials
Continuing
education
Oklahoma N/A* Board recognizes
specialists. (O.A.C.
195:10-9-2)
Certificate of satisfactory
completion of advanced training
program in Oral Surgery approved
by the Commission on Dental
Dental Association and in a
hospital approved by the Council
on Hospital and Institutional
Dental Service of the American
Dental Association. (O.A.C.
195:10-9-2)
Specialty Examination
required. (O.A.C.
195:10-11-10)
Silent. Yes. (O.A.C.
195:10-5-2)
Required. 60 hours
every 3 years. CPR
(O.A.C. 195:25-1-
2, O.A.C. 195:25-1-
3)
Oregon N/A* Board certifies
specialists. (Or.
Admin. R. 818-021-
0015)
Completion of a post-graduate
program approved by the
Dental Association OR certified.
(Or. Admin. R. 818-021-0015)
administered by
examiners appointed by
the Board who are
specialists in the same
specialty as the applicant
and passing the state
jurisprudence exam. (Or.
Admin. R. 818-021-
0017)
A diplomate of or a fellow
in a specialty board
accredited or recognized
Association OR
(Or. Admin. R. 818-021-
0015)
Yes. (Or. Admin.
R. 818-021-
0011)
Required. 40 hours
every 2 years. (Or.
Admin. R. 818-021-
0060)
Pennsylvania 110 (as of
5/2007)
No. Successfully complete a specialty
training program approved by the
ADAs Commission on Dental
Accreditation. (49 Pa. Code
33.203)
Silent. Silent. Yes. (49 Pa.
Code 33.107)
Required. 30 hours
per biennial period.
(49 Pa. Code
33.401)
State Workforce
License as a
specialist required
required
Certification
Reciprocity/
licensure by
credentials
Continuing
education
Rhode Island N/A* No. Completion of a post graduate
program approved by the
Dental Association OR
certification required to advertise
as specialist. (CRIR 14-140-007,
Section 27.0)
Silent. Individual must be a
diplomate of or a fellow in
a specialty board
accredited or recognized
Association OR
educationally qualified to
advertise as a specialist.
(CRIR 14-140-007,
Section 27.0)
Yes. (CRIR 14-
140-007, Section
5.0)
Required. 40 hours
every 2 years. (CRIR
14-140-007, Section
5.0)
South Carolina N/A* Required. (S.C.
Code Ann. 40-15-
220)
Applicant must meet current
educational requirements as set
forth by the American Dental
Association for ethical
announcement of a practice limited
to that specialty. (S.C. Code Ann.
40-15-260)
Theoretical and practical
specialty examination OR
certified. (S.C. Code
Ann. 40-15-250)
A diplomate of a national
certifying board
recognized by the
American Dental
Association may be
granted a specialty license
without examination by the
Board. (S.C. Code Ann.
40-15-250)
Yes. (S.C. Code
Ann. 40-15-
270) The board
may issue a
license by
credentials to an
applicant who
has been licensed
to practice
dentistry in any
state if the
applicant
complies with the
provisions of
Reg. 39-1 B.
(S.C. Code Ann.
40-15-275)
Required. 14 hours
per year. (S.C. Code
Regs. 39-5)
South Dakota N/A* No. Completion of postdoctoral
training which is recognized and
approved by the American Dental
Association Commission on Dental
Accreditation. (ARSD
20:43:04:01)
Silent. Silent. Yes. (S.D.
Codified Laws
36-6A-47)
Required. 100 hours
every 5 years. CPR
(ARSD 20:43:03:07)
State Workforce
License as a
specialist required
required
Certification
Reciprocity/
licensure by
credentials
Continuing
education
Tennessee N/A* State Board
"certifies"
specialists. (Tenn.
Comp. R. & Regs.
R. 0460-2-.06)
Successful completion of advanced
study in Oral and Maxillofacial
Surgery of 4 years or more in a
graduate school or hospital
accredited by the CODA or the
ADA and the Board. Has also
successfully completed a residency
and a clinical fellowship, of at least
one (1) continuous year in
duration, in esthetic (cosmetic)
surgery accredited by the American
Association of Oral and
Maxillofacial Surgeons or by the
Accreditation OR certification
required. (R.0460-2-.06).
All specialty applicants
shall submit to an oral
examination even if
certification from an
American Board in a
specialty is accepted in
lieu of submitting proof
of successful completion
of a residency program in
a specialty. (Tenn. Comp.
R. & Regs. R. 0460-2-
.06)
Holds privileges issued by
a credentialing committee
of a hospital accredited by
the J oint Commission on
Accreditation of
Healthcare Organizations
(J CAHO). (Tenn. Comp.
R. & Regs. R. 0460-2-.06)
Yes. (Tenn.
Comp. R. &
Regs. R. 0460-2-
.01)
Required. 40 hours
every 2 years. (Tenn.
Comp. R. & Regs. R.
0460-1-.05). Two out
of the 40 hours must
consist of a course
pertaining to chemical
dependency education
and/or shall be a
course designed
specifically to address
prescribing practices.
Texas 260 (as of
5/2007)
Board issues
"license by
specialty exam."
(22 TAC 101.2)
Successfully complete training in
an American Dental Association
approved specialty in an education
program that is accredited by the
Dental Association OR certified.
(Tex. Occ. Code 256.002)
Successful completion of
a specialty examination
administered by a
regional examining board
designated by the State
Board of Dental
Examiners. (22 TAC
101.2)
Been currently or
previously certified as
"Board Eligible" by an
American Dental
Association-approved
specialty board or
(Tex. Occ. Code
256.002)
Yes. (Tex. Occ.
Code 256.101)
Required. 12 hours
per year. (Tex. Occ.
Code 257.005)
Utah N/A* No. Completed an ADA accredited
educational program beyond the
dental degree required for
advertisement as specialist.
(U.A.C. R156-69-502)
Silent. Silent. Yes. (Utah Code
Ann. 58-69-
302)
Required. 30 hours
every 2 years. (U.A.C.
R156-69-304a)
State Workforce
License as a
specialist required
required
Certification
Reciprocity/
licensure by
credentials
Continuing
education
Vermont N/A* No. Individual must meet the
educational standards set by the
Commission on Accreditation of
Dental and Dental Auxiliary
Programs of the American Dental
Association OR be certified to
advertise as specialist. (26 V.S.A.
809)
Silent. Eligibility to take the
A.D.A. approved certifying
board in that specialty OR
educationally qualified in
order to advertise as
specialist. (26 V.S.A.
809)
Yes. (26 V.S.A.
805)
Required. 800 hours
every 5 years. (CVR
04-030-080, Section
4.11)
Virginia 160 (as of
5/2007)
Board certifies
specialists. (18
VAC 60-20-310)
Complete an oral and maxillofacial
residency program accredited by
the Commission on Dental
Accreditation or a clinical
fellowship. (18 VAC 60-20-310)
Silent. Hold board certification
by the American Board of
Oral and Maxillofacial
Surgery (ABOMS) or
board eligibility as defined
by ABOMS. (18 VAC 60-
20-310)
Yes. (18 VAC
60-20-310)
Required. 15 hours
every year. CPR
certification also
required. (18 VAC 60-
20-50)
Washington 140 (as of
5/2007)
No. Must be entitled to such specialty
designation under the guidelines or
requirements for specialties
approved by the Commission on
Dental Accreditation and the
American Dental Association.
(WAC 246-817-420)
Must be entitled to such
specialty designation
under the guidelines or
requirements for
specialties approved by
the Commission on
Dental Accreditation and
the Council on Dental
Education of the
American Dental
Association (WAC 246-
817-420)
Silent. Yes. (WAC
246-817-130)
Required. 21 hours
every year. (WAC
246-817-440)
State Workforce
License as a
specialist required
required
Certification
Reciprocity/
licensure by
credentials
Continuing
education
West Virginia N/A* Board issues
certificates of
qualification in a
specialty of
dentistry. (W. Va.
CSR 5-1-5)
In order to qualify for certification
in this specialty, the licensee shall
have a minimum of three full-time
academic years of at least eight
calendar months each of graduate
or post-graduate education,
internship or residency approved
by the Council on Dental
Education of the American Dental
Association. (W. Va. CSR 5-1-5)
Silent. Silent. Yes. (W. Va.
Code 30-4-9)
Required. 35 hours
biennially. (W. Va.
CSR 5-1-10)
Wisconsin 50 (as of
5/2007)
No. Successfully completed a post
doctorate course approved by the
Dental Association in a specialty
recognized by the American Dental
Association required for practice as
a specialist. (Wis. Adm. Code DE
6.02)
Silent. Silent. Yes. (Wis. Stat.
447.04)
Required. 30 credit
(Wis. Stat. 447.056)
Wyoming N/A* No. Dentists who announce as
specialists must have successfully
completed an educational program
accredited by the Commission on
Dental Accreditation, two (2) or
more years in length, or be
certified. (WCWR 024-034-006)
Silent. Silent. Yes. (WCWR
024-034-003,
Sec. 2)
Continuing education
required to renew
basic life support.
(WCWR 024-034-
004, Sec. 2)
All information gathered from state statutes and codes, italicized text denotes information taken from board websites, or conversations with the Board. State Workforce numbers all
retrieved J uly 7, 2008 from U.S. Department of Labor - Bureau of Labor Statistics. *N/A data cannot be published because of federal data privacy standards. ** Indicates information
from state specific available labor and market information for the occupation.
Figure 2. State scope of practice regulations for oral and maxillofacial surgeons
State Citation for dentist
scope of practice
Separate definition for scope of practice of oral and maxillofacial surgeons
Alabama Code of Ala. 34-9-
6
No
Alaska Alaska Stat.
08.36.360
No
Arizona A.R.S. 32-1202 No
Arkansas A.C.A. 17-82-102 No
California Cal Bus & Prof Code
1625
"Oral and maxillofacial surgery" means the diagnosis and surgical and adjunctive treatment of diseases, injuries,
and defects which involve both functional and esthetic aspects of the hard and soft tissues of the oral and
maxillofacial region. (Cal Bus & Prof Code 1638)
Colorado C.R.S. 12-35-103 No
Connecticut Conn. Gen. Stat.
20-123
A person who is licensed to practice dentistry under this chapter, who has successfully completed a postdoctoral
training program that is accredited by the Commission on Dental Accreditation or its successor organization, in
the specialty area of dentistry in which such person practices may: (1) Diagnose, evaluate, prevent or treat by
surgical or other means, injuries, deformities, diseases or conditions of the hard and soft tissues of the oral and
maxillofacial area, or its adjacent or associated structures; and (2) perform any of the following procedures,
provided the dentist has been granted hospital privileges to perform such procedures: (A) Surgical treatment of
sleep apnea involving the jaws; (B) salivary gland surgery; (C) the harvesting of donor tissue; (D) frontal and
orbital surgery and nasoethmoidal procedures to the extent that such surgery or procedures are associated with
trauma. (Conn. Gen. Stat. 20-123)
Delaware 24 Del. C. 1101 No
D.C. D.C. Code 3-
1201.02
No
Florida Fla. Stat. 466.003 "Oral and maxillofacial surgery" means the specialty of dentistry involving diagnosis, surgery, and adjunctive
treatment of diseases, injuries, and defects involving the functional and esthetic aspects of the hard and soft
tissues of the oral and maxillofacial regions. (Fla. Stat. 466.003)
scope of practice
Georgia O.C.G.A. 43-11-17 Oral and maxillofacial surgery is the specialty of dentistry that includes the diagnosis, surgical and adjunctive
treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft
tissues of the oral and maxillofacial region. A dentist who represents himself or herself as an "oral and/or
maxillofacial surgeon," "specialist in oral and/or maxillofacial surgery" or similar term has completed the
educational requirements stated in the American Dental Association's specialty practice guidelines in existence
at the time the representation is made. (Ga. Comp. R. & Regs. r. 150-11-.01)
Hawaii HRS 448- No
Idaho Idaho Code 54-901 No
Illinois 225 ILCS 25/17 No
Indiana Burns Ind. Code Ann.
25-14-1-23
No
Iowa Iowa Code 153.13 Oral and maxillofacial surgery is the specialty of dentistry which includes the diagnosis, surgical and adjunctive
tissues of the oral and maxillofacial region. (650 IAC 28.5(153))
Kansas K.S.A. 65-1422 Oral and maxillofacial surgery means that branch of dentistry concerning the diagnosis and the surgical and
adjunctive treatment of disease, injuries, and defects involving both the functional and esthetic aspects of the
hard and soft tissues of the oral and maxillofacial region. (K.A.R. 71-2-2)
Kentucky KRS 313.010 No
Louisiana La. R.S. 37:751 Oral and Maxillofacial Surgery--the specialty of dentistry which includes the diagnosis, surgical, and adjunctive
treatment of diseases, injuries and defects involving both the functional and aesthetic aspects of the hard and
soft tissues of the oral and maxillofacial region. (LAC 46:XXXIII.301)
Maine 32 M.R.S. 1081 No
Maryland Md. HEALTH
OCCUPATIONS
Code Ann. 4-101
No
Massachusetts ALM GL ch. 112,
50
No
scope of practice
Michigan MCL 333.16601 The practice of oral (maxillofacial) surgery includes the diagnosis and surgical and adjunctive treatment of the
diseases, injuries, and deformities of the human mouth, jaws, and associated maxillofacial structures. The
specialty of oral (maxillofacial) surgery shall include all of the following: (a) The preliminary performance of a
history and physical examination for the purpose of assessing medical, dental, and anesthetic risks for
contemplated oral and maxillofacial surgery. (b) The appropriate radiological and laboratory diagnosis. (c) The
anesthetic, surgical, and adjunctive management for diseases, injuries, and deformities of the human mouth,
jaws, and associated maxillofacial structures. (Mich. Admin. Code. R. 338.11513)
Minnesota Minn. Stat.
150A.05
No
Mississippi Miss. Code Ann.
73-9-3
Oral and maxillofacial surgery is the specialty of dentistry which includes the diagnosis, surgical and adjunctive
treatment of diseases, injuries and defects involving both the functional and aesthetic aspects of the hard and
soft tissues of the oral and maxillofacial region. (CMSR 50-010-001)
Missouri 332.071 R.S.Mo The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries
and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and
maxillofacial region. (20 CSR 2110-2.085)
Montana Mont. Code Anno.,
37-4-101
No
Nebraska R.R.S. Neb. 71-
183
No
Nevada Nev. Rev. Stat. Ann.
631.215
No
New Hampshire RSA 317-A:20 No
New Jersey N.J . Stat. 45:6-19 A licensed dentist whose credentials have been approved and who has been granted privileges by the medical
staff of a public or private licensed hospital or other public or private institution in this state and who has been
approved by the governing board of the hospital or institution may: a. Diagnose and treat patients admitted for
acute or chronic illness, injury or deformity within the province of the human jaw and associated structures and
complete and authenticate medical records of patients admitted or treated for dental or oral and maxillofacial
surgical problems; and b. Prescribe medication and treatment for patients admitted for dental or oral and
maxillofacial surgical problems. (N.J . Stat. 45:6-19.5)
New Mexico N.M. Stat. Ann. 61-
5A-4
No
scope of practice
New York NY CLS Educ
6601
No
North Carolina N.C. Gen. Stat. 90-
29
A graduate of a medical college approved by the Liaison Commission on Medical Education or an osteopathic
college approved by the American Osteopathic Association, is a dentist licensed to practice dentistry under
Article 2 of Chapter 90 of the General Statutes, and has been certified by the American Board of Oral and
Maxillofacial Surgery after having completed a residency in an Oral and Maxillofacial Surgery Residency
Program approved by the Board before completion of medical school. (N.C. Gen. Stat. 90-9)
North Dakota N.D.C.C. N.D. Cent.
Code, 43-28-01
No
Ohio ORC Ann. 4715.01 No
Oklahoma 59 Okl. St. 328.19 The diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional
and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. (O.A.C. 195:10-9-2)
Oregon ORS 679.010 Oral and Maxillofacial Surgeryis the specialty of dentistry which includes the diagnosis, surgical and adjunctive
tissues of the oral and maxillofacial region. (Or. Admin. R. 818-001-0002)
Pennsylvania 63 P.S. 121 Oral and maxillofacial surgeon is a dentist who limits his practice to the part of dental care which deals with the
diagnosis, the surgical and adjunctive treatment of diseases, injuries and defects of the oral and maxillofacial
region. (55 Pa. Code 1149.2)
Rhode Island R.I. Gen. Laws 5-
31.1-1
No
South Carolina S.C. Code Ann. 40-
15-70
No
South Dakota S.D. Codified Laws
36-6A-32
No
scope of practice
Tennessee Tenn. Code Ann.
63-5-108
That specialty branch of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases,
injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and
maxillofacial regions. Oral and Maxillofacial Surgery includes the treatment of the oral cavity and maxillofacial
area or adjacent or associated structures and their impact on the human body that includes the performance of
the following areas of Oral and Maxillofacial Surgery, as described in the most recent version of the Parameters
and Pathways: Clinical Practice Guidelines for Oral and Maxillofacial Surgery of the American Association of
Oral and Maxillofacial Surgeons: (a) Patient assessment; (b) Anesthesia in outpatient facilities, as provided in
T.C.A. 63-5-105 (6) and 63-5-108 (g); (c) Dentoalveolar surgery; (d) Oral and craniomaxillofacial implant
surgery; (e) Surgical correction of maxillofacial skeletal deformities; (f) Cleft and craniofacial surgery; (g)
Trauma surgery; (h) Temporomandibular joint surgery; (i) Diagnosis and management of pathologic conditions;
(j) Reconstructive surgery including the harvesting of extra oral/distal tissues for grafting to the oral and
maxillofacial region; and (k) Cosmetic maxillofacial surgery. (Tenn. Comp. R. & Regs. R. 0460-1-.01)
Texas Tex. Occ. Code
251.003
The practice of the dental specialty of oral and maxillofacial surgery includes the diagnosis of and the surgical
and adjunctive treatment of diseases, injuries, and defects involving the functional and aesthetic aspects of the
hard and soft tissues of the oral and maxillofacial region. (Tex. Occ. Code 251.003)
Utah Utah Code Ann. 58-
69-102
No
Vermont 26 V.S.A. 721 No
Virginia Va. Code Ann.
54.1-2711
Certification is required for an oral and maxillofacial surgeon to perform aesthetic or cosmetic procedures.
Such certification shall only entitle the licensee to perform procedures above the clavicle or within the head and
neck region of the body. Based on the applicant's education, training and experience, certification may be
granted to perform one or more of these or similar procedures: Rhinoplasty; Blepharoplasty; Rhytidectomy;
Submental liposuction; Laser resurfacing or dermabrasion; Browlift (either open or endoscopic technique);
Platysmal muscle plication; and Otoplasty. (18 VAC 60-20-290) Certification shall not be required for
performance of the following: 1. Treatment of facial diseases and injuries, including maxillofacial structures; 2.
Facial fractures, deformity and wound treatment; 3. Repair of cleft lip and palate deformity; 4. Facial
augmentation procedures; and 5. Genioplasty. (18 VAC 60-20-300). "Maxillofacial" means pertaining to the
jaws and face, particularly with reference to specialized surgery of this region. 54.1-2700. "Oral and
maxillofacial surgeon" means a person who has successfully completed an oral and maxillofacial
residency program, approved by the Commission on Dental Accreditation of the American Dental Association,
and who holds a valid license from the Board. 54.1-2700.
scope of practice
Washington Rev. Code Wash.
(ARCW)
18.32.020
Oral and maxillofacial surgery means the specialty of dentistry that includes the diagnosis and surgical and
adjunctive treatment of diseases, injuries, and defects of the hard and soft tissues of the oral and maxillofacial
region. (Rev. Code Wash. (ARCW) 18.32.020)
West Virginia W. Va. Code 30-4-
15
"Oral and maxillofacial surgery" is the specialty of dentistry which includes the diagnosis, surgical and
adjunctive treatment of diseases, injuries, and defects involving both the functional and aesthetic aspects of the
hard and soft tissues of the oral and maxillofacial regions. (W. Va. CSR 5-1-2)
Wisconsin Wis. Stat. 447.01 No
Wyoming Wyo. Stat. 33-15-
114
No
Figure 3. State board operating information for oral and maxillofacial surgeons
State Regulatory body Authority Composition Appointment procedure Special procedures
Alabama Board of Dental
Examiners
Code of Ala. 34-9-
43
6 members: 5 licensed dentists, 1
licensed dental hygienist
Dentist members are nominated
by dentists and elected by an
election conducted by the Board
of Dental Examiners. Dental
hygienist is nominated by dental
hygienists and elected by an
election conducted by the Board
of Dental Examiners. Five year
terms.
Board members receive
compensation in addition to
per diemexpenses set for
government employees.
(Code Ala. 34-9-41)
Alaska Board of Dental
Examiners
Alaska Stat.
08.36.070
9 Members: 6 licensed dentists; 2
licensed dental hygienists; 1 public
member
Appointment by the Governor. Not applicable.
Arizona Board of Dental
Examiners
Ariz. Rev. Stat. 32-
1207
11 members: 6 licensed dentists; 2
members
Appointment by the Governor.
Four year terms.
Not applicable.
Arkansas Board of Dental
Examiners
Ark. Code Ann.
17-82-208
9 Members: 6 licensed practicing
dentists; 1 licensed practicing dental
hygienist, 1 consumer representative, 1
elderly representative
Five year terms.
The Board fixes the salary of
the Secretary-treasurer of the
Arkansas State Board of
Dental Examiners. (Ark.
Code Ann. 17-82-209)
California Dental Board of
California
Cal. Bus. & Prof.
Code 1611.5
14 Members: 8 practicing dentists, 1 of
which is a member of a faculty of any
California dental college, 1 of which
practices in a nonprofit community
clinic; 1 registered dental hygienist; 1
registered dental assistant; 4 public
members
Appointment by the Governor,
except for 2 public members.
Senate Rules Committee and
Speaker of the Assembly each
appoint a public member. Four
year terms.
The current statute will
become inoperative on J uly 1,
2008. (Cal. Bus. & Prof.
Code 1611.5)
Colorado Board of Dental
Examiners
Colo. Rev. Stat. 12-
35-107
10 Members: 5 dentists: 2 dental
hygienists; 3 public members
Four year terms.
Not applicable.
Connecticut State Dental
Commission
Conn. Gen. Stat.
20-103a, 20-107, 20-
114
9 Members: 6 dental practitioners; 3
public members
Terms coincide with termof
appointing Governor.
Not applicable.
Delaware Board of Dental
Examiners
24 Del. Code
Ann. 1106
9 Members: 5 licensed dentists; 1 dental
hygienist; 3 public members
Three year terms.
Not applicable.
D.C. Board of Dentistry D.C. Code 3-
1204.08
7 members: 5 licensed dentists; 1
licensed dental hygienist; 1 consumer
member
Appointment by the Mayor,
subject to the consent of the
council. Three year terms.
Members of the Board receive
compensation in addition to
reimbursement for expenses.
(D.C. Code 3-1204.06)
Florida Board of Dentistry Fla. Stat. 466.004 11 Members: 7 dentists; 2 dental
subject to confirmation by the
Senate. Four year terms.
Not applicable.
Georgia Board of Dentistry O.C.G.A. 43-11-7 11 Members: 9 dentists; 1 practicing
resident dental hygienist; 1 consumer
member
Five year terms.
Not applicable.
Hawaii Board of Dental
Examiners
Haw. Rev. Stat.
448-6
12 Members: 8 practicing dentists; 2
members
Not applicable.
Idaho Board of Dentistry Idaho Code 54-
912
8 Members: 5 dentists; 2 dental
hygienists; 1 consumer member
Five year terms.
Not applicable.
Illinois Board of Dentistry 225 ILCS 25/6 11 Members: 8 dentists; 2 dental
hygienists; 1 public member
Appointment by the Director of
Professional Regulation. Four
year terms.
Not applicable.
Indiana Board of Dentistry Ind. Code Ann. 25-
14-1-2
practicing dental hygienist; 1 public
member
Three year terms.
Not applicable.
Iowa Board of Dental
Examiners
Iowa Code Ann.
153.33
9 Members: 5 members licensed to
practice dentistry; 2 members licensed to
practice dental hygiene; 2 public
members
Senate. Three year terms.
Not applicable.
Kansas Dental Board Kan. Stat. Ann. 74-
1406
Four year terms.
Not applicable.
Kentucky Board of Dentistry K.R.S. 313.220 9 Members: 7 licensed dentists; 1 public
member; 1 licensed dental hygienist
Four year terms.
Not applicable.
Louisiana Board of Dentistry La. Rev. Stat.
37:760
licensed dental hygienist
Senate. Five year terms.
Not applicable.
Maine Board of Dental
Examiners
32 M.R.S. 1073 9 Members: 5 members of the dental
profession; 2 dental hygienists; 1
denturist; 1 public member
Five year terms.
Not applicable.
Maryland Board of Dental
Examiners
Md. HEALTH
"OCCUPATIONS"
Code 4-205
hygienists; 3 consumer members
Four year terms.
Not applicable.
Massachusetts Board of
Registration in
Dentistry
ALM GL ch. 112,
43
9 Members: 6 dentists; 2 public
members; 1 dental hygienist; 2 dental
assistant advisory members
Five year terms.
Not applicable.
Michigan Board of Dentistry Mich. Comp. Laws
333.16101 -
333.16349
specialists; 4 hygienists; 2 registered
dental assistants; 3 public members
Appointment by Governor,
Specialty Task Force advises
the Board in specialty areas.
The Task Force consists of 9
members: 1 non-specialty
dentist; 1 prosthodontist, 1
endodontist, 1 oral and
maxillofacial surgeon, 1
orthodontist, 1 pediatric
dentist, 1 periodontist, 1 oral
pathologist, and 1 public
member. (Mich. Comp. Laws
333.16624)
Minnesota Board of Dentistry Minn. Stat.
150A.04
9 Members: 2 public members; 5
dentists; 1 registered dental assistant; 1
registered dental hygienist
Four year terms.
Not applicable.
Mississippi Board of Dental
Examiners
Miss. Code Ann.
73-9-13
8 Members: 7actively practicing
dentists; 1 actively practicing dental
hygienist
Senate. Six year terms.
Not applicable.
Missouri Dental Board R. S. Mo. 332.031 7 Members: 5 dentists; 1 dental
hygienist; 1 public member
Appointment by the Governor
Not applicable.
Montana Board of Dentistry Mont. Code Ann.
37-1-307
10 Members: 5 dentists; 1 denturist; 2
dental hygienists; 2 public members
Not applicable.
Nebraska Board of Dentistry Neb. Rev. Stat. 71-
112.03
10 Members: 6 dentists, 2 of which are
involved in teaching; 2 dental hygienists;
2 public members
Appointment by the State Board
of Health. Five year terms.
Not applicable.
Nevada Board of Dental
Examiners
Nev. Rev. Stat. Ann.
631.190
member; 1 member representing
disadvantaged dental patients
Three year staggered terms.
Not applicable.
New Hampshire Board of Dental
Examiners
N.H. Rev. Stat. Ann.
317-A:4
with approval of the council. Five
year terms.
Not applicable.
New Jersey Board of Dentistry N.J . Stat. 45:6-3 11 Members: 8 dentists; 1 dental
Four year terms.
Board members receive
additional compensation for
participating in examinations.
(N.J . Stat. 45:6-1.1)
New Mexico Board of Dental
Health Care
N.M. Stat. Ann. 61-
5A-10
Five year terms.
Not applicable.
New York Board of Dentistry N.Y. Educ. Law
6603
licensed dental hygienists; 1 certified
dental assistant
Appointment by the Board of
Regents. Five year terms.
Not applicable.
North Carolina Board of Dental
Examiners
N.C. Gen. Stat. 90-
22
licensed dental hygienist; 1 non-voting
public member
Elected by North Carolina
dentists. Three year terms.
Not applicable.
North Dakota Board of Dental
Examiners
N.D. Cent. Code,
43-28-06
hygienist; 1 consumer member
Five year terms.
Not applicable.
Ohio Dental Board Ohio Rev. Code
Ann. 4715.03
13 Members: 9 licensed dentists, 2 of
which are specialists; 3 dental hygienists;
1 public member
subject to consent of the Senate.
Four year terms.
Not applicable.
Oklahoma Board of Dentistry 59 Okl. St. 328.15 11 Members: 8 dentists; 1 dental
Public members are appointed by
the Governor while the dentists
and dental hygienists are elected.
Three year terms.
Not applicable.
Oregon Board of Dentistry Or. Rev. Stat.
679.250
9 Members: 6 licensed dentists, 1 of
which is a specialist; 2 licensed dental
Not applicable.
Pennsylvania Board of Dentistry 63 P.S. 122 13 Members: Secretary of Health;
Director of the Bureau of Consumer
Protection; Commissioner of
Professional and Occupational Affairs; 7
licensed dentists; 1 licensed dental
with the consent of the Senate.
Six year terms.
Not applicable.
Rhode Island Board of
Examiners in
Dentistry
R.I. Gen. Laws 5-
31.1-4
Three year terms.
Not applicable.
South Carolina Board of Dentistry S.C. Code Laws 40-
1-70
hygienist; 1 public member
One dentist and the public
member shall be appointed by the
Governor, 6 dentists are elected
by South Carolina dentists. Six
year terms.
Not applicable.
South Dakota Board of Dentistry S.D. Codified Laws
36-6A-14
hygienists; 1 resident public member
Three year terms.
Not applicable.
Tennessee Board of Dentistry Tenn. Code Ann.
63-5-105
practicing dental hygienists; 1 practicing
registered dental assistant; 1 public
member
Three year terms.
Not applicable.
Texas Board of Dental
Examiners
Tex. Occ. Code
254.001
subject to consent of the Senate.
Six year terms.
Not applicable.
Utah Dentist and Dental
Hygienist
Licensing Board
Utah Code 58-1-
202
member
Appointment by the director of
the Division of Occupational and
Professional Licensing subject to
approval by the Governor. Four
year terms.
Not applicable.
Vermont Board of Dental
Examiners
Vt. Stat. Ann. tit. 36
767
Five year terms.
Not applicable.
Virginia Board of Dentistry Va. Code Ann.
54.1-2400
Four year terms.
Not applicable.
Washington Dental Quality
Assurance
Commission
Wash. Rev. Code
18.32.0357
public members
Four year terms.
Not applicable.
West Virginia Board of Dental
Examiners
W. Va. Code
30-4-5
licensed dental hygienist; 1 certified
dental assistant; 1 public member
with the consent of the Senate.
Five year terms.
Not applicable.
Wisconsin Dentistry
Examining Board
Wis. Stat. 447.02 11 Members: 6 dentists; 3 dental
subject to Senate confirmation.
Not applicable.
Wyoming Board of Dental
Examiners
Wyo. Stat. 33-15-
101
hygienist
subject to the consent of the
Not applicable.

Copyright 2009 American Medical Association
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Copyright 2009 American Medical Association
AE13:08-0956:pdf:4/09

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