Dental School
What Happens in Dental School?

04/04/05

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Here is a breakdown of what to expect each year during your Dental School career!

For more information about Stony Brook School of Dental Medicine, please visit their website:
http://www.hsc.stonybrook.edu/dental

Created by Dr. Jeffrey Gordon on his website (http://www.dentalcomfortzone.com)
and Modified by
Salvatore Coscia

Get the “Inside Scoop” on Dental School – Part I  
Sophomore year, a rough ride for the dental student- Part II

The dental clinic, a testing ground the last two years of dental school, Part III
The Dental Residency – the experience begins afterwards, Part IV
The Hospital Clinic- where “real” learning begins


Get the “Inside Scoop” on Dental School – Part I 

In dental school, you have ten hours of lecture and/or lab five days a week, take about 100 credit hours per year, and have only a couple of weeks off in the summer. In college, many students take a part time job. In dental school, that is next to impossible.

Have you ever wondered what dental school is like? For college students considering a career in health care, the options can be overwhelming. The problem is that it’s often difficult to get an insider’s look at what the program is like. In this four part series, prospective dental students and those who are just curious can find out what is involved with becoming a dentist.

One important question that is often asked is "How is dental school different from the challenging college curriculum it takes to get there?" The answer is that there is a vast difference between dental school and college. In college, you may have four hours of lecture four days a week; take about 32 credit hours per year, and have three and a half months off during the summer. In dental school, you have ten hours of lecture and/or lab five days a week, take about 100 credit hours per year, and have only a couple of weeks off in the summer. In college, many students take a part time job. In dental school, that is next to impossible.

The first year of dental school has numerous lectures. The medically oriented courses include: gross human anatomy (dissection of cadavers), biochemistry, neuroanatomy, pathology and physiology. Some of the dental courses include: dental anatomy and occlusion, operative dentistry, oral biology, all the associated labs, as well as many other courses. The dental labs are where dental students first begin to train their hands to do dental treatment. In dental anatomy lab, we had to create teeth from melted wax. In operative dentistry lab, we practiced drilling out cavities on plastic tooth replicas. Both the medical and dental classes have numerous written quizzes and examinations.

The dental laboratory has the highly stressful practical examinations. During a “practical”, you would be given a set amount of time to do a dental procedure on a plastic tooth, for instance. The criteria for passing these examinations are very stringent, and are often considered one of the most.

Sophomore year, a rough ride for the dental student- Part II

There are stretches in the sophomore year where there is a quiz every single day, no end to the usual examinations in all of the other courses, and laboratory projects that would take into the wee hours of the morning to complete.

The second year of dental school is, in my opinion, the most difficult. The hours of lecture are still numerous (about four or five hours a day), but the amount of laboratory work increases tremendously. This is important because treatment of patients begins in the end of the second year of dental school, and the laboratory is where dental procedures are learned in a “safe” environment. The dental courses consist of the more advanced aspects of the courses taken the previous year, including fixed prosthodontics, complete dentures and partial dentures, oral surgery and pain control, pediatric dentistry, all the associated labs, and many more. The dental practical examinations become even more difficult, and the workload is intense. There are stretches in the sophomore year where there is a quiz every single day, no end to the usual examinations in all of the other courses, and laboratory projects that would take into the wee hours of the morning to complete.

Some of the medically oriented courses dental students take in the second year include microbiology, pharmacology, and others. In case you’re wondering about the heavy emphasis on medical courses, here’s why. Dental students, and dentists, are not just treating teeth -- they are, in fact, treating a whole person. A dentist doing a procedure as “simple” as a filling is actually performing a surgical procedure. Anesthetic is being used to block nerve channels; tissue is being removed, and so on. If a patient has an unusual reaction during treatment, a dentist must be trained to know how to handle it.

In the second year, there is a little more "hands-on" experience. The first injection is given to… you guessed it, another dental student.  However, it is done all with blunt needles, but I would say it’s wise to try and find a kind and gentle soul.

After the dental student completes the first two years of dental school, he or she must take the National Dental Boards, part 1. This part of the certification examination deals with testing the cumulative knowledge of the first two years of dental school. Second year dental students are tested on gross anatomy and neuroanatomy, histology, biochemistry, physiology, microbiology, pathology, and dental anatomy. The exam is challenging, but most students are well prepared and pass the examination, enabling them to start treating patients in the dental clinic in their third year.

The second year of dental school offers very little contact with patients. Dental students will routinely chart and clean each other's teeth, but that is about it. However, the program at SUNY-Stony Brook School of Dental Medicine is progressive, getting dental students to perform a certain number of fillings and oral surgery procedures during the second year of dental school.

The dental clinic, a testing ground the last two years of dental school, Part III

The best way to explain how a very "green" dental student treats a patient would be both very slowly, and with a lot of supervision.

The third and fourth years of dental school is when dental students begin the hands-on training required for the treatment of patients. In the third year of dental school, lectures are reduced from four or five hours a day to about two. Dental students still have course work such oral pathology, oral medicine, orthodontics, pediatric dentistry, etc., but now the labs and practical examinations are replaced with treating patients on the dental clinic floor.

The best way to explain how a very "green" dental student treats a patient would be both very slowly, and with a lot of supervision. A small filling that would take no more than 10 to 15 minutes in a regular dental office today could take nearly three hours for a student in dental school. Dental students must show the dental instructor every step involved during the treatment of a patient.

During the fourth year of dental school, there is even less classroom lecture, and the majority of time is focused on finishing clinical requirements for graduation. In other words, there are predetermined numbers of procedures required of the dental student to graduate. For example, the student may need to do eleven arches of dentures, twenty crowns or caps, two bridges, ten root canals, two biopsies, four complex extractions, and etc. Finishing the clinical requirements on time is very difficult and stressful because dental students move at a virtual snail's pace in the dental clinic.

Senior dental students also need to be prepared for the clinical board exam known as the NERB or Northeast Regional Board Exam in the Northeast and the National Dental Boards part 2. The preparation for the clinical board exam is stressful in and of itself. The dental school gives a series of mock clinical board examinations that must be passed to qualify to take the real board examination at the end of the fourth year. The clinical boards are a two-day process where dental examiners come to the dental school and test every qualified dental student on a series of dental procedures on live patients, and on plastic teeth. There is also a written component to the exam. The test is designed to see if the student is competent enough to practice dentistry without supervision.

The National Dental Boards Part 2 is a two day, twelve hour written test that covers all course work covered during the third and fourth years of dental school. The exam is comprehensive, and also includes many slide questions based on clinical scenarios. To be licensed to treat patients, dental students must graduate from a four year accredited dental school, pass both parts of the National Dental Boards, and pass the clinical board examination.

The Dental Residency – the experience begins afterwards, Part IV

Unlike medical school, where graduates are generally required to take at least three years of residency prior to being able to practice, a dentist can begin treating patients directly out of dental school.

One of the most important decisions to make in a professional career is to do a hospital-based residency after dental school. Unlike medical school, where graduates are generally required to take at least three years of residency prior to being able to practice, a dentist can begin treating patients directly out of dental school. The funny thing is, many dental students think that they are actually ready to treat patients right out of dental school. New dental graduates suffer from "not knowing what they don't know". Dentistry is far more complex than recent dental graduates realize. By going to a residency, either a hospital-based General Practice Residency (GPR) or an advanced education in general dentistry (AEGD), a young dentist can gain enough experience to begin to competently treat patients.

The experience at a dental residency is intense, demanding, and rewarding. The yearlong program is structured with lectures in the morning, and then clinic for the rest of day. In contrast to dental school, where two or three patients are seen during a typical day, the hospital clinic schedules at least ten. Each day, residents treat patients in the clinic with some level of supervision by a different team of dental specialists, depending on the day of the week. The advantage of this system is that the inexperienced dental resident has a specialist in each area of dentistry to ask questions and get advice when treating patients. So, if I you were going to plan to do a complicated treatment on a patient’s gums, you could purposely schedule that patient on a day when you knew a periodontist (specialist of gum disease) would be in the clinic. The residency gives young dentists a unique opportunity to routinely work under the guidance of a variety of dental specialists. This is of paramount importance because the general dentist acts as the “gatekeeper” and has to manage or sometimes delegate every aspect of their patient’s dental care.

The residency also includes three, one-month rotations. The first month may be devoted to oral surgery, the next, for diagnosis and treatment of temporomandibular joint (TMJ) disorders and dental phobia, and the last for general anesthesia. Dental residents are also required to stay overnight in the hospital for call once every few days.

 

The Hospital Clinic- where “real” learning begins

At the hospital clinic, most dental residents treat at least ten patients a day, and the dental problems are often more advanced.

The dental clinic provides invaluable experience for dental residents. Unlike the slow-paced, controlled atmosphere of dental school, the hospital clinic is busy, and dental residents have to think on their feet. In dental school, two or three patients are usually seen per day, and the treatment required is basic, taking several hours to complete. At the hospital clinic, most dental residents treat at least ten patients a day, and the dental problems are often more advanced. Aside from routine dental treatment, patients at the dental clinic also come in with dangerous oral infections, oral cancer, and with complicated and debilitating medical problems.

There is an old adage that says experience is a hard teacher because she gives the test first, and the lesson afterwards. Indeed, a dental residency is a testing ground for the novice dentist, but unlike the adage, residents have very skilled and experienced dentists to help with their daily “tests”. Each weekday, the clinic is taught by a different dental specialist. A weekly schedule could be structured as the following: on Mondays, instruction by the pedodontist (specialist for children), and then treat children in clinic that day. The orthodontist (specialist who straightens teeth with braces) teaches on Tuesdays, the prosthodontist (specialist of rebuilding and replacing teeth) on Wednesdays, the periodontist (specialist of gum disease) on Thursdays, and the endodontist (specialist of root canals) on Fridays. This system proves to be very important in the early training of a dental resident. For example, as a dental student, I was only permitted to perform a few root canals in my four years of dental school. At residency, I will be able to complete many root canals, and the more difficult ones with the aid of a root canal specialist. This early instruction and oversight is critical for any new dentist, and provides a unique and irreplaceable opportunity.

The hospital is also a place where dental residents treat patients with serious illnesses, and on multiple medications. These patients are far sicker than those dentists see in private practice. In fact, that is why they are staying at the hospital in the first place. When these patients have dental problems, they often need to be escorted to the clinic in a wheelchair, while others require emergency treatment at bedside or in the emergency room. Dental residents work closely with physicians from many different specialties to safely treat these patients. It is hard to overstate the importance of the experience in the hospital dental clinic. The dental residency will give an added degree of confidence and competence when treating complex dental problems on healthy patients as well as those with serious medical conditions.  Good Luck to all those individuals considering a career in the wonderful world of dentistry.



 

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