General and Pediatric Dental Surgery Residency

Yale Dental Surgery offers two residency programs: a one-year General Practice Residency (GPR) and a two-year Pediatric Dentisty Residency. All subspecialities of dentistry are represented in our programs and are taught by licensed, board-certified voluntary faculty of the Department of Surgery at Yale University School of Medicine. Residents train in other services throughout Yale-New Haven Hospital, including rotations in Anesthesia, Internal Medicine, Pediatrics, and Internal and Emergency Medicine departments. Yale Dental Surgery also trains Oral and Maxillofacial Surgery (OMFS) Residents from the Hospital of St. Raphael. In 2005, our program will train nine (9) residents: two in Oral and Maxillofacial Surgery (OMFS); three in General Practice Dentistry; and four in Pediatric Dentistry.

General Practice Residency Program
Brian Singletary, D.M.D., M.S.
Chief, Section of Dental Surgery
Assistant Clinical Professor of Surgery
Chief of Dentistry, Yale-New Haven Hospital
Program Director, General Practice Residency Program

Yale-New Haven Hospital (YNHH) offers a fully-accredited one-year residency in all phases of dentistry, as mandated by the American Dental Association. This certificate program is designed to develop essential clinical skills, attitudes, judgment and abilities related to the comprehensive practice of dentistry. The program is also structured to provide training in the management of medically, physically, and mentally compromised patients in a hospital environment. In addition to comprehensive training in all disciplines of dentistry, the dental resident will participate in restorative dentistry and oral surgical procedures in the operating room. The resident will be on off-service rotations in YNHH's Department of Anesthesiology (3 weeks), YNHH's Pediatric Dental Department (2 weeks in Pediatric Dental Clinic, 1 week in Pediatric Medicine Clinic), Internal Medicine (2 weeks), Emergency Medicine (2 weeks), and OMFS training through both YNHH and the Hospital of St. Raphael, and will be required to be on-call on assigned nights to treat oral and maxillofacial emergencies.

Dentistry is a dynamic profession and we strive to assure that our program mirrors the evolution. Our patient base provides ample opportunities for gaining or expanding the resident's experience in disciplines such as implant dentistry, fixed and removable prosthodontics, esthetic dentistry, conscious sedation, pain management beyond the use of local anesthetics, and more. Rotations to anesthesia help to improve your skills in medical risk assessment and overall patient management. In addition to the department's clinic setting, the resident will be able to provide comprehensive dental care in the operating room and work with physicians and other health care providers throughout the hospital. Clinical training is supplemented with an array of lectures, seminars and conferences throughout the year. In addition to these didactic activities, the resident will be required to submit a research paper at year's end. The resident will have the privilege of working with a variety of dental and medical specialists in both clinical and classroom settings.

Yale-New Haven Hospital's Dental Clinic is open to the general public, and all patients are seen by appointment for comprehensive care and to address dental emergencies.

The GPR program is clinically oriented, with 80 percent of the resident's time devoted to providing dental care. The remaining time is devoted to medical rotation and various non-clinical didactic experiences. Lectures are held at YNHH as well as the Hospital of St. Raphael, and the majority of clinical training occurs at YNHH's Dental Clinic.

Pediatric Dentistry Residency Program
Dr. Elise Cozzi
Pediatric Dentistry
Interim Program Director, Pediatric Dentistry Residency Program

The Pediatric Dentistry Program is a two-year program. Residents treat children under the age of 16, with an emphasis on medically, physically, and mentally compromised patients including special needs patients. Pediatric Dentistry Attendings and Residents examine each patient and carry out a treatment plan specific to the patient's needs.

The Pediatric Dentistry Program's objectives are to provide educational experiences that are evidence-based, extending the resident's clinical skills in oral diagnosis and understanding of the physical, psychological and social development of the child patient. The resident should expect to become more proficient in comprehensive pediatric dental care in the areas of basic and advanced clinical knowledge, critical judgment, manual dexterity, and, child patient management in the office and operating room settings. Comprehensive care includes medical and dental history record-taking, behavioral management, appropriate radiograph ordering, appropriate consultations, diagnosis and treatment planning, routine preventive dentistry, restorative dentistry, orthodontics, stainless steel crowns, conscious sedation, general anesthesia, and appropriate recall frequency. The curriculum includes didactic courses in biostatistics and epidemiology, microbiology, pharmacology, genetics, cardiology, embryology, anatomy, oral pathology, and clinical courses addressing informed consent, maxillofacial radiology, child abuse, trauma, and other dental issues.

The Dental Clinics
The Dental Clinics serve as full-service dental offices for the general public, as well as the clinical facility for our residency programs. Yale-New Haven Hospital's Department of Dentistry operates as a private practice facility while continuing to fulfill the compassionate mission of the hospital. This affords residents the opportunity to understand and appreciate the treatment needs of patients from diverse socioeconomic backgrounds. Because some patients are severely medically compromised, residents learn to integrate necessary medical management strategies into the dental treatment plan. Our residents provide consultations on inpatients and may render follow-up treatment as needed.

Our clinics feature
-11 treatment rooms, 5 in GPR and 6 in Pediatric Clinic;
-State of the art and newly renovated dental operatories which are equipped for four-handed dentistry with an Adec chair and Adec unit side-delivery systems;
-Digital, traditional, and panoramic x-ray units;
-Separate reception areas for children and adults; and,
-Computer-equipped conference rooms which also serve as resident study rooms.
Personnel include three receptionists, two secretaries, a financial coordinator, clinic manager, seven dental assistants, an OMFS surgeon, pediatric dentists, and over forty Dental Attendings.

General Practice Residency Curriculum
Our challenging didactic curriculum components include: physical diagnosis; weekly conferences and seminars; monthly grand rounds and case discussions; literature review and case-based learning; Oral Pathology seminars; Blood-Borne Pathogens Training; Infection Control Training and OSHA Training; ACLS and PALS courses and certification; and regional or state dental meetings.

Our didactic curriculum objectives are to: (1) Understand the principles and techniques of physical diagnosis and their relevance to pertinent medical conditions and the implications for dental treatment; (2) Develop an understanding of dental literature and be able critically to review articles for accuracy, pertinence, and validity; (3) Understand the principles of diagnosis and treatment planning and the variability in treatment modalities as an approach to clinical care; (4) Understand the different dental treatment modalities using evidence-based or scientific principles and criteria; (5) Understand the various medical conditions that may alter dental care and the manner in which it is rendered; (6) Learn various principles and techniques in all disciplines of dentistry to improve the resident's ability to provide comprehensive treatment; (7) Understand and manage the various pathological conditions that may occur within and around the oral cavity; (8) Understand the requirements for infection control and OSHA compliance; (9) Develop an understanding for advanced study groups, local, state, and national organizations; and, (10) Develop an appreciation for quality continuing dental education.

Upon completion of this program, a resident should be fully prepared for a professional career in any chosen career tract. This is accomplished through these strategic curriculum objectives: (1) Understand the role of dentistry as it relates to the total health care of the patient, especially those who are physically, mentally or medically compromised; (2) Understand and appreciate the role of a dentist on the medical staff of a hospital in the comprehensive treatment of patients in a hospital environment; (3) Recognize and evaluate systemic diseases and how they affect oral health; (4) Understand the implications of various types of clinical laboratory data and their use in the diagnosis and treatment of oral disease; (5) Understand and utilize appropriate consultations from other subspecialties of medicine and dentistry before final preparation and presentation of comprehensive treatment plans; (6) Understand and appreciate the pharmacological actions of drugs used in treating oral and systemic disease; (7) Manage the dental problems of the pediatric, adult and geriatric patient; (8) Recognize the importance of preventive dental care and its role in the total success of dental treatment; (9) Interact with dental assistants, billing coordinator, and secretaries in an office type environment; (10) Interact with a broad range of health care providers, such as physicians, pharmacists, and residents in training; (11) Understand the rationale, indications, and use of inhalation and intravenous drugs for control of pain and apprehension in the conscious patient; (12) Understand the implications for use of general anesthesia to facilitate dentistry in the operating room; (13) Provide comprehensive dental care including periodontal treatment, fixed and removable appliances, restorative procedures, oral surgery, operative dentistry, endodontics, and orthodontics for patients from various socioeconomic backgrounds; (14) Understand hospital organization, protocol, and administration; (15) Understand and demonstrate the need and desire to work as a team with a shared vision; and, (16) Understand the hospital's role in comprehensive health care.

Periodontal Program
Dr. Harold Horton
Section Chief of Periodontics

This program exposes the General Dentistry resident to periodontics from a diagnostic and therapeutic perspective, instilling the need to integrate periodontics into generalized treatment planning. Residents treat all periodontal patients under the direct supervision of licensed and board-certified periodontists. Residents obtain full mouth radiographs, diagnostic casts, and create treatment plans with the attending Periodontist. Residents may carry out initial patient preparation in the absence of a periodontist, but patients requiring subsequent periodontal surgery must be evaluated by a periodontist before surgery. Any surgery by a dental resident must be performed in the presence of a periodontist. On occasion, residents will be allowed to observe periodontal surgery in an office setting of an attending faculty member's private office. This will familiarize the dental resident with private office procedures and patient management.

The objectives of the Periodontal Program are to develop in-depth ability to diagnose and coordinate the treatment of periodontal diseases. The resident is expected to gain knowledge of currently available treatment modalities and to develop skills to execute periodontal procedures which lend themselves to integration in the practice of General Dentistry. The resident will gain additional knowledge in diagnosis and treatment planning integrating periodontics, general dentistry, orthodontics, and prosthodontics. Additional material covered includes non-surgical periodontal therapy, antibiotic and chemotherapeutic agents. The introduction of surgical therapy will include apically repositioned flap, modified Widman flap, free surgical grafts, osseous resection, gingivectomy and other crown lengthening procedures, and osseous grafting.

Oral Surgery Program
Leonard Skope, D.D.S.
Chief of Oral Surgery

General Dentistry residents are expected to perform oral surgical procedures in the Dental Clinic and they are encouraged to participate in Oral and Maxillofacial operating room cases at the Hospital of St. Raphael. The educational objectives include simple exodontias; surgical exodontias; oro-facial wound repair; treatment of acute and chronic infection of dental origin; oral surgery for the compromised host; and, diagnosis and treatment of pathological lesions of the mouth and jaws.

Endodontic Program
Dr. Bertrand Weisbart
Section Chief of Endodontics

General Dentistry residents are expected to learn how to diagnose pulpal disease and orofacial pain, including concise methods of testing for pulpal pathology and accurate interpretation of test results. The resident will become familiar with conditions that mimic endodontic disease and the appropriate treatment of endodontic disease.

Orthodontic Program
Orthodontic treatment involving full banding is performed under the supervision of Orthodontic Attendings. Patient consultation is done by the General Dentistry resident with an Orthodontic Attending, and all subsequent treatment will be performed under the same supervision. The educational objectives include learning the methods of diagnosing patients with orthodontic problems; differentiating modalities of orthodontic treatment; being aware of the extent to which private practice general dentists ought to become involved in orthodontic treatment; and, learning minor orthodontic tooth movement applicable to private practice.

Prosthodontic Program
In the Prosthodontic Program, the resident treats patients requiring fixed and removable prostheses. The treatment plan developed by the resident will be carried out under the guidance of an Attending Prosthodontist or General Dentist. The educational objectives are to familiarize the resident with various prosthodontic principles and procedures in fixed and removable prosthodontics; to teach the clinical application of different dental materials used in prosthodontics; and, to learn to manage patients who may be geriatric, medically compromised, physically compromised, or have special needs.

Pain Management
Pain management is taught in all programs and utilized where appropriate. Pain management, beyond the use of local anesthesia, may include nitrous oxide, oral, and intravenous sedations.

Special Programs
Yale-New Haven Hospital is dedicated to preventive dentistry for mentally diabled patients. We are committed particularly in the areas of: restoration; oral exams; dental prophylaxis; radiographs; and, general anesthesis in the operating room. We perform operating room procedures on the 1st Wednesday of each month, and hold clinic office visits on the 4th Wednesday of each month.

Internal Medicine Rotation
The General Practice Dentistry Resident will spend two full weeks under the direct supervision of a Hospital Internal Medicine Attending Physician who will oversee and assess the resident's education in medical history record-taking; physical examination; ordering of appropriate radiographs and laboratory body fluid analyses; diagnosis; patient admissions; daily in-patient treatment and progress notes; and, patient discharges from the Hospital. The purpose of this rotation is to give the resident first-hand experience in the medical management of patients; to learn to integrate medical and dental correlations where applicable; to gain more experience in evidence-based learning; and, to improve the resident's ability to communicate effectively with their medical colleagues.

Emergency Medicine Rotation
The General Practice Dentistry Resident will spend two full weeks in the Emergency Department under the supervision of an Emergency Room Physician who will oversee and assess the resident's education in triage; medical history recording; physical examination; pain assessment; treatment of mostly non-acute emergency cases that present to the emergency room, including cases that may require hospital admission; and, discharge and follow-up with appropriate medical service(s). The purpose of this rotation is to train the resident to recognize obvious and subtle signs of medical and mental instability of patients; improve diagnostic, physical examination, and referral skills; and, to improve the resident's ability to communicate effectively with their emergency medicine colleagues.

Pediatric Medicine Rotation
The General Practice Dentistry Resident will spend one week in the Pediatric Primary Care Center under the supervision of Pediatricians who will oversee and assess the resident's education in history-taking from parents and children; physical examination of children; diagnosis; and, medical management of childhood diseases which may include inpatients and outpatients. The purpose of this rotation is to give the resident training in the medical management of children; to be able to recognize obvious and subtle signs and symptoms of medical and mental instability in the pediatric patient; to improve the resident's diagnostic and appropriate referral skills; and to improve the resident's ability to communicate with their Pediatric Medical colleagues. This Rotation is done in conjunction with a rotation in Pediatric Dentistry.

Pediatric Dentistry Rotation
The General Practice Dentistry Resident will spend three weeks in the Pediatric Dentistry Center, one of which will be in the Pediatric Primary Care Center, under the direct supervision of Pediatric Dentists who will oversee and assess the resident's education in the dental treatment of children and their parents. All dental services offered for the dental management of children will be taught including pain management using chemical agents beyond local anesthesia. The purpose of this rotation is to give the resident familiarity, comfort, knowledge, and expertise in comprehensive dental care of children and their parents; to learn to correlate and coordinate appropriate dental treatment with the age of the child taking into consideration and monitoring the growth and development of the child; to make appropriate referrals when indicated; and, to improve the resident's communication with their Pediatric Dentistry colleagues.

Anesthesia Rotation
The three-week Anesthesia Rotation will provide Residents with an overview of the scope of medical anesthesia and its application in dentistry. The goal of the anesthesia rotation is to train residents in operating room procedures and protocol, including oral and nasal intubation. Emphasis will also be placed on pre-operative preparation and post-operative management of patients. Additional anesthesia emergencies, pharmacological and physiologic action of general anesthesia agents will be covered. The rotation consists of lectures, demonstrations, and operating room duties. The Anesthesia Rotation also affords the resident the opportunity of working with the staff anesthesiologist in the operating room performing inhalation and spinal anesthesia, intravenous sedation techniques, and to learn pain management beyond the use of local anesthesia.

Oral and Maxillofacial Surgery Rotation
Senior OMFS Residents from the Hospital of St. Raphael share this rotation at YNHH's Department of Dentistry for a period of one year. The purpose of this rotation is to enable the OMFS Residents to learn to diagnose, treat, and manage complex OMFS, medically compromised, and trauma cases. The goals of this rotation are for the OMFS resident to perform OMFS procedures in clinic(s) and operating room(s) under the direct supervision of OMFS Attendings of YNHH Departments of Dentistry, Plastic Surgery, and Otolaryngology when on rotations in those respective departments. The OMFS residents gain experience in teaching by serving as Chief Resident for and helping to train GPR and Pediatric Dental Residents in basic OMFS under the direct supervision of OMFS Attendings. This will enable the OMFS resident to develop communication skills for working in a team of OMFS surgeons, general dentists, orthodontists, endodontists, periodontists, maxillofacial prosthodontists, and other physician colleagues in hospital patient care.

Oral Pathology Seminar Series
All residents in the Department of Dentistry participate in clinical case reviews with an oral pathologist on a biweekly basis. This gives residents an important opportunity to recognize, discuss, and understand oral lesions, associated benign or malignant oral and systemic diseases, and differential diagnosis for these lesions. The goals of this case review series is to teach residents to think critically when examining patients, to utilize the information gathered to be confident in their diagnosis, and recommend appropriate treatment when indicated.

Applications
American Dental Education Association
1625 Massachusetts Avenue, NW
Suite 600
Washington, DC 20036-2212
Phone: 800.353.2237
Fax: 202.667.4983
http://www.adea.org/PASS/default.htm
Our program participates in the Postdoctoral Dental Residencies Program ("The Match") through National Matching Services, Inc. Accordingly, you must participate in the Match in order to be accepted into our program.

National Matching Services
20 Holly Street, Suite 301
Toronto, Ontario
Canada, M4S, 3B1
Phone: 416.977.3431
Fax: 416.977.5020
http://natmatch.com
The Application deadline is November 2nd. After applications are received and reviewed, you will be contacted only if you are selected for an interview. The interview is a full day and allows you to interact with current residents and faculty. Any questions may be directed to Roxanne Niblack at 203.688.2465