Advanced Education In General Dentistry | VA Maine Health Care - Veterans Affairs

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Program Description

The Advanced Education in General Dentistry (AEGD) Program is a fully accredited  one-year post-doctoral  program in clinical dentistry with a didactic component in  general dentistry. The primary focus of this program is to improve the clinical skills taught in an undergraduate dental school program. The clinical and didactic training and experiences are at a level of skill and complexity beyond that accomplished in a pre-doctoral program. The program currently accepts two residents per year. Each resident is assigned a modern, well-equipped dental operatory and a full-time chair-side dental assistant. The facilities and staff support all clinical, educational, and research activities of the program.

Clinical and didactic instruction covers the range of dental disciplines, emphasizing practice management and care for the medically compromised and dentally complex patients. Approximately 85% of time will be spent providing direct patient care and 15% will be directed toward non-clinical and didactic activities. 95% of our patients are out-patients.

In addition, the individual resident can identify major areas of interest, such as specific clinical disciplines or research. Upon satisfactory completion of the program, residents receive a certificate in Advanced Education in General Dentistry.

Duty, Leave, Stipend

Appointment One full year, starting approximately the first week in July (subject to change)

Clinic Hours 8:00 am to 4:30 pm, Monday - Friday

After-Hours Call Duty

Residents alternate, each covering every other week Monday-Friday

Annual Leave 10 days (vacation)
Accumulates by approximately one day per month

Sick Leave Up to 7 days
Accumulates by approximately one day every other month

Stipend: Approximately $55,000

Administrative Leave*Up to 5 days

*5 days of official leave may be approved to attend professional meetings and continuing education courses and to take State Board Examinations. Any tuition or travel costs will be the responsibility of the resident.

Clinic and Facilities Description

Dental Clinic: The clinic consists of ten fully-equipped dental operatories and one oral surgery suite.  The clinic is equipped with a full complement of modern dental materials as well as a computerized patient record system, digital panoramic and intra-oral radiography, rotary endodontic equipment, and dental implant surgical and prosthetic equipment.  In addition, located within the clinic, is an i-CAT cone beam CT scan for use with complex cases that require high definition 3D diagnostic images. 

Hospital scrubs and long sleeve clinic attire are provided daily. The dental laboratory, patient reception area, staff conference room, bathrooms and locker rooms are located within the clinic.

Dental Operatory: Single chair operatory with digital intra-oral radiography, intra-oral camera, and individual computer station and monitor for doctor and assistant.

Dental Lab: In-house dental lab with a full-time CDT who provides a full range of dental laboratory support, except for RPD frameworks and porcelain/ceramic crowns (both are sent to outside labs).

Auxiliary Staff: Three full-time dental hygienists, eight full time dental assistants and one full-time receptionist.

VA Facilities: Togus VA Medical Center is a 67-operating bed facility with general medical, surgical, intermediate and mental health beds, as well as a 100 bed Nursing Home. Opening in October 1866, Togus VAMC is the oldest veterans' facility in the country.  Togus is located approximately four miles east of Augusta, the state capital. The Togus campus encompasses 500+ acres of buildings and natural woodlands.  The first veteran was admitted to Togus on November 10, 1866. The campus also has an indoor gymnasium (with a workout equipment and a heated pool), cafeteria, post office, canteen store, ATM machine, chapel and outdoor tennis court, basketball court, softball field and walking trails.

Clinical Staff:

Full-Time Staff:

Dr. Nicholas Sirois, Program Director
DMD: Tufts Univ. School of Dental Medicine, 2011
AEGD: VA Maine Healthcare Center, 2012
General Dentistry practice since 2012

Dr. John Coke, Assistant Chief of Dental Service
D.D.S: Emory University, Atlanta, GA 1983
GPR: University of Medicine and Dentistry of New Jersey, Newark, NJ 1984
U.S. Air Force Dental Corps, 25 years
General Dentistry, VA Bangor CBOC since 2013

Dr. Heather Masters
DDS: University of Maryland School of Dentistry, 2013
AEGD: VA Maine Healthcare Center, 2014
General Dentistry, VA Bangor  since 2014

Dr. Myra S. Gay
DDS: University of Texas Health Science Center at San Antonio 1997
AEGD: Ft. Campbell, KY 1998
General Dentistry: Togus VAMC 2017

Dr. Alex Gale D.M.D:  University of Connecticut School of Dental Medicine, 2017
AEGD: Togus VAMC, ME, 2018
General Dentistry, Togus VAMC since 2018

Dr. Jennifer Miedema
DMD: University of New England CDM, 2017
AEGD: VAMC Togus, ME, 2017-2018
General Dentistry, Togus VAMC since 2018
 
Part-Time Staff

Dr. Donald Bandy, DDS
D.D.S: University of Texas H.S.C., San Antonio, 1978
GPR: General Leonard Wood Army Hospital, Ft. Leonardwood, MO, 1979
OMFS: Walter Reed Army Medical Center, 1992
Diplomate, American Board of Oral and Maxillofacial Surgeons, 1994

Consulting Staff

Dr. Michael T. Cwiklinski
DMD: U. of Pennsylvania,
Periodontics: Tufts University
Private Practice, Portland, ME

Dr. Stephen Morse
DMD: Tufts University,
Periodontics: Boston University
Private Practice, Portland, ME

Dr. Todd Mellin
DMD: Medical University of South Carolina
Endodontics: Medical College of Virginia
Private Practice, Portland, ME

Orientation
Orientation to the program begins the first week. The resident is introduced to dental clinic policies and protocols, clinical privileges, computerized patient record system (CPRS) and other operational details of a hospital based dental practice. A Resident's Manual is provided to serve as a reference source for clinic and hospital policies and procedures and for information on dental materials and equipment.

Goals and Objectives

The intent of the clinical program is to enable the resident to meet the following goals and objectives:

1. Providing emergency and multidisciplinary comprehensive oral health care.
   1. Evaluating, diagnosing, and treating dental emergencies and infections.
   2. Integrating multiple disciplines into individualized, comprehensive, sequenced treatment plans for patients with uncomplicated and complex needs.
2. Obtaining Informed Consent
   1. Obtaining informed consent for dental treatment by discussing with the patient or guardians of patients, the following: diagnosis, treatment options, and benefits and risks of treatment.
3. Functioning effectively within interdisciplinary health care teams, including consultations and referrals.
   1. Consulting with and obtaining clinical and diagnostic input from other health care providers.
   2. Making referral to other health care providers when appropriate
4. Providing patient focused care that is coordinated by the general practitioner.
   1. Functioning as the patient’s primary and comprehensive oral health care provider.
   2. Formulating treatment plans that are compatible with that patient’s ability to understand and care for.
5. Directing health promotion and disease prevention.
   1. Using universal precautions and occupational hazard prevention procedures in the practice of dentistry.
   2. Promoting accepted prevention strategies to improve the patient’s oral health & overall health.
6. Assessing, diagnosing, and planning for multidisciplinary oral health care for a wide variety of patients, including special needs patients.
   1. Obtaining and interpreting the patient’s chief complaint and medical, dental and social history.
   2. Obtaining and interpreting diagnostic data to arrive at a differential, provisional or definitive diagnosis for patients with complex medical problems and significant physical limitations.
7. Managing the delivery of patient focused oral health care.
   1. Building rapport and confidence with patients and putting the patient’s best interest first.
   2. Providing patient care by working effectively and efficiently with a chairside dental assistant, using four-handed dental techniques.
   3. Practicing effective time-management during dental procedures.
8. Operative Dentistry
   1. Performing operative dentistry using a wide range of dental materials.
9. Fixed and Removable Prosthodontics.
   1. Replacing missing teeth effectively using removable partial dentures and full dentures.
   2. Replacing missing teeth effectively using uncomplicated and complicated fixed prosthetics.
10. Periodontal Therapy.
    1. Diagnosing and treating early periodontal disease and moderate localized periodontal disease using surgical and non-surgical techniques.
11. Endodontic Therapy
    1. Performing uncomplicated non-surgical anterior endodontics.
    2. Performing uncomplicated non-surgical posterior endodontic.
12. Oral Surgery
    1. Performing surgical and non-surgical extraction of teeth.
    2. Performing uncomplicated pre-prosthetic oral surgery.
    3. Performing oral soft tissue biopsies.
    4. Surgical placement of uncomplicated dental implants.
13. Pain and anxiety control utilizing behavioral and pharmacological techniques
    1. Using behavioral management techniques to aid in controlling pain and anxiety.
    2. Using pharmacological agents to help control pain and anxiety.
14. Managing medical emergencies.
    1. Anticipating, preventing, diagnosing and providing initial treatment for medical emergencies that may occur during dental treatment.
15. Managing dental implant treatment planning, placement and prosthetic restoration.
16. Managing oral mucosal diseases via initial exam, biopsy, initial therapy and referral as needed.
17. Managing TMD and orofacial pain by performing a TMD evaluation and initial therapy. 

Didactic Program
The intent of the didactic program is to complement clinical experience with the following:

• Weekly webinar series on various disciplines of general dentistry
• Bi-monthly lectures on Periodontics topics by periodontist consultant
• Monthly treatment planning/case presentation sessions
• Monthly literature review sessions
• ACLS provider course
• BLS re-certification

Rotations and Special Clinics

• Oral Surgery: Direct supervision by an Oral Surgeon two full days per month.
• Periodontics: Direct supervision by a Periodontist one half-day per month.
• Practice Management:  Review practice management topics, one hour every other month.
• Anesthesia Department Rotation: one week
• Community Service Project
• ENT: One clinic day, one Surgical day

Overall Goals and objectives

• Provide the resident with multidisciplinary comprehensive training in general dentistry, including emergency treatment, preventive dentistry and dental treatment modalities that encompass most dental disciplines.
• Improve resident's competency and confidence while caring for a wide variety of patients, including those with special needs.
• Manage delivery of patient care by applying concepts of patient and practice management and quality improvement. Function effectively in this environment within interdisciplinary health care teams. Utilize professional ethics, patient-centered care, adaptability and acceptance of cultural diversity in professional practice.
• Apply scientific principles to resident education using critical thinking, evidence-based decision-making and technology-based information retrieval systems.
• Understand veterans' oral health needs and engage in community service.

Past Residents' Experiences
The following represents an approximation of the chair-side procedures an average resident accomplishes in one year.

PROCEDURE Numbers

Comprehensive oral evaluations 50 - 75

Endodontic canals filled 20 - 30

Complete denture units 15 - 20

Removable partial denture units 15 - 30

Surgical placement of dental implants 0 - 20

Implant supported crowns seated 5 - 15

Simple/Surgical Extractions 200 - 300

Biopsies 5

Anterior Composite Surfaces 250 - 350

Posterior Composite Surfaces 150 - 250

Alloy Restoration Surfaces 125 - 200

Fixed units (PFM, FGC, Ceramic) 25 - 50

Periodontal surgical procedures 5 - 10

             

Applications
Residents must meet the following requirements:

• Be a citizen of the United States
• Be a graduate of a dental school accredited by the American Dental Association.
• Meet licensure requirements necessary to be licensed to practice dentistry in any state of the U.S. or District of Columbia. Dental license is not required.

All qualified candidates will receive equal consideration regardless of race, color, national origin, sex, age or sexual orientation.

To apply to this program:

1. Complete an application at the Postdoctoral Application Support Service (PASS)
       Web Site:    American Dental Education Association     
        Telephone:      800-353-2237 
2. Complete VA application form ( VA Form 10-2850D) and submit to:

   Nicholas Sirois, D.M.D.
   Program Director
   VA Maine Health Care System
   Dental Service (160)
   1 VA Center
   Augusta, ME 04330

         Tel: 207-623-8411 ext. 5304
         Fax: 207-626-4741
         E-mail:  nicholas.sirois@va.gov

Deadline:  Applications should be completed no later than October 15th.

Interviews
When all application materials have been received, interviews and tours of the clinic and facility will be arranged by invitation from the Program Director,. These interviews are normally scheduled from November through early December.

Maine Resources:
Official Website of the State of Maine *
City of Augusta, Maine **
City of Portland, Maine **

  *Links will take you outside of the Department of Veterans Affairs Website.
**Links will take you outside of the Department of Veterans Affairs Website.  VA does not endorse and is not responsible for the content of the linked web site.

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