Why Should You Have a Certificate in Third Molar Surgery Proficiency?
After an intensive surgery course with so many concepts to assimilate and implement, instructors often wonder, “How much did doctors really learn?” Third molar surgery is a part of dentoalveolar surgery and an extension of surgical extractions. It requires expertise in patient evaluation and selection, oral anatomy, a knowledge of advanced oral surgery techniques, and the ability to prevent or manage a myriad of potential surgical complications. It is a discipline that calls for competence but also confidence to step into situations where you don’t always know in advance what it will take to create the best outcome. This proficiency assessment is a measure of cognitive knowledge of removing impacted third molars. This does not assess operative expertise although the two are related.
How Can This Acknowledgment of Training Help Your Practice?
It is a documentation of your cognitive level of knowledge from study and experience. Besides the personal satisfaction, it is a message (if desired) to your patients, your professional liability carrier, the state board, and your peers that you have the skills and capability to perform third molar surgery.
Third Molar Proficiency is Knowing:
- Which cases require a CBCT and for which cases would a pano be sufficient.
- Which teeth are obviously indicated for removal.
- Which teeth are perhaps the easiest and most straightforward (erupted thirds or in late teens with roots not fully formed).
- Which cases require sedation.
- Which teeth should be followed (surveilled) for possible future removal (less than 1/3 root formation other situations).
- Which teeth may be best “not attempted” by anyone (late 20s or older, no symptoms, no pathology).
- Which cases are best referred to specialists (depends on your knowledge, ability, and experience).
- Which teeth would likely be indicated for a coronectomy.
- How “Pell and Gregory” plus age and access influence difficulty.
- When is it appropriate to remove only one tooth when more are present (community health clinic, indigent patient, one tooth with pericoronitis).
- How to efficiently, quickly, predictability, and safely perform the procedure.
Variables vs. Absolutes in Surgery
In oral surgery, some clinicians do things one way and some another. Those items to which I am referring are acceptable either way. Most are “personal preference.”
- The type of retractor used (Minnesota, Seldin, Austin, etc.).
- Types of elevators.
- How many sutures in a given situation (some may not place any).
- Envelope vs. triangular flap (would depend on the situation).
- 702 vs. 703 bur.
- Steroids or not? Which steroid?
- How one holds excess suture material while suturing.
- How to section teeth.
- How to prescribe antibiotics.
- How to treat dry sockets.
- This assessment includes knowledge gained from completing Continuum 4 Third Molar Impaction Surgery.
- Textbook: Contemporary Oral and Maxillofacial Surgery, 7th Edition by James R. Hupp, Myron R. Tucker, Edward Ellis III
You will be assessed 100+ questions on the following:
- Chief complaint, severity of a patient’s medical condition, functional capacity, emotional status.
- Indications and contraindications
- Difficulty of the procedure. Age, Pell and Gregory and other classifications. Maxillary and mandibular.
- Root morphology.
- The surgical procedures
- Access, bone removal, sectioning, tooth delivery, closure
- Prevention and/or management of complications
- Intraoperative and postoperative patient management
Completion of this certificate requires a score of 85% or higher with no more than two attempts.
After completing the assessment, please contact the Continuum 4 course manager. A certificate will be sent to you via email.
KCSI Continuum 4: Third Molar Impaction Surgery Course is 14 CE hours. The KCSI Third Molar Surgery Proficiency Certificate, a suggested post course assessment for KCSI Continuum 4, is an additional 3 CE hours.
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