Career opportunities in periodontics: A road map to the future.

A solid career plan is crucial as it can provide a roadmap to the future. The motivating factors for selecting any career are complex, and periodontics is no exception. Periodontics is a dynamic profession that includes sophisticated treatment planning and a wide variety of treatment modalities ranging from conventional to advanced therapies. It is a unique branch of dentistry that enables both saving teeth and also replacing them in an effective way with implants. The purpose of this article is to provide an overview of various career opportunities for a periodontist. Career options in periodontics are manifold and diverse, enabling a periodontist a professionally gratifying and secure lifestyle. Future of the profession of periodontics appears exciting and rewarding but is not likely to happen without great effort and challenges. However, periodontics is not a static field and continues to evolve leaving a periodontist with no dearth in career opportunities. Copyright:

INTRODUCTION

A solid career plan is crucial as it can provide a roadmap to the future. The motivating factors for selecting any career are complex, and dentistry is no exception [Figure 1]. It becomes difficult to choose the best option that would fulfill both passion and income. Many issues may be considered when choosing a career, including one's own strengths and weaknesses, interests, desires and willingness, and financial ability to complete a possibly lengthy period of training. Other factors include the type of work involved in a particular career, availability of good employment opportunities, work environment, financial rewards, and interpersonal motives.[1]

Figure 1

Factors effecting career choice

HISTORY

The specialty of periodontics has a long history dating back to prehistoric times, as witnessed by written evidence from various civilizations. All well-established cultures mentioned gingival and periodontal diseases in their historical records and have emphasized their remedies and prevention strategies. W. Riggs has seemed to have been the first individual to limit his practice to periodontics and therefore can be considered the first specialist in this field.[2] In India, the seed for graduate program in periodontics was sown by Dr. G. B. Shankwalkar and the baton was taken by several illustrious teachers who made the profession what it is today. The rapid progress in the field of periodontology owes a great debt to all those pioneers who were the iconic gurus who left a blazing trail that later generations emulated to the profession's present preeminent status.

PERIODONTICS AS A CAREER AND LIFESTYLE

Periodontics is a dynamic profession that includes sophisticated treatment planning and a wide variety of treatment modalities ranging from conventional to advanced therapies. It is a comprehensive specialty that provides opportunities in academics, clinical practice that is evidence based and driven by sound scientific knowledge, paving a way for newer frontiers in research. Periodontics can be described as a cornerstone of dentistry where every other specialty revolves around it in terms of keeping the teeth healthy so that other treatments can be rendered. It is a unique branch of dentistry that enables both saving teeth and also replacing them in an effective way with implants. Overall, periodontics is challenging as a specialty which is ever-changing and rewarding with feasible working hours.[3]

CAREER OPTIONS IN PERIODONTICS: A ROAD MAP TO SUCCESS

In describing the responsibility and the scope of practice of periodontists, the American Academy of Periodontology presently states that a periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease and in the placement of dental implants.[4] Periodontists are also experts in the treatment of oral inflammation. Periodontists receive extensive training in these areas, including 3 additional years of education beyond dental school. They are familiar with the latest techniques for diagnosing and treating periodontal disease.

Periodontists are also trained in performing cosmetic periodontal procedures. In the past few decades, as an esthetically pleasing smile has become a key element of periodontal and implant therapy, various surgical techniques have been developed to improve esthetic outcome and functional restoration.[5] It is the responsibility of the dental team mainly a periodontist to understand optimal esthetics and to be able to provide effective treatment for the patient.

Career options in periodontics are manifold and diverse, enabling a periodontist a professionally gratifying and secure lifestyle [Figure 2].

Figure 2

Career opportunities in periodontics

Private clinical practice

Periodontist, as a clinician attending to sole periodontal problems, has metamorphosed into a different role. He/she has become a plastic surgeon, a smile designer, and an implantologist and an able health care worker improving general health through maintenance of periodontal health. Clinical practice in periodontics represents a multitude of practice settings which include a general private practice or specialty practice in dental clinics, polyclinics, and multispecialty hospital setting. A periodontist is trained to perform in following areas as a part of specialty clinical practice. The wide array of clinical options gives a periodontist scope to choose and plan his career [Figure 3].

Figure 3

Various practice settings in private clinical practice

Government sector

Globally, a periodontist is eligible for many jobs in the government sector, enabling a comfortable and secure work environment. The Government of India encourages dentists with many job opportunities in both the rural and urban sectors. Various areas of employment are provided by the Indian government [Figure 4].

Figure 4

Areas of employment in Indian government sector

Defense services

The defense/armed forces are a highly organized force which assigns specialist opportunities in the army, navy, and air force [Figure 5]. There is not only pride in serving the nation as a periodontist/dental officer, but it comes with many generous benefits that can aid in building a secure future. In addition to the financial incentives, placements in the defense services also offer low-cost/no-cost medical and life insurance, retirement plan options, housing allowances, and paid vacations. Periodontal health that indirectly reinforces general health would be a privileged prerogative of a serving periodontist officer.

Figure 5

Career options in defense services

Academics

An academic career involves employment in government and private dental colleges to teach undergraduate and postgraduate students. People will advance through several levels in the academic career ranging from assistant professor to fulltime chair, and such a culmination of academic career can be a rewarding and gratifying feeling.

Research career

We live today in an unprecedented age of discovery that has opened up many opportunities in oral, dental, and craniofacial research. Periodontal research is constantly revising the concepts of the past and preparing for the future. The impetus for research in periodontics is begun as a part of postgraduate curriculum. There is a need to take this forward which is possible with collaborative research. There are many national and international organizations that aid in this regard and provide funds to enhance the career in research [Figure 6]. Careers and training are available at government institutions, universities, and private corporate research centers.[6]

Figure 6

Research organizations in research career

Public health sector

Including periodontists in primary healthcare emphasizes the concept of integrating oral healthcare as a part of general healthcare. Oral systemic connection more often referred to as periodontal medicine becomes really relevant. Public health sector employs dentists and periodontists in the public health field through numerous governmental agencies to provide oral healthcare in remote areas. “Oral health for overall health” is not only a catchphrase but apt description of what a periodontist can do to improve the health of the society at large.

Dental product consulting

Another career opportunity is to work in the advisory and research departments of pharmaceuticals and various companies that manufacture products related to oral health and biomaterials that are used in periodontics.

Dental insurance

Many insurance companies may employ dentists in a number of roles, including claims review, scientific analyses and research, and administrative functions. Sometimes, it may require more than a dental degree and a history of clinical practice for high-level managerial positions.

Healthcare panels

The Central and State Government schemes are the model healthcare facility providers for central government employees and pensioners and are unique due to a large volume of beneficiary base and open-ended generous approach of providing healthcare. A periodontist as a board member can review, process dental claims, determine recipient eligibility, and monitor them for fraud and malpractice.

Dental organizations

Organized dentistry describes the efforts of all the organizations that work to positively contribute to the dental profession. It encompasses the efforts of the Indian Dental Association members at the national, state, and local level, as well as specialty societies and organizations that represent diversity in dentistry. The Indian Society of Periodontology is one such body, which is a sole force that is dedicated to upholding the standards of periodontology in the country. International bodies that focus on health such as UNICEF and WHO also provide career opportunities to dentists including periodontists.

Administration

Dental service organizations contract with dental practices to provide administrative and operations' management. In this model, a periodontist can work as an employee who provides nonclinical and administrative functions, such as accounting and marketing. However, this might necessitate additional training in understanding marketing and business management.

Overseas career

There is good value and demand for periodontists in the Middle Eastern countries, UK, Australia, New Zealand, USA, and Canada. However, many nations do not recognize the Indian degree and may require an additional qualification, for which further education may be necessary. Some countries which recognize the degree conduct licensure tests which enable the candidates to practice directly.

Academia: Further education

A Doctor of Philosophy program in Periodontics provides a variety of clinical and didactic research experiences intended to understand certain aspects of the subject in greater detail.

Numerous fellowship and postgraduation courses in lasers, implantology, esthetic dentistry, and regenerative medicine are offered by various institutions in India and abroad. These programs can always be an extra feather in the cap of a periodontist.

Hand in hand with allied fields

A periodontist has to keep abreast with advances in allied fields such as microbiology, immunology biotechnology, genetics and epigenetics, nanotechnology, natural and herbal medicine, 3D printing and dental imaging, and forensics. A healthy blend of the subject proper with contemporary other sciences will make the periodontist whole and perfect.

We have entered an exciting era of periodontal regeneration which is encompassing and integrating the principles of tissue engineering, molecular biology, stem cell biology, nanotechnology, and genetic engineering to alleviate the shortcomings of conventional therapies. This demands a wealth of knowledge and workforce supplemented with necessary funding to achieve the standards of research that are necessary to ensure success in the field. Here, the role of a periodontist to convert these concepts from theory to therapy is emphasized, thereby expanding his/her career opportunities in these allied fields.

FUTURE OF PERIODONTICS: QUO VADIS

Periodontology as a specialty has witnessed a dramatic change in the recent past owing to the advances in periodontal diagnostics, in surveillance systems, and in the goals and modes of periodontal therapy. These advances do not inevitably dismiss previous concepts but help to resolve their shortcomings. Furthermore, they impact future periodontal practices and careers most notably. Therefore, periodontists perceive the need for changes in the field of periodontology Current knowledge and innovations may be integrated and applied to reshape periodontics and potentially add great value to the specialty.[7]

Stratification model

One model for the future of periodontics involves patient stratification to allow patients to be treated according to the complexity of controlling the case and the systemic implications of the case.[7] The structure of managing patients based on stratification requires a multi-dimensional network that integrates periodontists, general dentists, and other selected specialists. This is enabled by digitalization and development of data portals that aid in the introduction of protocols for the management of less predictable cases.

Group model

It is important that a periodontist will continue to explore and advance his/her role not only in various aspects of healthcare but also change the profile of entire profession by fitting into multiple career roles requiring organizational collaborative networks. The next horizon for the specialty probably involves more integration of periodontics with medicine and also greater integration with certain segments of dentistry creating a group model.[8]

Tele-periodontics

This is a novel concept that merges the innovative technology of telecommunications and the field of periodontics [Figure 7]. This new field will have an infinite potential where access to a specialist will be provided at a grass-root level, enhancing effective delivery of therapy and information to the rural and underprivileged areas.[9]

Figure 7

Conceptual model of tele-periodontics

These models efficiently integrated into our working systems with government aid will not only provide more career opportunities to periodontist but also allow more predictable management of complex interdisciplinary clinical scenarios. The profession needs visionary practitioners to broaden the current knowledge and integrate the recent innovations to not only improve patient care but also enhance the value of a periodontist in healthcare delivery.[7]

OBSTACLES AND CHALLENGES

As an old African proverb goes, “Smooth seas do not make skillful sailors,” a periodontist would face various challenges and obstacles in his/her professional growth and career cycle.

It is unfortunate that most of the undergraduate students consider periodontics uninteresting and insipid as they do not get much clinical exposure in their curriculum other than manual scaling during their undergraduate years. They hardly get an opportunity to witness or assist complex periodontal surgical procedures and usually lack the understanding of interdisciplinary periodontics.[10] Therefore, the motivation to take up periodontics as a specialty for postgraduation is very low to begin with.

Second, a very interesting phenomenon termed as “innovator's dilemma”[11] was described by Christensen and Clayton, where the general dentists have taken over most of the periodontal care owing to newer technologies and procedures becoming more and more simplified. It is a perplexing situation for a periodontist as most of his/her specialty work is taken care of by a general practitioner who has gained some level of proficiency by attending some basic courses. The mushrooming of dental clinics and overcrowding of dentists in big cities will only add to the woes of a periodontist, with the patients preferring to go to the nearest dentist.

With a large number of postgraduate periodontists graduating every year, the challenge of finding job opportunities for all is an increasingly difficult task. Another important barrier is financial insufficiency where a periodontist has constraints to set up his/her own practice/procure equipment, due to insufficient funds.

As rightly stated by McGuire and Scheyer, “If the specialty of periodontics is to remain the premier caregiver for the diagnosis and treatment of periodontal diseases and replacement of the lost dentition, we must face and successfully overcome many new challenges.”[12]

CONCLUSION

Future of the profession of periodontics appears exciting and rewarding but is not likely to happen without great effort and challenges.[7] One of the greatest strengths of periodontics is that it is not a static field; rather, it continues to evolve and readjust its focus on the basis of innovations and advances in contemporary research in allied fields. With the paradigm shift in treatment options and inclusion of implantology as its forte, a periodontist will face no dearth of career opportunities. It will be at the end of the beginning rather than at the beginning of the end.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.