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The Advanced Education in General Dentistry-1 (AEGD-1) Residency

Our residency program operates within the Fayetteville VAMC dental service on the ground floor of the main hospital building in a brand new, state-of-the-art clinic that contains 26 dental treatment rooms and an on-site dental laboratory. The clinic is fully digital, including CBCT, CAD-CAM, and 3D printing technologies. The faculty consists of 11 staff dentists including a service chief, assistant chief, an AEGD program director, an assistant program director, a prosthodontist, and an adjunct periodontist. The dental service also employs multiple hygienists, lab technicians, and lead and clinical assistants.

Program Description:

The Advanced Education in General Dentistry-1 (AEGD-1) Program at the Fayetteville, North Carolina Veteran Affairs Medical Center (VAMC) is a one-year residency that accepts five residents per year. Our goal is to provide the general dentist with continued opportunity for professional growth and advancement. This comprehensive program prepares the resident to meet the oral health needs of a wide variety of medically compromised ambulatory and hospitalized patients. It also advances the residents’ knowledge and skill in clinical dentistry by exposing them to a significant number of supervised, comprehensive treatment experiences. The program provides residents with the opportunity to interact with physicians, nurses, pharmacists, social workers and other health care professionals as part of a multi-disciplinary health care team.

The program curriculum is conducted at the postgraduate level (PGY-1) and consists of didactic and clinical instruction in nearly all areas of dental treatment modalities under the guidance of experienced professionals.

Emphasis is made in the treatment planning and comprehensive treatment of medically compromised patients through direct faculty supervision and case presentations where all aspects of patient management are discussed.

Residents have the opportunity to place and restore dental implants. The didactic phase of the program consists of literature reviews, conferences, lectures and demonstrations at the VA Medical Center as well as interaction with our Department of Defense partners at Fort Bragg. Operating room cases and rotations to other services are some of the activities that complement the clinical curriculum. Rotations in Primary Care, Anesthesiology and the Urgent Care are designed to facilitate the residents’ experiences with medically compromised patients, hospital and surgical protocols, physical evaluation and medical assessment and increase their knowledge of systemic diseases and the medications used to treat our patients. As part of the program’s community service, residents and staff provide oral surgery services at a local dental clinic that provides care to low income individuals.

CODA Commission on Dental Accreditation

The program in Advanced Education in General Dentistry is accredited by the Commission on Dental Accreditation [and has been granted the accreditation status of Approval Without Reporting Requirements.]  The Commission is a specialized accrediting body recognized by the United States Department of Education. The Commission on Dental Accreditation can be contacted:

The Commission on Dental Accreditation
211 East Chicago Avenue
Chicago, IL 60611
 

The Commission’s web address is: Commission on Dental Accreditation (CODA) (ada.org) *. 

*This link takes you outside of the Department of Veterans Affairs Website. VA does not endorse and is not responsible for the content of non-VA linked websites. The link will open in a new window.

The Commission on Dental Accreditation has accredited the postdoctoral program in Advanced Education in General Dentistry. However, this education area is not one of the American Dental Association’s recognized dental specialty areas. Therefore, dentists graduating from this program cannot announce that they are specialists, as recognized by the American Dental Association.

Opportunity to File Complaints

The Commission on Dental Accreditation will review complaints that relate to a program’s compliance with the accreditation standards. The Commission is interested in the sustained quality and continued improvement of dental education programs but does not intervene on behalf of individuals or act as a court of appeal for treatment received by patients or individuals in matters of admission, appointment, promotion, or dismissal of faculty, staff or students.

The Commission will consider only written, signed complaints; oral and unsigned complaints will not be considered. The Commission on Dental Accreditation can be contacted at: 

The Commission on Dental Accreditation
211 East Chicago Avenue
Chicago, IL 60611
 

AEGD Program Goals

1. Act as primary care provider for individuals and groups of patients. This includes providing emergency and multidisciplinary comprehensive oral health care, providing patient focused care that is coordinated by the general practitioner; and directing health promotion and disease prevention activities.

2. Plan and provide multidisciplinary oral health care for a wide variety of patients including patients with special needs.

3. Manage the delivery of oral health care by applying concepts of patient and practice management and quality improvement that are responsive to a dynamic health care environment.

4. Function effectively and efficiently in multiple health care environments within interdisciplinary health care teams.

5. Apply scientific principles to learning and oral health care. This includes using critical thinking, evidence or outcomes-based clinical decision-making and technology-based information retrieval systems.

6. Utilize the values of professional ethics, lifelong learning, patient centered care, adaptability, and acceptance of cultural diversity in professional practice.

7. Understand the oral health needs of communities and engage in community service.

*Based on ADA guidelines

Intended Outcomes

The AEGD Residents are expected to make a full-time commitment to the program during their academic year. This translates to on-time attendance at all scheduled lectures and conferences while devoting time beyond regular clinic hours to program related activities. Residents are encouraged to participate actively in all case presentations and treatment planning discussions and critically analyze and discuss scientific articles during the literature review meetings.

Residents are expected to diagnose and treat veteran patients in a diligent and compassionate manner and to relate well and respectfully to fellow workers and the general public. Appropriate dress and appearance is required for all activities associated with the program. Scrub-wear is provided.

Dental Residents are evaluated daily on their knowledge through interactions with mentors in the clinical setting, literature reviews, treatment planning conferences and during case discussions. Their treatment skills are also evaluated daily through clinical observations, review of lab cases, daily and monthly record reviews and other contact with mentors.   Resident’s skills are assessed and critiqued whenever they are observed and residents are informed of ways to improve clinical skills, dental record entries and/or patient management techniques. Informal counseling is used to identify both strengths and weaknesses and includes advice on how to provide better dental care for their patients. Formally, residents are evaluated quarterly in writing by the mentors and director using the Dental Resident Rating Report.

AEGD-1 Program Objectives

A. Operative Dentistry:

1. Restore single teeth in the permanent dentition with a wide range of materials and methods.

2. Place restorations and perform procedures to enhance the patient’s facial esthetics.

3. Restore endodontically treated teeth.

B. Restoration of Edentulous Space

1. Replace missing teeth for patients utilizing removable prostheses.

2. Replace missing teeth for patients utilizing uncomplicated (6 units or less) fixed prosthesis.

3. Communicate prosthesis design to laboratory technicians in a professional and effective manner and evaluate the resultant prosthesis.

4. Integrate implant dentistry with conventional dental therapy

5. Diagnose, plan, and place conventional implants

6. Restore uncomplicated endosseous conventional implants with fixed or removable prostheses

C. Periodontal therapy:

1. Diagnose and treat early and moderate periodontal disease using surgical and non-surgical procedures.

2. Diagnose and manage advanced periodontal disease.

3. Evaluate the results of periodontal treatment then establish and monitor a periodontal maintenance program.

D. Endodontic therapy:

1. Diagnose and treat pain of pulpal origin.

2. Perform uncomplicated non-surgical anterior and posterior endodontic therapy.

3. Manage uncomplicated non-surgical molar endodontic therapy.

4. Treat or manage endodontic complications

E. Oral surgery:

1. Perform surgical and non-surgical extraction of teeth.

2. Perform uncomplicated hard and soft tissue pre-prosthetic surgery.

3. Treat or manage patients with complications related to intra-oral surgical procedures

F. Evaluation and treatment of dental emergencies:

1. Diagnose and treat patients with intra-oral dental emergencies and infections.

2. Diagnose and manage intra-oral hard and soft tissue lesions of traumatic origin.

G. Pain and anxiety control utilizing behavioral and pharmacologic techniques:

1. Provide control of pain and anxiety in the conscious patient through the use of psychological interventions, behavior management techniques, local anesthesia and oral conscious sedation techniques.

2. Prevent, recognize and manage complications related to the use and interactions of drugs, local anesthesia and oral conscious sedation

H. Medical Emergencies:

1. Anticipate, diagnose and provide initial treatment and follow-up management for medical emergencies that may occur during dental treatment.

I. Oral Mucosal Diseases and oral and maxillofacial pathology

1. Diagnose and manage common oral mucosal lesions by accurately describing and developing a reasonable differential diagnosis and treatment plan.

2. Demonstrate use and knowledge of appropriate medications to treat oral-facial diseases

3. Perform biopsy of oral tissue and correctly complete tissue submission form for microscopic evaluation

4. Recognize and diagnose common oral maxillofacial pathology

J. Temporomandibular disorders and orofacial pain:

1. Demonstrate the ability to diagnose simple facial pain/TMD and manage with either pharmacologic agents or splints or combination of both.

2. Diagnose, treat or refer patients with orofacial pain

K. Occlusal disorders:

1. Diagnose and manage patients with occlusal problems such as worn dentition, poor anterior guidance, traumatic occlusion, centric relation prematurity, or occlusal plane discrepancy

L. Assess, diagnose, plan and provide emergency and comprehensive multidisciplinary oral healthcare for a wide variety of patients including those with special needs:

1. Obtain and interpret the patient’s chief complaint; medical, dental and social history; and review of systems. 2. Function as the patient’s primary and comprehensive oral health care provider.

3. Use available diagnostic and prognostic information to integrate multiple disciplines into an individualized, comprehensive and sequenced treatment plan for patients with complex needs.

4. Develop and carry out dental treatment plans for patients with special needs such as complex medical problems, significant physical limitations and developmental disabilities

5. Modify the treatment plan, as indicated, to effectively manage unexpected circumstances or individual patient needs.

M. Obtain informed consent:

1. Obtain informed consent for dental treatment by discussing with patients or guardians of patients the following: findings; diagnoses; risks, benefits, alternatives, and process of various treatment options, realistic treatment expectations, and patient responsibilities during and after treatment.

N. Function effectively within interdisciplinary health care teams including consultation and referral:

1. Obtain and interpret clinical and radiographic data and additional diagnostic information from other health care providers or other diagnostic resources.

2. Make referrals to, and obtain consultations from, professional colleagues for the assessment of medical, psychological, and social problems presented by dental patients

O. Provide and manage delivery of patient-focused care that is coordinated by the general practitioner:

1. Develop and carry out dental treatment plans for patients, including patients with special needs in a manner that considers and integrates the patient’s medical, psychological and social needs.

2. Consult with dental specialists and coordinate patients’ care with dental specialists determined by the patient’s treatment plan.

P. Direct health promotion and disease prevention activities:

1. Participate in community programs to assist in the prevention and reduction of oral disease.

2. Use accepted prevention strategies such as oral hygiene instruction, nutritional education and pharmacologic intervention to assist patients in the improvement and maintenance of their oral and systemic health.

Q. Use advanced dental treatment modalities as defined by the program:

1. Incorporate conventional implants in the patient’s treatment plan

2. Use implant retained removable prosthesis whenever indicated to restore edentulous and partially edentulous patients

3. Perform surgical extractions whenever the clinical situation requires

4. Use CBCT to diagnose osseous lesions and plan implant placement

R. Physical evaluation and medical assessment:

1. Obtain and interpret the patient’s chief complaint, medical, dental and social history and review of systems

2. Know the indications for common lab studies and how to interpret their results

3. Understand the relationship between oral health and systemic disease

4. Interpret a physical evaluation performed by a physician to determine its impact on dental treatment

S. Practice Management:

1. Provide patient care by working effectively with allied dental personnel and performing sit-down four-handed dentistry.

2. Employ and promote ethical principles in the practice of dentistry and in relationships with patients, personnel and colleagues.

3. Understand, and participate in, a system for continuous self-evaluation and quality improvement in a dental practice.

4. Understand basic principle of business management and practice development

Salary and Benefits

Salary is approximately $60,000 per year.  The residents are entitled to 14 days annual leave and six days of sick leave accrued during the academic year.  Residents are also eligible for life insurance and health insurance at a greatly reduced rate. 

 

Hours of Duty

The residents work four 10-hour days (7 am to 5:30 pm) per week and will be on a day off schedule of Monday one week and Tuesday the next or a Thursday Friday schedule.  Residents are expected to take minimal non-business hour call. The program observes all federal holidays (9 per academic year).

How To Apply 

This program DOES participate in PASS (beginning with the 2023-2024 application cycle), but NOT MATCH.  We DO NOT require the ADAT.

The application deadline for the class beginning in July 2024 will be 1 October, 2023 with interviews taking place on 11 October, 2023 (by invite only).

Fayetteville, NC AEGD-1 PASS website: https://programs.adea.org/PASS/programs/999

The general application requirements in the PASS application are:
 

  1. Be a U.S. citizen
  2. Be a graduate (DDS or DMD) of an ADA accredited dental school.
  3. Complete application form, VA Form 10-2850D (Application for Health Profession Trainees)
  4. Dental school transcripts, grade point average, and class standing.
  5. National Board Scores.
  6. Curriculum Vitae, resume, or biographical sketch.
  7. Brief essay stating motivation for attending this AEGD Program.
  8. Three letters of recommendation from dental school faculty.

 

Frequently Asked Questions

Do Residents do cleanings on their own patients?

Rarely do residents do dental cleanings; we have hygienists that do routine prophylaxis.  Residents may perform root plane/scaling on patients with periodontal disease.

Are there dental assistants available for the residents?

Yes, each resident has an assigned assistant, dental operatory and an established pool of patients

Do your residents “moonlight” at local dental practices?

Yes, the residency staff encourages our residents to work in local practices to help them understand what is expected of a dentist in private practice.

Are your residents allowed to place implants?

Yes, we have three different implant systems (one tissue level and two bone level) that residents use.  Historically the average resident will place between 25 and 30 implants during our program.  The majority of the implants are for single tooth replacement; residents also place and restore implants to support partials and dentures.

How much lab work does a resident in your program do?

We have a lab with four lab techs who perform mainly removable procedures and pour impressions, and repair removable prostheses.  We are supported by a central dental lab that does all fixed prosthesis, flexible partials and metal partial frameworks. The residents are expected to trim dies, make surgical stents, do diagnostic waxings for treatment planning cases, and survey and design casts for partial dentures.

Is there IV sedation training?

No, residents rotate through anesthesia and are exposed to sedation, general anesthesia and airway management.

What are you looking for in a resident?

We are looking for dentists that have good clinical skills and can work well as part of a team. Historically, individuals selected have been in the top half of his/her dental class.

Contact Us

For additional information or to schedule a visit, contact the Program Director via e-mail: Bryan.Roach@va.gov.  Or mail or call:

Bryan Roach, D.D.S.
Director, AEGD-1 Residency Program
Fayetteville VAMC Dental Service (160)
2300 Ramsey St.
Fayetteville, NC 28301
Phone:  (910) 822 7030
Fax:  (910) 482 5050

David Samuelson, D.D.S.
Asst. Director, AEGD-1 Residency Program
Fayetteville VAMC Dental Service (160)
2300 Ramsey St.
Fayetteville, NC 28301
Phone:
Email: David.Samuelson@va.gov
Fax: