Oral Maxillofacial Radiologists

Oral Maxillofacial Radiologists (OMRs) play a vital role in patient health as expert consultants to a referring dentist or physician. By helping to choose the proper examination, directing radiology technologists (the personnel who operate radiologic equipment) in the proper performance of quality examinations, interpreting the resulting radiographic images, recommending further appropriate examinations or treatments when necessary, and conferring with referring physicians and dentists for patient diagnosis and treatment, OMRs provide patients with services beyond what general dentists and other dental specialists offer.

In dental settings, OMRs typically have access to CT or MRI post-processing workstations, which incorporate sophisticated technology to process CT or MRI image data, including exporting files to other computer files or printers. OMRs may perform CT and MRI image post processing at special post acquisition stations, where data is enhanced for improved viewing and identification purposes. The process is faster, simpler and keeps scanners available by moving workloads to acquisition consoles. Using such methods allow the delivery of even more sophisticated services in TMJ or implant imaging.

Private practice OMRs typically provide standard intraoral and panoramic radiography, but often also offer a combination of TMJ and implant tomography, orthodontic radiographic examinations and diagnostic consultations. Some may offer ultrasounds and nuclear medicine.

Nuclear medicine, also known as radionuclide examinations, uses X-ray-like radiation. However, the method of use differs from X-rays and produces different-looking images. Certain pharmaceuticals are used that can have adverse effects on patients, particularly pregnant or breast-feeding women.

Oral Maxillofacial Radiologist Training and Education

Specialization in OMR requires completion of an American Dental Association accredited residency program. On the pre-doctoral level, OMR is taught as a separate subject in most dental schools in North America, but curricular guidelines for pre-doctoral programs are not uniform. However, post-graduate programs are uniform.

Offered at five universities in the United States and Canada, OMR postdoctoral programs require an additional two, to two and a half years for clinical certification in OMR. Combined degrees at the Masters and Doctorate levels require additional years of study: Masters of Dental Science degree, three years; a PhD in Oral Biology, five years.

Courses include extensive study work in radiation physics, biology and protection; imaging technology and computer-based image evaluation; and interpretation of conventional radiographic images, as well as advanced modalities such as CT, CBCT, MRI and Ultrasound. Students also receive a strong background in head and neck anatomy and disease, clinical and microscopic pathology, oral medicine and research methods.

When an OMR finishes his or her graduate program, he or she undergoes an examination to become a member of the American Board of Oral and Maxillofacial Radiology (AAOMR), typically a requirement to practice.

Where to Find an Oral Maxillofacial Radiologist

OMRs can work in either academic or private settings and are qualified for several careers, such as teaching in dental or medical schools, conducting research, or providing radiographic services to patients in a clinical and/or private setting. Most OMRs work in all of these areas.

Education: Most OMRs work in dental schools, where their responsibilities include didactic and clinical education of dental, dental hygiene and/or graduate dental students. In addition to intraoral and panoramic radiology, dental education includes digital image production, subtraction radiography, CT, MRI and other techniques. Additionally, OMRs integrate instruction in image production with interpretation of disease, combining radiology with oral pathology, diagnosis and medicine.

Some OMRs have appointments at medical schools or hospitals in radiology departments, where they have access to imaging modalities usually not included in dental schools, such as CT, MRI and arthrography, a diagnostic procedure to determine joint pain, such as TMJ. Arthrography images are obtained by injecting contrast dye into joints, allowing OMRs to view structures not visible with ordinary X-rays. A special type of X-ray, called a fluoroscopy, is used to take photos.

Unlike dental school-based OMRs, hospital-based OMRs participate in case conferences for neuro- and head and neck radiology. They deal with many patients with traumatic and neoplastic (pertaining to malignant, abnormal tissue) disease. OMRs working in academic medical centers also teach medical students and radiology residents.

Research: OMR faculty members are required to perform scholarly research. The type of research and time devoted to it varies depending on the institution, availability of patients and equipment, the OMR’s interests, and grant funding.

Practice: Most OMRs in academic settings provide patients with radiographic services that their general dentists or other specialists cannot perform. Patient referrals for tomographic evaluation of the TMJ or prospective implant sites have grown common in intramural radiology practices. CT or MRI post-processing workstations are found in many facilities and allow dental school-based OMRs to deliver more sophisticated services in TMJ and implant imaging.

Some OMRs have private practices outside of dental schools. These private practitioners provide intraoral and panoramic radiography, as well as performing TMJ and implant tomography, orthodontic radiographic examinations and diagnostic consultations. Some OMRs affiliate with radiology practices; others opt for a home-based private practice, which relies on the Internet to relay patient scans and reports to referring dentists and physicians.