Hans Lennros wrote in message ...
>Your post makes me think; where to draw the line between the
>area of responsibilty of an oral surgeon and a ENT-surgeon?
>In the US that is.
That line depends on the residency program and what either is qualified to
do by what experienced and training was obtained in the program. Oral
Surgeons here do blepharoplasties and other nontraditional procedures. OS
residencies are now 4 -6 years in the US and in some the student can obtain
an MD degree and do a 1 year general surgical residency.
I know OS's who are comfortable removing squamous cell CAs with nodal
involvement and others who refer to ENT people after a bx confirms that a
lesion is malignant. OTOH, I know ENT people who would reduce a fractured
mandible (they often end up screwing up the occlusion - lack of training in
that area) and ENT people who call in the Oral Surgery people. Both ENT and
OS people here, especially the younger, more recently trained ones, also do
other facial cosmetic procedures (big bucks in this area: no insurance
As a graduate of an oral medicine program, I do a number of soft tissue
biopsies each year, but if it is malignant I immediately refer the patient
for a tumor "work-up". Pre-malignant lesions I follow, looking for
recurrence. Most general dentists would never do this; I do this because
of my oral medicine residency and the experience and training I received.
The scope of your practice is conditioned by the education and post-graduate
programs you've taken. That said, I've come across suspicious lesions that
I knew were malignant and instead put the patient in the hands of a
competent oral surgeon.
As you can see, the "scope of practice" can vary according to background.
But you better be able to prove that you have that background if you are
going to venture beyond the practice of general dentistry as defined by
As a general rule though, the phrase "practice of medicine" means, to a US
dentist, treating ailments outside of what you were taught in dental school
and your post graduate hospital residency.