Orthodontic Residency

Annual (Vacation) Leave
All postgraduate students receive ten (10) working days of annual vacation per year. Vacation time is defined as time for personal recreation or business that is distinct from professional continuing education or professional meetings. Vacation leave is granted at the discretion of the Program Director. Annual Leave must be approved, in writing, by the Program Director in advance. Postgraduate students are not granted compensation time for working on legal holidays unless specifically provided by the Program Director according to departmental policy. Time off for job interviews and for setting up private practices must be taken as annual leave unless approved by the Program Director. Annual leave must be scheduled in advance and cannot accrue from one year to the next.

Administrative (Professional) Leave
Administrative leave is defined as time allotted for continuing education at approved professional meetings in conjunction with the educational objectives of the program. Approval for administrative leave to attend continuing education courses, board examinations, and/or other professional development activities is at the Program Director’s discretion. Approval is based on merit relative to the student’s professional development. Each resident is allowed ten (10) working days per year of approved administrative leave. Administrative leave must be scheduled in advance, should be considered in the context of conflicting with patient care responsibilities, and cannot accrue from one year to the next.

Sick Leave
Sick leave shall be granted on a case-by-case basis. If a resident is absent from work due to illness for more than three (3) consecutive days, a physician’s clearance statement from the primary treating physician must be presented prior to the resident returning to work. Illnesses of the resident or the resident’s spouse, child or parent may be considered a qualifying event under the Family and Medical Leave Act (FMLA). Residents who are absent from work to care for a spouse, child, parent, spouse’s parent, brother or sister may request special medical leave status. The Program Director may request the resident provide a medical certification statement from the treating physician indicating the nature and seriousness of the illness of either the resident or the resident’s qualifying family member. The resident may be required to “make up” the time missed in accordance with the Residency Program and Board Eligibility Requirements.

Bereavement Leave
Bereavement leave of three (3) days shall be given per death of an immediate family member (i.e., parents, grandparents, siblings, children or spouse). The resident is required to have the approval of the Program Director. The resident may take additional annual leave upon approval of the Program Director.

Professional Leave of Absence
Professional Leave of Absence may be granted under special circumstances and will be handled on an individual case-by-case basis by the Program Director and Department Chair. The Resident may be required to “make-up” the time missed in accordance with the Residency Program and Board Eligibility requirements. Both Military Leave and Jury Duty are covered under this policy. Residents must follow Departmental Procedures when requesting a Professional Leave of Absence and must submit this request in writing.

Professional Liability Insurance: Students enrolled in the postgraduate program are covered for professional liability under the State of South Carolina Insurance Reserve Fund. The coverage extends beyond the time in residency from incidents that occurred during their formal training (i.e., “tail coverage”). The malpractice insurance is not applicable to off-campus patient care.

In order to meet the goal of providing a wide range of clinical and didactic experiences grounded in a process of critical analysis, the postgraduate program provides the following:

• Clinical orthodontic care involving the diagnosis and treatment of children in the primary and mixed dentitions to include space supervision, guidance of eruption, interceptive orthodontic, growth modification, and Phase I early orthodontic treatment procedures.
• Clinical orthodontic care involving the diagnosis and treatment of patients in the young permanent dentition to include comprehensive management using both non-extraction and extraction protocols.
• Clinical orthodontic care involving the diagnosis and treatment of adults to include comprehensive management using non-extraction and extraction protocols as well as orthognathic surgical procedures and coordinated restorative - prosthetic management.
• Craniofacial anomalies: Clinical management of children and adolescents with craniofacial anomalies are experienced in the Department's role as a primary care component of the MUSC Craniofacial Team.
• A structured curriculum of seminar and laboratory exercises supports the clinical experiences in addressing the parameters of orthodontic care for children, adolescents and adults from the primary through the mixed into the permanent dentitions.
• All postgraduate students will prepare comprehensive case reviews that document clinical management of patients following format criteria of the American Board of Orthodontics. Besides documenting performance of quality care, the case reviews will enhance the postgraduate's ability for critical analysis and patient documentation.
• Teaching experience through serving as clinical and laboratory instructors in the predoctoral orthodontic curriculum during the third year of the program on a one-half day a week basis.
• Interdepartmental seminars and courses provided through the Biomedical Sciences and Clinical Core curriculum supplement the postgraduate student's knowledge base.
• Each postgraduate student conducts a and a comprehensive literature review - case report which is of publishable quality. Besides providing informational service to the profession, the experience of conducting research will enhance the student's ability for critical analysis.
• Exposure to practice management and dental care delivery through seminars and visits to varied private and public clinic sites.

An overview of the curriculum components and distribution for the three years of the program are:

Percentage Distributions

Laboratory Exercises

• First Year: 10%
• Second Year: 5%
• Third Year: Not Applicable

Clinical Early Treatment

• First Year: 10%
• Second Year: 10%
• Third Year: 10%

Clinical Orthodontics

• First Year: 40%
• Second Year: 50%
• Third Year: 50%

Clinical Orthognathic Surgery

• First Year: 5%
• Second Year: 5%
• Third Year: 5%

Craniofacial Anomalies

• First Year: 5%
• Second Year: 5%
• Third Year: 5%

Didactic/Seminars*

• First Year: 20%
• Second Year: 15%
• Third Year: 15%

Research

• First Year: 10%
• Second Year: 10%
• Third Year: 10%

Teaching

• First Year: Not Applicable
• Second Year: Not Applicable
• Third Year: 5%

*Includes daily case presentations with attending faculty in treatment planning

Dental Clinics Building
The Orthodontic Postgraduate Clinics, seminar rooms, and resident offices are located on the fourth floor of the clinical facility. Directly adjacent to the Postgraduate Clinics and educational areas for Pediatric Dentistry, the programs share this entire floor of the facility. Specific to Orthodontics, the facility provides a 20 operatory clinical area with a combined open-bay and closed-bay arrangement with full equipment for delivery of comprehensive orthodontic specialty care for children, adolescents, and adults as overseen by Program faculty. The facility has full digital capabilities for all patient records as well as computer-based technology in all operatories and teaching centers. Treatment areas are supported by full radiographic capabilities with all panoramic and cephalometric radiographic projections digital based and compatible with a computer-based records system (Dolphin). Cone-beam CT scanning is available within the clinical building.

The Postgraduate Orthodontic Clinic has a full reception / business office area with adjacent patient records storage area, patient consultation rooms, in-house sterilization areas, appliance laboratory, and storage rooms. The laboratory areas adjacent to the clinical section are fully equipped for the preparation of diagnostic casts and fabrication of retainers, space maintainers and minor tooth movement appliances. It contains vaccumixers for mixing stone, model trimmers, soldering, and welding devices, lab-bench hand-pieces, and supplies necessary for basic laboratory procedures. A faculty / resident office, a library / conference room, and computer / video-imaging center are also located adjacent to the clinical area.

College of Dental Medicine Basic Sciences Building
In addition to clinical experiences at the Orthodontic Postgraduate Clinic, the program also provides pediatric dental and orthodontic lectures and seminars in the main College of Dental Medicine building, the MUSC Basic Sciences Building. Located in the MUSC complex about a two minute walk from the Orthodontic Clinic, the Basic Sciences Building primarily serves as the predoctoral dental student classroom and laboratory site. Residents may provide supportive care on a rotational basis over the course of the program in a teaching role for dental students in the predoctoral curriculum.

MUSC Shawn Jenkins Children's Hospital
In addition to the primary resident clinic, the Orthodontic Postgraduate Program as a component of the MUSC Shawn Jenkins Children's Hospital (SJCH), has affiliated experiences and responsibilities for children and adolescents with special needs. The large population base at SJCH offers the opportunity for numerous contacts with other pediatric clinics (e.g., Craniofacial Anomalies, Oncology, Pediatric Cardiology) in support of comprehensive oral-dental health care for patients with associated medical problems. All Postgraduate Orthodontic students attend and participate in the clinical activities of the Team as related to children and adolescents with craniofacial anomalies. The Orthodontic Postgraduate Program serves as a primary referral source for children with orthodontic treatment needs that are provided by the Children’s Rehabilitation Services (CRS) of the South Carolina Department of Health and Environmental Control (SC DHEC).

Faculty Offices
Faculty offices are located at 173 Ashley Avenue, BSB 347, in the MUSC complex, adjacent to the Dental Clinics Building.

For profiles of orthodontics faculty in the Department of Advanced Specialty Sciences and Division of Applied Craniofacial Sciences, please visit our Administration & Faculty page.

Clinical Orthodontic Care/Patient Pool & Policies
The majority of assigned cases will represent adolescent and adult orthodontic biomechanics requiring fixed, band-bond Edgewise appliances to comprehensively manage the presenting malocclusion using both extraction and non-extraction protocols. The goal of clinical orthodontic care in the MUSC Orthodontic Postgraduate Program is to allow each resident the opportunity to experience the full range of orthodontic treatment levels involving the diagnosis and treatment of children, adolescents, and adults. As the traditional patient base of orthodontic care, the diagnosis and treatment of adolescents in the young permanent dentition will include comprehensive management using both non-extraction and extraction protocols. Diagnostic and treatment experiences in primary and mixed dentition patients will include considerations in space supervision, guidance of eruption, interceptive orthodontics, growth modification, and phased “early” treatment procedures. Orthodontic care in adults will include comprehensive treatment using non-extraction and extraction protocols to include orthognathic surgical and coordinated interdisciplinary restorative - prosthetic management procedures.

Seven to eight half-day clinic sessions per week (approximately 28 hours weekly) is scheduled for the supervised clinical orthodontic management of patients by the postgraduate students throughout the three years of the program. The projected clinical experience is to have each postgraduate student work-up and initiate treatment on 40 to 50 patients over the course of the first academic year. In the second year, each student will work-up and initiate care on additional 5 to 10 patients for a total start load of approximately 50 to 60 patients over the first two-years of the curriculum. Third year residents should not be starting cases. Any unfinished transfer cases from graduating third year residents will pass back to the next third year class.

Screening, patient selection, and assignments will emphasize a distribution of malocclusion categories across age groups for each individual resident. Patients are assigned by level of malocclusion complexity to ensure a broad distribution of experiences for each student.

• The majority of assigned cases will represent adolescent and adult orthodontic biomechanics requiring fixed, band-bond Edgewise appliances to comprehensively manage the presenting malocclusion using both extraction and non-extraction protocols.
• Interceptive and multi-phased procedures in growing patients to manage the developing occlusion (e.g., anterior crossbites, thumb habits, functional posterior crossbites, space supervision cases) will be treated in a coordinated “Age-Appropriate Orthodontic Clinic” in conjunction with residents in pediatric dentistry. Growth modification procedures for managing skeletal dysplasias will build on conventional comprehensive procedures in child and adolescent patients with growth potential.
• As a component of the MUSC Medical Center, the Orthodontic Postgraduate Program has affiliated experiences and responsibilities for children and adolescents with special needs. The population base offers the opportunity for numerous contacts with other clinical services (e.g., Craniofacial Anomalies, Oncology, Pediatric Cardiology) in support of comprehensive oral-dental health care for patients with associated medical problems.
• Orthodontic procedures in adults to manage complex malocclusion requiring interdisciplinary care to include orthognathic surgery, aligner technology, prosthetic dentistry, periodontal disease, and temporomandibular dysfunction will complete the broad distribution of patient assignments.

All patients receiving care in the Postgraduate Program in Orthodontics must have their treatment documented completely through a resident – faculty attending protocol to include the following:

• Diagnosis & Treatment Planning: Potential patients will be presented in case analysis-seminar format with comprehensive records available for assessment and a problem list outlined during each presentation. In consultation with the attending faculty orthodontist, a comprehensive treatment plan and biomechanics sequence will be determined. The resident will be responsible for documenting the presentation summary with the final treatment plan signed by both the resident and attending consultant.
• Provision of Orthodontic Treatment: Postgraduate Orthodontic Program patients are treated under the supervision of an attending faculty member.

Postgraduate students who complete the full 34-month Postgraduate Program in Orthodontics at MUSC will be expected to develop their skills and knowledge to the level of a specialist in orthodontics as approved by the ADA Commission on Dental Accreditation. Completion of the program will enhance specialty skills of each postgraduate student beyond that of their predoctoral education with significant advances in the following major areas of practice.

Diagnostic Skill

The postgraduate student will have had considerable didactic background and direct contact with patients exhibiting a variety of malocclusion presentations. Recognition of malocclusion parameters and hereditary conditions is expected. Familiarity with specific orofacial patterns or their consequences is mandatory. Knowledge of physical, mental, and emotional development is essential. Speech problems associated with oral or dental problems should be discriminated from other causes. Common and rare defects of the teeth, oral tissues, and skeletal structures should be recognized. Residents should be especially skilled in obtaining and interpreting diagnostic aids in children, adolescents, and adults. These aids would include in-depth clinical examinations, intraoral radiographs, panoramic films, cephalometric films, study models, and occlusion analysis with articulators. The postgraduate student should be able to make correlations between basic sciences and clinical applications.

Treatment Planning

The postgraduate student should be able to prepare and present treatment plans which utilize the diagnostic training received. The treatment plans should be comprehensive with treatment provided in an efficient sequence. Postgraduate students should have an accurate assessment of their ability to deliver treatment.

Patient Management

The postgraduate student should have superior abilities to achieve the cooperation of children, adolescents, adults and parents. The postgraduate student should have good communication skills and an understanding of behavior principles. Application of these skills with motivational tools will enable the graduate to modify patient behavior.

Provision of Orthodontic Treatment

The postgraduate student will be able to provide high quality orthodontic care for child, adolescent, and adult patients. Clinical expertise will be attained in the diagnosis and treatment in the primary and mixed dentitions (space supervision, interceptive procedures, growth modification, multi-phase early treatment), the young permanent dentition (comprehensive non-extraction and extraction protocols) and adult patients (orthognathic surgery, coordinated restorative - prosthetic management).

Collaboration

The postgraduate student should develop considerable skill in establishing rapport and cooperation with dental and medical colleagues. Referrals to appropriate professionals or from other professionals occur frequently and the postgraduate student should be familiar with the courtesy and importance of these activities. The postgraduate student should be able to make, or respond to, all appropriate consultation requests.

Research

The postgraduate student will be able to evaluate original dental research articles for methodology, results, statistical interpretation, conclusions, and implications. Ability to understand and conduct research will be developed from the required research project. The major research goal is an understanding and appreciation of published research.

Teaching

The postgraduate student will have developed considerable teaching skills by preparing and presenting lectures and providing undergraduate clinical supervision. These skills should provide the postgraduate student with a strong foundation for patient education and professional presentations.

Practice Management and Auxiliary Utilization

The postgraduate student should be well prepared for most aspects of practice administration and efficient auxiliary utilization.

Critical Thinking

The postgraduate student will establish an approach to learning which utilizes aspects of continual inquiry and critical thinking. The development of a lifelong attitude of study and advancement is anticipated.