The graduating oral and maxillofacial radiologist is highly knowledgeable in all aspects of radiology and has a solid understanding of the pathologic basis of disease and the correlation between clinical, histological, and radiographic findings.  The radiologist is prepared for a career that centers on teaching in dental or medical schools, conducting research, or providing radiographic services to patients.  Most OMRs combine all of these to some extent. 

The majority of OMRs are situated in dental schools.  Responsibilities include didactic and clinical education of dental, dental hygiene, and/or graduate dental students.  In the past, most instruction was limited to intraoral and panoramic radiology, with limited inclusion of plain-film images.  Nowadays, however, dental education must include digital image production, subtraction radiography, CT, MRI, and other techniques.  In addition, the recent emphasis on problem-based and case-based learning at many schools enables the OMR to integrate instruction in image production with interpretation of disease, thereby combining radiology with oral pathology, diagnosis, and medicine.  OMRs have full opportunity to teach a wide variety of material, utilizing their broad-based education.

OMRs also are responsible for establishing policies regarding radiographic selection criteria, radiation safety, and quality assurance.  They make decisions regarding the purchase of equipment, the use of films and film-screen combinations, processing techniques, and other aspects of clinical operation.  As faculty members, they also participate on committees at the dental school or university level.  OMRs are often valuable additions to committees such as Radiation Safety, Research, and Graduate Education.

On a typical day, the OMR faculty member might teach a class, conduct a small group seminar on radiographic imaging or interpretation, supervise students in radiographic technique while in the clinic, review radiographic interpretation of images with students as they evaluate their patients, or perform a consultation on a challenging case.  Other activities can include research and provision of specialized radiographic services for referral patients.

Some OMRs have appointments at medical schools or in hospital Radiology departments.  These environments provide access to imaging modalities not usually included in dental schools, such as CT, MRI, and arthrography.  Hospital-based OMRs participate in case conferences for neuro- and head and neck radiology.  They gain exposure to many patients with traumatic and neoplastic disease, unlike the dental school-based radiologist.  OMRs working in academic medical centers also teach medical students and radiology residents.

Education is a quite fulfilling career for trained oral and maxillofacial radiologists.  The need for OMRs in schools of dentistry is growing more acute, paralleling the increasing shortage of dental faculty members in general.  Employment opportunities for OMRs in education should be quite good for the foreseeable future.  Certification by the American Board of Oral and Maxillofacial Radiology will most likely be required for appointment to a full-time OMR faculty position, indicative of the specialty status of oral and maxillofacial radiology.

Scholarly activity is required of faculty members, and it follows that dental and medical faculty conduct the vast majority of research in radiology.  In a document on ideal OMR Departmental Characteristics prepared by the American Academy of Oral and Maxillofacial Radiology, it is recommended that a full-time faculty member be allowed to devote approximately 30% of assigned time to research.  The type of research and time allotted for it varies, however, depending on the mission of the institution, the availability of patients and equipment, and the interests of the radiologist.  OMRs at some universities conduct investigations into new imaging technology, such as detailed evaluations of the physical and mechanical basis of imaging systems or comparative measures of their diagnostic efficacy.  Other researchers examine the biologic effects of radiation.  Some institutions make use of their extensive patient populations and generate clinical reports that advance our knowledge of the patterns of disease.  Many schools of dentistry provide money to support the scholarly activity of their faculty members.  Grant money for research is also available from private industry and organizations such as the Radiological Society of North America, which provides Scholar Grants and Seed Grants for OMRs in the early years of an academic appointment.  Researchers with more experience compete successfully for funding from the National Institute for Dental and Craniofacial Research.  The opportunities for creative activity are limited only by the imagination of the radiologist.

Most OMRs in academic settings provide patients with radiographic services beyond the scope of general dentists and other specialists.  Referral of patients for tomographic evaluation of the TMJ or prospective implant sites has become more and more common in intramural radiology practices.  CT or MRI post-processing workstations are found at many facilities and allow dental school-based OMRs to deliver even more sophisticated services in TMJ or implant imaging.  Dental schools that have graduate programs in periodontics and prosthodontics or that operate orofacial pain centers often provide many patients for the OMR.

Some OMRs, however, establish private practices outside the confines of dental schools.  These practitioners provide standard intraoral and panoramic radiography, but also perform TMJ and implant tomography, orthodontic radiographic examinations, and diagnostic consultations.  Some OMRs affiliate with radiology practices that offer a wide range of procedures such as nuclear medicine and ultrasound.  With specialty status recently granted by the ADA to oral and maxillofacial radiology, it is likely that increasing numbers of OMRs may elect to practice in the private sector.

A career as an oral and maxillofacial radiologist can be an enriching and professionally fulfilling one.  If you would like more information about this exciting specialty, please contact:
Executive Director
American Academy of Oral and Maxillofacial Radiology