Raman Bhardwaj discusses his career choices to date and what inspired him in the pursuit of periodontics.
How did you first get into medicine and dentistry?
There are doctors in my family and it was their influence that first led me to consider a career in healthcare. I looked into several career options while at school and my eventual decision was informed by work experience and voluntary work carried out with local dentists, hospitals and general medical practitioners.
This was time well spent as it provided an opportunity to put myself in the shoes of the clinicians and see what the professions are really all about. I had always been strong at the sciences but I also enjoyed creative subjects like art and technology, so dentistry seemed the perfect fit.
What inspired you to pursue your specialty?
During my vocational training I had decided that I wanted to carry out further postgraduate training, so I embarked on a year as an oral and maxillofacial surgery senior house officer (SHO). This was a very demanding year but a fantastic experience which gave me a taste for surgery. I considered pursuing a career as a maxillofacial surgeon but the thought of medical school didn't appeal and so I spent two further years working as an SHO.
One of these SHO posts was a position in periodontics at Birmingham Dental Hospital which I spent managing patients with severe periodontitis referred to secondary care. I carried out lots of periodontal surgery and still relish the highly intricate nature of procedures like regeneration and mucogingival surgery. I was hooked on periodontics and decided to apply for specialist training. I was accepted onto the part-time Masters in Clinical Dentistry programme at Kings College, London and spent the next four years training in periodontics and implant dentistry.
How does it differ from other specialties or settings?
The training pathway I undertook is different from that of several other specialities in that it is self-funded. It is offered on a part-time basis which allows trainees to work part-time to help fund the course.
The specialty requires broad scientific knowledge with aspects of microbiology, pathology and immunology being particularly relevant. The training is demanding but the job is highly rewarding. The satisfaction of helping patients maintain their dentition cannot be overstated, particularly when they present terrified that they will lose all their teeth. The management of patients requiring multi-disciplinary care also provides the opportunity of working closely with restorative and orthodontic colleagues.
One of the particular challenges of periodontics is the strong influence that patient behavioural factors have on treatment outcome. Much of my day is spent counselling patients on their oral hygiene habits, smoking and general medical health.
Whilst this can occasionally be a source of frustration, affecting positive behaviour change is very fulfilling and a crucial part of the job. An empathetic but persuasive manner definitely helps!
What additional skills have you learned as a result?
During my training, in addition to learning how to manage periodontal diseases I also learned how to place and restore dental implants and manage implant complications. As a result, a significant portion of my week is now spent carrying out implant work. I also get a lot of referrals for management of peri-implantitis. This is an increasingly important area of the speciality and the number of cases we see is likely to continue to grow as the amount of implant work performed increases.
Recently I have become involved in the medico-legal aspects of periodontics and I have carried out further training to enable me to act as an expert witness in the resolution of medico-legal disputes.
What advice would you give to anyone considering this specialty?
Specialist training in periodontics is a demanding but highly rewarding career pathway. Upon completion of training there are options of working in hospital and/or specialist practice, teaching and pursuing research interests. There are opportunities to work closely alongside specialist colleagues and to become involved in implant dentistry.
I would recommend those interested in a career in periodontics undertake dental core trainee posts in oral and maxillofacial surgery and restorative dentistry. I would also advise joining the British Society of Periodontology (BSP) which has an excellent and very informative website. The BSP organises regular meetings which are a great way to learn more about the speciality and meet both specialists and fellow trainees.
BDS (Bris), MFDS RCS (Eng), MClinDent (Perio), MPerio RCS(Ed) Specialist in Periodontics
Raman graduated from Bristol Dental School in 2005 and holds a Master of Clinical Dentistry (Periodontics) qualification and Membership in Periodontics at the Royal College of Surgeons, Edinburgh. He is registered with the GDC as a specialist in periodontics and works at several referral practices, providing a range of treatment including the management of gum disease, mucogingival surgery for treatment of gum recession, crown-lengthening, periodontal regeneration, placement of dental implants and treatment of implant complications.
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