May 2014 E-Newsletter

Emerging Career Opportunities, APICES 2014 and More!

As you all know, the AAE 2014 Annual Session recently concluded in Washington, D.C. I am delighted to say that it was an amazing show of “striving for perfection,” with more than 3,500 attendees. In this issue we hope to provide a unique insight into this Annual Session through the eyes of a new educator as well as a resident.

The Career Fair at the Annual Session demonstrated a good turnout with potential employers from as far as Canada. For the first time, it was a sponsored event supported by Radman, White & Associates, a very healthy sign for the future growth of the Career Fair. Our special thanks to Radman, White & Associates. I am sure this event proved to be a “win-win” situation for both the residents and the employers.

As you might have observed over the past few years, there has been an increase in the number of residents with dental degrees from outside the U.S. This issue of The Paper Point includes an article that provides some basic information for foreign trained dentists who are seeking to establish themselves as endodontists in the U.S.

I would also like to take this opportunity to personally invite you all to the annual meeting exclusively organized for our residents and new practitioners – I’m talking about APICES. This year APICES is being hosted by the University of Texas Health Science Center at Houston, August 8-9. Please mark your calendars, and watch for emails with more detailed information about registration. Among the many reasons to attend, this will be a great opportunity to visit a state-of-the-art dental school. It is one of the few schools offering Microscope experience in the UG endodontic clinics. I look forward to meeting you all in Houston. Meanwhile, I wish you good luck in all your endeavors.

I cannot conclude without recognizing the hard work, meaningful contributions to committee activities, and dedication put forth by Ms. Debby Rice, Ms. Alyson Hall and all the RNPC members. Thank you!

Make sure to check out the Crazy Case!

- Manpreet S. Sarao, B.D.S., D.D.S, Resident and New Practitioner Committee Chair



AAE 2014 Annual Session from a Resident's Perspective

By Nicole A. Shinbori, D.D.S.

The 2014 AAE Annual Session in Washington, D.C., was the first Annual Session I have attended, and I was excited to see what the meeting had to offer for current endodontic residents.

As we all know, endodontic residency is two to three demanding years of our lives when we learn the most about current literature, modern techniques and new materials.

However, I was pleased to discover that the Annual Session lectures and workshops offered unique perspectives and innovative research not always found in textbooks and the Journal of Endodontics. Session topics ranged from improving microsurgical outcomes to managing difficult canal anatomy to endodontic staff management. So much was presented that the only way to listen to it all will be through the Live Learning Center.

As a resident, my favorite moment of the meeting was walking around during the table clinic/scientific research presentations and discussing the multitude of studies with my fellow residents. It was an impressive display of hard work and dedication by the residents from each program to push the AAE to new heights as our specialty continues to “strive for perfection.”

On Friday evening, Treloar & Heisel sponsored the Resident Reception, where attendees were able to catch up with old and new friends alike.

From my perspective, the AAE Annual Session is a definite “must” during residency. The meeting not only gives residents a much-needed break from residency for a few days, but it also presents the invaluable opportunity to connect with alumni, hear lectures from the legends of endodontics and meet with vendors about new products before they come to market. With the 2014 AAE Annual Session in the books, I return to residency informed and inspired, and I look forward to Seattle in 2015.


AAE 2014 Annual Session from a New Educator's Perspective

By Melissa Marchesan, D.D.S., M.S., Ph.D.


As a newer educator, attending the 2014 Annual Session in Washington, D.C., provided a professionally and personally rewarding experience.

The communication with faculty members from other schools allowed for the discussion of mutual concerns and solutions to everyday issues related to teaching. Listening to the different presentations not only informed me of what others are doing, but also inspired new research ideas. The presence of all the vendors together in the exhibit hall was certainly beneficial to compare and experience new technologies – files, irrigating devices and even types of plastic teeth available for teaching predoctoral students. In addition, it is always enjoyable to reunite and socialize with former graduates, former classmates and dear friends from the United States and all over the world.

One thing I will certainly try to keep in perspective after this meeting is a remark made by the keynote speaker, James M. Bradley, at the President’s Breakfast as he was speaking about his father and six other young men raising the American flag on Mt. Suribachi, “Challenge your own impossibility!”


Roadmap to Endodontics in the U.S. for Foreign Trained Dentists: An Overview

By Manpreet S. Sarao, B.D.S., D.D.S., M.S.D.

The United States of America has been and will remain a preferred destination for dental professionals around the world looking for greener pastures. This land of opportunities offers a broad scope of professional growth.

Amidst the available options, one needs to consider his or her immigration status, professional background, family circumstances and financial stability. As challenging as it is to move to a new country, a carefully planned strategy will help you realize your dream of specializing in endodontics in the U.S.

I will elaborate on the following areas:

  • Professional Background
  • Licensing
  • Immigration Status
  • Career Options

Professional Background

Once you graduate from a residency program, your options will depend on whether you have a D.D.S. accredited by the Commission on Dental Accreditation or not. With a North American D.D.S., you have the liberty to start your own practice or become an associate. Residents with foreign dental degrees have limited options of practicing only in states that accept CODA non-accredited dental degrees. The other option is to pursue an academic career.

Your future goals and your past professional qualifications will decide the appropriate course of action for you. For one whose dream is to practice as a clinical endodontist, graduating with a North American D.D.S. before seeking specialty training will provide more freedom in the selection of your final destination. Endodontists trained outside North America seeking an academic career would benefit from training directly in a graduate endodontic program that accepts foreign dental degrees. If your goal is to pursue a full-time academic or research career, technically speaking, you do not need to acquire a U.S. D.D.S.


There are three basic requirements to obtain a dental license in the U.S.:

  • Dental Degree
  • National Board Dental Examination, Parts I and II
  • Clinical Exam – WREBS, CREDTS, etc.

Most states require you to have a CODA-accredited dental degree. Some states, like Texas, Virginia and Wisconsin, will license individuals with foreign dental degrees if they have completed a U.S. advanced specialty training program. Some states require a two-year advanced specialty program, while others require a one-year advanced general dentistry program. So, it really depends on where you want to go, and you would need to research the requirements of that particular state. It’s also prudent to understand that the requirements change from time to time. Some states have the provision of licensing individuals with foreign dental degrees who have practiced for five or more years in another state in the U.S.

Immigration Status

Immigration status plays a key role in your professional career. If you are a U.S. citizen or a U.S. resident, then all doors are open. But, if you are doing a residency program on a student visa (F-1) or a dependent visa (H-4), then your options are limited and you may have to jump through multiple hoops to realize your dream.

After graduating from a residency program on a student visa, you get a 12-month Optional Practical Training period during which you can practice, teach or do whatever you want related to endodontics. You can apply for the OPT through the university’s immigration office 90 days before your graduation date. You have the liberty to pick the start date of your 12-month OPT, within two months of your graduation date. This information becomes important when you are trying to maximize your stay in the U.S., so you have ample time at hand to figure out your future placement. You are not required to have a job offer at the time of OPT application. I would recommend using this 12-month period to identify a good employer who is willing to process your work visa (H-1B) at the completion of OPT. It is important that your employer is also willing to process your permanent residency (Green Card) application when you start working on an H-1B. It has become extremely challenging to obtain an H-1B visa in the past couple years and it’s projected to stay the same in the coming few years unless major changes are instituted.

On April 1 each year, the United States Citizenship and Immigration Services begins accepting applications for H-1B visas from potential employers offering private practice jobs. The annual quota (cap) for H-1B visas is 65,000 in the Regular category and another 20,000 visas in the Master’s exemption category (applicants with an advanced degree). In 2012 and 2013, the USCIS received more than 120,000 applications from April 1 to April 5. In such a scenario when USCIS receives more applications than the cap, they institute a lottery and the lucky people who are chosen receive H-1B visas. As an endodontist with an advanced degree, you’ll get two chances to be picked in the lottery; first in the Master’s exemption category and then in the Regular category. If you are granted an H-1B visa, you can begin working no sooner than October 1 of the same year. It is critical to keep track of your deadline dates and plan ahead of time.

All universities employing full-time faculty are exempt from the H-1B cap. This means that if you get hired by a university for a full-time position, you do not have to worry about the H-1B cap of 65,000 or 20,000. Also, unlike the private practice employers, universities can apply for work visas at any time of the year and are not required to submit the applications beginning April 1. Since the process is complex, it’s a good idea to seek professional help from immigration attorneys if you are planning to seek an H-1B visa for a private practice job.

Another option for seeking U.S. permanent residence is to explore the EB-5 Immigrant Investor category. Under this program, you need to invest $500,000 to $1 million and become eligible for a U.S. Green Card. Again, it’s a complex process and I would recommend consulting an immigration attorney specializing in Immigrant Investor visas.

Career Options

By now you must have realized that you have multiple options if you are a U.S. citizen/resident and you have a CODA-accredited dental degree. You can start your own practice, become an associate, work as a faculty or join the U.S. Armed Forces. If you are doing your residency program on a student (F-1) visa, then your main options are either to obtain an H-1B visa under the cap in order to work as an associate or pursue an academic career. You cannot start your own practice or join the armed forces. Your options are further narrowed if you do not have a North American D.D.S.

I hope this information will be helpful in planning your future career moves. I would be happy to answer any questions and can be reached at


Emerging Career Opportunities

The Resident and New Practitioner Committee’s annual Career Fair held at the AAE’s Annual Session was not only a terrific and free resource for residents and new practitioners to view current job opportunities, but it is continually an excellent way to scope out the kinds of career paths endodontic training can provide.

During the 2014 Fair in Washington, D.C., representatives from private practice, education and practices affiliated with dental service organizations (DSO) were all in attendance. The search for the first post-residency job can sometimes feel daunting, as dentistry continues to evolve from the traditional solo/small practice into many different practice models and residents evaluate their own professional and financial goals. 

Private Practice

A variety of endodontists from individual and multi-specialty practices were in attendance at the 2014 Career Fair. Each of the practices had a description of the position they were hoping to fill. Several of them were seeking a full-time or part-time associate, while others were looking for an individual to buyout (or proceed with the intent to buyout) their practice. Practitioners from California to Texas to Massachusetts set up at tables to discuss business opportunities with young endodontists.


Each year, a few tables at the Career Fair are occupied by dental schools looking for young endodontists considering careers in education. An academic career can be active and fulfilling. With opportunities in research and clinical teaching, there are many different paths to take within education. Working directly with future endodontists is one of the most rewarding parts of a career in education. “I always knew that, at some point in time, I would end up back in education. While I was applying to graduate programs, I knew the time was perfect to make the commitment,” said Dr. Anne E. Williamson, program director at the University of Iowa. “Students and graduate students keep me young and mentally sharp, not to mention, let me play on their softball team!”

Dental Support Organizations and Large Group Practices

The 2014 Career Fair had representation from Great Expressions and Pacific Dental Services. These companies are members of the Association of Dental Support Organizations and are looking for dental specialists to affiliate with general practitioners in a particular geographic area. An important common thread among these companies is that most new practitioners are going to be “employees” subject to an employment contract. Regardless of whether the employer is a small group practice or a larger corporate entity, this document will define the relationship. With that in mind, the ADA has a new, free-to-members online publication, Employment Agreements, the Devil’s in the Details. It is not a substitute for attorney review or representation, but it provides a solid overview and highlights overlooked provisions that can spring to life in unexpected ways. The AAE highly recommends that residents take advantage of this great new resource.

The AAE’s October issue of the Communique included an article entitled “Real-Life Perspectives on Emerging Endodontic Practice Models.” The article featured profiles of young endodontists practicing in different settings.

The Fair was sponsored by Radman, White & Associates, which specializes in endodontic transitions including selling, buying or seeking an associateship. Radman, White & Associates forms relationships with young endodontists to help them find the best fit for their needs.

The AAE’s 2014 Career Fair reflected the diverse options that are currently available to new endodontists, and residents took advantage of the opportunity to talk to dental recruiters and representatives from organizations seeking to hire young specialists.




APICES 2014: Deep in the Heart of Texas

Travel to the largest city in Texas and the fourth-largest city in the U.S. for the 11th annual AAE Advanced Programs in Clinical Endodontics Symposium, August 8-9, 2014, at the University of Texas Health Science Center at Houston. Come experience some true Texas hospitality, y’all, visit the institution’s new, state-of-the-art endodontic facilities and learn about the art and science of endodontics with your future colleagues.

This year, the APICES planning committee is making a change to the schedule. The program will begin the afternoon of Friday, Aug. 8, and wrap up with the Saturday Night Social Event. Attendees should plan to travel to Houston Friday morning and depart Sunday morning. Accommodations will be provided for Friday and Saturday nights. 

APICES 2014, there’s an app for that! The APICES mobile app will roll out in early summer for free download for the meeting. Download the app on iPhone, iPad, Android or Blackberry devices to get a jumpstart on your experience. The app can be used to view the meeting schedule, exhibitors and sponsors, maps, AAE social media and more! Watch for more information about the downloadable app to come.

A sneak preview of the APICES 2014 program was released to all residents in March 2014 via email. Click here to review the world-class speakers traveling to speak directly to residents.

In addition to these features, Houston is a first-class city full of southern hospitality. The resident planning committee there is working hard to arrange a weekend experience with a variety of activities to showcase this, including an evening at Minute Maid Park to see Houston’s own MLB team, the Houston Astros, take on their cross-state rivals, the Texas Rangers. Saturday night will find residents enjoying the sights and sounds of old Paris at The de Gaulle! Named after the legendary Charles de Gaulle airport, the experience you will receive at this restaurant and bar is unlike anything outside of Paris! Enjoy cocktails, music and fellowship in a beautiful, new spot in town.

APICES accommodations will include free hotel stay for Friday and Saturday nights for all residents at the Marriott Medical Center! Transportation to the scientific program and all events will be provided. Don’t miss out on these comfortable and free accommodations.

Continue to watch for more information about APICES 2014 at the University of Texas Health Science Center at Houston!



Crazy Case: Intentional Replantation Tooth #18

By Justin R. McAbee, D.M.D., M.S.D.

The patient presented with complaint of mild, intermittent discomfort in the lower left. Thorough clinical and radiographic evaluation revealed that tooth #18 had failing endodontic treatment. Previous dental history of this tooth was initial endodontic treatment and crown in Italy three years prior, followed by conventional retreatment one year prior. Radiographs were obtained from the endodontist that performed the retreatment to assess lesion size (Figs. 1 and 2). 

Treatment options were discussed at this time as extraction, retreatment, apicoectomy or intentional replantation. After thorough discussion of all treatment options, intentional replantation was determined to be the treatment of choice in an effort to retain the tooth.

Profound local anesthesia was obtained. Forceps-only extraction was completed without complication. The socket was gently debrided and irrigated with sterile saline. The tooth was held in a moist cotton 2x2 while apicoectomy was completed in-hand. 

The retropreps were prepared using a surgical ultrasonic tip, and MTA retrograde fillings were placed. The canal morphology at the apex was found to be a “C-shaped” canal, of which only part was sealed with gutta-percha and sealer from previous endodontic treatment. The tooth was replaced within approximately four minutes, and one 4-0 gut suture was placed interproximal to #18 and #19.  At one week recall the tooth was stable and asymptomatic. The patient was unable to return for a two-month recall at the time of this writing, but reports no problems over the phone.

Submit your Crazy Case to for a chance to be featured in an upcoming issue of The Paper Point!

American Association of Endodontists
211 E. Chicago Ave., Suite 1100
Chicago, IL 60611-2691
Phone: 800/872-3636 (U.S., Canada, Mexico) or 312/266-7255
Fax: 866/451-9020 (U.S., Canada, Mexico) or 312/266-9867


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