Most dentists do not have to complete a residency. After finishing four years of dental school, graduates can pass a licensing exam and begin practicing general dentistry right away. This makes dentistry fundamentally different from medicine, where every physician must complete at least three years of residency before treating patients independently. That said, a growing number of dental graduates choose to do a residency voluntarily, and certain paths within dentistry absolutely require one.
General Dentists Can Skip Residency in Most States
In 48 states, a dental school graduate who passes the required licensing exams can open a practice or join one without any postgraduate training. The two exceptions are New York and Delaware, which both require completion of a one-year postgraduate residency (called a PGY-1) before granting a general dental license.
Even in states where it’s optional, roughly a third of dental graduates pursue a one-year general residency before entering practice. These programs give new dentists more supervised clinical experience, exposure to complex cases, and confidence treating patients with medical complications. Two types of general residency exist, and they serve slightly different purposes.
GPR vs. AEGD: Two Types of General Residency
A General Practice Residency (GPR) takes place in a hospital setting and emphasizes managing dental patients who have significant medical conditions. Residents rotate through hospital departments, learn to handle emergencies, and treat patients under sedation or general anesthesia. The hospital environment means GPR residents regularly work alongside physicians and surgeons.
An Advanced Education in General Dentistry (AEGD) program focuses more heavily on clinical dentistry itself. Residents spend their time refining skills in areas like implants, endodontics, and complex restorative work rather than hospital rotations. Both programs typically last one year, though some offer a second year aimed at training future dental educators.
Neither program leads to a specialty designation. Graduates of GPR and AEGD programs are still general dentists, just ones with additional training and clinical hours under their belt.
Specialists Must Complete a Residency
If a dentist wants to specialize, a residency is mandatory. The American Dental Association recognizes 12 dental specialties, each requiring its own accredited residency program after dental school. The length varies considerably depending on the field:
- Two-year programs: Endodontics (root canals), pediatric dentistry, oral and maxillofacial pathology, oral and maxillofacial radiology, and dental public health. Oral medicine requires two to three years.
- Three-year programs: Periodontics (gum disease), prosthodontics (crowns, dentures, implants), and dental anesthesiology.
- Two to three years: Orthodontics programs vary, with some structured as two-year and others as three-year tracks. Orofacial pain programs range from one to three years.
- Four to six years: Oral and maxillofacial surgery is the longest and most intensive dental residency. The four-year track focuses on surgical training, while the six-year track includes medical school and earns the resident both a dental degree and a medical degree (MD).
Oral surgery stands out as the closest dental residency to a medical one. Residents operate in hospitals, manage trauma cases, treat cancers of the jaw and face, and perform reconstructive procedures. The six-year pathway is one of the longest training tracks in all of healthcare.
How Dental Residents Get Matched to Programs
The process resembles the medical residency match but uses its own system. Dental students apply through a centralized service called ADEA PASS, which sends applications to residency programs. Programs review applications, conduct interviews, and rank their preferred candidates. Separately, National Matching Services runs the Dental Match, which pairs applicants with programs based on both parties’ ranked preferences. These are two distinct organizations handling two steps: ADEA PASS manages the application, and National Matching Services determines the final placement.
Not every program participates in the Match. Some residencies, particularly in oral surgery, handle their own selection process outside the centralized system.
Pay and Cost During Residency
Dental residents in hospital-based programs and specialty residencies receive a stipend, similar to medical residents. At a major institution like the Mayo Clinic, first-year residents earn roughly $75,000 per year, with pay increasing modestly each year of training. By year five, the stipend reaches about $89,000. These numbers vary by institution and region, but they give a realistic range.
Some specialty programs, particularly in orthodontics and a few other fields, charge tuition on top of or instead of paying a stipend. This means some dental residents actually pay for their advanced training rather than earning a salary during it, which is a significant financial consideration when choosing a specialty path. The financial structure depends heavily on whether the program is university-based or hospital-based.
Board Certification After Residency
Finishing a specialty residency doesn’t automatically make someone board certified. It makes them “board eligible,” meaning they’ve completed the required training and can sit for the certification exam in their specialty. Board certification itself is a voluntary step that involves passing a rigorous examination and committing to ongoing continuing education to maintain the credential. A board-certified specialist has demonstrated a higher level of verified competence, though specialists can legally practice after residency completion alone.
For patients, this distinction matters when choosing a specialist. A periodontist or orthodontist who is board certified has gone a step beyond the minimum training requirements, though both board-certified and board-eligible specialists have completed the same residency programs.