Everyday Oral Surgery

Welcome back to another exciting installment of Every Day Oral Surgery! Today’s guest is full arch implant expert, Dr. Arshiya Sharafi. Tune in to get to know the man behind the forceps as we discuss his education history, the opportunities that lead him to specialize in arch implant cases, and where he learned his trade. From observing surgeries at every opportunity to teaching his own courses, this episode contains a wealth of information for anyone in the field of oral surgery. We find out why people often run into difficulty with full arch implants (a lack of experience), what Arshiya includes in his workup, and how he ensures his patients are attending their follow-ups. We also hear how you can reduce the time spent on full arch cases, benefitting the patient, the local dentist, and your bottom line! Don’t miss out on this engaging episode!Key Points From This Episode:Welcome to Dr. Arshiya Sharafi: where he grew up, why he studied dentistry at a state school, and how he ended up in oral surgery in California. What Arshiya spends most of his time doing nowadays (full arch cases). The lessons learned from Clear Choice: techniques, how to run a consult, how the lab works, and more!Why you can run into difficulty when you don’t do full arches regularly. Arshiya’s tips for how to reduce time and pain in full arch cases: bringing in other experts, setting a day aside for the surgery, and converting the case with assistance. Why it's so important to be efficient, for business, the dentists, and the patients!What Arshiya’s workup looks like: why he prefers analog. How to ensure you get patient follow-up.Why Arshiya doesn’t care about the number of implants you have, but rather whether they’re stable. The importance of angling implants!Why implants should be placed free-hand, but bone reduction should be guided. The main reason Arshiya sees redos. Why the phrase “graftless solution” is not something Arshiya advertises, even though he does minimal grafting. How Arshiya learned zygomas!Why it’s so crucial to know your anatomy when you’re doing zygomas. How Arshiya gets new cases: organically, through word of mouth, or advertising. Where to contact Arshiya (Email and Instagram).Rapid-fire questions and answers: Arshiya’s favorite book, why he’s addicted to golf, his unique choice of forceps, and more!Links Mentioned in Today’s Episode:Dr. Arshiya Sharafi on Instagram — https://www.instagram.com/san_diego_oralsurgery/Dr. Arshiya Sharafi’s Email — asharafidds@yahoo.comTeeth express classes by Dr. Arshiya Sharafi — https://teethxpresscourses.com/All the Shah's Men: An American Coup and the Roots of Middle East TerrorKilling Geronimo: The Hunt for Osama bin LadenDr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Many oral maxillofacial surgeons don't treat TMJ issues due to the lack of success following surgical intervention. Today's guest is turning this approach on its head, with a novel surgical technique he learned from the premier oral surgery hospital in China! Dr. Julian Wilson traveled to Shanghai as part of his fellowship, where he learned how to perform a new technique for disc plications. Tune in to hear how this has impacted his scope of practice and the way he thinks about TMJ surgery. We hear a step-by-step breakdown of how this surgery is performed, as well as who the ideal candidate is, and the outcomes that Julian has seen in his practice. We also get to know Julian on a more personal level through Grant's rapid-fire questions. Tune in for all this and more, today!Key Points From This Episode:An introduction to Dr. Julian Wilson, oral maxillofacial surgeon and specialist in disc plications.Julian’s journey into oral surgery: from dentistry to fellowship. How a two-week trip to a hospital in China set Julian up to specialize in temporomandibular surgery using a unique technique. How Julian approaches patients: differentiating myofascial pain from mechanical issues, and why conservative treatment is usually best initially. The shift in thinking from the treatments offered in the ‘80s and ‘90s, to disc plication from the early 2000s. How a disc plication surgery works: a step-by-step walkthrough. Why the technique that Julian uses is not a true disc plication but is closer to a discectomy. The benefits of disc plication on young patients: cartilage regeneration and addressing an issue not commonly treated.What causes TMJ issues, and when to do a disc plication.The alternative surgeries to Julian’s disc plication, and their benefits and disadvantages. The checklist that Julian goes through to decide if he will recommend a disc plication.How Julian prepares his patients’ expectations about the outcomes of surgery. Which components of the surgery contribute to pain reduction. Why Julian doesn’t operate when patients are using pain medication chronically.Where to contact Julian to ask about this technique. What Grant was taught about plication surgery, and why he was told: "It wouldn't work".The three books Julian recommends: Never Split the Difference, Fooled by Randomness, and Naked Statistics. The mantra that Julian uses to embrace complications and challenges. Links Mentioned in Today’s Episode:Dr. Julian Wilson Email — julian.j.wilson@KP.orgNever Split the Difference: Negotiating As If Your Life Depended On ItFooled by Randomness: The Hidden Role of Chance in Life and in the MarketsNaked Statistics: Stripping the Dread from the DataDr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Today’s guests are a trio of full-scope surgeons who together, run a fellowship in St. Louis. Tune in to hear how they each ended up doing fellowships, and why they decided to get involved in this one! We discuss the characteristics their ideal candidate has, and how becoming a full-scope surgeon will launch your career. Find out why being the only oral and maxillofacial surgery fellowship in St. Louis enables fellows to mold their own program, and what happens after the fellowship. We hear from each of today’s guests (and Dr. Stucki) about their board exam experiences, and why Drs. Findlay and Reti chose to produce the Oral Board Review for Oral and Maxillofacial Surgery. For all this, and so much more, press play now!Key Points From This Episode:What today’s guests (Dr. Reti, Dr. Findlay, and Dr. Tentido) have in common. The emphasis of the fellowship: trauma, TMJ, and plastic surgery. How the fellowship works with the academic year. What the ideal candidate looks like: eager to learn with a good work ethic. The importance of preparing for the oral board, and why Drs. Reti, Findlay, and Tentido know so much about the process. The benefits of being the only academic center in St. Louis: fellows can mold their own fellowship. What happens after the fellowship, and why it’s important to become more comfortable with the full scope of oral surgery. Where you can find Oral Board Review for Oral and Maxillofacial Surgery, and where the inspiration for it came from. What’s coming in 2022: the launch of the Board Review Course at St. Louis.Why Oral Board Review for Oral and Maxillofacial Surgery was a passion project and not a nest egg.Stories from each of these Dr’s board exam experiences: from citing papers to the authors to being asked "zebra" questions. Tips on how to answer the board questions. Damian’s experience of the fellowship, and why he’s grateful for it. How the fellowship has ensured that Robert continues to learn and stay up to date with the literature. Rapid-fire questions and answers: their favorite books, the non-oral surgery habits that help keep them sane, the forceps used to extract tooth number 12, and their favorite quotes.Links Mentioned in Today’s Episode:Dr. Robert Reti Phone — 314-822-3322Dr. Damian Findlay Phone — 314-251-6725Dr. Gregory Tentido Phone — 636-400-6725The American Association of Oral and Maxillofacial SurgeonsOral Facial Surgery Institute Oral Board Review for Oral and Maxillofacial Surgery: A Study Guide for the Oral BoardsThe 5 AM ClubI Love You, Stinky FaceSpeechless: Controlling Words, Controlling MindsDr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Welcome back to another episode of Every Day Oral Surgery! Today I talk to oral surgeon and movie maker, Dr. Eli Tabari. Tune in to find out why engaging in a passion project can be so rewarding, and the words of advice Eli has for anyone hesitating to embark on their passion project. We discuss the challenges Eli faced in making the movie, as well as why he splits his time between hospitals, trauma, and private practice. Hear case studies where Eli has learned important life lessons, and why young surgeons should learn about business finance. Get to know Eli through rapid-fire questions, and so much more in this inspirational episode!Key Points From This Episode:Welcome to Dr. Eli Tabari, where he studied and how he got into maxillofacial surgery through trauma departments. How growing up in the area where you choose to set your private practice can benefit you. Why Eli chose to make a movie and the serendipitous events that lead to its production. The challenges Eli faced to make the movie: shoestring budgets, full-time work, and finding locations. How the name “Back in The NO” came about. What motivated Eli to make the movie: the love he has for oral surgery. Words of advice for others with passions outside of oral surgery: “Go for it”, and “If you can, do it now”. How Eli got actors and actresses to work for free or experience. Why Eli focuses on infections in the hospital, and why it's so important to build relationships with anesthesiologists. Case studies where the role of the oral surgeon and the anesthesiologist overlap. The pros and cons of dividing your time between hospitals, private practice, and trauma. Why Eli admires Every Day Oral Surgery as a passion project. Advice to young surgeons getting out of school: enjoy every minute, and learn about business finances. Rapid-fire questions: hobbies that sustain Eli ('80s music and book writing), his favorite movie (Back to the Future), the forceps used to extract tooth number 14 and so much more!Books that Eli and Grant enjoyed, and why. Why Eli loves the episode of Seinfeld where they traveled to LA, and the well-written episode of The Office addressing racism. How you can contact Eli.Another book (and movie!) recommendation: Ready Player One.Links Mentioned in Today’s Episode:Dr. Eli Tabari Email — oralsurgery@hotmail.comDr. Eli Tabari Phone — 559-246-1303Back in The NOThe House of GodReady Player OneDr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Today I’m welcoming back Dr. Mark Engelstad to the podcast, a man from whom everyone can learn a great deal about the technical and non-technical sides of being an oral surgeon. Our discussion today covers the complex and controversial realm of condyle fractures, an innovative, ‘gentlemanly’ technique for treating orbital fractures, and the problem with how the oral surgery profession deals with trauma calls. Borrowing from The Beginning of Infinity, Mark sees problems as inevitable and solvable, and feels passionately that every single patient, regardless of the reason they are being operated on, deserves the very best care.Key Points From This Episode:Why condylar fractures are different from other types of facial fractures.What makes condylar fractures complicated. Advice from Mark for how to decide what to do about a condylar fracture as an oral surgeon. The importance of treating orbital fractures correctly the first time around. Mark explains the technique he uses for orbital fracture operations.Benefits of working in the maxillary sinus when doing an orbital implant. Problems with the way trauma calls are handled.How Mark’s perspective on trauma patients differs from many other medical professionals.The book which changed Mark’s view on the world. An explanation of knowledge graphs and why Mark finds them so useful to his work.A quote which Mark has carried with him throughout his career. Links Mentioned in Today’s Episode:The Beginning of Infinity — https://www.thebeginningofinfinity.com/ Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Today’s guest specializes in the treatment of facial injuries, cleft jaw surgery, orthognathic surgery, and the education of the upcoming generations of oral surgeons. Dr. Mark Engelstad’s passion for teaching is palpable and his approach inspiring. He has recently stepped back slightly from his program director role to focus on another exciting project; the development of a database for medical professionals to keep track of everything that they have done during their careers. Mark is a firm believer in the value of fellowships and that the thing that matters most at your graduation is what you’ve done in the years leading up to that day; regardless of whether you’ve done a double degree or a single degree, or where you did it. Our conversation also covers Mark’s view on diversity, and the approach that we should be taking to increase it within the field of OMS.Key Points From This Episode:Mark shares what attracted him to the field of oral surgery.What Mark’s main surgery areas of focus are.The software startup that Mark is in the process of developing. Why Mark is a huge supporter of fellowships. What the purpose of a fellowship is, and why it differs from residency.The minimum experience requirement to become accredited as an oral surgeon.Reasons that people choose not to do fellowships. Mark’s passion for surgical education, and his approach to helping his students thrive.Why Mark believes that nobody should be a program director for more than 10 years. When it makes sense to go the double-degree route, and when it doesn't. The factor that matters most on graduation day. Variations amongst the double-degree programs that exist. A comparison of the general surgery requirements of different medical specialities. Mark shares his opinion on the importance of diversity in the OMS field, and the approach that he advocates for achieving this.Links Mentioned in Today’s Episode:Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Writing patient notes is a simple (albeit boring) task that can have major implications if not done correctly. There are certain things that should always be included in patient notes, and others that should never be, and in today’s episode Scott, Jake, and I share some examples of what’s on each of those lists. Scott also gives us a rundown of the electronic medical records system that he uses, and with pharmacies heading towards a total ban on paper prescriptions, everyone will benefit from hearing his advice. Although writing notes is certainly not the most exciting part of being an oral surgeon, we recommend putting an episode of Seinfeld on in the background to make it a whole lot more manageable! Key Points From This Episode:A description of DSN, the electronic medical record system that Scott uses. How Scott and his assistant collaborate to be most efficient in capturing a patient's information. The phrase that Scott never allows in his notes. How DSN manages the sending of prescriptions.  A downside of DSN, which is in the process of being addressed.Why it’s important to make it clear in your notes if your patient has refused non-surgical treatment to restore a tooth.Other examples of what you should be putting into your notes. Issues that can arise if you haven’t written down reasons for undertaking a procedure. How pharmacies are driving the switch from paper prescriptions to electronic records.The TV show that helps me get through the note-writing part of my day. Links Mentioned in Today’s Episode:DSN Software Inc. — https://www.dsn.com/ Todoist — https://todoist.com/ Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

When looking for ways to finance his dental degree, Dan Hammer came across the Health Professional Scholarship offered by the Navy. His receipt of this scholarship formulated the trajectory of his career as an oral surgeon. Dan’s journey has involved treating war warriors as a GPR, completing a head and neck fellowship, and helping to develop the digital adaptation of the “jaw in a day” surgery. Following in the footsteps of many OMS pioneers, he has done all of this with a single degree, and he explains why he does not believe he is not disadvantaged by this fact. Although there are some tradeoffs to working in the military, there are also numerous benefits, and Dan openly discusses the pros and cons of his chosen career path in today’s episode. Dan also offers some valuable advice around getting as much exposure as possible to your fields of interest (no matter how trivial an activity may seem), listening to the opinions of other professionals (even if you don’t agree with them), and a key to optimal parenting! Key Points From This Episode:Why Dan joined the Navy.Dan’s experience as a GPR in Bethesda, Maryland in 2011. What inspired Dan to do a head and neck fellowship. Where Dan is currently working. Some of the pioneers in the OMS field who had a single degree. Legal and political elements of practicing surgery with a single degree.Benefits of working in the armed forces. Dan’s first flap out of fellowship. The collaborative multidisciplinary environment that Dan works in. Compensation that Dan receives through working in the military. A tradeoff that you need to accept when you become an active-duty oral surgeon. The variety of procedures on which Dan spends his time. Dan explains the “jaw in a day” surgery in more detail, as well as the “digital jaw in a day” adaptation that he and his team came up with.The value that lies in listening, and getting as much exposure as you can in your fields of interest.The correlation between Dan’s work and home life. Advice from Dan around raising children. Dan’s favorite quote: Comparison is the thief of joy. Links Mentioned in Today’s Episode:Dr. Dan Hammer on Instagram — https://www.instagram.com/drdanhammer/?hl=en Leaders Eat Last by Simon Sinek — https://simonsinek.com/product/leaders-eat-last-book/ Extreme Ownership by Jocko Willink — https://www.amazon.com/Extreme-Ownership-U-S-Navy-SEALs/dp/1250067057 Can’t Hurt Me by David Goggins — https://www.amazon.com/Cant-Hurt-Me-Master-Your/dp/1544512287 Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Today’s guest is an oral and maxillofacial surgeon who specializes in alveolar cleft grafting, cleft orthognathic surgery, and distraction. Through these life-changing procedures, Dr. Chris Viozzi is doing his part to give back, and he does this not only through treating patients within the US, but also those outside of it during 10-day mission trips he was doing twice a year prior to the pandemic. In today’s episode, Chris explains the variation that exists amongst the patients he treats, as well as amongst the techniques that can be used for the procedures he does. We also discuss donor sites, follow-ups, and common concerns relating to cleft surgeries. Chris is not fellowship-trained, and his OMS basic training was more than enough to get him to his current position on the Mayo Clinic’s Cleft and Craniofacial Clinic team. Key Points From This Episode:The craniofacial team that Chris is a part of, and his niche within the team.Other medical professionals who make up the craniofacial team.Diversity amongst the patients that Chris and his team treat at the clinic.  Vital understandings that anyone doing alveolar cleft grafting must have. Elements of alveolar cleft grafting that have evolved over time. Examples of the variety of techniques for alveolar cleft grafting that exist. Why the iliac crest is usually the best donor site. Common concerns around allografts.  Chris shares why Infuse was black-boxed by the FDA, and his opinion on using it for alveolar cleft grafting.Timing of follow-ups post alveolar cleft grafting.Why Chris avoids corticocancellous blocks whenever possible. The approximate percentage of alveolar cleft grafting patients that need cleft orthognathic surgery later in life. Differences between Asian and Caucasian children in terms of the likelihood of requiring orthognathic surgery.Where Chris acquired the majority of his cleft surgery skills. Chris’s experience doing mission trips, and the perspective he gained as a result. The lack of continuity of care in many countries outside of the US.Challenges to OMS involvement in cleft surgery. Book recommendations from Chris.Chris’s favorite OMS tool.  Links Mentioned in Today’s Episode:Dr. Chris Viozzi — The Immortal Life of Henrietta Lacks — http://rebeccaskloot.com/the-immortal-life/ Quiet — https://www.quietrev.com/quiet-the-book-2/ Medical Missions for Children — https://www.mmfc.org/ Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

In this episode, I’m joined by two repeat guests, Drs. Jake Stucki and Scott Weiskopf, who are here for a discussion around every oral surgeon’s indispensable tool: forceps. In today’s episode, we take a virtual trip around the mouth and share which of the large variety of forceps we think are preferable for taking out each type of tooth, although it’s important to note that there are many different ways of doing things and what works for us might not work for you. We also have some valuable advice to share around how to avoid a root tip breaking, and even how you can prevent your patient from swallowing a tooth (speaking from experience!). Key Points From This Episode:What forceps are used for, and when to use them.Scott’s favorite forcep.Each of us shares what we think the best forcep is for removing maxillary molars.Common problem that Scott sees occurring when students start out with the more aggressive forceps. Forceps that we generally use for upper and lower premolars. A comparison between some of the many ashes that exist. Circumstances under which you should be removing tissue. Why the concept of “apical pressure” can be confusing. The tool that Scott starts every tooth removal procedure with. What Jake and I like to use the cow horn for. Scott’s approach to removing mandibular molars. Our thoughts on using a hand piece.How the root shape determines which tools we use. Benefits of using rongeurs. Scott and I share how we like to hold forceps. When you should swap one forcep out with another during a procedure. Advice to avoid breaking the root tip off. Experiences we have had of patients swallowing a tooth, and how to avoid this!Tips for using throat packs.Links Mentioned in Today’s Episode:A.Titan — https://www.atitan.com/ KLS Martin Group — https://www.klsmartin.com/en/disciplines/dental-and-oral-surgery/ Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059