Everyday Oral Surgery

Today’s guest, Dr. Frank Dolwick, has been a TMJ surgeon for over 50 years, since the days when focusing on TMJ patients would earn you the lowest ranking position in the US Air Force! In fact, Frank was one of the people who was instrumental in evolving this type of surgery and elevating it within the medical field, as you will hear today, and he is now considered a giant in the TMJ specialty. In this episode, you will also learn about the two categories of pain that TMJ patients fall into (myalgia and joint) and the differences between how each of these problems should be approached, the numerous benefits of doing arthrocentesis procedures rather than arthroscopies, and why oral surgeons need to change the way we think about pain!  Key Points From This Episode:Frank shares an overview of his educational background and the early days of his oral surgery career. Ray White; the surgeon who introduced Frank to TMJ surgery. How TMJ surgery has changed over the years that Frank has been working as an oral surgeon. Pros and cons of the technological advancements in TMJ surgery. Frank’s experience as a TMJ surgeon in the US air force. The disastrous period of the alloplastic implants.When and how arthroscopy was introduced in the United States. Frank’s first time doing a joint lavage and what the outcome was.The numerous reasons that Frank sees arthrocentesis as his most significant contribution to the oral surgery field.Advice for young surgeons regarding TMJ. How TMJ patients today differ from the TMJ patients Frank was treating in the early days of his career. Two categories that TMJ patients generally fall into. Frank’s advice on getting myalgia problems under control.How Frank treats TMJ patients who only have joint pain.Factors that determine whether Frank will use steroids of PRGF when doing an arthrocentesis procedure. Circumstances under which Frank will conduct an arthroscopy. Why the decision to do an open joint surgery should not be taken lightly.The benefits of botox in treating myalgia patients. Frank’s opinion on total joint replacement surgery, and the success rate that he sees with these procedures. Why you can’t eliminate chronic pain with total joint replacement surgery.Examples of places where you can go to learn about arthroscopy and arthrocentesis. The length of time Frank spends on his initial consultations with TMJ patients. How we, as oral surgeons, need to change our mindset with regard to pain.  Links Mentioned in Today’s Episode:Dr. Frank Dolwick Email — fdolwick@dental.uf.eduDr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Today’s guest, Dr. George Kushner, has been working full-time in academia for the past 28 years, and he wouldn’t have it any other way. Every day he is making a difference in people’s lives, being mentally stimulated, and earning enough money to live a great life outside of work; what more could you ask for? George is the Chairman of the Department of OMS at the University of Louisville, and today he shares with us how he and his colleagues (in particular the late Dr. Brian Alpert) have created an environment which is defined by a caring attitude and a healthy work/life balance, or in George’s words; “the Louisville way.” In our discussion we also cover some of the technological advancements which are being driven forward by residents, George’s unusual site of choice for bone grafting, and what it means to “run your training program like a Greek tragedy” (and why you shouldn’t do that!). Key Points From This Episode: George shares what his educational and professional journey has consisted of to date. The influential role that Dr. Brian Alpert played in George’s life, and the lives of many others.What you can expect as a student attending dental school at the University of Louisville.How the University of Louisville tries to make it as easy as possible for dental students to go to medical school.The trauma heavy nature of the OMS department at the University of Louisville.A broad outline of the dental school schedule at the University of Louisville.Challenges and benefits of working in academia. How George’s department creates a healthy, balanced work environment. George’s approach to teaching oral surgeons. Why George is a big fan of AO North America. Examples of technological advancements in the oral surgery field that George and his team are embracing. George’s site of choice for bone grafting.Benefits of using ViviGen.  The importance of having “a lot of tricks in your bag” as an oral surgeon. Numerous reasons that George recommends a career in academia. Why George believes that playing team sport throughout his life has made him a better surgeon. What it means to “run your training program like a Greek tragedy,” and why you shouldn’t do this.George explains what “the Louisville way” is.   Links Mentioned in Today’s Episode:Dr. George Kushner Email — AO North America — https://aona.org/our-community/cmf Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

This episode is pure gold for any oral surgeons out there who are interested in setting up their own practice! In September 2020, Dr. Dustin Haupt opened the beautiful office that he built from scratch, and in today’s episode he lets us in on many of the tips and tricks which have resulted in its success. From deciding between what brand of chair to purchase, to the best way to set up your cassette, there are a wide variety of factors to take into consideration, each of which comes with a financial implication. Prior to opening his practice, Dustin spent a whole year visiting exhibition halls and getting a hands-on experience of the equipment available, so if you don’t have the time to do that yourself before opening your practice, this episode will provide you with all the information you need!  Key Points From This Episode: The process that Dustin went through before deciding on the office equipment he was going to use.Why Dustin didn’t choose the sterilization equipment for his office himself, and who he entrusted this job to. Dustin’s reasoning for choosing a true surgical chair as opposed to a traditional dental chair.A comparison between MTI and Boyd surgical chairs. Factors that led to Dustin choosing an EPM monitor.The software that Dustin uses in his practice. What Dustin’s anesthesia monitors cost, and why he has chosen to have one in each room of his practice.Pros and (very few) cons of the BN air drills that Dustin and I use. Why Dustin prefers corded to cordless equipment.Our shared appreciation for KLS products. The instruments that Dustin keeps in his cassette, and why a cassette is his preferred method of storage. Benefits of the auto drain and autofill system that Dustin has installed in his office.Dustin’s commitment to ensuring that his staff don’t get burnt out. Training that Dustin does for every assistant that he brings into his team. Burs that Dustin uses for different procedures. Implant kits and IV bags that Dustin uses in his office. Why Dustin always uses an IV bag during surgery. Advice from Dustin for anyone wanting to set up their own oral surgery practice.  Links Mentioned in Today’s Episode:Dr. Dustin Haupt on LinkedIn— https://www.linkedin.com/in/dustin-haupt-94605563/Avos Dental Specialists —https://www.avosds.com/meet-us/dr-dustin-haupt/ MTI — https://mti.net/ Boyd — https://www.boydindustries.com/products/oral-surgery/surgical-chairs-and-tables/ EPM — https://www.gegridsolutions.com/multilin/catalog/epm9900p.htm Mindray — https://www.mindray.com/en/ BN Air Drill — https://www.bnproducts.com/tools/aeropro-rp17101-38-reversible-air-drill/ KLS Martin — https://www.klsmartin.com/en/ Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

As Dr. Robert (Bob) McNeill knows all too well, being on the State Dental Board means that you have to put up with a lot of mistrust from fellow medical professionals who (wrongly) believe that you have ulterior motives. Through his many years of experience on both sides of the fence, Bob has come to understand that communication is one of the most valuable skills that an oral surgeon can learn. Examples of other valuable skills that Bob advocates for are stress-relieving techniques, such as meditation, and the ability to practice hypnosis, which is especially pertinent with the anesthesiology battle that oral surgeons are currently facing. Bob has so many fields of interest, and although he sometimes struggles to balance them all, it makes for a fascinating conversation which I hope you enjoy as much as I did!  Key Points From This Episode: Bob shares an overview of what his OMS journey has looked like to date. One of the main reasons that people get reported to the board. How people often respond when they find out that Bob is on the State Dental Board. The song which helps patients and surgeons relax (and the time that it didn’t work).Benefits of working in a multispecialty practice. Post-op complications that Bob commonly sees as a member of the State Dental Board.Examples of how Bob communicates effectively with his patients. Bob’s thoughts on hypnosis, and when he likes to use this technique. Opportunities that Bob has been afforded through being a Dental Board member.What an amygdala hijack is, and how to deal with it. Different communication strategies and how to know when to use which one. The importance of self-care for oral surgeons.I share the reasons that motivated me to start the Everyday Oral Surgery podcast.Relaxation techniques that have worked wonders for Bob and I.The approximate percentage of board complaints that are related to poor communication.Why you should tend towards the minimum with regard to anesthetic drugs. A rapid fire round with Bob.   Links Mentioned in Today’s Episode: The Surgical Dental Specialists — https://www.dfwdentalimplants.com/ Robert G. McNeill on LinkedIn — http://linkedin.com/in/robert-g-mcneill-dds-md-mba-facd-87012715Between Two Teeth — https://www.youtube.com/channel/UC4KXk4VI0STVSCM_7eDnBPw/videos?app=desktop Lifespan by Dr. David Sinclair — https://lifespanbook.com/ Headspace — https://www.headspace.com/ Calm — https://www.calm.com/ Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Many oromaxillofacial surgeons take their right to anesthetize their patients for granted. Recently there has been a move to rescind this right, and talking to us today about why this is a disaster for patients and oromaxillofacial surgeons alike, is Dr. Chris Viozzi. Chris returns on this episode to remind us of the vital role of anesthesia in making dental procedures painless for patients, and what the field can expect in the way of updated safety and training procedures. Find out why the anesthetizing of a patient is so much more important than the procedure itself, and what you can do to support the fight for oromaxillofacial surgeons’ anesthetic qualification. We hear how disasters are like Swiss Cheese (all the holes have to be there), and what dentistry has learned from the aviation industry. For all this, and so much more, tune in today!Key Points From This Episode:Welcome back to Dr. Chris Viozzi, discussing the debate surrounding anesthesia (a reminder that his opinions are not reflective of official bodies). The double standards applied to medical procedures compared to dental procedures, and how the media portrays tragedies. Who is qualified and able to dissect the underlying cause of an anesthetic event, How oromaxillofacial surgeons can be safe when providing anesthesia to patients.Why Chris needs to reign in his residents' pre-surgery consult talking. How to prepare patients for surgery.The power of suggestion in reassuring your patients. How the board exams help early-career oromaxillofacial surgeons become competent in anesthetics. Why the questions in the board exams are structured the way they are. The benefits of being board certified regarding medical insurance and hospital employment requirements. How to avoid medico-legal issues: establish a good rapport with your patients, do quarterly reviews or training sessions, and evaluate your practice model.  The importance of resource management in preventing disasters!What private practice and academic surgeons can do to support the fight for oromaxillofacial surgeons’ anesthetic qualification. The questions you can ask to open critics' minds to other viewpoints. Why it’s important to focus on the anesthesia first, and then the surgery itself. Chris’s thoughts on anesthesia as a kindness to dental patients. A case study of Chris's, demonstrating the unique scenarios that oromaxillofacial surgeons are exposed to when administering anesthetic, compared to hospital cases. Why disasters are like Swiss Cheese: all the holes have to be present for a disaster to happen. The links between aviation and surgery. Links Mentioned in Today’s Episode:Dr. Chris Viozzi on LinkedIn — https://www.linkedin.com/in/christopher-viozzi-759605126/Dr. Chris Viozzi Phone — 507-284-2511Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Today, you’ll hear from Dr. Ole Jensen, an Oral and Maxillofacial Surgeon and the Founder and Chairman of the Board of Ditron Dental Implants, who is known worldwide in the field of dental implants and reconstructive surgery. In this episode of Every Day Oral Surgery, Dr. Jenson shares his experience with zygomatic implants and reflects on the way we do them now and whether or not it is the best approach for our patients. He shares how his thinking about zygomatic implants has evolved over the years and, while he has no desire to reinvent the wheel, so to speak, he promotes the benefits of taking a more customized approach on a case-by-case basis. We also touch on why he suggests seeking mentorship, taking a more conservative and less invasive approach, and learning to do pterygoid implants first, as well as the benefits of constantly improving your diagnostic and technical skills. Dr. Jensen also shares a number of valuable resources, recommended organizations, and books, so make sure not to miss this detailed and highly informative episode!Key Points From This Episode:Dr. Jensen shares a brief overview of his experience with zygomatic implants.Direct vision and protection for a long-distance process like zygomatic implants.Insight into some of the main criteria that Dr. Jensen assesses to determine if a patient will benefit from zygomatic implants.How his thinking about zygomatics has evolved without ‘reinventing the wheel’.What he recommends for surgeons looking to gain more experience with these implants.The importance of learning by doing and seeking mentorship.Why Dr. Jensen promotes being more conservative and less invasive.His advice: learn to do pterygoid implants before you do zygomatic implants.Dr. Jensen shares some useful resources on pterygoid implants.The importance of working within the boundaries of your knowledge.The relationship between sinus infections or disease and zygomatic implants.Sinus grafting and zygomatics; learn more about the benefits of a ‘graftless’ technique.Dr. Jensen’s tip for younger surgeons: join the Academy of Osseointegration (AO)!Dr. Jensen shares a recommended read: Peri-implant Infection: Etiology, Diagnosis and Treatment by Frank Schwarz and Jürgen Becker.Some final words of advice from Dr. Jensen regarding overdenture implants.Links Mentioned in Today’s Episode:Dr. Ole Jensen on LinkedIn — https://www.linkedin.com/in/ole-jensen-6b871512a/Dr. Ole Jensen Email — olegjenson@icloud.comDitron Dental Implants — https://www.ditrondentalusa.com/‘Rescue implant concept: the expanded use of the zygoma implant in the graftless solutions’ — https://pubmed.ncbi.nlm.nih.gov/21492800/‘The Pterygoid Plate Implant: A Solution for Restoring the Posterior Maxilla’ — https://pubmed.ncbi.nlm.nih.gov/7751116/‘A ‘Graft Less’ Approach for Dental Implant Placement in Posterior Edentulous Sites’ — https://pubmed.ncbi.nlm.nih.gov/31613937/‘The use of BMP around zygomatic implants’ —Academy of Osseointegration 2022 Annual Meeting — https://ao2022.osseo.org/AAOMS Dental Implant Conference — https://www.aaoms.org/meetings-exhibitions/2021-dental-implant-conferenceDr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Not everybody is going to have the desire or ability to run their own laboratory when they graduate from oral surgery, but it is Dr. Simon Young’s belief that every oral surgeon should graduate with an understanding of the scientific process. Simon’s own introduction to the field of clinical research happened completely by chance when he was volunteering at a local hospital looking to enhance his CV before applying to dental school. Now, as Director of Research at The University of Texas Health Science Centre at Houston, his working life consists of 75% protected research time, with the rest divided between clinical work at a county hospital, working with residents, and even a little bit of private practice. Tune in today for a deep dive into Simon’s fascinating world, which may leave you reconsidering your choice of specialty as an oral surgeon! Key Points From This Episode:Simon’s introduction to the field of research.What Simon’s career as a researcher has looked like.The process that Simon and his team went through in order to receive the prestigious R01 grant.Some stories which highlight the importance of networking as a researcher. What Simon’s working week consists of. Advice for getting involved in research as an oral surgeon. The mentoring program for residents that Simon has integrated into his program. Why Simon believes that every oral surgeon should have an understanding of the scientific process. Values that Simon’s department prioritizes. How Simon helps students identify the field of research they are interested in. Hear more about Simon’s passions and life philosophies during our rapid fire question round. Links Mentioned in Today’s Episode:Dr. Simon Young Email — Simon.Young@uth.tmc.edu Dr. Simon Young on LinkedIn — https://www.linkedin.com/in/simon-young-7a2875/ The University of Texas Health Science Centre at Houston — https://www.uth.edu/ Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

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