Everyday Oral Surgery

“No worldly success can compensate for failure in the home.” Alongside the fact that we are all oral surgeons, another commonality that I have with the two guests on today’s show is that we all went (or are currently going) through our oral surgery residency with at least one child. Dr John Tannyhill is the Director of Harvard’s School of Dentistry Oral Surgery Program and Dr. Michael Baron is an oral surgery resident at Mount Sinai, and they are here to share advice about maintaining a healthy work-life balance. There is no one-size-fits-all approach, and there will always be compromises that have to be made, so the key is to communicate openly with your significant other. We discuss important factors to take into account when deciding whether a residency program is “family friendly” or not, how some institutions accommodate for the unique income trajectory of oral surgeons, and why residents with families are likely to be more efficient than those without. For all of us, our “why” is our family, and we couldn’t do what we do without them, which is why we all recommend less (or no) moonlighting; there are so many other ways to get rid of your debt without sacrificing time at home! Key Points From This Episode:Michael and John share what their professional paths have looked like, and how these intersected with their family lives. Factors that contribute to making oral surgery programs “family friendly.”Compromises that you are likely to have to make in order to achieve a work-life balance.The importance of communicating with your significant other. A story about an interaction that Michael had with a landlord in Boston. Challenges of finding affordable housing as an oral surgery resident. The unique income trajectory of oral surgeons, and how banks accommodate for this.Ways that some programs prioritize oral surgeons who have families. How hospitals look after their residents in terms of health insurance.Health insurance options for students.John and Michael’s experiences of medical school compared to residency.A difficult time I went through during my residency and the support that my wife gave me during this time.Michael shares a story which highlights how difficult it can be to balance work and family life. Why residents with families are usually more efficient with their time than those without. The pros and cons of moonlighting, and why none of us would recommend it. Value in having conversations with previous residents. Changes that have occured in residency programs over the years. Support that Michael is receiving in his residency program. A rapid fire round with John and Michael.Links Mentioned in Today’s Episode:Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720 441 6059

The etiology, diagnosis, and treatment of temporomandibular joint (TMJ) and orofacial pain disorders are frequently challenging, and misdiagnosis and multiple failed treatments are common in this patient population. Today, we are joined by Dr. Louis Mercuri, an experienced oral maxillofacial surgeon, Clinical Consultant for TMJ Concepts, and Visiting Professor at Rush University Medical Center in Chicago, who has practiced in the state of Illinois for many years. Over his career, Dr. Mercuri has obtained research funding, published extensively, and been invited to lecture locally, nationally, and internationally on subjects related to the diagnosis and non-surgical and surgical management of temporomandibular joint disorders (TMD). In this episode, Dr. Mercuri shares some pearls for diagnosing and treating TMD patients, including the tricks and techniques he uses during examination to determine if the condition is intra-articular or extra-articular, how he communicates with unhappy TMD patients, and what resources he provides them with, plus so much more. This is a fascinating and informative conversation about TMD with a foremost expert on the subject, so make sure not to miss it!Key Points From This Episode:Learn about Dr. Mercuri’s dental and surgical training and his current practice setup.Advice for young surgeons who are interested in doing TMJ surgery: learn from others.Complications he has observed in TMD patients, many of which start with misdiagnosis.Diagnosis is key, as is knowing the difference between intra-articular and extra-articular conditions and what operation is required to treat it.Tricks Dr. Mercuri’s uses during examination to determine if TMD is intra- or extra-articular.Why some patients don’t respond to botox and others only feel relief for a few months.Why Dr. Mercuri says you should never operate for pain or promise 100 percent pain relief.The ‘bio-psycho-social’ etiology of TMD and the role that para-functional habits play.What Dr. Mercuri means when he says a well-informed patient is a partner in treatment.The benefits of what he calls a ‘hands in the pocket’ diagnosis.Indications for a total joint replacement, including dysfunction and degenerate changes.Learn more about the custom joint that Dr. Mercuri developed and its benefits.The importance of the social aspect of communicating with an unhappy TMD patient.The resources that Dr. Mercuri provides for TMD patients to take home with them.With the right patient, the right time, and the right equipment, you’ll get a good result!What Dr. Mercuri recommends for the oral surgeon who needs a good counterpart to help with non-surgical procedures.The important distinction that he makes between dentists, oral surgeons, and ‘pain doctors’.Useful medications that Dr. Mercuri prescribes diagnostically, like a low-dose of Elavil.Advice for younger surgeons looking to treat TMD patients: keep up with the literature!Links Mentioned in Today’s Episode:Dr. Louis Mercuri Email — TMJ Concepts — https://www.tmjconcepts.com/Rush University Medical Center — https://www.rush.edu/OMSNIC — https://www.omsnic.com/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720 441 6059

Suturing has a variety of purposes; it helps to quicken the healing process, minimize bleeding, and hold things in place. There are also a number of different categories that sutures fall into, for example, natural, synthetic, resorbable, and non-resorbable. In today’s episode, I’m joined by my brother, Dr. Jake Stucki, for a discussion around the basics of suturing, and some of the suturing techniques that are commonly used by oral surgeons. We go through a number of cases that we have personally dealt with, and explain what informed our decisions around the type of suture we used in each case, as well as some of the mistakes we have made along the way!  Key Points From This Episode:Jake shares a few of the reasons that oral surgeons suture. Problems with doing a loose suture.Conclusions from studies that looked at results when suturing was done versus when it wasn’t.How oral surgeons generally deal with mandibular compared to maxillary third molar sites. The different categories of suture.Why a surgeon would use a non-resorbable suture.When it is a good idea to use fast-gut.A mistake Grant made when suturing a child with severe autism. Squaring the knot; what this suturing technique entails, and how long it can last if done correctly. How to decide how many knots to place and tips for keeping them tight. Advice for dealing with a very large flap. The benefits of switching sides when suturing.Links Mentioned in Today’s Episode:Dr. Jake Stucki Email — jakestucki@gmail.comDr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720 441 6059

In today’s episode we are joined by Dr. Aaron Liddell, a repeat guest on the podcast; because he has so much valuable knowledge to share one episode wasn’t enough! The main focus of our conversation today is fractures. Over the past few years, and particularly since the start of the COVID-19 pandemic, Aaron has noticed an increase in the number of fracture cases that he is being called in to treat. He goes into detail about how the different approaches he utilizes to deal with a variety of fractures, using real world examples of patients he has worked with. Aaron offers advice to any surgeons who aren’t used to working in this particular realm of oral surgery which will help avoid unnecessary long term damage. So for all this and more from our great guest, join us on Every Day Oral Surgery!Key Points From This Episode:Trends that Aaron has noticed in Denver over the past few years.Ways that the COVID-19 pandemic had an impact on the volume of fractures Aaron was called to treat.The best way to avoid fracturing a jaw when taking out a third molar.How Aaron’s approach to taking out third molars has changed over time.An example of a patient who was inappropriately managed by another surgeon, and the damage control that Aaron had to do. Advice Aaron would give to surgeons around dealing with cases that are unusual to them.A strategy that Aaron uses in order to avoid using force when taking out a tooth.Factors which determine the order in which Aaron will deal with mandible fractures if the patient has multiple.How Aaron deals with any fractures situated at the mid-neck level or below. Aaron shares his thoughts about hybrid fixation systems.Approaches to dealing with different types of low condylar neck fractures. When Aaron uses rigid treatments and when he uses non-rigid treatments. Links Mentioned in Today’s Episode:Dr. Aaron Liddell — https://www.coloradooralsurgery.com/meet-us/dr-aaron-t-liddell-md-dmd-facs/ Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720 441 6059

Today, we are joined by Dr. Ian Lehrer, an oral maxillofacial surgeon practicing in Dana Point, California. In this episode, we discuss how to prepare to join a practice after you have completed your residency program. Dr. Lehrer has some valuable and practical tips to share, including the value of keeping in touch with your upper level residents and attending meetings at the American Association of Oral and Maxillofacial Surgeons (AAOMS) and the American College of Oral and Maxillofacial Surgeons (ACOMS). We also touch on contract negotiations and choosing between money, scope of practice, and location, as well as the benefits of joining group practice, proving your worth, and building relationships. Tune in today! Key Points From This Episode:An introduction to Dr. Ian Lehrer, his education, and his practice.How he figured out which practice to join after residency, starting with researching different cities and the practices in each area.The value of keeping in touch with your upper level residents after your residency.Another helpful tip: make sure to attend annual AAOMS and ACOMS meetings.Utilize all the resources that you have available to you, including courses and observerships.Advice for contract negotiations: consider your location and how much leverage you have.Different kinds of contracts you can expect, like an associateship in Dr. Lehrer’s case. Why Dr. Lehrer says defining your location is the most important thing when searching for a job; work where you want to live!Picking out one of three options: money, scope of practice, and location.The benefits of joining a group practice, including learning from the experience of others.Dr. Stucki highlights the importance of having a good work ethic and proving your worth.The value of building relationships; Dr. Lehrer encourages listeners to reach out to him.Rapid fire questions: Dr. Lehrer shares the best book he read this year and non-oral surgery skills that assist him in daily oral surgery.Ending on a note: “You can either go through life and be humble or you will be humbled.”Links Mentioned in Today’s Episode:Dr. Ian Lehrer on LinkedIn — https://www.linkedin.com/in/dr-ian-s-lehrer-865b56ab/Dr. Ian Lehrer on Instagram — https://www.instagram.com/drianlehrer/Dr. Ian Lehrer Email — lehrer@niguelcoastoralsurgery.comNiguel Coast Oral & Facial Surgery — https://www.niguelcoastoralsurgery.com/American Association of Oral and Maxillofacial Surgeons (AAOMS) — https://www.aaoms.org/American College of Oral and Maxillofacial Surgeons (ACOMS) — https://www.acoms.org/Osteo Science Foundation — https://www.osteoscience.org/Man’s Search for Meaning — https://www.amazon.com/Mans-Search-Meaning-Viktor-Frankl/dp/0807014273/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720 441 6059

Dr. Elda Fisher, our guest on today’s show, works with a highly disenfranchised cohort. Although transgender people make up 0.6% of the US population, they struggle with a lack of access to the kind of healthcare that Elda specializes in; facial gender affirmation surgery. As Elda explains, maxillofacial surgeons are uniquely qualified to do this type of surgery, and she is hopeful that in the future, there will be a more well-developed connection between them and the patients who are seeking to feminize or masculinize their faces. In this episode, Elda explains the life changing capacity of gender affirmation surgery, and offers examples of some simple strategies that surgeons can use to ensure that there is congruency between their patient’s face and their intended gender. As director of the oral and maxillofacial surgery residency program at the University of North Carolina, Elda also shares what she loves about working in an academic setting, some of the biggest learnings she has had during her time as a teacher, and the qualities that she looks for in potential residents. Key Points From This Episode:Elda’s journey to specializing in gender affirmation surgery. The size of the transgender population in the United States. Challenges to providing gender affirmative care. Why maxillofacial surgeons are so well equipped to do gender affirmative surgeries.Gender affirmation surgeries that are covered by insurance, and those that are not.Why there are a limited number of studies which demonstrate positive effects of gender affirmative surgery. Elda shares some simple strategies that surgeons can use to feminize or masculinize a face.  The number of patients in UNC’s transgender health program.Why Elda has found it particularly rewarding working with transgender patients. How Elda navigates the psychosocial dynamics of gender affirmative surgery. The first step towards performing successful cosmetic surgery and gender affirmation surgery.Primary orthognathic surgeries that Elda does as part of her gender affirmative procedures. Learnings that Elda has had through her position as a teacher.Elda’s strategy for giving feedback to her residents. What Elda loves most about working in an academic setting. Qualities and experience that Elda looks for in potential residents. The life changing and lifesaving potential of gender affirmation surgery.Links Mentioned in Today’s Episode:Dr. Elda Fisher — https://dentistry.unc.edu/people/elda-fisher/ Dr. Elda Fisher Email — elda.fisher@unc.edu Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720 441 6059

Today we are joined by oral and maxillofacial surgeon Dr. Myron Tucker. Dr. Tucker had a private practice in North Carolina for 18 years before he stepped away from full time surgery in 2009. Our guest has had a prolific career on the research side of the business, publishing a number of textbooks and offering his experience to support to students of the science. In our conversation, we get to hear Dr. Tucker's perspectives on building a successful practice, the patience and planing this requires, the benefits of pairing with someone more experienced, and how an open attitude to continual learning is the best stance to adopt. We also talk about why disability insurance is always a good idea, and Dr. Tucker's personal experience of this during his retirement. Listening in, you will get a real sense of a true professional, someone who has stayed invested and engaged in the work he loves, so make sure to join us for this inspiring conversation!Key Points From This Episode:Dr. Tucker's history in the dentistry field and the different positions he has filled over the years. The passion that has kept Dr. Tucker involved after his supposed retirement. Advice about pursuing a career in orthognathic surgery.  The importance of patience when building a successful practice.Common mistakes made by new surgeons; tips from Dr. Tucker for those starting out. The end of Dr. Tucker's career and practice and the lessons he learned going into retirement. Why Dr. Tucker strongly recommends getting disability insurance! The best book that Dr. Tucker has read this year: Say Nothing. Dr. Tucker's passion for woodworking and how this aided his work as a surgeon. The tools Dr. Tucker preferred for tooth extraction!  The love that our guest has for sailboats and being on the water; some of the beautiful boats he has owned. A quote about mistakes that has always resonated with Dr. Tucker!Links Mentioned in Today’s Episode:Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720 441 6059Dr. Myron Tucker — https://www.linkedin.com/in/myron-tucker-19ab80127Osteo Science Foundation — https://www.osteoscience.org/Stryker — https://www.stryker.com/Say Nothing — https://www.amazon.com/Say-Nothing-Murder-Northern-Ireland/dp/0385521316The Jackal — https://www.rottentomatoes.com/m/jackal

In Today's episode of Everyday Oral Surgery, we take a look at how oral surgeons who run their own practice are uniquely positioned to benefit from the many perks and points that various credit cards have to offer. We welcome back an old friend of the show, Dr. Scott Weiskopf, who has been using credit cards in his practice for many years to save tens of thousands of dollars on first-class travel across the globe. Tuning in you’ll hear Scott share his tips on how to get started and determine which type of credit card is best suited to your goals. Scott offers useful tips and tricks for keeping track of different cards, including a handy app called AwardWallet, and explains how to earn points on a variety of expenses from dining out to acquiring office supplies. We also hear from Scott about how to split points with your business partner. He also explains some of the risks involved in using a credit card for your business and how they can easily be avoided. To find out how you can start earning free travel on existing expenses, tune in today!Key Points From This Episode:We welcome back today’s guest Dr. Scott Weiskopf.Introducing today’s topic: credit card points and how to use them in your practice.Why oral surgeons who own a business are uniquely qualified to benefit from credit card points.How to determine which credit card is best suited for your goals.How Scott uses a range of credit cards to get benefits for different expense categories.Scott shares estimates of the money he’s saved on his recent trips.How Scott manages the complicated process of managing his various cards.Why Scott prefers credit cards to airline-specific cards.How to get the most value out of a credit card for your practice.Instances where a credit card is not a good choice.Some of the risks involved in using a credit card for your practice.How Scott splits the credit card points with his business partner.Why taking out additional credit cards doesn’t make a big impact on your credit score.Get to know Scott a bit better in our lightning question round.Links Mentioned in Today’s Episode:The Globe Trotter Teacher — https://www.theglobetrottingteacher.com/AwardWallet — https://awardwallet.com/Scott’s email — scottweiskopf@gmail.comProject Hail Mary — https://www.amazon.com/Project-Hail-Mary-Andy-Weir-ebook/dp/B08FHBV4ZXShawshank Redemption — https://www.imdb.com/title/tt0111161/The Goonies — https://www.imdb.com/title/tt0089218/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720 441 6059

Oral and maxillofacial surgeons are currently able to sedate patients and operate on them, although that privilege is under threat due to safety concerns. Dr. Robert Bosack, who has been a surgeon since before Mellampati scores were invented, is passionate about enhancing safety protocols for surgeons in order to preserve the right to anaesthetize and operate, and of course, to ensure minimal tragedy takes place in theatre. Problems can occur from the moment a patient is sedated until after they have walked out of surgery, and in today’s episode you’ll hear stories about a wide variety of potential issues. More importantly, you’ll hear about how to prevent these from occurring, and what to do if you run into serious trouble. Robert also shares a variety of resources where you can vastly broaden your scope of knowledge on safety in the operating room, including many that he has created himself. Key Points From This Episode:What the world of oral surgery was like when Robert graduated. How Robert’s practice is structured. Why Robert encourages all oral and maxillofacial surgeons to join the American Dental Society of Anaesthesiology. The model that oral and maxillofacial surgeons use for operating is under scrutiny. How Robert thinks safety should be measured. Dental Patient Safety Foundation; what this organization, that Robert co-founded, does. The value of role play in improving safety in surgery.Where you can access online training programs for surgery safety.How surgeons are taught to deal with impending airway obstructions, and the problem with this.Complications that occur in surgery due to human factor engineering.6 characteristics of people who are likely to have a tough airway. SSSR: Simple, Shared, Structured Responses, and an example of how these can play out in surgery.The importance of building relationships with paramedics.Airway management’s golden rule.How to test your patient’s level of sedation and understand whether or not they are in danger.Some of the challenges that surgeons can run into while their patient is sedated.Robert’s airway algorithm.When to call 911, and why you should never feel shame in doing so.Post-surgery reactions that patients may experience.The strategy Robert uses to connect with his patients. What you can expect to learn from the talk Robert is giving at the ADSA Chicago conference.Links Mentioned in Today’s Episode:Dr. Robert Bosack — https://www.linkedin.com/in/robert-bosack-8473ab24/ Anaesthetic Complications in the Dental Office by Robert Bosack —  https://www.amazon.com/Anesthetic-Complications-Dental-Office-Prevention/dp/0867154489 Dental Patient Safety Foundation — https://www.dentalpatientsafety.org/ Dental Anaesthesia Online — https://www.daoce.org/ ADSA Chicago — https://www.adsahome.org/chicago Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720 441 6059

Today’s guest is not only an oral surgeon, but an author and an MBA graduate as well. Dr. Dean DeLuke spent 30 years in private practice before transitioning to full-time academia, which is where he has spent the last 10 years. Dean explains what he loves so much about being an academic, and why he would recommend it to any oral surgeons on a part-time or full-time basis. He also shares how having an MBA benefited him in a variety of ways, and what inspired him to write Shedrow. This episode is slightly unusual in that Dean puts Grant in the hot seat for a little bit, with a few questions that will give you insight into the personal reasons that motivated him to start this podcast. Soon to be facing retirement, Dean is full of experience and wisdom, and we hope you learn as much from this episode as we did! Key Points From This Episode:Time that Dean spent in private practice, and what he loves about working as a full-time academic currently. The book that Dean wrote, and what inspired him to write it. Elements that Dean loved about writing a book, and those that he didn’t like very much. Reasons that Dean decided to do an MBA, and how it has benefited him. The impetus behind Dean’s decision to go into full-time academics. Differentials between earnings in private practice and academia, and how these have been reduced over the years.A study that Dean and a colleague did to determine satisfaction levels of academics. Advice from Dean for young oral surgeons interested in writing. The future of Dean’s writing career.Why Dean encourages oral surgeons to enter the world of academia.Business advice for young oral surgeons.The strategy Dean recommends that graduates use to pay off student debt. What Dean would have done differently if he could go back in time. How Dean’s hobby of slalom water skiing positively impacts him professionally. Dean puts Grant into the hot seat with some questions about the podcast.Links Mentioned in Today’s Episode:Dr. Dean DeLuke — https://www.linkedin.com/in/dean-deluke-631b1b19/ Shedrow by Dean DeLuke — https://www.amazon.com/Shedrow-Dean-DeLuke/dp/0983490007 Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720 441 6059