Everyday Oral Surgery

San Francisco is a densely populated area, thus a highly competitive market, but there are still ways to establish yourself as an oral surgeon if you decide to set up shop there. Today we talk to Dr. Aldrich Sy, a past classmate of Dr. Stucki’s, about his experiences practicing in the San Francisco area and how he has managed to get his name out there and succeed in this tough landscape. For Dr. Sy, San Francisco is a great place to live, and he was prepared to do whatever it took to make headway in the first few years after graduating from residency. After chatting a bit about Dr. Sy’s education and reminiscing about college, we jump right in and hear about the steps he took to start practicing professionally. He talks about receiving an offer from an assistant professor from UCSF to come and join him at his existing practice. We speak about how well this relationship has been going and the importance of trust in maintaining it. From there, Dr. Sy describes all the things he did to start receiving his first few patients, from literally knocking on the doors of other dentists in the area, to giving lectures at medical and dental schools and more – anything to get a foot in the door. The main message we get from Dr. Sy is that as a young oral surgeon hoping to make it in the Bay Area, you need to be willing to leave your ego at the door, be a good person, and give freely of yourself without expecting anything in return. As we discuss today, oral surgeons depend on general dentists for referrals even though they are more qualified, so the better your reputation in these circles, the more you’ll thrive. For some great insights from Dr. Sy about the value of doing good for others when trying to make it in a competitive landscape, tune in today.Key Points From This Episode:An introduction to Dr. Sy: His career ambitions, education, and current practice.How Dr. Sy’s current practice partnership is going and the place of trust in this relationship.What Dr. Sy does in such a densely populated area to keep his practice thriving.Finding a niche, building relationships, giving lectures: How Dr. Sy got his name out there.Oral surgeons depend on general dentists for referrals even though they are more qualified.The need for oral surgeons to swallow their pride while building their early careers.Being a good person and a go-giver to survive in competitive San Francisco.Remembering that you can’t please everybody and not feeling bad for saying no to some referrals.Trying not to squeeze money out of patients and only doing what is necessary to help them.Being generous with one’s phone number and communicating frequently with patients and dentists.How to handle big quantities of follow-ups with patients after surgeries.Being flexible with your plan for how to make it as an oral surgeon.The idea that many surgeons don’t end up having the right personality for San Francisco.Tradeoffs about living in San Francisco: Expenses, lifestyle, tax, and more.Qualified oral surgeons are adaptable due to many being weeded out during residency.Links Mentioned in Today’s Episode:Dr. Aldrich SyUCLAUCSFAAOMSThe Go-Giver

The time maxillofacial and oral surgeons spend in residency is invaluable, but sometimes what you learn in practice can be just as beneficial. This sentiment is echoed by Dr. Ryan Sheppard, today’s guest, who is on the show to talk about platelet therapy and internal sinus lifting techniques. We open the episode by taking a look at Ryan’s history in surgery, the influences of having a surgeon for a father, as well as how being trained in Texas and Chicago gave Ryan unique perspectives on surgery. Turning toward the present day, Ryan tells us about the changes he’s made to his surgery, touching on the use of ketamine during procedures and why he prefers his patients to be light on drugs rather than being on a heavy dose. On the topic of dosage, Ryan shares how a patient’s own drug habits can affect how he approaches their anesthesia. As our conversation progresses, we cover the highlight of the show as Ryan dives into his PRF technique, how it aids healing, and why dry sockets are less likely to occur from his method. He goes on to explain other techniques, including his Sticky Bone technique, which uses platelets and bone grafting. After hearing why Sticky Bone keeps the bone as a unit and why it’s easier to pack, we delight in some humor and hear a couple of Ryan’s Texas-isms. To find out what socks on a hen feel like, and a whole lot more, be sure to join us today!Key Points From This Episode:Introducing today’s guest, maxillofacial surgeon Dr. Ryan Sheppard.Ryan shares a brief history of his professional life.Contrasting the training that Ryan received in Texas versus Chicago.Why Ryan enjoys working in a four-man team.How Ryan’s life drastically changed when a hurricane hit the city he was living in.How Ryan has adapted his training into a per-scenario style of surgery.Changes Ryan has made to evolve his practice. Hear how Ryan’s implant techniques have improved over the years.How Ryan uses something called the “PRF clot”.Ryan tells us in detail how he performs the PRF technique.The patient benefits from using PRF.Ryan explains the Sticky Bone technique. The most important aspects of Ryan’s practice outside the realm of surgery.How you can learn from yourself, and perfecting your own techniques.The peculiar southern phrases Ryan says to his patients.How people who are regular users of marijuana need higher doses of ketamine.Ryan discusses various drilling techniques.Links Mentioned in Today’s Episode:School of Dentistry UABUniversity of TexasAstra TechNobel BiocareBlue Sky BioDr. Joe Funderburk

Building a practice is not something that’s taught in dentistry school. Instead, you need to dramatically expand your business skills to make a success of your new practice. Today we speak with Dr. Curt Hayes about how he built his practice from scratch and why he removed narcotics from his pain management strategy. We open our conversation by exploring Curt’s training and career, which includes caring for troops who were injured in Afghanistan. We then dive into what he did to build his practice, the challenges he needed to overcome, and his top learnings from opening a business. We then focus on what Curt did to grow his practice. He shares the value that business books have brought him and the importance of hiring the right people for the right jobs. We touch on how you can get referrals from engaging with your dentists in your area and how speaking with other carers can help you with your cases. A key theme in this episode, Curt highlights how uses alternative pain-relieving strategies while avoiding narcotics. After talking about the link between oral surgeries and opioid exposure, Curt gives listeners specifics about how he uses EXPAREL in his procedures. Near the end of the episode, we discuss how his approach to narcotics has impacted his sedation techniques and why you should separate yourself from your patient’s issues. Tune in for more insights into building a practice, the benefits of using EXPAREL, and removing narcotics from your procedures. Key Points From This Episode:Introducing today’s guest, maxillofacial surgeon Dr. Curt Hayes.Exploring Curt’s training and many career highlights.Hear what Curt learned from treating injured soldiers coming out of Afghanistan. Details about Curt’s practice and what he spends the bulk of his time on.Overcoming the challenges of opening a private practice. The prairie dog problem; dealing with unexpected costs.Curts talks about how long it took to develop a steady stream of clients.How business books have helped guide Curt’s practice.Insights into how Curt built his customer base. The value of engaging with your local dentistry community.How Curt’s has changed his practice by using alternative pain management strategies. Why limiting your patient’s exposure to opioids is better for your community. Specifics on how Curtiuses EXPAREL. What led to Curt’s passion again using opioids in his practice.  How Curt’s anti-narcotics approach has impacted his sedation techniques.What you feel matters: creating a practice that you’re proud of.Curt shares some final advice on continual learning and not being affected by your patient’s problems. Links Mentioned in Today’s Episode:Dr. Curt HayesCoal Creek Oral Surgery and Dental Implant CenterWilford Hall Medical CenterSimon SinekWhat’s Your Why? On AmazonEXPARELNPRColorado-CUREPacira

The career of an oral surgeon is intimately linked to the responsibilities of their assistants, but the topic of how to train assistants is not frequently spoken about. Today on the show Dr. Stucki sits down with his co-host Dr. David Salomon and they have a productive discussion about approaches to training assistants, as well as bite block usage and patient positioning during surgery. The show begins on the topic of assistant training, and we hear about the different ways our hosts have tackled this important side of the practice. Dr. Stucki likes to give his assistants as much responsibility as possible, while Dr. Salomon is more hands-on in his own capacity, and listeners get to hear about the pros and cons of each approach as well as some contextual factors that have influenced these differences. From there, our hosts tackle the issue of bite block usage, highlighting the value of moving the block during surgery for better access, as well as the fear-inducing idea of removing it completely and the possibilities this technique offers. This leads to a discussion on how to use other tools like sweethearts and electric drills to free up the hands of assistants where possible. Toward the end of the show, Dr. Stucki and Dr. Salomon exchange their thoughts on patient positioning, weighing in on how it affects the surgeon’s posture, the role of assistants, the process of surgery, and more. Be sure to catch today’s episode.Key Points From This Episode:Differences in approach to delegating to assistants between Dr. Stucki and Dr. Salomon.Tradeoffs between how much work it is to train an assistant and the extra work the surgeon does otherwise.The plus side of having assistants who have extra responsibility for keeping them engaged.Routines and approaches our hosts use to train their assistants.How Dr. Stucki and Dr. Salomon’s contexts influence their approaches to training assistants.Complexities around assistants making mistakes; common mistakes that bother our hosts.How Dr. Stucki trains his assistants to do IV sedation and Dr. Salomon’s views on this.Nuances of bite block usage: Benefits, context-specific requirements, and more.How Dr. Stucki and Dr. Salomon use sweetheart retractors and guide their assistants to do so.The goal of saving assistants’ hands by using sweethearts, electric drills, and more.Dr. Stucki’s usage of the bite block for maxillary impacted third molar cases.Fear around taking bite blocks out during surgery but how much is possible if done correctly.A discussion of the topic of patient positioning and how it relates to assistant use and surgery.Preferences around having a chinner assistant who can get in the way of the surgeon.The value of putting patients in a sniffing position for keeping the airways open.Dental chairs versus surgery chairs: Which work better for oral surgery and patient positioning.Getting patients in the right position before sedation to save yourself the strain.Final thoughts on the value of training assistants well and topics for future shows.Links Mentioned in Today’s Episode:Dr. David SalomonDr. Grant Stucki Contact — 720-775-5843

Many complications can arise during anesthetization due to factors like patient history. Surgeons need to proceed with caution during this process, taking extra care to learn about a patient’s context, even if it is not solely their responsibility to gather this information. Today’s guest is Dr. Louis Halkias, here to talk about how he takes extra care with anesthetization, as well as weigh in on new technologies that are changing the practice of oral surgery, his method of training assistants and residents, and more. Dr. Halkias is a Clinical Associate Professor at the University of Illinois in the Department of Oral and Maxillofacial Surgery, and he has also been practicing privately at Oral Surgery Associates since 1998. We begin our conversation by hearing about Dr. Halkias’s education and career and then move on to talk about some of the changes he has seen from a technical and insurance perspective in recent years. We then discuss some of the procedures Dr. Halkias performs most frequently and he shares about what a game-changing technology Versah Densah Burs have been for him. We get into his approach to grafting and implants and he touches on some of his favorite brands and the need to use the same ones frequently. On the topic of anesthetization, Dr. Halkias takes a deep dive into his process, and we have a productive exchange about dosage, complications, patient history, and new technologies. We also have a great chat about working with assistants, zooming in on how Dr. Stucki and Dr. Halkias like to train theirs to work with instruments and stay focused during surgery. For all this and other points about running a shared practice, handling referrals, and good communication, tune in today.Key Points From This Episode:A brief overview of Dr. Halkias’s education and career, and his role at UIC.The biggest changes Dr. Halkias has seen in the specialty, and what procedures he does most.How much the Versah Densah Burs have changed Dr. Halkias’s practice, and how to use them.What Dr. Halkias’ grafting techniques look like these days and what materials he is using.Whether Dr. Halkias ever sees an inflammatory response to grafting materials.How high resident debt is these days and Dr. Halkias’s approach to training students.The approach of working in a group practice and splitting profits at Dr. Halkias’ practice.Advice from Dr. Halkias for oral surgeons who experience back pain.The benefits of giving back and Dr. Halkias’ advice for surgeons who want to do so.Tips from Dr. Halkias for surgeons who want to communicate better with patients.Dr. Halkias’s approach to training his assistants and the values he instills in them.Approaches to assistants handling instruments between Dr. Stucki and Dr. Halkias.Complexities around anesthetization: Tools, patients on medication, referrals, etc.How the practice of implants is changing thanks to guides and scanners.What brands Dr. Halkias is comfortable using and why he is reluctant to change brands.Dealing with abutments and implants that have been fitted incorrectly.Links Mentioned in Today’s Episode:Dr. Louis HalkiasOhio State UniversityNorthwestern Dental SchoolUniversity of IllinoisOral Surgery AssociatesVersahDr. Grant Stucki Contact — 720-775-5843

Today’s guest is Dr. Joseph Funderburk, Oral and Maxillofacial Surgery Specialist at Grand Junction Oral Surgery, Colorado. He joins us on the show to talk about running a practice and share some of his techniques for surgery procedures too. Dr. Funderburk received his Doctor of Dental Surgery degree from the University of Colorado Health Sciences Center (UCHSC) in Denver, and he kicks the show off talking about his education and plans to set up a practice in his hometown thereafter. Grand Junction is a small town and Dr. Funderburk talks about the challenges of inserting himself into the small community of oral surgeons there. He shares the story of how he eventually struck a deal with an older surgeon to buy his practice, thereafter partnering with him for many years, and why he is having to take on a new associate now. We speak to Dr. Funderburk about the challenges of running a practice, hearing him weigh in on some of the techniques he is using to market his business. From there, we take a deep dive with Dr. Funderburk into the world of instruments, anesthesia, and techniques around implants and bone grafting. Dr. Funderburk talks about his use of a precordial stethoscope, nasal hood, Versah drills for implant placement, and his protocol around drug administration for putting his patients to sleep. For all this and more, be sure to tune in today.Key Points From This Episode:An overview of Dr. Funderburk’s education and experiences joining a practice after.The story of how Dr. Funderburk bought a practice from an older surgeon in Grand Junction.Reasons why typical partnerships don’t work and how Dr. Funderburk navigated this.How the first phases of the partnership worked out regarding logistics and staff.Why Dr. Funderburk ended up taking on a new associate who will become a partner at his practice.Some of the biggest challenges Dr. Funderburk faces as a practice owner.Systems Dr. Funderburk has put in place to market his practice; integrating his staff with that of other practices.The mission statement at Dr. Funderburk’s practice; ways his services go beyond what is required.Recent changes to Dr. Funderburk’s techniques and the benefits of these shifts.The protocol at Dr. Funderburk’s practice regarding administration of anesthesia drugs.Devices and setups Dr. Funderburk uses to administer anesthesia drugs.Why Dr. Funderburk had to work harder recently; how things are going with his new associate.Dr. Funderburk’s techniques for taking out upper maxilla molars; why he doesn’t use forceps.Approaches to grafting and implants at Dr. Funderburk’s practice.Techniques for implant placement in the posterior maxilla using Versah drills.Advice from Dr. Funderburk for future guests on this podcast.Links Mentioned in Today’s Episode:Dr. Joseph FunderburkColorado State UniversityVersahGrand Junction Oral SurgeryDr. Grant Stucki Contact — 720-775-5843

Today’s guest is Dr. Alan Felsenfeld, here to talk about how he has found meaning in his dynamic career through mentorship, community work, best practices, and building good relationships with patients and fellow residents. Dr. Felsenfeld is currently retired but still very active in the community, and he is still affiliated with the UCLA Medical Center where he was a full-time faculty member since 1995. Prior to that, he was in hospital administration, after which he trained to be an oral surgeon at County Hospital in Chicago and then went into private practice in the East San Gabriel Valley. Dr. Felsenfeld has made many pivots in his career and we talk about the motivating forces behind these changes, hearing him weigh in on the value of staying fulfilled. For him, teaching, leadership, and giving back to the profession were major driving forces, and he talks about how his choices lead him closer to these activities, thereby keeping him motivated and inspired. We also get into some of the technical sides of surgery, talking about the correct use of instruments and some of the difficult cases Dr. Felsenfeld undertakes in his capacity as an affiliate at a university medical center. We also have a great discussion about Dr. Felsenfeld’s abilities to communicate so well, and he speaks about how far humor, jargon avoidance, and not taking himself too seriously can go in daily relations. Tune in today!Key Points From This Episode:A brief history of Dr. Felsenfeld’s training and current affiliation with UCLA.Advice for young surgeons who want to give back despite post-medical school debt.Dr. Felsenfeld’s path into academia and how he stays motivated on a daily basis.How Dr. Felsenfeld bypasses the political aspects of working in academia.Having several career pivots and why Dr. Felsenfeld gave a lecture on reinventing yourself.A closer look at why and how Dr. Felsenfeld transitioned from hospital administration into oral surgery.Dr. Felsenfeld’s memories of training in Chicago, his co-residents, and the fun times they had.Mandibular tori, implants, extractions: Surgeries Dr. Felsenfeld performed recently.Common mistakes Dr. Felsenfeld sees younger surgeons make; correct tool usage.Difficult cases Dr. Felsenfeld deals with and how these cases are often referred to universities.Communication tips: Having good humor, avoiding jargon, not taking yourself too seriously.Things Dr. Felsenfeld does to take his mind off his job; why he loves flying small planes.How difficult but important it is to stop performing surgeries once you get too old.Dr. Felsenfeld’s experiences with his grandkids and what they are interested in.Final words from Dr. Felsenfeld about how to find meaning in an oral surgery career.Links Mentioned in Today’s Episode:Dr. Alan FelsenfeldUCLACounty Hospital ChicagoThe Dental Board of CaliforniaAAOMSDr. William FlickDr. Charles BertolamiDr. Grant Stucki Contact — 720-775-5843

In the discipline of oral surgery, cases can get complicated for highly technical reasons, but perhaps it is the emotionally complex cases that present the biggest challenges. Today, we speak to Dr. Ole Jensen about his experiences with challenging cases, also diving into the contributions he has made to the field of implants. Dr. Jensen received his DDS degree from Northwestern University School of Dentistry, completed his Anesthesiology Residency at Northwestern University School of Medicine, and his Oral and Maxillofacial Surgery Residency at the University of Michigan. His research interests are bone grafting, dental implants, and distraction osteogenesis, and he has authored three textbooks on oral surgery as well as more than 25 articles. Dr. Jensen begins our conversation talking about his dynamic education, sharing how he got interested in anesthesiology, oral and maxillofacial cancer, tracheostomy, intubations, and how he trained in the Brånemark System after his studies at ‘the school of hard knocks’. We move onto the subject of implants, and Dr. Jenssen talks about the groundbreaking contributions he has helped make to shape new technologies that enhance antimicrobial action to prevent peri-implantitis in different ways. Toward the end of our conversation, we talk about why Dr. Jensen is familiar with difficult cases and the reason that some of the most challenging ones are due to emotional reasons. Wrapping up, Dr. Jensen shares some lines from the Rambam physician prayer for oral surgeons who hope to give back to the community in ways as significant as his. Tune in today.Key Points From This Episode:An overview of Dr. Jensen’s education and training in the Brånemark implant system after school.Dr. Jensen’s pursuit of anesthesiology and the medical and surgery side of dentistry at college.The experience in intubations and tracheostomies Dr. Jensen had in his training.A case where a patient expired during an anterior mandibular dental implant replacement.The story behind ClearChoice and the role Dr. Jensen played in steering the company.Nanotechnology by Nobio to enhance antimicrobial action on implants to prevent peri-implantitis.The dental implant company called Ditron Dr. Jenssen started and the precision implants they make.The tolerance of microns between machine parts Ditron Ltd. makes which is too small for bacteria.Some of the work Dr. Jensen is still doing; starting an oral and maxillofacial surgery training program in Salt Lake City.Zygomatic implants and other tough cases Dr. Jensen did daily and why.Links Mentioned in Today’s Episode:Dr. Ole JensenClearChoiceUniversity of MichiganNorthwestern University School of MedicineNorthwestern University School of DentistryBrånemark SystemPer-Ingvar BrånemarkHadassahNobioDitron DentalDitron Ltd.University of UtahDr. Grant Stucki Contact — 720-775-5843

If oral and maxillofacial surgeons can find the time to commit to their local hospitals and associations beyond their private practices, the integrity of the specialty will be more securely protected. This is a belief held by today’s guest, Dr. Alexis Olsson, and his career shows it. Dr. Olsson is an Oral and Maxillofacial Surgeon practicing in Chicago, Illinois. He is currently Chief of Oral and Maxillofacial Surgery at Northwestern Memorial Hospital and Anne and Robert H. Lurie Children’s Hospital, as well as Professor of Clinical Otolaryngology and Head and Neck Surgery at Northwestern University Feinberg School of Medicine. He is also an active member in the oral and maxillofacial surgery community through his service to both AAOMS and well IAOMS. In this episode, we talk to Dr. Olsson about how he grew his practice to straddle the public and private spheres with such equal measure, while also hearing about as the techniques that have defined and are defining his practice today. We hear his thoughts on the current landscape of the oral and maxillofacial surgery specialty too, where he talks about the forces that are jeopardizing it, the need for new surgeons to take an active concern in its survival, and what is to be done in this regard. For a conversation rich in insights that span the technical and social sides of oral surgery, tune in today.Key Points From This Episode:Dr. Alexis Olsson’s education and career in both private and academic settings.How Dr. Olsson was able to grow his career in the academic as well as private space.Staying afloat in competitive downtown Chicago by being dedicated to patient care.The recent value of virtual surgical planning and new technology for Dr. Olsson’s practice.Challenges in Dr. Olsson’s career; less personal relationships between patients and doctors.Advice from Dr. Olsson for new surgeons who have a desire to protect the profession.Rewarding parts of being a teacher and Dr. Olsson’s hopes for his students’ futures.‘Taboo’ but effective techniques Dr. Olsson used early on and new tricks for optimizing surgery.How Dr. Olsson goes about doing implants generally – his case by case approach.When Dr. Olsson will do a flapless implant; biological characteristics of patients.Dr. Olsson’s philosophy of being conservative with soft tissue manipulation.The approach Dr. Olsson has to reconstructions and how things have become more aggressive.Dr. Olsson’s approach to doing molar immediate implants.What communication techniques and bedside manner should look like for surgeons.Final comments from Dr. Olsson about the need for oral and maxillofacial surgeons to protect their specialty and represent it well.Links Mentioned in Today’s Episode:Dr. Alexis OlssonNorthwestern UniversityNorthwestern Memorial HospitalLurie Children’s HospitalNorthwestern MedicineNorthwestern University Feinberg School of MedicineNorthwestern Dental CenterAAOMSIAOMSDr. Mark C. HuttenDr. Grant Stucki Contact — 720-775-5843

Succeeding as an oral surgeon is about far more than academic and clinical talent. It also requires you to be a leader and a salesperson. This is just one of the many great insights today’s guest, Dr. Thomas Schlieve, shares with us. With advanced fellowship training in oral, head and neck oncologic surgery, Thomas is the current Graduate Program Director at Parkland Memorial Hospital in Dallas. In this episode, we learn more about his pathology passion and how he has earned the nickname ‘The Dead Bone Doctor of Dallas’. Thomas walks us through some of the most common cases in his pathology-focused practice, along with his frustrations when trying to treat cancer. We hear about why he advocates for incisional biopsies, the importance of not waiting to intervene with head and neck cancers, and how having patients come in with biopsies eases his workload. The conversation then moves away from the surgical side of things, where we talk about growing as a leader to be a better surgeon. Here, Thomas shares what he has gained from How to Win Friends & Influence People and how he has applied this knowledge to improve his practice. As someone who works on the academic side of things, Thomas has a firsthand understanding of what it takes to be a great oral surgery resident, and we wrap the show up by hearing these top tips. For all this and more, be sure to tune in today!Key Points From This Episode:Get to know Thomas, his training, and what he is currently doing.The pathology cases that Thomas spends most of his practice time on.Thomas’s patient-specific approach to treating osteonecrosis and the techniques he uses.Advice Thomas has for effectively handling osteonecrosis.Thomas’s frustration when something cancerous is removed and no legion is left to see.Why you should not wait for a head or neck cancer to grow before intervention.How patients coming in with biopsies helps Thomas chart an effective course of treatment.The way that different margins are marked by pathologists.Hear why Thomas believes you should declare an excisional biopsy.Success as a surgeon is about more than clinical talent; you have to be a good leader too.How Thomas changed his approach to referrals and leadership generally.Takeaways from How to Win Friends & Influence People that Thomas and Grant have used in practice.The importance of letting patients vent and giving them space to offload.Thomas’ approach to patient education and giving them information feel most comfortable.Asking open-ended questions and mirroring: How these techniques get patients to open up.Being caring as a leader and how this helps all aspects of your practice.Why Thomas has grown more cautious about implants since his residency.Thomas's approach to immediate implants and being clear on timelines with patients.Hear what Thomas looks for in potential residents.The impact that upbringing has on the grit that is required to become a surgeon. Links Mentioned in Today’s Episode:Dr. Thomas SchlieveParkland HospitalSchool of Dentistry Marquette UniversityUniversity of Illinois at Chicago College of DentistryHow to Win Friends & Influence PeopleDale Carnegie TrainingDr. Grant Stucki Contact — 720-775-5843