Everyday Oral Surgery

In this episode of Every Day Oral Surgery, we talk about osteomyelitis, a rare disease that manifests in a range of patients and is often difficult to diagnose, with expert Dr. Benjamin Hechler. Dr. Hechler is an Assistant Professor and Oral and Maxillofacial Surgeon at Duke University Health System and specializes in oral, head, and neck oncologic surgery. We unpack the various challenges associated with diagnosing osteomyelitis and hear the gold standard regarding treatment. Listeners will learn about the different types of osteomyelitis which can manifest and the steps to take to treat osteomyelitis effectively. We also find out why you should not rely on imaging for diagnoses, why it is considered a surgical issue, and when osteomyelitis can become more advanced and spread. Discover the first steps to take when dealing with osteomyelitis diagnoses, the people most at risk, how to avoid additional surgeries, and when it is appropriate to use antibiotics for treatment. Tune in to learn everything you need to know about osteomyelitis to ensure that your patients get the best treatment possible with Dr. Benjamin Hechler!Key Points From This Episode:We start the show by learning the official definition of osteomyelitis.Dr. Hechler outlines the different classifications of osteomyelitis.The best approach to diagnose osteomyelitis.Why you cannot diagnose osteomyelitis from a CT scan alone. What you should consider when reviewing the radiologist report. Problems associated with diagnosing osteomyelitis.When Dr. Hechler thinks you should send the patient for more advanced imaging.Whether there is a timeline in determining if the patient has any osteomyelitis infection.Hear about patient factors that will increase the likelihood of osteomyelitis.Discussion about the possible reasons someone may suffer from osteomyelitis.Immediate steps to take when you first suspect the possibility of osteomyelitis.What you should do once osteomyelitis has been confirmed from biopsies. Learn when osteomyelitis can become more advanced and extend below the canal.The role of antibiotics in treating the different types of osteomyelitis.Dr. Hechler’s approach to determining the extent of surgery needed to treat osteomyelitis.A rundown of the adjunctive treatments available and if they are effective. We discuss the challenges for surgeons when defining osteomyelitis.The different types of treatments available for diffuse sclerosis-related issues. Links Mentioned in Today’s Episode:Dr. Benjamin Hechler on LinkedIn — https://www.linkedin.com/in/ben-hechler/Duke University Health System — https://www.dukehealth.orgVA Durham health care — https://www.va.gov/durham-health-care/Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.linkedin.com/in/david-hirsch-126210bb/Everyday Oral Surgery on LinkedIn — https://www.instagram.com/everydayoralsurgery/ Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Thanks for joining us for another episode of the Everyday Oral Surgery podcast. Today we are joined by Dr. Shaun Young of MOSAIC Maxillofacial Surgical Arts in Tampa Bay, Florida. Dr. Young has a lot of experience with trauma cases and in this episode, we learn about the evolution of his implant and bone grafting techniques and the technology that has allowed for a smoother surgical process. Dr. Young explains the challenges of vertical ridge augmentation and breaks down the benefits of customized titanium mesh versus traditional mesh for these tricky bone graft cases. Tune in to find out how to gain access to this revolutionary technology, as well as apply and retrieve the mesh in operation. If you’re looking to pursue a full-scope practice, this episode is for you!Key Points From This Episode:Dr. Shaun Young’s training history and current practice setup.Dr. Young’s advice for residents looking to pursue a full-scope practice.The scope of Dr. Young’s practice.How his implant and bone grafting techniques have evolved over time.The importance of soft tissue in the long-term maintenance of implants.What value Dr. Young has gleaned from Dr. Istvan Urban’s books.Challenges of vertical ridge augmentation.The techniques Dr. Young finds most effective.The benefits of ReOss’ customized titanium mesh.How to access the new dental regeneration technology in the US.How to avoid complications in challenging bone graft cases.Customized titanium mesh versus traditional mesh.How to apply and retrieve the customized mesh in operation.The screws Dr. Young prefers to use in ridge augmentation cases.Dr. Young answers our rapid-fire questions!Links Mentioned in Today’s Episode:@thefaceguys on Instagram — https://www.instagram.com/thefaceguysDr. Shaun Young Email — shaunryoung@gmail.comDr. Shain Young Phone — (813) 390-9325MOSAIC Maxillofacial Surgical Arts — www.mosaicsurgery.comVertical and Horizontal Ridge Augmentation by Dr. Urban — https://www.amazon.com/Vertical-Horizontal-Ridge-Augmentation-Perspectives/dp/1786980002Vertical 2 by Dr. Urban — https://www.amazon.com/Vertical-Next-Level-Tissue-Augmentation-ebook/dp/B09LMQ9N5TReOss — https://www.reoss.eu/Geistlich — https://www.geistlich.com/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059Everyday Oral Surgery — www.everydayoralsurgery.com

Joining us in conversation is Dr. Jacob Stucki, to discuss the recently updated whitepaper on office-based anesthesia. Tune in today to hear what is outlined in the White Paper update and what the implications are for practitioners. Dr. Grant Stucki shares his biggest take-home from the article, and the doctors explore the critical starting point for anesthesia. Disease categories, heart failure, asthma, and renal diseases are among our talking points today, with a part of our conversation dedicated to the distinction between pediatric and adult patients. Next, we unpack what it means to treat the patient, and not the monitor, and discuss the two parts of emergency preparedness, as outlined by the White Paper update. Find out why this model is important, and why it’s worth taking 20 minutes out of your day to read the paper.Key Points From This Episode:Today’s topic: the recently updated whitepaper on office-based anesthesia.Reasons for the recent update: for members, and to highlight their good work for others.The importance of anesthesia for oral surgeons.AAOMS training for anesthesia and its requirements.What the White Paper includes about the history of anesthesia and AAOMS.The AAOMS team model which includes a minimum of three highly trained professionals.The dividing line when a patient experiences discomfort.Techniques including using local to reduce the need for other methods.What Dr. Grant Stucki considers the biggest take home message of the article.Where safe anesthesia starts and why it is critical.The profile of a patient you are looking for: healthy patients or those with a systemic condition that is well controlled.The difference between ASA2 and ASA3 disease and how there isn’t a category for moderate diseases.Which candidates to take off your list of options to sedate.Why it is important to know enough about heart failure to be able to recognize it.Addressing the issue of asthma within candidates for anesthesia.Hepatic and renal disease.The importance of treating pediatric patients differently, and not just like small adults.Risks connected to treating pregnant patients.What it means to treat the patient, not the monitor.The two parts to emergency preparedness: systems, and practice.Dr. Grant Stucki’s experience saving the lives of two patients in an emergency situation.Scenarios you should go over: multiple health issues, asthma, overdoses, heart attacks, allergic reactions, and more.The importance of having scrimmages in the different areas of the office.Simulation tools you can look forward to using to train staff.Why this model is important.Links Mentioned in Today’s Episode:Dr. Jake Stucki LinkedIn — https://www.linkedin.com/in/jake-stucki-ab19a593/Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/?hl=en Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/ Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Welcome to another episode of Every Day Oral Surgery. Today we are joined by maxillofacial surgeon, Dr. Heshaam Fallah to discuss the new innovative technology, FaceID, that is being used to create custom plates for orthognathic patients. Tuning in, you’ll hear all about Dr. Fallah’s impressive professional background, the surgeries he is focused on today, and how virtual surgery is being used in his practice. We also discuss how FaceID works, why it is more accurate than other surgery technology, how long the process takes, and how the plates fit. Next, we look at the equipment required to use FaceID, how it saves time, and how it is helpful for treating sleep apnea before Dr. Fallah shares with us the cons of this technology. Tune in for some very valuable advice from Dr. Fallah for using FaceID!Key Points From This Episode:Introducing today’s guest, Dr. Heshaam Fallah.A brief overview of Dr. Fallah’s professional background and how he got to where he is now. The types of procedures Dr. Fallah is focused on today. Virtual surgery: the new oral surgery technology that is being developed. How cutting guides assist during surgery and the problems associated with them. How FaceID works and why it is so much more accurate than any other surgery technology. What the preparation looks like and how long the process takes. What the custom plates look like and how they fit as compared to regular plates. The big con of FaceID: the cost. Why cost isn’t much of an issue for Dr. Fallah’s practice. How FaceID’s accuracy is saving so much time for surgeons. Dr. Fallah shares some advice for surgeons who want to start using FaceID. The office equipment required to do FaceID. Why FaceID is very helpful for sleep apnea. As usual, we end with some rapid-fire questions for Dr. Fallah. Links Mentioned in Today’s Episode:Dr Heshaam Fallah on LinkedIn — https://www.linkedin.com/in/heshaam-fallah-23424668/Why We Sleep — https://www.amazon.com/Why-We-Sleep-Unlocking-Dreams/dp/1501144316Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/?hl=en Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/ Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Coming out of residency, oral surgeons are instantly faced with the need to be business savvy as they navigate the professional world, particularly if they’re looking to go private. Unfortunately, most of us lack a background in business. Today, we are joined by Dr. Paul Rollins, one of three partners at Falls Oral Surgery and Dental Implant Center, to investigate how to assess a practice’s operations and evaluate whether they’re a good fit for you. Dr. Rollins breaks down the basic principles of business as they apply to oral surgery, from the difference between production and collections to how to calculate your overhead costs. We discuss the value of time and dependable employees, as well as how to gauge the profitability of a practice for you as an individual. If you’ve decided to pursue a private practice but aren’t sure which steps to take, this episode is for you! Tune in to hear all you need to know about analyzing a private practice you’re looking to join or purchase.Key Points From This Episode:Introducing our guest, Dr. Paul Rollins.The challenges of pursuing a private practice with no business background.Dr. Rollins’ business background.Basic business principles and advice for getting into private practice.How to evaluate a practice to ensure it’s a good fit for you.What you’re buying into when you buy a practice.The difference between production and collections/revenue.The biggest expenses OMS practices incur.How to calculate your overhead costs.How the number of partners impacts the overhead of a practice.Salaries versus distributions.The difference between operating income and net income.How to gauge the profitability of a practice for you as a partner.The importance of having a good lawyer and accountant on board.Examples of fixed, variable, and mixed costs.Dr. Rollins’ current practice setup at Falls Oral Surgery and Dental Implant Center.How to calculate return on investment in the oral surgery world.The value of having good employees.The importance of prioritizing time value for yourself and your employees. The importance of comparing various practices before making a decision.Final words of advice for residents looking to join or acquire a private practice.     Links Mentioned in Today’s Episode:Dr. Paul Rollins on LinkedIn — https://www.linkedin.com/in/paul-rollins-25248848/Dr. Paul Rollins Email —Falls Oral Surgery and Dental Implant Center — https://www.fallsoralsurgery.com/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Placing dental implants is a complicated and delicate procedure that requires absolute accuracy. Depending on the situation, this can be difficult and time-consuming and requires the patient to be operated on for uncomfortably long periods. What if there was a way to improve the accuracy of the procedure while making it faster and less invasive for patients? In this episode, we speak to Dr. Ryan Kriwanek about his experience using X-Nav, an exciting technology helping improve implant procedures. Dr. Ryan Kriwanek is an Oral and Maxillofacial surgeon practicing in Newport Beach, California, and has a keen interest in implant surgery, related bone grafting procedures, and orthognathic surgery. In our conversation, we learn everything you need to know about X-Nav based on Dr. Kriwanek’s experience using the system. We learn about the steps involved with using X-Nav, the challenges and limitations of the system, what types of procedures it can be used for, the associated learning curve, how to bill patients, and much more! Tune in to learn about the pros and cons of an exciting new technology changing the way implants are done with expert Dr. Ryan Kriwanek!Key Points From This Episode:Introduction about Dr. Kriwanek’s professional background.What type of procedures takes most of his time.He outlines his experience of using the X-Nav system.A breakdown of the steps involved in using the X-Nav system.The challenges and limitations of using X-Nav in his practice.Reasons why he does not sedate patients while using the system.Examples of the types of procedures that X-Nav can be used for.Whether Dr. Kriwanek uses the system in conjunction with a guide.Dr. Kriwanek explains the instances when he does not use the system.Other technologies in dental surgery that Dr. Kriwanek has come across.How he calculates the cost of using the system for billing patients. Advice Dr. Kriwanek has for young surgeons interested in using the technology.How long it takes to set up the practice and train staff on the X-Nav system.The support that is provided for surgeons using the system. Dr. Kriwanek shares a story about when using X-Nav did not go to plan.We end the show with some rapid-fire questions for Dr. Kriwanek.Links Mentioned in Today’s Episode:Dr. Ryan Kriwanek on LinkedIn — https://www.linkedin.com/in/ryan-kriwanek-aab62b4b/Dr. Ryan Kriwanek Email — rkriwanek@gmail.comX-Nav Technologies — https://x-navtech.com/Nobel Biocare — https://www.nobelbiocare.com/en-usEveryday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.linkedin.com/in/david-hirsch-126210bb/Everyday Oral Surgery on LinkedIn — https://www.instagram.com/everydayoralsurgery/ Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Welcome to another episode of Everyday Oral Surgery! Joining us in conversation today is Dr. David Hirsch, an oral and maxillofacial surgeon practicing in New York. During today’s conversation, you’ll hear about Dr. Hirsch’s journey of building his expertise leading up to today. Learn about the role of 3D printing in changing the dental industry, and how he has used the ‘Jaw in a Day’ technique since the early days of its inception. This episode is brimming with advice for young surgeons about training, collaboration, and ego. Dr. Hirsch is driven by passion and reminds listeners that following your heart is an essential component of creating a successful career. Get a book recommendation from Dr. Hirsch’s senior colleague, find out which unexpected unrelated activity improves his dexterity as a surgeon, and much more today! Key Points From This Episode:An introduction to Dr. David Hirsch, oral and maxillofacial surgeon practicing in New York.His education at NYU followed by a Head and Neck Fellowship with Dr. Eric Dierks. The ten years he spent managing practices in NYU before moving to Lennox Hill Hospital.Selling his private practice during the heat of COVID to become Senior Vice President of dental medicine at Northwell.His background in wrestling and his role as the unofficial team doctor. How the advent of 3D printing has changed the dental industry.The ‘Jaw in a Day’ technique and how he has used it through his evolution. What it has been like to be the first oral and maxillofacial surgeon to do head and neck surgery in NYC.The importance of putting your ego aside, collaborating and learning from others.Why being in a competitive environment makes him better at his job. His advice for oral surgeons choosing a direction: you have to do what you love!Why young surgeons should take the opportunity to train as much as they can. The best book Dr. Hirsch has read in the past year: After the Roof Caved In.How Dr. Hirsch’s fly fishing skills improve his dexterity as an oral and maxillofacial surgeon.Which forceps he uses to extract Tooth 14: a standard 150.His favorite film: Vision Quest.Why Dr. Hirsch is excited to hear from surgeons and patients across America. Links Mentioned in Today’s Episode:Dr. David Hirsch Email — dhirsch5@northwell.eduDr. David Hirsch on LinkedIn — https://www.linkedin.com/in/david-hirsch-126210bb/Dr. David Hirsch on Instagram — https://www.instagram.com/doctor.davidhirsch/Head and Neck Surgical Associates — https://head-neck.com/After the Roof Caved In — https://www.amazon.com/After-Roof-Caved-Immigrants-Journey/dp/1951627245Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.linkedin.com/in/david-hirsch-126210bb/Everyday Oral Surgery on LinkedIn — https://www.instagram.com/everydayoralsurgery/ Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/ Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Welcome to another episode of Every Day Oral Surgery! Today, we are joined by Jake Stucki to discuss some tips on using nitrous and oral sedation effectively. In this short episode, you’ll hear about the impetus for today’s topic, what could be happening when a patient says the nitrous isn’t working, and the pros and cons of using nitrous, as well as why you shouldn’t just crank it higher. We also discuss a potentially better method of sedation than anesthesia, some of our experiences of using oral sedation, and the importance of using proper dosage, plus some tips for handling pediatric sedation and the importance of knowing who is a good candidate for what type of sedation. Finally, we mention why oral surgeons often avoid the use of nitrous. To hear all this and more, tune in now!Key Points From This Episode:The impetus for today’s topic: a discussion about nitrous oxide with Jake.What could be happening when a patient says the nitrous isn’t working. The benefits of nitrous. The negative effects of nitrous. The importance of inspecting the system before cranking it higher if patients aren’t feeling it.The dangers of diffusion hypoxia with nitrous.Why a lower dosage of oral sedative combined with nitrous may be better than anesthesia. A look at when you shouldn’t use nitrous. What we have experienced when it comes to oral sedation. The importance of being aware of dosage and laws in different states. How we handle pediatric sedation. Why we put an IV in, regardless of the sedation method, when the patient falls asleep. The importance of knowing what patients need what type of sedation and how much.Why oral surgeons often avoid nitrous: the size and bulkiness of it.Links Mentioned in Today’s Episode:Jake Stucki on LinkedIn — https://www.linkedin.com/in/jake-stucki-ab19a593/Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/ Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/ Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Note writing feels like the bane of every oral surgeon’s existence, but is essential for your protection. Every aspect of your note could be used to help you in a medical-legal situation or hurt you. Today, we are joined by Connecticut-based OMS, David Salomon to discuss how to avoid and combat medical-legal issues with efficient note writing. We talk about the importance of forming good note-writing habits, and what those are, including tips for making the process as painless and efficient as possible. We break down what to include in your notes to avoid medical-legal issues, and share an example of notes being examined in a malpractice case. To further protect yourself, clear communication and an empathetic bedside manner are key, and in this episode, we cover the best ways to communicate with your patients before, during, and after a procedure, particularly in the case of a complication. Tune in to find out how best to protect yourself from medical-legal complications and be the best OMS you can be!Key Points From This Episode:Introducing today’s guest, Dr. David Salomon.Today’s topics: how to avoid and combat medical-legal issues.How we feel about the process of note writing.The importance of starting early and forming good habits, when it comes to note writing.The multifunctional purpose of note writing.Tips for making the process more efficient and painless.The skill required for writing succinct notes.What to include in your notes to avoid medical-legal issues.An example of notes being examined in a malpractice case.Why it’s important for oral surgeons to prioritize good note writing.Why it’s advisable to include probing depths in your notes, as well as reasons for extraction.The importance of making individualized notes for each patient and including everything that was discussed with the patient prior to the procedure.How to approach note writing for procedures involving anesthesia.Where to find suitable note templates!Why time-stamped, descriptive computer-written notes are preferable.How best to communicate with patients before and after a procedure to avoid legal complications.How to communicate a surgical complication to a patient during and post-procedure.The advantage of empathy and a good bedside manner.Dr. Stucki’s experience of an extortion attempt by a patient and how he handled it.Links Mentioned in Today’s Episode:Dr. David Salomon — https://www.linkedin.com/in/david-salomon-b8ab1431/OMSNIC — https://www.omsnic.com/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Our guest today, Dr. Raza Hussain, is a firm believer that Oral and Maxillofacial Surgeons who run their own private practices possess a unique set of skills that set them up to be excellent leaders. This can be especially relevant to public institutions like hospitals. Running your own private practice enables you to be an expert, not just in oral surgery, but also in the business side of things, like sourcing equipment, managing finances, and instituting an HR department. Tuning in you’ll hear Dr. Hussain unpack what he’s learned from his experiences working in public hospitals, the leadership training he underwent, and what his association with the Department of Veterans Affairs has taught him about leadership. We delve into what it takes to run a private practice, the benefits of being skilled in multiple areas, and the difficult decisions leaders in healthcare need to make on a regular basis. Dr. Hussain also shares his advice for young surgeons who are interested in leadership and why he would like to see more Oral and Maxillofacial Surgeons taking up leadership positions. Tune in for a deep dive into what it means to be a leader, the importance of being involved in public health leadership, and much more!Key Points From This Episode:Get to know our returning guest, Dr. Raza Hussain.How hospital committees affect the level of care healthcare professionals can provide for their patients.The leadership training Dr. Hussain underwent, sponsored by the Department of Veterans Affairs.What Dr. Hussain learned about the budgeting process for public institutions like hospitals.Why Oral and Maxillofacial Surgeons who have run their own private practices are uniquely suited to leadership positions in hospitals.The differences and similarities between running a private practice and working in a public institution.Dr. Hussain’s advice for young surgeons who are interested in leadership.Some of the difficult decisions you need to make as a leader.The precision and analytical skills that ​Oral and Maxillofacial Surgeons possess and why they are beneficial as a leader.The importance of being a good leader no matter what setting you’re in.Why healthcare providers need to be involved with budgeting and leadership decisions.Examples of how to educate your patients when they query costs or procedures.Why Dr. Hussain believes Oral and Maxillofacial Surgeons need to become more involved in broader healthcare leadership, both locally and globally.Links Mentioned in Today’s Episode:Dr. Raza Hussain — https://dentistry.uic.edu/raza-hussainUniversity of Illinois at Chicago (UIC) College of Dentistry — https://dentistry.uic.edu/Dr. Raza Hussain email — raza.hussain@va.govEveryday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/?hl=en Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/ Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059