Everyday Oral Surgery

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

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

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

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

Residency is the perfect learning environment for young maxillofacial surgeons, with valuable skills and know-how shared among professors and peers alike. Once qualified, the transition into private practice or starting a practice of your own can be quite daunting. Our guest today is an old-time friend and expert maxillofacial surgeon, Dr. William “Billy” Hull, who has plenty of guidance to share. To kick things off, we take a look at Billy’s academic and professional history. Having studied at The University Of Illinois At Chicago Medical Center, he has since moved into various private practice settings and is now a partner at his own practice. From picking the right partners to the best way you can build functional working relationships with them, Billy shares his biggest lessons with us. He then dives into seniority, hierarchy dynamics, and the best ways to manage compensation, before providing insight on why you should move into an established practice for your first gig. As our conversation continues, Billy talks about how he has evolved as a surgeon, telling us about his favorite tools and the reasons he uses them. Sprinkled throughout our conversation, Billy reminisces about his old days in residency, offering comical anecdotes and explaining why humor is an important part of his job. Remember to floss and be sure to tune in!Key Points From This Episode:Introducing today’s guest, maxillofacial surgeon Dr. William “Billy” Hull.Billy shares details about his professional history.Hear about the lessons Billy has learned over the years.How hierarchy can influence the success of a practice. Exploring the pros and cons of having a good partner.Why the relationships you build during residency are so important.The art of drawing up a partnership contract that fairly distributes compensation.Knowing what healthy competition is between partners.Hear Billy’s humorous anecdotes about his residency.Billy tells us how he has evolved as a surgeon since leaving medical school.Why spreading your legs can be better than bending over while performing surgery.Billy touches on why he won’t use a hall drill.Hear about the 703 and its finesse as an oral surgery tool.Find out how Billy’s incision design has changed over the years.Why PRF is preferred over dry-socketing. Billy’s preference of BioHorizons over Straumann and Nobel Biocare.Hear about how Billy keeps a balance between humor and professionalism.Links Mentioned in Today’s Episode:Dr. William Hull on LinkedIn.The University Of Illinois At Chicago Medical CenterBioHorizonsNobel BiocareStraumann

Talking less and listening more empowers your patients and helps you better serve their needs. This insight is provided by Dr. Justin Evanson of Pacific Dental Services. Today we speak to Justin about his work as an Oral and Maxillofacial Surgeon, what he’s done to overcome his challenges, and the ways that he’s improved his practice. We open our conversation by exploring his training and the procedures that he most commonly administers. He dives into what he has recently changed to make his daily routine better, including the new additions to his surgical kit. After talking about the benefits of a new suturing technique, we discuss why he prefers healing abutments to cover screws, and why Justin rarely conducts upper molar immediate implants. We ask Justin how he follows up with patients who have other dental providers, his answers highlighting the importance of communicating with both patients and their providers. We then touch on his approach to anesthesia which leads to Justin explaining how he quickly builds connections with his patients. Near the end of the episode, Justin reflects on his two most difficult cases and what he did to get through them. Tune in to hear more of Justin’s top tips on improving your oral surgery practice. Key Points From This Episode:We introduce today’s guest, Oral and Maxillofacial Surgeon Dr. Justin Evanson. Hear about Justin’s training at Parkland Hospital in Dallas, Texas.Justin shares details about his current practice and the procedures he often performs. Top tips from Justin on how you can improve your surgery.Using the figure-eight suturing technique developed by Dr. Daniel Buser. Swapping out different sized healing abutments over time. Why Justin rarely does upper molar immediate implants. Follow-up and dealing with patients who have other dental providers. Justin’s philosophy on anesthesia and how he applies it with patients. Exploring the most challenging aspects of Justin’s daily routine. How you can develop a connection with patients that you only see once or twice. Why Justin doesn’t talk people into procedures that they have reservations about. Offering quality care to all of your patients — even if that means long appointments. Details on Justin’s two most difficult cases and how he got through it.Justin shares some final practical advice to help listeners in surgery. Links Mentioned in Today’s Episode:Dr. Justin Evanson on LinkedInPacific Dental ServicesColumbia UniversityParkland Hospital UT Southwestern Medical CenterJohn Peter Smith HospitalBien AirVersahDr. Daniel Buser International Team for ImplantologySalvin Dental Specialists BaxterDigital Dental SolutionsZack ReynoldsNobel BiocareDr. Grant Stucki Contact — 720-775-5843

As a small community, oral and maxillofacial surgeons need to share what they have learned to ensure everyone's practice thrives. In today’s show, Dr. Raza Hussain gives us insights into the knowledge he has gained through both his academic and faculty surgery work. Raza practices in Chicago, where he is the Chief of Oral and Maxillofacial Surgery at the Jesse Brown Veterans Administration Medical Center. We dive right in, discussing Raza’s approach to dealing with peri-implantitis, where he shares why he uses the controversial implantoplasty as a treatment and the importance of collaborating with the restorative doctor. We then hear about the most difficult cases Raza has encountered working at a VA hospital. From transmandibular implant removal to necrotizing fasciitis, Raza has handled incredibly unique cases that many oral and maxillofacial surgeons are unlikely to encounter over the course of their careers. The conversation then moves onto protecting oral and maxillofacial surgeons’ outpatient anesthesia rights and why the current campaign to remove these rights is unfounded. Raza acknowledges that support staff might not be well-trained, but he believes that it is the practicing surgeon's responsibility to get his team on the same page. He shares what those of us in private practice can do to ensure we will continue to be allowed to do jobs in a way that is best for our patients. To hear this and more, be sure to tune in today!Key Points From This Episode:Get to know Raza, his professional experience, and what he’s up to now. The improvements that Raza has made with his implants over the last few years.What Raza does with implants that have two or three threads exposed on the buccal.Why Raza uses an implantoplasty to treat implants that have deteriorated.The level of bone loss or peri-implantitis which prompts Raza to intervene.The importance of having a good relationship with the restorative doctor when treating peri-implantitis.Patients are unlikely to change their habits, so surgeons should try new techniques.Hear why removing transmandibular implants is so difficult.Insights into the trickiest case Raza has had to treat that involved necrotizing fasciitis.Why Raza has not changed his third molar extraction technique much over the years.Coronectomy versus piezo: Which technique results in greater complication.Tried and trusted methods; why Raza sticks with a regular course of antibiotic treatment for third molar extractions.How Raza’s anesthetic technique has changed seeing as his wife is an anesthesiologist.Why trying to take oral surgeons’ right to outpatient anesthesia is misguided.Raza’s firm approach to putting patients to sleep and why he does not tolerate joking around at that time.The bad press that oral and maxillofacial surgeons get when anesthesia goes wrong.Negative outcomes of not allowing oral and maxillofacial surgeons to administer anesthesia.What oral maxillofacial surgeons in private practice can do to support the profession’s rights.The complications that Raza has seen with TMJ disorders and his preferred courses of treatment.Links Mentioned in Today’s Episode:Dr. Raza HussainUniversity of Illinois at Chicago (UIC) College of DentistryJesse Brown VA Medical CenterAAOMS

Today Dr. Stucki interviews Dr. Scott Weiskopf, an oral and maxillofacial surgeon practicing in Tennessee in the Memphis area. Ever since he introduced a fully digital workflow and started printing his own surgical guides, his dental surgery practice has been transformed because it allows him to produce and place top-quality implants. In this conversation, Dr. Weiskopf shares how his appointments with patients who need implants typically proceed, when in the process the guides are made, and the handful of cases where placing the implant freehand is still better. Tuning in, listeners will get a sense of the cost implications of printing the guides yourself, how it benefits your patients and practice, and where you can purchase the cheapest – yet effective – 3D printing equipment. Our guest shares details on his grafting techniques and materials, how he approaches third molar extractions, and what he favors in terms of instruments. The two also discuss drugs and dosages and share a bit about their work philosophies. Key Points From This Episode:What switching over to a fully digital workflow meant for his dental surgery practice. The benefits of having surgical guides when doing implants.Get a sense of how the appointments proceed for implant consultations and surgery. The cost implications of printing the guides yourself rather than having it printed by a big lab. Where you can purchase a 3D printer and why you don’t need a dental-specific one. Dr. Weiskopf talks about the handful of times he has had to adjust the guides. Learn why he works almost exclusively with the Straumann Dental Implant System.    What his grafting technique looks like and why he switched to a different membrane. Dr. Weiskopf’s graft materials of choice, including allograft, xenograft, and DBM putty. How using the guides differs from placing the implants freehand and when the latter is more appropriate. The benefits of having patients see and ask about the latest in dental technology. How your software determines the ease with which multiple implants can be created. Learn what has changed in his third molar extraction technique since his residency. Dr. Weiskopf talks about his preferred tools and why he picks up the instruments himself. The value of having a second assistant and what his typical drugs and dosages involve. The idea that when you permit something, you are inadvertently promoting it. Links Mentioned in Today’s Episode:Dr. Scott Weiskopf Straumann Dental Implant System Nobel BiocareBioXclude