Everyday Oral Surgery

In this solo episode with your host Dr. Grant Stucki, listeners will hear all about avoiding the mistake of taking out the wrong tooth. While this is not a glamorous topic, it is still an important one since too many patients have left their dentist’s office with the wrong tooth missing. Very little is said and taught on this issue because it seems like such a simple thing to get right. In general surgery, doctors initial the area of the body that will be operated on to ensure that everyone is on the same page and the right part of the body is identified. Even so, there have been instances where a patient who needed a hip replacement left with a tendon repair they didn’t need, so removing the wrong tooth is not so far fetched. Just the idea of making this mistake puts some oral surgeons in a low-grade seizure state, especially if they’ve come close to this experience. Today Dr. Stucki shares examples of some of the cases where you might be more likely to make a mistake or be distracted and discusses some of his trusted procedures to ensure that he gets the right tooth every time. Key Points From This Episode:Dr. Stucki shares his experience of taking out the wrong tooth during his residency training. How difficult it was for him to get over the mistake and how affected his confidence level. The identifiers he looks for on the referral notes to ensure that he works on the right tooth. Checking the financial agreement to see which procedures have been signed and paid for. The procedure he walks through with every patient to identify and verify the right tooth.  What Dr. Stucki does right before he begins working on the tooth.The importance of the surgeon, patient, and assistant being on the same page. Awareness of scenarios and cases in which you are more likely to remove the wrong tooth. What plowing down cactuses in Tucson, Arizona, and today’s topic have in common. Examples of high-risk cases for taking out the wrong tooth, including two impacted molars. What you can do to ensure that you have identified the correct supernumerary tooth.  How time constraints can contribute to you confusing patients and cases.Internal and external distractions that can give way to mistakes during surgery.

As surgeons, we must ensure the highest and best use of our time, and an important part of this is creating systems and delegating unnecessary duties. Joining us today to share his insights on this is Dr. Thomas Sarna, an oral and maxillofacial surgeon, based in Fayetteville, Arkansas, and one of Grant’s mentors during residency. In this episode, Thomas walks us through some of his systems and the tasks he no longer does, including fielding calls, pre or post-op preparations and briefings, and calling around for referrals. Although creating structures and processes takes a lot of work and training on the frontend, once staff is up to par, surgeons have much more energy to do what they love, and ultimately create the most efficient practice possible. We also touch on communicating risks with clients and balancing being transparent with ensuring the patient remains comfortable and at ease. Thomas shares his approach and what he believes is the right amount to share. Along with this, we discuss the use of technology in Thomas’ practice and why he still prefers to take hand-written notes, how he handles communicating with difficult parents or patients, and the importance of knowing your staff’s strengths and weaknesses and drawing on them accordingly. It was a great conversation, and there is always so much to learn from one another's practices. To hear more, be sure to tune in today!Key Points From This Episode:How creating systems to delegate duties has changed Thomas’ practice.The benefits of confirming patient appointments and improvement in efficiency.Why Thomas does not give his cell number to patients and leaves his assistants to field calls.Hear more about what Thomas’ schedule looks like and how COVID has affected it.The brief nature of Thomas’ consults and what he tells the patients.Walking patients through options if numbness is a concern when the root is in the same place as the nerve.Thomas’ approach to communicating risk with patients.Following the acute versus chronic rule when it comes to sinus perforation repair.Using the buccal fat pad method and training NTs how to do it.‘Good’ patients versus ‘bad’ patients and how Thomas thinks about this.The story behind why Thomas calls his difficult procedures ‘The Grant Stucki Clinic.’Some of the best things Thomas learned in residency that he carried into practice.Knowing your staff’s strengths and weaknesses and placing them in the right position.Instances of difficult communication with parents and patients Thomas has had.Why Thomas prefers doing wisdom teeth over implants.The frustration that both Thomas and Grant feel at patients constantly being on their phones.The use of tech in Thomas’ practice, including a cloud-based EMR.Why Thomas still takes notes by hand which then gets digitized after.Hear why Thomas has sedated patients sitting up rather than lying down.Take your wisdom teeth out when you are a teenager!Communicating wisdom teeth removal post-op care instructions.Why not using antibiotics is ‘career suicide’ according to Thomas.Links Mentioned in Today’s Episode:Dr. Thomas SarnaDr. Scott WeiskopfGoogle GlassHow to Win Friends & Influence PeopleThink and Grow RichDr. Grant Stucki

Dr. Eric Blamires, an oral and maxillofacial surgeon from Colorado, shares his insights on surgical techniques and patient management. He emphasizes the importance of surgeon ergonomics and personal health for longevity in the field. Eric discusses practical ways to build rapport with patients, especially teens, in busy settings. He also dives into streamlined wisdom tooth extraction methods and his approach to suturing and grafting, along with strategies for managing helicopter parents during procedures. Tune in for valuable tips!

Although residency training can be comprehensive in many ways, it is vital to find what works for you as a surgeon once you are in practice. Today’s guest, Dr. David Salomon, has done just that, tweaking his anesthesia technique over time to administer it efficiently, in the least resource-heavy way possible. As a prestigious doctor working in Connecticut, David runs a successful private practice. In this episode, David talks about why he has mostly stopped using fentanyl and the results he has seen from making this change. While David has been open to changing his anesthesia technique, he also recognizes that it is not possible to have a one-size-fits-all plan for every patient. He talks about developing your intuition to understand what a patient needs. We also learn more about David’s grafting technique, some of the tweaks he is currently making, and the outcomes so far. We then turn our attention to the practice side of things, where David talks about some of the daily difficulties he faces, the role his assistants play and how he handles their training, and the importance of communicating and managing expectations. Not only is David an excellent surgeon technically, but the care and empathy he extends to his patients really sets him apart. To hear more from this inspiring doctor, be sure to tune in today!Key Points From This Episode:Some of the small things David has changed in his practice that have had a big impact.David’s grafting technique and how it has evolved over time.Two things David has noticed about nylon sutures compared with chromic and vicryl sutures.The differences between mineralized and demineralized bone grafts.Techniques David is implementing from Bone Augmentation in Implant Dentistry.Why David does not do that many immediate implants.What David has seen with how some patients get inflamed after a bone graft.How David manages patients’ pain and how he guides them through it. David’s typical sedation protocol and his approach to optimizing the process.How David handles children and adults who are afraid of needles.The most challenging things that come up in David’s daily practice.Why David usually does not sedate children and what he does instead.David’s interest in music, the band he was in for years, and playing songs during surgery.How David has trained his assistants and his emphasis on self-sufficiency.Why David prefers to grab his own tools and do the sutures himself.Benefits of waiting until the end of a procedure to do the sutures.The role an office manager can play in managing assistants and dealing with issues.Keeping lines of communication open and how this counteracts drama with staff.The importance of being a good listener and making patients feel heard and understood.Communicating potential risks in a more human way and how David tackles this.How an empathetic approach can help with even the most difficult patient.The question David asks to break the ice when he meets clients for a consult.David's positive experience of residency and the feeling of camaraderie he misses.Links Mentioned in Today’s Episode:Dr. David SalomonBone Augmentation in Implant DentistryPickles PubDr. Grant Stucki

Have you ever been at a conference where you heard an intriguing technique or tip from a fellow oral and maxillofacial surgeon or dentist that you then implemented effectively in your practice? We know we have. Welcome to the Every Day Oral Surgery podcast, where we hope to share some techniques and personal experiences that could be beneficial to your surgical or dental practice. In this episode, host, Dr. Grant Stucki, introduces himself, where we learn more about his professional and personal life. He also shares the story of how a lower back injury from playing basketball in college plagued him for years after school and well into his practice. We hear how changing sides has helped alleviate his pain. While this may seem like a small tweak, it is not easy because not only will you be slowed down, but you will have to work on strengthening your weaker hand. Oral surgery and dentistry, in general, can be particularly hard on the lower back, so even if you are not in pain yet, it is well worth taking preventative measures to ensure you remain pain-free. We look forward to many more conversations, so be sure to tune in for the start of this exciting journey!Key Points From This Episode:The goal of this podcast – To share practice techniques that can potentially help yours.A quote from Better, a great book about the meaning of being a surgeon.Get to know Grant, his education and training, and his full-on family life.Playing ‘morning ball’ while at UCLA and how Grant’s signature fadeaway led to an injury.The extent of Grant’s injury which he found out after a triathlon and treatments he followed. Some challenges that came with switching sides and how Grant strengthened his left hand.The benefits that Grant has seen from switching sides, including reduced back pain.Even if you do not struggle with back pain, take preventative measures before it happens.Why surgeons might be hesitant to switch sides.What studies have shown about dentists and lower back pain? Links Mentioned in Today’s Episode:Dr. Grant StuckiDr. Grant Stucki on LinkedInBetter: A Surgeon's Notes on PerformanceAtul GawandeUCLA School of DentistryUniversity of Illinois at ChicagoMichael JordanKarl MaloneHakeem OlajuwonLeBron JamesKobe BryantDirk NowitzkiIronman TriathlonPubMed