Welcome To My Top 10 Oral Surgery Tips 

In this video I share my top 10 oral surgery tips and recommendations. I cover items and techniques I rely on almost daily in my private practice as an oral surgeon. While not ranked in any particular order of importance, I will present the tips numbered 10 down to #1.

10. C-Sponge

I highly recommend using a C-sponge during all oral surgery procedures. I had a scare where a colleague dropped an instrument down a patient's throat when no sponge was used. Fortunately the patient was fine, but this reinforced the critical need for airway protection. I prefer disposable and sterilizable C-sponges for efficiency. Having a sponge between surgical instruments and the pharynx is essential for preventing foreign objects from entering the airway.

9. Hemostatic Gauze

Hemostatic gauze containing an absorbable cellulose is enormously helpful for controlling bleeding after extractions and surgery. It can be placed directly into extraction sockets and will promote clotting. This is especially useful for patients on anticoagulants or with other bleeding risks. The gauze resorbs during healing so no removal is required. I keep a large supply available at all times for both routine and complicated cases.

8. Disposable Scalpel

While any scalpel blades can be dangerous, I switched his practice to using disposable scalpels with a built-in blade for added safety. This prevents the need to handle loose blades. The disposable scalpels have a shield that covers the blade when not in active use. I adopted this from my hospital colleagues and feel the extra cost is well worth it to protect my surgical team from potential injury.

7. Russian Forceps

Russian forceps are ideal for retrieving dental fragments, teeth, and root tips. The wide paddle design and tooth pattern allow excellent grasping of teeth, bone, and restorative materials versus traditional hemostats. I always keeps several Russian forceps on hand for extraction cases and recommends them for anyone doing extractions in their practice.

6. Surgical Time Out

Implementing a "surgical time out" before starting procedures is another hospital technique I adopted. Simply reviewing critical details verbally - like the patient name, planned procedure, tooth number, allergy check, etc. - can prevent errors and wrong site surgeries. It also gives staff permission to speak up if anything seems amiss before making the first incision.

5. Diode Laser

While very useful for soft tissue procedures, I find diode lasers most invaluable for controlling surgical bleeding that is difficult to stop. Whether from soft tissue, bone, or a vessel, the laser can reliably coagulate refractory hemorrhage. In the video I describe a case where ER efforts failed to stop bleeding after an extraction but the diode laser achieved hemostasis quickly.

4. Side Cutting Ronguers

While technically intended for bone removal, I rely heavily on side cutting ronguers for removing root tips. In the video I describe learning this technique in the military when lacking good extraction forceps. With experience, the sharp beaks of the ronguers efficiently grasp and extract retained roots. Just avoid too much pressure and breaking the root tip.

3. Plate Rich Fibrin

PRF or platelet rich fibrin is a major part of my armamentarium for dental implants, grafting, and recovery. PRF enhances bone graft outcomes and reduces postoperative swelling. I offer a free introductory PRF course for clinicians wanting to get started with this helpful adjunct. Find it at PRFBasics.com

2. CBCT

I consider CBCT imaging a standard of care for oral surgery. While controversial, believe the 3D radiographic views have improved diagnosis, planning, and outcomes versus traditional x-rays. On occasion, CBCT findings have led me to defer surgery after identifying risks not visible on 2D films. Overall, CBCT make me a more informed, thoughtful surgeon.

1. Surgical Headlight

Relying on overhead surgical lights alone is insufficient - a headlight should be worn for all procedures. Even in ideal conditions, a headlight improves direct illumination and visibility. With experience, I rarely use the overhead light. I explain how essential headlights become when vision is obscured by bleeding or deep access is required. I have happily used the same LED MED headlight for many years without issue.

I look forward to hearing from listeners regarding their own top surgical tips and recommendations. I welcome feedback and suggestions at [email protected] and will gladly try out new techniques that others find invaluable.