Bill Klaproth (host): This is OMS Voices, an AAOMS podcast. I'm Bill Klaproth. And with me is Dr. Travis Rudd, who is here to discuss dental extractions, simple and surgical. Dr. Rudd, thank you for being here today.

Travis Rudd: Thank you. It’s my pleasure to be here.

Bill Klaproth (host): Yeah, it’s great to see you. So, what are common reasons for tooth removal?

Travis Rudd: So, some common reasons for tooth removal would include wisdom teeth that are impacted, other teeth can be impacted that need to be removed as well. Sometimes teeth have severe decay, large cavities, or they can be broken or fractured beyond repair and need to be removed at that point because they're an infection risk.

Bill Klaproth (host): So in the title, I said we're going to talk about simple and surgical. So, what is a simple tooth extraction?

Travis Rudd: So, a simple extraction is generally an extraction that can be made without having to make an incision in the gum tissue or using other specialized techniques, like a drill or something like that. Oral and maxillofacial surgeons perform simple extractions and sometimes they are also performed by like a general or a family dentist. And if the tooth is more complicated or perhaps the patient has a little bit more of a complicated medical history, sometimes it's better handled by a specialist like an oral maxillofacial surgeon.

Bill Klaproth (host): So, sometimes the tooth can be so severely decayed, it's just kind of hanging in there, if you will. And then, you can just go in there without the surgical extraction, just pull it then.

Travis Rudd: Yeah. Yeah. Sometimes they're fairly loose or they have roots that are very simple to get out. And that can be kind of a quick. And it's also called a routine extraction. It usually just means that it doesn't require advanced techniques to get it removed.

Bill Klaproth (host): So, let's talk about those advanced techniques. What is a surgical tooth extraction then?

Travis Rudd: Surgical tooth extraction is generally going to require things like a gum incision. It may require removal of bone and splitting of the tooth. Oftentimes the teeth may be broken down to a point where there's not a lot on the outside to grab a hold of and remove the tooth. And so, you have to get down inside of the bone and remove the tooth in several pieces. And it's a much more time-consuming process in that situation.

Bill Klaproth (host): Absolutely. In that case, that would also require Novocain or would it ever require anesthesia to put somebody out for an extraction?

Travis Rudd: That's a great question. So, oftentimes, because of the complexity of the procedure, that increases the stress level for the patient. Especially in the setting of an oral maxillofacial surgeon, you have several options available to help keep you more comfortable, including intravenous sedation or oral sedation, other things that can reduce the level of anxiety you might experience or even help you fall asleep while you're getting the treatment done.

Bill Klaproth (host): So then, Dr. Rudd, after either a simple tooth extraction or a surgical tooth extraction, are dental implants recommended?

Travis Rudd: Yeah. With the exception of wisdom teeth, dental implants are generally considered a great replacement option for teeth for many patients. They provide benefits like preventing bone loss, and then they, of course, improve the function of the mouth and being able to chew and stay comfortable. And so, getting the tooth out is really the first step to getting people back to having a healthy mouth, which often includes a dental implant.

Bill Klaproth (host): Which is really important. I mean, if you have a mouth full of diseased teeth, if you will, that can't be good for someone's overall health.

Travis Rudd: That's a great point. We're getting more and more evidence through scientific studies, that there's a big connection between the health of our mouth and the health of our cardiovascular system. So, having a healthy mouth can benefit our general health in ways that we didn't understand before.

Bill Klaproth (host): I would think mental health as well. If you've got crooked or missing teeth, you're probably very self-conscious all the time, is that right?

Travis Rudd: Yeah. I know in my own life, I had very crooked teeth as a kid. And when I got my teeth straightened, that was a life-changer for me.

Bill Klaproth (host): Yeah. It's like, "I have confidence now. I can smile and not feel embarrassed."

Travis Rudd: Yeah. I don't think I really appreciated how much that really means until I went through it myself.

Bill Klaproth (host): Yeah, absolutely. So when it comes to tooth extraction, our first step to oral health, as you said, do I need an oral surgeon to remove a tooth?

Travis Rudd: Some extractions really can be managed just like we talked about earlier. Simple extractions can sometimes be managed in a general or family dentist's office setting. But there are certain situations where it may be health conditions that the patient has that requires more of a specialist or just simply complicated extractions due to the tooth position or sometimes the anatomy of the roots’ position close to other anatomic structures that might be injured, like nerves or a sinus cavity. And those patients really benefit by having a specialist like an oral maxillofacial surgeon assist them in their care.

Bill Klaproth (host): Yeah. That's where an OMS certainly would come in for those more complicated tooth extractions.

Travis Rudd: Yes, sir.

Bill Klaproth (host): Dr. Rudd, thank you. This has been very fascinating. Anything else you want to add at this time about simple or surgical tooth extractions?

Travis Rudd: I'm just very honored to be a part of this. Thank you for having me.

Bill Klaproth (host): You're very welcome and we appreciate you being here. Once again, that is Dr. Travis Rudd. And for more information and the full podcast library, please visit MyOMS.org. And if you found this podcast interesting, please share it on your social media and don't forget to subscribe. Thanks for listening.