Selected Podcast
Wisdom Teeth: Facts Every Parent Needs to Know
Dr. James Swift, an oral and maxillofacial surgeon, discusses what parents need to know about wisdom teeth surgery. Learn when wisdom teeth may need to be removed, how to know the right time for surgery and who to contact for a consultation.
Featured Speaker:
James Q. Swift, DDS, FACS
Dr. James Swift is a tenured Professor and was Director of the Division of Oral and Maxillofacial Surgery at the University of Minnesota School of Dentistry for 25 years. He served as the Program Director of the Advanced Education Program in Oral and Maxillofacial Surgery for the second time in his tenure there. He recently served as Acting Dean in regards to promotion and tenure matters. He was named the University of Minnesota School of Dentistry Century Club Professor of the Year in 2001. Dr. Swift has authored over 100 manuscripts, articles, abstracts and book chapters. He has procured funding from the NIDH as a Principal Investigator, securing RO1 support for his scientific work. The James Q. Swift Professorship Endowment was founded and funded at the University of Minnesota in 2016. Dr. Swift received his Bachelors of Arts degree (cum laude) from Cornell College, Mt. Vernon, IA in 1976. He received his dental degree from the University of Iowa in 1980 and his oral and maxillofacial surgery training from the University of Oklahoma College of Medicine, completing his program in 1985. He is also a practicing oral and maxillofacial surgeon at the University of Minnesota. He served the American Board of Oral and Maxillofacial Surgery as President in 2005, as a Director for 6 years and as a member of the Examination Committee for 6 years. He served the American Dental Education Association as President in 2007-2008 and on the Board of Directors from 2002-2008. Dr. Swift served as a Director of the Oral and Maxillofacial Surgery Foundation (OMSF) from 2009-2012. Dr. Swift was elected to the Medical Professional Liability Association Board of Directors in 2015 and elected as its Secretary in 2016. He was elected MPL Association Vice Chair in 2018 and has ascended Chair of the Board of the MPL Association in May of 2020. He has served the AAOMS on numerous committees including service as an officer and chair of the Faculty Section. He received the AAOMS’s Daniel M. Laskin Award for the most outstanding Journal of Oral and Maxillofacial Surgery article published in 1998. He was named the University of Minnesota School of Dentistry Century Club Professor of the Year in 2001. He was the Oral and Maxillofacial Surgery Foundation’s (OMSF) Ambassador Service Award recipient in 2004. In 2011, Dr. Swift received the AAOMS/William J. Gies Foundation Gies Award for oral and maxillofacial surgery. He was given the ADEA Distinguished Service Award in 2009. He received the AAOMS’ R.V. Walker Distinguished Service Award in 2015. He is a Fellow of the International College of Dentists, the American College of Dentists and the American College of Surgeons. Dr. Swift was elected as a Member of the Board of the Gorlin Syndrome Alliance in 2020 and serves on committees of the GSA and Chairs the newly formed Medical and Scientific Advisory Committee of the GSA. Dr. Swift has been a Director of OMSNIC since 2006, served as Vice Chair from 2011 to 2013 and as Chair since 2014. Transcription:
Wisdom Teeth: Facts Every Parent Needs to Know
Bill Klaproth (host): This is OMS Voices, an AAOMS Podcast. I'm Bill Klaproth and with me is Dr. James Swift, who is here to discuss wisdom teeth facts every parent needs to know. Dr. Swift, thank you so much for being here.
Dr. Swift: Thank you Bill for having me.
Bill Klaproth (host): Absolutely. It's great to see you. So wisdom teeth, right? We all have them. They all erupt, if you will. When do wisdom teeth typically erupt in the mouth?
Dr. Swift: Well, there's variability with that, but sometimes in the late teen years to the early twenties. But if we wait to age 25, it's likely that if the wisdom tooth has not erupted by then than it's probably not going to, but that doesn't mean it's without disease. It just means that it's not going to come into the mouth and be functional. So you don't really want to wait until they hurt or that you wait until that point in time that you can make prediction as to whether there will be functional teeth then that you can treat or remove them without challenges if they are not functional.
Bill Klaproth (host): Okay. That's really interesting. So when we're talking about teens, and wisdom teeth. What are the signs that my teens wisdom teeth are coming in?
Dr. Swift: Well if you're going to your general dentist or your pediatric dentist, as you should be as your children grow up because they usually will observe or keep observing the oral cavity to such a great degree that they'll learn when there's time to consider and make a referral. And so if you're in doubt and you’re going to… with your child to a pediatric dentist or a general dentist, you should ask them what their thoughts are because many times they'll have an opinion as well. And then typically they’ll refer to an oral maxillofacial surgeon to have him or her decide how to proceed with the management of the teeth.
Bill Klaproth (host): Are there outward signs that, “Hey, something's going on there?” Like tender bleeding gums or jaw pain or their outward symptoms?
Dr. Swift: There are outward signs that do occur, and typically it is inflammation. So the gum tissue will turn red. In some situations there will be a bad taste, and it will create pain when the teeth are put together when they bite together in the back and the area where the third molar would be coming in back behind all of the other teeth.
Bill Klaproth (host): So can you explain to us, we hear the wisdom teeth are impacted or my sons or my child's wisdom teeth are impacted. What does impacted mean?
Dr. Swift: Impacted means that there is a structure either adjacent tooth or part of the jawbone where the wisdom tooth is sitting that's restricting it from coming in and being functional. So that it could and be in the mouth with the appropriate amount of gum tissue around it so that it can be maintained in good health by making sure that you brush it in that area. And if you neglect wisdom teeth that come into the mouth, and you don't brush them like you brush your other teeth, then plaque will accumulate and that will increase the potential risk of infection. And that might be a sign that there's a need to remove the wisdom tooth because it's not functional or erupted all the way.
Bill Klaproth (host): So generally, is it another tooth blocking that eruption? Is that generally what it is?
Dr. Swift: Yes. It's either another tooth, the tooth in front of it blocking it or the jaw not being big enough to have enough space to accommodate one more tooth.
Bill Klaproth (host): Okay. And this impaction, what other problems can or does it generally cause when we say a tooth is impacted.
Dr. Swift: Well, impacted means that something's preventing it, as mentioned, from erupting. And so if it can't come into the oral cavity completely, but only comes into the oral cavity is exposure to the oral cavity. Only partially allows bacteria that are around your teeth to get underneath the gum tissue where that tooth sits. And it likes it there cause it's dark and there's nutrition for the bacteria back there, and it's warm in there and there’s saliva. And so, it thrives the bacteria thrives, and it's really a place that generally infections occur relatively easily.
Bill Klaproth (host): Maybe a silly question here, do they ever come in and stay there, and we’ve got extra teeth they never erupt and there’s never a problem.
Dr. Swift: That is periodically what occurs. In fact, if they’re blocked to a great degree, and they don't get exposed to the oral cavity at all. They don't make a perforation to get, try to get in, then you can't necessarily just leave it there and not do anything about it because it's possible that over time the gum tissue can recede. That happens and people in their front teeth their gums will recede after a period of time, and as a result, then this tooth structure, the tooth root is exposed to the oral environment or bacteria that might create an infection or cavity in the tooth. And so, it's not a healthy place there.
The oral cavity is the dirtiest orifice in the human body. And there's lots of bacteria there. And so there's lots of potential for disease. And so it's not wise to leave a not totally erupted tooth or impacted tooth in position when it's exposed, because it has a high likelihood that there'll be an infection.
Bill Klaproth (host): So medically, it sounds like we need to get these teeth out of there. They need to be extracted.
Dr. Swift: Yeah, the data will show about 78 percent of these, if left in position, will create other types of problems at some point in time.
Bill Klaproth (host): It can be a 50-year-old and “oh my God, I've got a problem.”
Dr. Swift: That's correct. And it could be the tooth in front of it, or it could be in that tooth itself. If they get a cavity in it, and it needs a dental filling. It's hard to fill because it's so far back, it's not accessible to the dentist to even provide a filling in the wisdom tooth very easily. And so it's difficult to manage the health of it because it's so far back in the mouth.
Bill Klaproth (host): So for a parent listening to this, it's better to get the tooth out early while the child is young than to just, “Nah, we're going to let it go.”
Dr. Swift: That's what I did for my kids. And they both had their third molars out when they were about 18 because there just wasn't room in their jawbone to have the tooth erupt. And that's how I would treat my patient as I would treat my own children.
Bill Klaproth (host): Right? Well, my own kids same thing. And most people. I know that seems to be around the age. Although my one son, AJ, was I think 23 when he had his out, but that's not uncommon to be in your early twenties to have that done?
Dr. Swift: It's not uncommon in the early twenties and according to one textbook 25 is your you're an older adult. As far as wisdom, teeth are concerned. You're at the end of age 25. There should be a prediction that can be made by then.
Bill Klaproth (host): We were just talking about you don't want to be a 50-year-old and have the tooth in there. Are there other reasons, other harm that can be done by leaving an impacted wisdom tooth in place?
Dr. Swift: Yes, they're different pathology can form around the tooth. It can develop tumors or cysts around, so that doesn't always happen. It's not a given. But at the same time, there's a potential risk. And so the point is if they're not removed by age 25, then there's an obligation of the dental professional to do a complete examination of that area. And periodic X-rays, which might end up be being more expensive than just removing it, quite frankly, over a lifetime because you don't need the tooth to function to bite and chew things.
So I'm just leaving it there. Some people say, well, I still have mine, they don't hurt, so that's okay. But you're taking a risk because 78 percent of the time they'll either develop a cavity of some sort or periodontal disease. And that's disease process.
Bill Klaproth (host): And then you're dealing with that for the rest of your life, then. You don't want that. That's not a good thing. So you mentioned around 18 years of age. Is that the optimal time? I know you can't predict when the tooth is going to erupt, is that generally around the timeframe?
Dr. Swift: In that area. Late teens is reasonable because the thing that about removing it at late teens is the bones healthy typically, and the teenager is healthy, and the tooth many times is not yet fully formed. The roots are not fully formed, and as a result, as the roots of the wisdom teeth form, they can sometimes lock the tooth into some degree if they curve. And so, in some situations it's reasonable to take out the tooth. It's easier to take out when the roots are not yet fully formed.
Bill Klaproth (host): It's just good medical practice at that point to do that. So can we talk about the role of an OMS and wisdom teeth. And can you explain the training in OMS undergoes and how that makes them the best person to remove wisdom teeth?
Dr. Swift: So wisdom teeth removal is a large component of the training of the OMS. And I can tell you that from experience because I work in an academic environment, and I teach individuals how to take out wisdom teeth. And in that particular situation, that's a hands-on type of approach for an oral and maxillofacial surgeon, which many times, has to do at least a four-year training program. And in some situations, if they're going to get a medical degree along with their oral surgery training, it may take as many as six to seven years.
And so it's a lot of training after dental school. And there are some dentists that can with other experiences, outside of dental school, get better at taking out wisdom teeth. But oral and maxillofacial surgeons are required to do so in their training programs, to make sure that they're well talented in that technique or procedure. So, I would say that a board-certified oral and maxillofacial surgeon is your best bet.
Bill Klaproth (host): You don’t want to leave it up to chance. You want an expert in there with the potential complications, and you could be doing one. You could be doing four. That's a lot of surgeries at a time. Is that the right way to look at it: four different surgeries?
Dr. Swift: Yeah, there are four individual surgeries and so the a more gentle you can be when you provide those procedures, and the more skill that you have based upon experience doing it over and over again, is going to result in a better outcome.
Bill Klaproth (host): Since we're talking about parents and teens and kids and wisdom teeth, what is a big challenge that you have to overcome? Is it sometimes the fear of, “Oh, my child's going to be in pain” or “You're going to have to put my child out, how are they going to do it?” Is that a challenge?
Dr. Swift: Yes, it is Bill. In fact, you know, I have children, and both of them have had surgery. And as I said, they had their wisdom teeth out and there's always a concern for a caring parent about their child. If they're going to, undergo anesthesia or undergo a surgical procedure. And I always have to wonder in those situations, you have to wonder, “Is it necessary? Is this necessary to do this?” And some of that is going to be reliant upon how much you depend on the oral and maxillofacial surgeon to make that decision. You have to trust him or her to make that decision with the patient’s best interest in mind.
Bill Klaproth (host): I think that’s where having an OMS do this would put the parent at ease, knowing I’ve got an expert, somebody that’s got the training that you just described. The four years of training to do this, that would be comforting to a parent to go, “Okay, we need to get this done and you're going to be okay. You're in an expert's hands.”
Dr. Swift: Right. And like I said, there are some dentists out there that are good at the technique or procedure and may have had some other experiences in a hospital setting in some sites, some way shape or form. But in general, they oral and maxillofacial surgeon that gets to that level of board-certification. You know for a fact that based upon the curriculum and those training programs, they have had experience in doing third molar technique.
Bill Klaproth (host): So when we're talking about teens and wisdom teeth. What questions do you get asked the most? Or what would you like to say to that parent right now?
Dr. Swift: Again, what are the complications associated with this procedure? Is it necessary? This should, why are we doing this now? Those types of questions. Shall we wait? Would it be better? Or should we do it really early? Should we do it early when they're really young? And those types of questions. When they have an expectation that maybe they had their wisdom teeth out, and many times that decision is made by the parent. I didn't have mine out, so maybe my kid does need to have their wisdom, but that's not a good way to judge.
Bill Klaproth (host): Right. Absolutely. Well, this has really been fascinating. doctors with. Anything else you want to add before we wrap up?
Dr. Swift: Bill, I appreciate the opportunity to explain this in the way that we've had the opportunity to do so because I think it important that parents have a good understanding as to what they can do to make sure that they can assure that their child will be in the best hands when they have the procedure.
Bill Klaproth (host): Yeah. Well, thank you. Well, this is a great format for an expert like you to explain the process and explain the ins and outs on a more detailed level. So, it's been great to hear your answers and hopefully a parent listening to this right now certainly got informed and educated on this process. That's all you're looking for to inform a patient and to inform a parent. Is that right?
Dr. Swift: That's correct, Bill.
Bill Klaproth (host): Thank you so much for your time.
Dr. Swift: Pleasure to be with you. Thank you so much.
Bill Klaproth (host): Once again, that is Dr. Jim Swift. And for more information in the full podcast library, please visit MyOMS.org. And if you found this podcast interesting, please share it on social media, and don't forget to subscribe. Thanks for listening.
Wisdom Teeth: Facts Every Parent Needs to Know
Bill Klaproth (host): This is OMS Voices, an AAOMS Podcast. I'm Bill Klaproth and with me is Dr. James Swift, who is here to discuss wisdom teeth facts every parent needs to know. Dr. Swift, thank you so much for being here.
Dr. Swift: Thank you Bill for having me.
Bill Klaproth (host): Absolutely. It's great to see you. So wisdom teeth, right? We all have them. They all erupt, if you will. When do wisdom teeth typically erupt in the mouth?
Dr. Swift: Well, there's variability with that, but sometimes in the late teen years to the early twenties. But if we wait to age 25, it's likely that if the wisdom tooth has not erupted by then than it's probably not going to, but that doesn't mean it's without disease. It just means that it's not going to come into the mouth and be functional. So you don't really want to wait until they hurt or that you wait until that point in time that you can make prediction as to whether there will be functional teeth then that you can treat or remove them without challenges if they are not functional.
Bill Klaproth (host): Okay. That's really interesting. So when we're talking about teens, and wisdom teeth. What are the signs that my teens wisdom teeth are coming in?
Dr. Swift: Well if you're going to your general dentist or your pediatric dentist, as you should be as your children grow up because they usually will observe or keep observing the oral cavity to such a great degree that they'll learn when there's time to consider and make a referral. And so if you're in doubt and you’re going to… with your child to a pediatric dentist or a general dentist, you should ask them what their thoughts are because many times they'll have an opinion as well. And then typically they’ll refer to an oral maxillofacial surgeon to have him or her decide how to proceed with the management of the teeth.
Bill Klaproth (host): Are there outward signs that, “Hey, something's going on there?” Like tender bleeding gums or jaw pain or their outward symptoms?
Dr. Swift: There are outward signs that do occur, and typically it is inflammation. So the gum tissue will turn red. In some situations there will be a bad taste, and it will create pain when the teeth are put together when they bite together in the back and the area where the third molar would be coming in back behind all of the other teeth.
Bill Klaproth (host): So can you explain to us, we hear the wisdom teeth are impacted or my sons or my child's wisdom teeth are impacted. What does impacted mean?
Dr. Swift: Impacted means that there is a structure either adjacent tooth or part of the jawbone where the wisdom tooth is sitting that's restricting it from coming in and being functional. So that it could and be in the mouth with the appropriate amount of gum tissue around it so that it can be maintained in good health by making sure that you brush it in that area. And if you neglect wisdom teeth that come into the mouth, and you don't brush them like you brush your other teeth, then plaque will accumulate and that will increase the potential risk of infection. And that might be a sign that there's a need to remove the wisdom tooth because it's not functional or erupted all the way.
Bill Klaproth (host): So generally, is it another tooth blocking that eruption? Is that generally what it is?
Dr. Swift: Yes. It's either another tooth, the tooth in front of it blocking it or the jaw not being big enough to have enough space to accommodate one more tooth.
Bill Klaproth (host): Okay. And this impaction, what other problems can or does it generally cause when we say a tooth is impacted.
Dr. Swift: Well, impacted means that something's preventing it, as mentioned, from erupting. And so if it can't come into the oral cavity completely, but only comes into the oral cavity is exposure to the oral cavity. Only partially allows bacteria that are around your teeth to get underneath the gum tissue where that tooth sits. And it likes it there cause it's dark and there's nutrition for the bacteria back there, and it's warm in there and there’s saliva. And so, it thrives the bacteria thrives, and it's really a place that generally infections occur relatively easily.
Bill Klaproth (host): Maybe a silly question here, do they ever come in and stay there, and we’ve got extra teeth they never erupt and there’s never a problem.
Dr. Swift: That is periodically what occurs. In fact, if they’re blocked to a great degree, and they don't get exposed to the oral cavity at all. They don't make a perforation to get, try to get in, then you can't necessarily just leave it there and not do anything about it because it's possible that over time the gum tissue can recede. That happens and people in their front teeth their gums will recede after a period of time, and as a result, then this tooth structure, the tooth root is exposed to the oral environment or bacteria that might create an infection or cavity in the tooth. And so, it's not a healthy place there.
The oral cavity is the dirtiest orifice in the human body. And there's lots of bacteria there. And so there's lots of potential for disease. And so it's not wise to leave a not totally erupted tooth or impacted tooth in position when it's exposed, because it has a high likelihood that there'll be an infection.
Bill Klaproth (host): So medically, it sounds like we need to get these teeth out of there. They need to be extracted.
Dr. Swift: Yeah, the data will show about 78 percent of these, if left in position, will create other types of problems at some point in time.
Bill Klaproth (host): It can be a 50-year-old and “oh my God, I've got a problem.”
Dr. Swift: That's correct. And it could be the tooth in front of it, or it could be in that tooth itself. If they get a cavity in it, and it needs a dental filling. It's hard to fill because it's so far back, it's not accessible to the dentist to even provide a filling in the wisdom tooth very easily. And so it's difficult to manage the health of it because it's so far back in the mouth.
Bill Klaproth (host): So for a parent listening to this, it's better to get the tooth out early while the child is young than to just, “Nah, we're going to let it go.”
Dr. Swift: That's what I did for my kids. And they both had their third molars out when they were about 18 because there just wasn't room in their jawbone to have the tooth erupt. And that's how I would treat my patient as I would treat my own children.
Bill Klaproth (host): Right? Well, my own kids same thing. And most people. I know that seems to be around the age. Although my one son, AJ, was I think 23 when he had his out, but that's not uncommon to be in your early twenties to have that done?
Dr. Swift: It's not uncommon in the early twenties and according to one textbook 25 is your you're an older adult. As far as wisdom, teeth are concerned. You're at the end of age 25. There should be a prediction that can be made by then.
Bill Klaproth (host): We were just talking about you don't want to be a 50-year-old and have the tooth in there. Are there other reasons, other harm that can be done by leaving an impacted wisdom tooth in place?
Dr. Swift: Yes, they're different pathology can form around the tooth. It can develop tumors or cysts around, so that doesn't always happen. It's not a given. But at the same time, there's a potential risk. And so the point is if they're not removed by age 25, then there's an obligation of the dental professional to do a complete examination of that area. And periodic X-rays, which might end up be being more expensive than just removing it, quite frankly, over a lifetime because you don't need the tooth to function to bite and chew things.
So I'm just leaving it there. Some people say, well, I still have mine, they don't hurt, so that's okay. But you're taking a risk because 78 percent of the time they'll either develop a cavity of some sort or periodontal disease. And that's disease process.
Bill Klaproth (host): And then you're dealing with that for the rest of your life, then. You don't want that. That's not a good thing. So you mentioned around 18 years of age. Is that the optimal time? I know you can't predict when the tooth is going to erupt, is that generally around the timeframe?
Dr. Swift: In that area. Late teens is reasonable because the thing that about removing it at late teens is the bones healthy typically, and the teenager is healthy, and the tooth many times is not yet fully formed. The roots are not fully formed, and as a result, as the roots of the wisdom teeth form, they can sometimes lock the tooth into some degree if they curve. And so, in some situations it's reasonable to take out the tooth. It's easier to take out when the roots are not yet fully formed.
Bill Klaproth (host): It's just good medical practice at that point to do that. So can we talk about the role of an OMS and wisdom teeth. And can you explain the training in OMS undergoes and how that makes them the best person to remove wisdom teeth?
Dr. Swift: So wisdom teeth removal is a large component of the training of the OMS. And I can tell you that from experience because I work in an academic environment, and I teach individuals how to take out wisdom teeth. And in that particular situation, that's a hands-on type of approach for an oral and maxillofacial surgeon, which many times, has to do at least a four-year training program. And in some situations, if they're going to get a medical degree along with their oral surgery training, it may take as many as six to seven years.
And so it's a lot of training after dental school. And there are some dentists that can with other experiences, outside of dental school, get better at taking out wisdom teeth. But oral and maxillofacial surgeons are required to do so in their training programs, to make sure that they're well talented in that technique or procedure. So, I would say that a board-certified oral and maxillofacial surgeon is your best bet.
Bill Klaproth (host): You don’t want to leave it up to chance. You want an expert in there with the potential complications, and you could be doing one. You could be doing four. That's a lot of surgeries at a time. Is that the right way to look at it: four different surgeries?
Dr. Swift: Yeah, there are four individual surgeries and so the a more gentle you can be when you provide those procedures, and the more skill that you have based upon experience doing it over and over again, is going to result in a better outcome.
Bill Klaproth (host): Since we're talking about parents and teens and kids and wisdom teeth, what is a big challenge that you have to overcome? Is it sometimes the fear of, “Oh, my child's going to be in pain” or “You're going to have to put my child out, how are they going to do it?” Is that a challenge?
Dr. Swift: Yes, it is Bill. In fact, you know, I have children, and both of them have had surgery. And as I said, they had their wisdom teeth out and there's always a concern for a caring parent about their child. If they're going to, undergo anesthesia or undergo a surgical procedure. And I always have to wonder in those situations, you have to wonder, “Is it necessary? Is this necessary to do this?” And some of that is going to be reliant upon how much you depend on the oral and maxillofacial surgeon to make that decision. You have to trust him or her to make that decision with the patient’s best interest in mind.
Bill Klaproth (host): I think that’s where having an OMS do this would put the parent at ease, knowing I’ve got an expert, somebody that’s got the training that you just described. The four years of training to do this, that would be comforting to a parent to go, “Okay, we need to get this done and you're going to be okay. You're in an expert's hands.”
Dr. Swift: Right. And like I said, there are some dentists out there that are good at the technique or procedure and may have had some other experiences in a hospital setting in some sites, some way shape or form. But in general, they oral and maxillofacial surgeon that gets to that level of board-certification. You know for a fact that based upon the curriculum and those training programs, they have had experience in doing third molar technique.
Bill Klaproth (host): So when we're talking about teens and wisdom teeth. What questions do you get asked the most? Or what would you like to say to that parent right now?
Dr. Swift: Again, what are the complications associated with this procedure? Is it necessary? This should, why are we doing this now? Those types of questions. Shall we wait? Would it be better? Or should we do it really early? Should we do it early when they're really young? And those types of questions. When they have an expectation that maybe they had their wisdom teeth out, and many times that decision is made by the parent. I didn't have mine out, so maybe my kid does need to have their wisdom, but that's not a good way to judge.
Bill Klaproth (host): Right. Absolutely. Well, this has really been fascinating. doctors with. Anything else you want to add before we wrap up?
Dr. Swift: Bill, I appreciate the opportunity to explain this in the way that we've had the opportunity to do so because I think it important that parents have a good understanding as to what they can do to make sure that they can assure that their child will be in the best hands when they have the procedure.
Bill Klaproth (host): Yeah. Well, thank you. Well, this is a great format for an expert like you to explain the process and explain the ins and outs on a more detailed level. So, it's been great to hear your answers and hopefully a parent listening to this right now certainly got informed and educated on this process. That's all you're looking for to inform a patient and to inform a parent. Is that right?
Dr. Swift: That's correct, Bill.
Bill Klaproth (host): Thank you so much for your time.
Dr. Swift: Pleasure to be with you. Thank you so much.
Bill Klaproth (host): Once again, that is Dr. Jim Swift. And for more information in the full podcast library, please visit MyOMS.org. And if you found this podcast interesting, please share it on social media, and don't forget to subscribe. Thanks for listening.