The Difference Between an Oral Surgeon and a Dentist

🎙️ Podcast Introduction and Patient Success Story (00:00 - 01:21)

• Dr. Russ Lieblick and Dr. Brandon Rehrer introduce Oral Surgery Insights Episode 1
• Discussion of rewarding patient follow-up experience with complex reconstructive procedure
• Emphasis on how successful outcomes reinforce the value of their specialized work
• Reflection on the blend of technical skill yielding positive human results

🎓 Training Pathway Differences - Dental School Foundation (01:21 - 02:39)

• Both oral surgeons and general dentists begin with four years of dental school
• Dental school provides comprehensive education in diagnosis, prevention, and treatment of oral conditions
• This foundation equips graduates to become primary dental care providers
• Dental school serves as prerequisite for competitive oral surgery residency programs

🏥 Hospital-Based Surgical Residency Training (02:39 - 03:52)

• OMS residency programs are minimum 4 years, often extending to 6 years
• Programs may integrate MD degree or specialized fellowship training
• Hospital environment provides rotations through critical medical services
• Rotations include internal medicine, general surgery, critical care, emergency medicine, plastic surgery, otolaryngology, and anesthesiology
• Training focuses on managing systemically compromised patients and multidisciplinary hospital team function

💉 Comprehensive Anesthesia Training (03:52 - 05:13)

• Extensive training in moderate sedation, deep sedation (IV sedation), and general anesthesia
• Advanced airway management and pharmacology of anesthetic agents
• Patient monitoring techniques and handling anesthetic emergencies
• Unique anesthesia training among dental specialists
• Enables office-based surgical procedures with hospital-level safety standards

🦷 Scope of Practice - Wisdom Teeth and Complex Extractions (05:13 - 06:28)

• General dentists handle erupted or minimally impacted wisdom teeth
• Oral surgeons manage significant impactions, teeth encased in bone, horizontal growth patterns
• Advanced surgical techniques including bone removal and tooth sectioning
• Careful management around inferior alveolar nerve and maxillary sinus
• Use of CBCT imaging for precise risk assessment
• Specialized procedures like coronectomy to minimize nerve damage

🔧 Advanced Implant Surgery and Bone Grafting (06:28 - 07:46)

• Oral surgeons handle surgically complex implant scenarios
• Significant bone grafting procedures including sinus lifts and ridge augmentation
• Block grafts and particulate materials with membranes for bone rebuilding
• Management of implant complications and aesthetically challenging zones
• Expertise in bone biology and grafting techniques

🏗️ Specialized Surgical Procedures (07:46 - 08:56)

• Corrective jaw surgery with osteotomies and repositioning segments
• Diagnosis and surgical management of oral pathology, cysts, and tumors
• Salivary gland issues and soft tissue lesions management
• Acute facial trauma management with plates and screws
• TMJ surgery and surgical treatments for obstructive sleep apnea

🤝 Collaborative Healthcare Relationships (08:56 - 10:10)

• Strong collaborative relationship with general dentists and specialists
• General dentists serve as first point of contact and care coordinators
• Referral process ensures appropriate specialist care
• Collaboration with orthodontists, periodontists, endodontists, and prosthodontists
• Clear communication and sharing of records essential for smooth care transitions

😌 Patient Experience and Anxiety Management (10:10 - 11:22)

• Comprehensive approach to managing patient anxiety about surgery
• Thorough consultation process with active listening to concerns
• Clear explanation of diagnosis, procedures, risks, benefits, and alternatives
• Creating calm, professional, and reassuring office environment
• Ensuring patients feel fully informed and empowered to ask questions

🏥 Post-Operative Care and Follow-Up (11:22 - 12:37)

• Comprehensive post-operative support with clear home care instructions
• Managing expectations regarding swelling, bruising, and discomfort
• Accessible follow-up through scheduled visits and phone availability
• Prompt addressing of post-operative issues to reinforce patient confidence
• Commitment to combining surgical excellence with compassionate communication

📝 Summary and Future Episode Planning (12:37 - 13:54)

• Recap of core differences between oral surgeons and general dentists
• Emphasis on specialized hospital-based training and surgical expertise
• Both professions integral to comprehensive oral health care
• Planning for next episode on dental implants introduction
• Focus on what dental implants are and who benefits from them

00:00
Dr. Russ Lieblick
Welcome to Oral surgery Insights Episode 1 I'm Dr. Russ Lieblick, joined by my friend and partner, Dr. Brandon Rehrer. You know, I had a really rewarding experience this week following up with a patient who underwent a fairly complex reconstructive procedure a while back. Seeing them functioning well, confident again, those outcomes really reinforce the value of the work we dedicate ourselves to. 

00:28
Dr. Brandon Rehrer
They absolutely do, Russ. Those moments provide essential perspective. Successfully navigating a challenging surgical case, knowing the detailed planning and execution led to a tangible improvement in someone's quality of life. That blend of technical skill yielding a positive human result is incredibly gratifying. It certainly balances out the demanding nature of our specialty. 

00:48
Dr. Russ Lieblick
Well put. And reflecting on the nature of our specialty often brings us back to a topic that seems to generate frequent questions from patients and even sometimes from colleagues in broader healthcare clearly defining the role of an oral and maxillofacial surgeon and how it differs from that of a general dentist. 

01:05
Dr. Brandon Rehrer
It's a recurring theme. Undoubtedly we hear variations of so you're like a super dentist quite often. While meant well, it highlights a common lack of clarity about the distinct training pathways and the specific scope of practice that defines oral and maxillofacial surgery. Given that both fields operate within the crucial area of oral health, some confusion is understandable, but clarification is important. 

01:28
Dr. Russ Lieblick
Agreed, Perhaps the most fundamental differentiator lies in the postdoctoral training. Both journeys, of course, begin with the solid foundation laid during four years of dental school. That comprehensive education covers the diagnosis, prevention, and treatment of a wide range of oral conditions, equipping graduates to become primary dental care providers. 

01:47
Dr. Brandon Rehrer
Precisely, dental school provides that essential broad knowledge base for individuals pursuing oral and maxillofacial surgery. However, dental school serves as the prerequisite for entry into a highly competitive, rigorous hospital based surgical residency. These residency programs are typically a minimum of four years, with many extending to six years, particularly those integrating an MD degree or specialized fellowship training. This postgraduate period is where the specialization truly takes shape. 

02:16
Dr. Russ Lieblick
That hospital environment is key. Unlike dental school, which is primarily outpatient focused, the OMS residency immerses trainees within the hospital system. Years are spent rotating through critical medical services, internal medicine, general surgery, critical care, emergency medicine, plastic surgery, otolaryngology, and perhaps most importantly, anesthesiology. This provides invaluable experience in managing the systemic health of patients, understanding complex medical conditions, and functioning within a multidisciplinary hospital team. We learn to care for patients who are much more medically compromised than typically seen in a general dental setting. 

02:56
Dr. Brandon Rehrer
Along with those medical rotations is the intensive surgical training. Residents gain proficiency across the entire spectrum of oral and maxillofacial surgery. This isn't just about simple extractions. It encompasses managing complex dentoalveolar surgery like impacted teeth near vital structures, sophisticated dental implantology including advanced bone and soft tissue grafting, the intricacies of corrective jaw surgery, comprehensive management of facial trauma from minor injuries to severe fractures, surgical treatment of TMJ disorders, the diagnosis and surgical management of oral pathology ranging from benign cysts to malignant tumors and complex facial reconstruction following trauma or ablative surgery. The case volume and complexity seen in residency are orders of magnitude greater than in dental school, and the anesthesia training. 

03:45
Dr. Russ Lieblick
During residency deserves special emphasis. It's far beyond basic local anesthesia or nitrous oxide. We receive dedicated, extensive training in providing moderate sedation, deep sedation, often referred to as IV sedation, and general anesthesia. This includes advanced airway management, pharmacology of anesthetic agents, patient monitoring techniques and handling potential anesthetic emergencies. This comprehensive anesthesia training is unique among dental specialists and allows us to provide a level of comfort and safety for complex procedures performed in an office based surgical setting. 

04:20
Dr. Brandon Rehrer
That ability to safely deliver the full range of anesthesia is a defining characteristic of our specialty, enabling procedures that patients might otherwise need a hospital operating room for increasing access and convenience while maintaining rigorous safety standards. So summarizing the training General dentists are highly skilled primary oral health providers. After completing dental school, oral surgeons complete that same dental degree plus an additional four to six years of intensive hospital based surgical, medical and anesthesia training focused specifically on the complexities of the maxillofacial region. 

04:55
Dr. Russ Lieblick
This significant difference in training naturally leads to a distinct scope of practice. While our general dentist colleagues expertly manage the crucial aspects of ongoing oral health preventative care, fillings, crowns, bridges, root canals, gum disease treatment, routine cleanings and uncomplicated extractions. Our practice centers on surgical intervention and managing more complex conditions, taking wisdom teeth. 

05:19
Dr. Brandon Rehrer
As a prime example. Certainly, many erupted or minimally impacted wisdom teeth can be comfortably managed by general dentists. However, the cases typically referred to an oral surgeon involve significant impactions teeth completely encased in bone, teeth growing horizontally or severely angled, teeth positioned intimately close to the inferior alveolar nerve or maxillary sinus. Safely and efficiently removing these requires advanced surgical techniques, often bone removal, tooth sectioning, and careful manipulation around delicate structures. 

05:51
Dr. Russ Lieblick
That nerve proximity, especially in the lower jaw, is a constant consideration. Our training, often supplemented by advanced imaging like cbct, allows us to assess that risk precisely and employ specific surgical approaches, sometimes even procedures like coronectomy, removing the crown but leaving root tips near the nerve to minimize the potential for sensory disturbances. This level of surgical nuance is a core part of OMS training. 

06:17
Dr. Brandon Rehrer
Dental implant placement is another area with significant overlap but also clear distinctions. While implant placement is performed by various practitioners, oral surgeons routinely handle the surgically complex scenarios. This includes sites with inadequate bone volume necessitating significant bone grafting procedures like sinus lifts to augment the upper jaw or ridge augmentation using block grafts or particulate materials with membranes to rebuild deficient areas of the jawbone. Our surgical expertise in bone biology and grafting techniques is critical for these foundational procedures. 

06:50
Dr. Russ Lieblick
We also frequently manage implant complications or place implants in aesthetically challenging zones where precise positioning and soft tissue management are paramount. Corrective jaw surgery is another domain exclusive to oral surgeons due to its complexity involving surgical cuts in the jawbones, osteotomies, and repositioning segments to correct functional bite problems and associated facial disharmonies. 

07:15
Dr. Brandon Rehrer
Furthermore, diagnosing and surgically managing oral pathology, cysts, benign and malignant tumors, salivary gland issues, soft tissue lesions requires specific surgical and diagnostic skills honed during residency. And of course, managing acute facial trauma, from stabilizing jaw fractures with plates and screws to repairing complex facial lacerations, is a significant component of our hospital based training and practice. TMJ surgery and surgical treatments for obstructive sleep apnea also fall within our specialized. 

07:46
Dr. Russ Lieblick
Scope, so the breadth is considerable. While general dentists provide essential primary oral care, oral surgeons function as surgical specialists, focusing on these more involved procedures, leveraging our extended training in surgery, medicine, and anesthesia. 

08:02
Dr. Brandon Rehrer
An essential aspect of providing effective care is the strong collaborative relationship we maintain with our general dentist colleagues and other specialists. Healthcare rarely exists in a vacuum, and dentistry is certainly no exception. 

08:14
Dr. Russ Lieblick
Absolutely vital general dentists are usually the patient's first point of contact and the coordinators of their overall dental care. They play a crucial role in identifying conditions that warrant specialist evaluation. We rely heavily on their diagnostic acumen and their understanding of the patient's history when receiving referrals for surgical management. 

08:34
Dr. Brandon Rehrer
The referral process ensures patients receive care from the provider with the most appropriate skill set for their specific needs. A general dentist might refer for a wisdom tooth deemed too complex due to impaction or nerve proximity, or for implant placement in a site clearly requiring significant bone grafting visible on initial X rays, or for biopsy of a lesion they've detected during a routine exam. Clear communication, sharing of records, and imaging are key to a smooth transition of care. 

09:02
Dr. Russ Lieblick
And the collaboration extends beyond general dentists. We work closely with orthodontists, often for years, in planning and executing corrective jaw surgery cases. We coordinate with periodontists on complex implant cases involving gum health or soft tissue grafting. We may consult with endodontists regarding teeth near surgical sites or prosthodontists for planning the restorative phase of complex implant reconstructions. 

09:26
Dr. Brandon Rehrer
It truly functions as a network. After we handle the surgical component, extracting complex teeth, placing bone grafts and implants, performing jaw surgery, the patient often returns to their referring dentist or another specialist for the completion of their care, such as the final crowns on implants. The seamless integration requires ongoing communication and mutual understanding of each provider's role. 

09:49
Dr. Russ Lieblick
Maintaining these strong interprofessional relationships benefits everyone, most importantly the patient. It ensures continuity of care and leverages the collective expertise within the dental community for optimal results. 

10:02
Dr. Brandon Rehrer
While the technical aspects of surgery are obviously central, the patient experience surrounding these procedures demands equal attention. Given that patients often present with some level of anxiety about undergoing surgery, how we manage that aspect is critically important. 

10:17
Dr. Russ Lieblick
You're right, Brandon. That human element is fundamental. Our training, particularly the anesthesia component, provides us with the tools, pharmacological and communicative, to effectively manage patient apprehension. But beyond the sedation options, the consultation process itself is key. It involves actively listening to the patient's concerns, physical fears and expectations. Taking the time to thoroughly explain the diagnosis, the proposed procedure, the risks, benefits and alternatives in understandable language is non negotiable. Building rapport and trust is the first step toward alleviating anxiety. 

10:52
Dr. Brandon Rehrer
Creating a calm, professional and reassuring environment within the office also plays a role. From the initial contact with our staff to the preoperative discussion and the procedure itself, every touchpoint should convey competence and compassion. Ensuring the patient feels fully informed and empowered to ask questions, no matter how small they may seem, is vital. A well informed patient who feels heard is generally a less anxious patient and. 

11:16
Dr. Russ Lieblick
The care doesn't end when the surgery is over. Comprehensive post operative support is crucial. This includes clear, detailed instructions for home care, managing expectations regarding swelling, bruising and discomfort, and ensuring patients know how to reach us if they have any concerns or questions during their recovery. Promptly addressing any post operative issues reinforces their confidence in our care. 

11:39
Dr. Brandon Rehrer
Exactly. Providing accessible follow up, whether through scheduled post op visits or just being available for phone calls, makes a significant difference in the patient's overall experience and contributes to a smoother, more comfortable healing process. A positive surgical experience encompasses the entire journey. Not just the time spent in the operating chair. 

11:59
Dr. Russ Lieblick
That commitment to combining surgical excellence with compassionate patient focused communication is what defines high quality care in our field. We are treating individuals, not just surgical. 

12:09
Dr. Brandon Rehrer
Sites, so recapping the core differences Oral and maxillofacial surgeons undergo years of specialized hospital based training focused on surgery, medicine and anesthesia after completing dental school. This intensive preparation allows us to manage a wide array of complex surgical conditions affecting the entire facial region. This intensive preparation allows us to manage a wide array of complex surgical conditions affecting the entire facial Regional general dentists. 

12:37
Dr. Russ Lieblick
Provide essential primary dental care focusing on prevention, restoration and managing common oral health issues. Oral surgeons serve as the surgical specialist within the dental field, addressing complex extractions, implants, grafting, corrective jaw surgery, pathology, trauma and providing advanced anesthesia services, typically through referrals. 

12:57
Dr. Brandon Rehrer
Both professions are integral to comprehensive oral health and effective collaboration between general dentists and specialists, including ensures patients receive the most appropriate care tailored to their individual needs. Understanding these distinct roles empowers patients to seek the right provider for their specific situation. 

13:14
Dr. Russ Lieblick
Well said, Brandon. We sincerely hope today's discussion has offered valuable clarity on our specialty and how it interfaces with general dentistry. Thank you for joining us for this episode of Oral Surgery Insights. Building on our discussion of specialized procedures, perhaps for our next conversation we could provide an introduction to dental implants, really delve into what they are and who typically benefits from them. 

13:38
Dr. Brandon Rehrer
That's an excellent and very relevant topic to explore next, Russ. Dental implants are such a significant part of modern tooth replacement and a foundational understanding would be very beneficial for our listeners. We can certainly prepare for that. For today, we appreciate everyone for listening. 

13:53
Dr. Russ Lieblick
Take care.