I remember my wife’s bridesmaid recounting a story of her visit to the oral surgeon to get her wisdom teeth removed. I remember her anecdote being both horrific and hilarious in equal measure. As she was lying there feeling numb and ready to begin the procedure, her oral surgeon started by saying, “this will feel a bit like I am ripping your head off.” Perhaps there was an element of poetic license on the part of my friend, but she was never one for exaggeration. It is jaw dropping really. On what planet would this be considered an appropriate way to put anyone at ease, but it did make me laugh. I do sometimes enjoy schadenfreude, don’t judge!

I really do not think that such dramatic and inflammatory language should ever be used if you are hoping to have a relaxed cooperative patient. I could imagine a few making a run for it if they were told this! It is a rare patient who is not apprehensive in some form or fashion at the prospect of a dental extraction, never mind a wisdom tooth. So, I will always begin by “gently wobbling the tooth to check movement and anesthesia. You will feel some pressure building but it should be totally comfortable.” It is also a psychological boost for the patient to be given an element of control rather than lying there and being utterly helpless. “Let me know if you need me to stop at any stage or if you are not happy in any way. Stop me if you need to take a breath or if you are feeling any pain.”

There are some fantastic oral surgeons posting on social media: @bloodytoothguy @pnwoms to name a few. Their video content hopefully is demystifying oral surgery and leads more dentists into learning a dental discipline that many avoid. Watching videos, however, does not make you an oral surgeon and the importance of hands-on courses and mentoring are critical. This is something I am hoping to address by teaming up with an old hospital colleague and teaching hands-on oral surgery.

Like many disciplines in dentistry, oral surgery requires a combination of skill, empathy and an ability to communicate. Whilst being empathetic is important, it is also of little use if you end up hacking that carious root out and leaving behind a bloody mess. When extracting a tooth, I like to communicate to the patient that the goal is to remove the whole tooth comfortably and in a way that will give them as smooth a recovery as possible.

Is it possible that oral surgery can help grow your practice? Social media is currently awash with all the sexy treatments such as alignment, bleaching and bonding, the beautiful smile makeovers and the mediocre! Naturally, people like seeing these and it undoubtedly drives patients to your practice. But I have often been told that dental surgery is not a practice builder because patients do not enjoy the experience. This is an assertion I don’t wholly buy into. Whilst there is always going to be the patient who will make the speediest of escapes, I also have many patients who are full of smiles (somewhat lopsided granted) and gratitude that their extraction was much easier than expected. I am not so naive or arrogant to think that all my patients enjoy their extractions, but at the very least ensuring they do not have an unpleasant experience is an achievable goal.

Another stereotype I have heard often is that oral surgeons (and implantologists) are often arrogant and on a testosterone fueled joyride. Not exactly a glowing report and certainly does not consider the increasing number of excellent female surgeons. It is certainly not a reputation I am happy to perpetuate. It all starts with treating patients with a level of humanity and not by “ripping their head off.”