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Siouxland OMS on KELO Radio

Bill Zortman: Dr. Lou George and Dr. Denis Miller—oral surgery, Siouxland Oral Surgery Center.
Gentlemen, good morning!

Dr. Denis Miller: Good morning, Bill. How are you today?

Bill: Now, you guys have been through dental school, you became surgeons, and you come back and you work with dentists. So you’ve got a lot of things that you do for a lot of people. This morning, let’s talk about how you got to be surgeons.

Dr. Miller: Well for me, going through dental school first year, exposed to a number of different facets of dentistry and all the different specialties, and to me, the one that I gravitated towards was surgery; and coming from a medical family—my dad being a pediatrician and my mom being a surgical nurse—it just seemed like a logical progression to focus my dental school studies in oral surgery. And then after that, I went into advanced training in general dentistry at the hospital and then taught for a year in Ann Arbor, Michigan, in the department of oral surgery and taught dental students basic oral surgery that they can use in their practices, and then I got into oral surgery in Philadelphia.

Bill: So today, when we start talking about the fact that you are a surgeon, you’ve been there, as far as a dentist is concerned; you actually advise dentists because you guys have some meetings with them to make sure they understand what you do and what is new in the business.

Dr. Miller: Well for us, again, one of the main tenets of the way we run our practice is it’s a team approach, so it’s always a collaborative effort, and so things that are up-and-coming and new in oral surgery, different services and treatments that we can offer, things that have changed medically—many of the listeners maybe have heard of something called bisphosphonates, which are used to treat osteoporosis and other things, and we might get into that in another radio show. But that was something that was up and coming about five, seven years ago, so we were a resource for our general dental colleagues to bring them up to speed on patients that may be on those medications, among other things. 

Bill: From Siouxland Oral Surgery, Dr. Denis Miller and Dr. Lou George. Doctor, when we start talking about your experience, yours is a little different than your partner’s.

Dr. Lou George: Absolutely. My father was a general dentist in Springfield, Massachusetts, for quite some time throughout his life and basically, growing up around that environment, I knew that I wanted to pursue a field in dentistry. My father had always wished, I think, that he went on to do oral surgery. He always had a very large interest in that particular subspecialty. So when I went to dental school, I was already very interested in pursuing oral surgery, and after completing dental school at the University of Pennsylvania, I went on to do a one-year surgical internship at Allegheny General Hospital in Pittsburgh, Pennsylvania, that was specifically geared towards oral surgery, and then I went into my Oral Surgery program at Temple University Hospital in Philadelphia. Completed that and was fortunate enough to be invited to join Dr. Miller here back in Sioux Falls, at Siouxland.

Bill: Let’s talk about one of the services you have and that’s the anesthesia sedation services. Why is that important?

Dr. Miller: By the very nature of oral surgery, what we do is invasive, and a lot of people come to us that are in pain and a lot of times local anesthetics don’t work. Sometimes they have bad infections, and it’s just very uncomfortable for them to tolerate what we do. Other things such as the removal of wisdom teeth, it’s just hard to get back in the back of the mouth—some people gag a lot, some people can’t open a lot—and let’s face it, we’ve got the sharp pointy things that go round and round, and we don’t need moving targets. For patient comfort, it’s important, and for just being able to do a better job. Most times people will do better if we can either moderately or deeply sedate them (depending on the case) to get the job done—do a good job and have people walk away happy with what they had done.

Bill: That’s the concern that people have had for generations is, I don’t want the pain, I don’t want to go see a dentist; I’ll just put it off. But when they put it off, then it becomes a serious problem.

Dr. George: Absolutely. A lot of these situations usually involve maybe something that could have been taken care of quickly for the patient, and if they sit on this pain and then allow it to mature, it can certainly transform into a larger infection or a more serious situation that could perhaps even require hospitalization. So it’s really important to stay up on these things—when patients are not feeling well, to let their dentist know and then the dentist will treat them appropriately or make the appropriate referral, hopefully to our office so that we can expedite their care. It’s very important also what Dr. Miller said, the use of anesthesia in our office—I can’t tell you how many patients personally I’ve had who, usually older patients who have come in and they’ve been scared to death to come in and have this work done because they have poor memories of when they were younger and had to suffer different treatments in the chair. Then after we treat them with our medications and so forth, they say to me that fear is now displaced, and they would have no problem or any reservation coming to see us again, which is very, very important.

Bill: Bone Grafting procedures. Why are they important?

Dr. Miller: Typically, in our practice, bone grafting is laying the foundation for another procedure. Typically, it’s for the placement of dental implants. So if the patient is deficient in bone where we’d like to a place an implant, we have a number of different options. We can take bone from other parts of the oral cavity, from other parts of the body—that’s known as autologous bone grafts—and we can have semisynthetic grafts, and we can have synthetic grafts, so the whole bone grafting industry has morphed over the last 20 years. We even have grafting materials that are based on recombinant DNA technology, so you don’t have to worry about whether it’s synthetic or from yourself or sterilized from somebody else. And all of these different techniques have a place and a use, and it’s nice to have a bunch of different—we call them tools—in your toolkit, so if one grafting procedure doesn’t seem to be the right one, we have an alternative. So as oral surgeons being fully trained in all of these different things, we can offer our patients a number of different options, and that’s kind of unique to the specialty. And I think that we can offer patients a much better service by giving them a bunch of different options rather than just one or two. Like the old saying goes, if all you have is a hammer, then everything’s a nail.

Bill: Collaborative effort seems to be the two words that jump out with what you do, where you’ve been, who you work with, what you do for patients.

Dr. George: Well Bill, it’s very important to let our—let your listeners know as well—that everything starts usually at the office of their dentist, so very few people will just simply walk in or call us and say, “Hey, can you help us out with this situation?” So, you know, all of our referring dentists—who are absolutely fantastic—will take the patient in, do the necessary examinations, and then decide to call us in if they feel that something is presenting that is abnormal or something they want specialist surgeons to tackle. And we found working that way, we have a great report not only with our patients, but we always have those lines of communication open with the referring doctor. And most of the time, that is going to be the general dentist, but other times, it’s the endodontist or the orthodontist or even the physicians at one of our hospitals here in town.

Bill: Those people who that have questions, how do they start?

Dr. Miller: Yeah, for people who have questions, they can call us at 335-1080 Siouxland Oral & Maxillofacial Surgery.

Dr. George: Or they can visit us on our website at siouxlandoralsurgery.com

Bill: Dr. Lou George, Dr. Denis Miller — thanks for the visit.

Dr. Miller: Thanks for having us.

Dr. George: Thank you for having us, sir.