between an oral surgeon and it's a general dentist ward training is basically the same so you know undergrad dental school and then for oral surgery the training additional training can vary from four to six more years after them a school so we have some additional training to do specific procedures some are hospital made some are office based so you know it's oral surgery is a very broad spectrum specialty you know where we can do practicing many questions that have been asked to you and we decided to bring you on to have a talk about these general questions of the effect of dental vestry and and oral surgery as well and your kids were kind enough to come that happens as a result people come in with with problems and traumas and so forth as able to to correct that and improve the quality of life and i don't think either of them at least at this point are interested in doing wh but then i was i don't think i was a they were you know not really now so maybe as they get older and you know i don't know if they want to work with their dad or not to now that yeah coming my son will see what happens it will have a little bit of time it was interesting my  and so forth any time there's a problem you go like you know you know your issue fester do you have any comment now i mean i think you know every six months seems to be the standard unless like you said there are some issues and patients are on a more you know close follow up schedule but every six months seems to be that the standard so what you have made with kids it like age they dentist i would tell you from the time a little baby come into the dentist office and sit with your your brother your sister your mom or dad sit in the chair get familiar with the sounds and so forth and of course the babies generally don't have the need to be looked at bugs some some kids or something is a born with little to budge problem coming out but i would say start then because there's this fear that kind of develops some of it's thrown upon you from your parents and bad experience in the past are stories that are told if you come in and get used to all of that you don't have the strong the coming out and now you're you're not afraid and you take more interest in keeping your oral health up to the question development how do they still have their permanent i mean do they still have some abt them a permanent teeth or they have so sometimes it will most often is just patients specific but it seems like nowadays kids are being treated much earlier and you know when we're in school and saying like a lot of kids in high school i had braces you know nowadays they're pretty much done with their braces the time they get to high school and things have changed over the years whether to do the technique and being able to treat you know kids in an earlier age but you know i just think it depends on the patient you know their dentist we will bow you wait and there are many factors that go into that but i think it's pretty common to see kids now your age when with big metal ones and i think it's easier for them now days so i remember the biggest trauma it was the first day they put the spaces in i think my mouth they hurt for a week is that pressure was building up and you know then every time there was i just but it was like oh everybody needs them no that's not that's true it's not everybody and you know and there are a lot of theories about you know doing it well the jobs forming and growing and as opposed to waiting for the live element i mean it's really interesting the different theories that are out there  ready graphically on the x ray how much development there is because you have some kids who are you know fourteen years of age and have an x ray of someone who's eighteen years of age said her body develops a different stages a lot of it depends on the x ray not so much age depend yeah because a lot of times there's not enough room for the teeth the country so they come through part way and then that creates an opening which can object or to get in there so infection is is the most common issue and as you get older course you know i know that that you know a body just doesn't heal as well as as you do if you're sixteen or seventeen years of age in the surgery becomes a lot more difficult after older so we can if we can evaluate patients and kind of predict with some certainty who we feel may have problems in the future then we make the suggestion you know to get in there and brush it and second i was in dental school in cleveland there was a big program that we went to an outreach program that we went to the area schools and treated young kids and the sex success rate was tremendous as far as is gone you know and some of these kids probably even that have access to a concert and it was it was a wonderful program so yeah i think they do they don't last forever they where they knock out and so forth so you have to keep up on them what do you feel about that of the stuff now i mean i agree i think feelings are definitely beneficial you know like you said some teeth you know depending on the anatomy when there's deep fissures in greece which makes it difficult and that can increase the risk of cavities so sealant is i think  you know definitely a very good way to prevent cavities from developing and in fact that you know it's inexpensive it doesn't have any pain involved in it and you know there's no you know injections no drilling nothing you know and  another question what else can can do to prevent cavities well brushing is the biggest thing in my opinion brushing your teeth every time you eat  staying away from sugary things like shoes for example or if you drink juice you brush your teeth right away flossing is very important because you can't get a tooth brush in between  and so you want to get any debris out of there having your teeth cleaned i particularly don't every every three months but at least twice a year i tend to drink a lot of tea and coffee so my teeth stain a lot and in fact i'm due for a clean now so that that helps you know but brushing is probably the biggest thing is staying away from some sweet stuff much as maybe a general dentist you know some trauma to the teeth from sports whether it be basketball or soccer baseball not so much in football because you know they have the face mask but of course getting hit in football you know and the teeth banging against one another could fracture the teeth so that's why it's a mouthguard is very important but the other sports you know where the face is exposed to whether it's a baseball or an elbow in soccer or something like that and i think it's important for kids to to wear  a mouthguard because you know a lot of times when the tooth is is damaged most often it can't be replaced and that can be kind of traumatic for kids at a certain age to lose a front too kind of you know effective then they're the better ones that you have custom made for you and that's probably a better way to go because they're they're actually formed according to your anatomy of your taste and your john so forth  so it's important to keep that in mind yeah especially kids like yourself who have braces sure you know the ones that you purchase you know and the drugstore may not fit as well as as it should so typically with kids who embraces north and honest will make  face of course and my inner lips were all torn up for gas prices you know because there are fresh start there well yes now so yeah definitely mouth guards are are are recommended and in a lot of sports and even with someone with baseball you know the only thing is if you actually get hit with a ball and that to be honest with you is pretty uncommon you know with the number of baseball games that i've been to with these two can honestly tell you i really don't let me see kids get hit you know with the ball but it's surprising that there's not more trauma but i've seen i've seen some kids who who have lost some to high school kids you know when they get older and you know the ball is is now he's playing with cross so that it's actually required that they wear a mouth guard and if you do not have it in during the game it is a penalty so they're pretty strict and even it you know with lacrosse they have a they have a mask on they have a cage so they can't really get hit in the mouth with the ball per se but it is required that they were my for which is good you lose a baby two you're going to have a permanent to the comes in when you use a permanent two you're not talking some type of surgery some type of definitely the the one recommendation is to immediately pick it up put it in something like milk and they do sell some other solutions at the drug store you know that you can they have little kits that you can keep on hand but you know milk is probably the best thing but yes don't wipe it off don't rub it you know if it has darker whatever on it just kind of gently wash it and then soak it in the milk and call your desk if you want to try to get that tooth reimplanted within a certain period of time the longer you go the less likely out maybe a fracture broken jaw something like that but we typically do not see the patients who've lost who've had a tooth knocked out and we don't usually work you know reimplanted so a retest itself yes if the bone around the two that is is fractured which we will see occasionally there's really no way to reimplanted to because there's nothing stable around the to fold it in place so and that unfortunate situation  basically just smokeless tobacco so people who smoke cigarettes that's the smokeless i mean that's the tobacco one that you use that you smoke in a hail ok so it's not that's pretty much the same thing but not in a cigarette form it's what you just put in your mouth so the components of snuff can damage the tissues just like people who smoke it damages their long ok so the smoke is very irritating to the tissue and it does increase patients risk of developing or the whether you use the ones that come in a little pouch to some people think you know if you put if i use the power outage i have the power to kind of protect that it doesn't you know you're still exposing your tissue to to the product and that does increase patient's risk as i said developing whether it's pre cancerous changes work or cancer or cancer what they do with stuff for chewing tobacco is they actually add some chemicals and a lot of sugar to it and the and so forth and it's actually as far as oral cancer goes my opinion worse than the cigarette smoke because of what they do to make you want to put it in your mouth so i don't w as everybody knows i'm a practicing and longer but when i was in practice and i would see you immediately knew somebody in your chair who was rubbing stuff they were all there was always a change in the oral oral tissue or the  discolorations and so forth it was like i never even asked you to smoke not let alone what damage it did in the teeth and so forth i remember in school when we were when we were studying and th that's part of the problem because you know the athletes that these kids look up to you know baseball players things like that you know they're there constantly not all of them but the majority of them have some form of chewing tobacco you know so it gives it the impression that school but you know it you know i see it all the time and i see the damages you know that it takes on the tissue and the potential issues that patients will have with it so you know we always try to educate our patients who are snuff users to try to quit sometimes you know a lot of times we are doing biopsies on the areas to rule out precancerous lesions or cancers lesions and i think sometimes that kind of puts a little scare into the patient and  that's all they need to kind of quit that habit but yeah it's a bad habit yes cancer is nothing really more than broken d n a boss and that material that's not has the ability to break those d n a bonds  for cavity s on teeth you do preventative measures like cleaning or taking a little seeing a little cavity and stopping it from becoming a big cavity you see patients that have infections where they have swelling and so forth you treat that you do root canals a lot of general dentists like my brother for example the strain for orthodontic so he does braces as well general dentistry there is a variety of oral treatments and really we think about it we tend to focus on mouth that we're actually head and neck and we kind of like lose that a little bit because we get so specific but we we do exams and we look for swollen glands and a there where your dad when you see somebody coming in they've already have a pretty much a diagnosed problem usually yes because most of patients are referred in from someone like yourself to say hey you know here's the problem this is what we want to do whether it's removal of the tooth or you know evaluate a lesion in the mouth but a lot of times patients already been diagnosed and then sometimes they're not so and then when you say well you are leaders you're more trained to look at these lesions and do it worse maybe it's out there it's a little scary you know yeah i don't use the word scared or hesitant to do a biopsy and so forth as part of our training in our residency was strictly devoted to head neck path ology so we spent a fair amount of teeth removed for braces but we do a lot of two to move and a lot of times patients we can we can put them to sleep to to take the teeth out because a lot of times they don't really want to be awake so we can do anesthesia which we do exams so people who come in maybe have something in their mouth that the that the dentist wants us to take a look at and evaluate so on private practice that's kind of you know what we do now of course as i mentioned we were trained to do so many yeah i mean we we can do certain procedures in the office because the ability to to sedate or provide an outpatient anesthesia and then there are certain procedures that need to be done you know in a hospital but most of what we do private practice is done within the office itself your cases are always referrals from another practitioner joining us you don't really have people who just walk it we do but just you know the majority of our patients are referred basically do your four years of college in your four years of dental school maybe a year residency depending on what you want to do and then you can open up a practice or go into practice surgery can be an additional four to six years after dental school so four years of undergrad four years of dental school and then an additional four to six and i did five so it just depends on you know where you train right now well dr shawn and alec and e