3. Are they also board certified in dental anesthesiology?
Posted on January 7, 2016
“Hello, this is Dr. Amir Marashi, and I want to congratulate you for taking the initiative to review this free consumer guide. You see, I know that any time someone needs work done on their mouth, teeth, or gums, it can be a scary experience.
There are many choices available to you as a consumer, and it can be incredibly difficult to know which one to choose or even how to distinguish one choice from another!
Well, because I want each and every one of my patients to feel absolutely comfortable when they come to my office, I’ve created a list of the 21 questions everyone should ask their oral surgeon before even setting foot in their office.
Why do you need to ask these questions? Because you need to have a way of distinguishing between those doctors that are going to only create more pain and those that can actually take it all away!
So, before you do anything else take a few minutes right now to read through these 21 questions. We’d love it if you’d give us a chance to show you just how simple an oral surgery procedure in our office is, but even if you don’t come to us, I hope this helps you feel good about the choice you ultimately make.”
1. First and foremost, are they, in fact, oral and maxillofacial surgeons?
Many dentists advertise that they do oral surgery. They do not have nearly the training or experience that an oral surgeon has. For example, I have seven more years of training beyond the dental school and all I do is surgery.
2. How much experience do they have, and are they board certified in oral and maxillofacial surgery?
The American Board of Oral and Maxillofacial surgery has established criteria for competence and knowledge that determine a sufficient and acceptable performance for safe practice of the specialty and examines qualified candidates.
Those individuals who demonstrate achievement of the requisite training, experience, and knowledge are granted Diplomate certificates.
3. Are they also board certified in dental anesthesiology?
American Board of Dental Anesthesiology grants Diplomate status to surgeons with training and expertise in administration of general anesthesia in a safe and effective manner.
4. Do they keep abreast of the new research with the regular continuing medical education?
In the fast-paced and ever-changing world of medicine and surgery, it is critical for the physician to be committed to lifelong learning through regular continuing medical education.
5. Are they on staff at the hospital, and are they in good standing?
This cannot be stressed enough. The majority of surgeries an oral surgeon does can be safely done in an outpatient office setting. However, it is crucial that the surgeon has hospital privileges in case complications arise and there is a need for hospitalization.
6. Have they ever been the subject of a disciplinary action from a professional board?
This goes without saying. If there are a lot of complaints or disciplinary actions, then that may be cause for concern.
7. Do they keep up with the Advanced Cardiac Life Support re-certification?
The guidelines for resuscitation are constantly being evaluated and changed. It is very important to have regular certification and to keep up with the advances.
8. Is the oral surgeon also a medical doctor?
There are a lot of good qualified oral surgeons that are single degree or just DDS. However, I think it just makes sense that having also gone to medical school will enable the oral surgeon to be well-rounded and able to take better care of the patients with more complicated medical problems.
9. Does the office practice strict infection control?
Any outpatient medical or surgical facility should be like a small version of a hospital. The same infection control guidelines should be followed.
10. What is their infection rate?
Simply ask if the office is actively keeping track of their post-operative infections.
If they are not tracking this data, there is no way they can even have an educated answer. There is not a single surgeon that does not have any infection. However, strictly adhering to infection control principles and practicing sterile techniques should minimize the number of infections.
11. What is the surgeon’s rate of nerve injury?
The rate of nerve injury following removal of third molars ranges from 1.5 to 8.4%. That means out of every hundred cases, there may be up to 8 patients that have numbness of the tongue, lip, and chin post-operatively. I believe that through careful, meticulous surgery, this number can be kept very close to zero.
Again, ask if the office is actively tracking the number of post-operative neurological impairment.
12. Do they reuse some disposable items such as IV bags and needles?
You would think that this is not happening anywhere in the USA. There was a case right here in Charlotte, NC. You don’t need a medical degree to figure out that the IV bags, tubing, and needles that are supposed to be disposable should not be shared with other patients to save a buck or two.
13. Is the doctor involved in all the aspects of the care?
In some offices, the consultation means, watching a video. Or the staff will do most of the interaction and explaining. I firmly believe that the doctor (who is the most informed in the office) should be the one that is involved in every aspect of the care, particularly the consultation.
14. Will you have the same surgeon from the consultation to surgery and post-operative period?
In many large practices, there are several oral surgeons and one may have different doctors from consultation to actual surgery. I know because I worked in those type practices.
15. Does the doctor do only one surgery at the time, or are there multiple sedated patients, usually watched by a dental assistant while the doctor goes from room to room?
This is a big pet peeve of mine. I strongly believe that each patient deserves the undivided attention of the surgeon during the whole process. That means that the doctor is present from the beginning to the end of the procedure. Not walking in when the patient is asleep and rushing to another sedated patient.
16. Will the doctor personally call every patient after each surgery?
This I also believe is very important. It establishes good communication with the patient. A lot of problems that patients may have usually occur early on in the post-operative course. By personally calling, the doctor can assess the patient’s post-operative course and take care of any problems that may be present.
17. Will the surgeon give you his or her cell phone number, or do you have to go through an answering service to get in touch?
In today’s multi-doctor practices, it is near impossible to have direct access to your surgeon. Often one has to go through answering services, nurses, and physician assistants. Having the doctor’s cell number gives the patient the comfort and confidence that they have support in their post-operative course.
18. Can the surgeon’s staff recommend him, and have they had or will they have surgery in that office?
Again, it goes without saying that the best judge of a surgeon is the people who see his or her work every day. For all of the staff to have confidence in the surgeon is a testimonial to his or her abilities, and the opposite is a real red flag.
19. Are they utilizing the latest technology, or are they still practicing the way they were trained decades ago?
Patients often benefit from the utilization of state-of-the-art equipment and technologies that have shown to improve the surgical outcomes.
20. How do they manage their complications?
Ask if there is a charge for follow up appointments if a complication arises. If there is a problem—for example, nausea—that is not resolved by medication, will the patient be sent to the ER or can they can come in the office for prompt personal care?
21. Do they have systems in place to continuously check the resuscitation equipment and medications?
Complications are not scheduled! Being prepared is vital. Following the hospital model, it is very important to regularly check to make sure all of the equipment is functional and all the medication that is needed during resuscitation is present and not expired.
We sincerely hope this information has been beneficial to you as you seek out relevant information to help you make a decision about your oral surgery care. Remember, you are in charge of your health and you should only go where you feel most comfortable so don’t be shy to ask these questions.
In most cases, a quality oral surgeon will have no problem answering each of these questions and if anything, it lets them know that you’re an educated consumer and that you expect nothing but the best in quality of service and care.
Again, if you have any other questions that haven’t been answered in this consumer guide please don’t hesitate to contact our office directly at (704) 542-9600.
We’re here to help and to make your oral surgery experience a pleasurable one!
Amir Marashi, MD, DDS received his undergraduate training at Mercer University in Atlanta where he was elected to the Phi Kappa Phi honor society. He attended dental school at the University of Minnesota where he earned his Doctor of Dental Surgery degree with distinction.
Dr. Marashi completed his oral and maxillofacial surgery residency at Louisiana State University and the University of Rochester. He also attended medical school at Louisiana State University where he received his Doctor of Medicine degree Cum Laude, followed by a year of medical residency.
After residency, Dr. Marashi joined the faculty as an assistant professor in the department of surgery at Louisiana State University in Shreveport, training oral and maxillofacial surgery residents. Dr. Marashi is board certified by the American Board of Oral and Maxillofacial Surgery.