Centered on Health 9-21-23 - The role of an oral surgeon, from wisdom teeth extractions to dental implants with Dr. Greg Strull

Centered on Health 9-21-23 - The role of an oral surgeon, from wisdom teeth extractions to dental implants with Dr. Greg Strull

Episode Transcript

(00:00):
It's now time for Centered on Healthwith Baptist Health one use radio Wait forty
w HS. Now, here's doctorJeff Tublin. Good evening, everyone,
and welcome to tonight's episode of Centeredon Health with Baptist Health. Here on
news radio eight forty w HS.I'm your host, doctor Jeff Tumlin,

(00:21):
and we're joined as always by misterJim Finn, our producer, who is
on call to take your calls totalk to tonight's guest. That phone number
to call in is five oh two, five seven one, eight four eight
four. We want you to callin and be a part of the show
tonight. We are fortunate to havewith us doctor Gregory Stroll, who is
going to be talking to us aboutthe role of an oral surgeon, from

(00:43):
wisdom teeth to extractions to dental implants. Doctor Stroll is an oral and maximo
facial surgeon who has practices in bothLouisville and Seymour, Indiana. He went
to dental school at the University ofLouisville, and then he did his training
at the Interface Medical in Brooklyn,New York, the Wycoff Hospital in New
York in Brooklyn, and the Hospitalfor Joint disease in Manhattan, and we're

(01:07):
very fortunate to have doctor Stroll becausethis is the first time we've actually covered
this topic on our show. AndDoctor Stroll, I understand that you are
not are only our guest tonight,but are an avid listener to the show,
So welcome to tonight's show. Well, thank you very much for having
me this meet this evening, DoctorTublin. And before we get started,

(01:27):
if you're more comfortable calling me Greg, that is fine with me. Well,
thank you, and you can callme Jeff as well. So we
do love having you on. Thisis a topic that we haven't had the
opportunity with myself or either our previoushost to ever cover, so we're really
excited to hear about what you do. So in that vein, tell us

(01:48):
what do you do as an oraland maxilo facial surgeon. What is that?
Well, an oral and maxillo facialsurgeon, which is also sometimes called
oral surgeon, facial surgeon, oraland facial surgeon, or just simply oms
are experts of the face, mouth, and jaw surgery. When it comes
to dentistry. In addition to oralsurgery, there are other specialties of dentistry

(02:14):
that I'll just mention those just sothat everyone listening has an idea and it's
familiar with the rest of what dentistryinvolves and what it does. So there
are endodonists who treat rucanus for patients. Many people are probably familiar with orthodonists
who provide teeth straightening. There areperiodonists who treat periodontal disease or gingevitis,

(02:39):
which is inflammation of the gums,and they also treat periodontitis, which is
gum and bone disease. There areprostodonists who repair natural teeth and replace misty
teeth on a larger scale than ageneral dentist would. There are oral and
maxillofacial radiologists who interpret image is inthe head and necks specifically, as well

(03:02):
as oral and maxillofacial pathologists who treatand read pathology and identify microscopically pathological legions
which are a different breed than ageneral pathologist would would do. There's pediatric
dentists which deal with children with infants, children, adolescents, and including those

(03:24):
with special healthcare needs. And thenthose are those involved with the dental public
health specifically sorry specifically what an oraland maxillo facial surgeon. Does they take
care of health issues related to yourface, mouth, and jaw through procedures

(03:45):
that include extractions and removal of teeth, wisdom teeth management and surgery, dental
implant surgery, treatment of facial injuriesand trauma, corrected jaws surgery, treatment
of oral and head neck cancers,treatment and surgery of obstructive sleep athnea,

(04:08):
facial cosmetic surgery, clef flip andpalace surgery, treatment of and treatment of
TMJ, and facial pain. Well, we're going to try and touch on
as many of those that you doin your practice as we can tonight.
But tell us a little bit aboutyour practice. How is it set up?
What are the typical patients that yousee, Because you just gave us

(04:30):
a very long list of different specialties. So if somebody were to come see
you, what are the kinds ofthings you're doing on a daily basis in
your practice that somebody might see youfor on a daily basis. We're doing
extractions, we are treating wisdom teeth, we are performing dental implant surgery,

(04:53):
we are treating trauma. Those arethe big things that we do in our
practice. An oral surgeon. Onceyou go to once you get through your
undergraduate training and your four years ofdental school and your residency in surgical training,
which could be anywhere from four tosix years at a typically at a

(05:14):
Level one trauma center, because oralsurgery is part of the Level one trauma
service that you would find, sayat University of Louisville or University of Kentucky.
There are oral surgeons that then furthergo on and get additional graduate training
to do more complex and advanced surgeriessuch as the cleft flip and palette surgery
at in next surgery, things likethings like that, so power practice those

(05:39):
is what is considered a dental alvelerpractice meaning what what does that mean that
it's just mostly about the guns andteeth or what it's mostly dealing with extractions
like I said, wisdom teeth removal, dental implant, dental implant surgery,

(06:00):
facial trauma, other types of surgeriesthat we might do. Our gum procedures
such as a for neck to mewhere you which is what where you loosen
gum tissue that's intinging on certain structuresin the mouth and what do we what
do we need to know about thestructure of the mouth to understand when you
talk to us in a little bitabout wisdom, teeth and extractions and implants,

(06:25):
and we're gonna talk about those things. What do we what do we
need to know about the analotomy ofthe mouth. Well we'll start, we'll
start in the front, and we'llstart with as a as a child,
children have twenty teeth, and asyou age, those baby teeth are either
come out on their own in somecases they have to be removed, and

(06:47):
then as an adult you end upwith thirty two teeth. So so that
everyone's familiar with what we're discussing,the upper jaw and the lower jaw,
the upper jaw called the maxilla,and the lower jaw called the mandible,
each have sixteen teeth, and startingin the front, the two front teeth
on the top or the fore frontteeth on the top are called the incisors.

(07:09):
And then as you move off ofthe front, you get to the
teeth that look pointing, and thoseare called the canines. And then two
teeth back from that are called thepremolars, and then you get to the
molars. Whereas the counting back fromthe front to back, you get the
first molar, the second molar,and then the third molar, and the
third molar in particular is what peopledescribe as wisdom teeth or third molars.

(07:33):
That's why they're called the third bowlers. I understand. And then are you
doing most of these in your office? Do you have a hospital practice?
Where does somebody get these procedures doneon a typical for a typical routine procedure
like this, for a typical routescene procedure, they're done typically in an

(07:55):
outpatient setting in an oral surgeon's office. We have the ability to provide local
anesthesia. We have the ability toprovide nitrous oxide anesthesia or laughing gas,
and we have the ability to provideintravenous conscious sedation or moderate sedation as well.
So we have those for those variousoptions for patients when they come into

(08:16):
an office. And how do mostpeople get to you? I mean,
I guess I would think most peopledon't think to themselves, oh, I
need to just ghost to an oralsurgeon. So is this Do you get
most of your referrals from primary caredoctors or from other dentists or other oral
surgeons that don't do what you do? Where do you get most of your

(08:37):
patients from? Well? Oral surgeriesI was describing earlier because it's part of
when the residency training programs are partof a general hospital setting. Much of
our referral network, and we arean important link to both dentistry and physicians.
So many of our patients as anoral surgeon come from the general public.

(09:00):
They come from referring General Dennis Restoreto Dennis even physicians in practice as
well. That's fantastic. Well,we already have some questions that we're going
to get to right after the firstbreak, So we're going to take a
quick break here, and I wantto let everybody know you're listening to Send
It on Health with Baptist Health hereon News radio eight forty w h AS.

(09:22):
Our phone number is five oh two, five seven one, eight four
eight four if you want to callin and join the conversation, we have
a caller on the line we're gonnaget to right after this break about wisdom
teeth. So stay tuned. We'retalking with doctor Gregory Straw. We welcome
back every one and two. SentIt on Health with Baptist Health here on

(09:45):
News Radio eight forty w h AN. I'm your host, doctor Jeff Coblin
and we're talking tonight with doctor GregoryStraw, who is a oral and maxillofacial
surgeon who's talking to us tonight aboutwisdom teeth, extractions, dental implants and
all of the above. So ourproducer Jim Fenn is still on standby to
take your calls that number five Otwo five seven one eight four eight four

(10:07):
if you'd like to join in onthe conversation and doctor Stroll welcome back.
We have several people waiting to askyou of your expertise, so we're going
to start with Clay, who hasa question about wisdom teeth. Clay,
you are on with doctor Stroll andwelcome to send it on Health. Hello,

(10:30):
Hello Clay, Hello Clay. Yes, yes, doctor Stroll. Yeah,
yes, you are on with doctorStraw. I'm forty five years old
and I've never had my wisdom teethout, and my kids have all had
that word and teeth that do Ineed to get my wisdom teeth that because

(10:52):
they're they're bothering me a little bit. I get some food impacted in there
at some Thomas and it's a botherand my wife nagnet get out and I
don't want to do it, butam I at a health risk for that.
Well, that's a that's a greatquestion, Clay, thank you very
much for bringing that up. Yoursis a little different because if you are

(11:16):
having having pain and having issues,you should have them evaluated. Because pain
or no pain, your wisdom teethshould be checked annually because pain free doesn't
necessarily mean disease free. And theworst thing that you can do is ignore
your wisdom teeth. One of thereasons that you can have problems is just
what you're saying is that you're gettingfood packed in in the area. It

(11:39):
can lead to infection, it canlead to damage to the adjacent teeth.
You really should have it evaluated tosee the position of the teeth and see
if they are all necessary to beremoved, because sometimes at forty five you
may only have to have the onetwoth out that's being that's problematic at this
point, So you should certainly havethem evaluated and looked at. People tell

(12:05):
me that and then they say youget all four not necessarily. Again,
you need to be evaluated with someclinically and radiographically to see the status of
the teeth and make sure what exactlyis going on with them. But you
wouldn't necessarily have to have all fourof them now, and then I can
get evaluated on how many I needon a visit and then do it same

(12:30):
day. You can, certainly,yes, if you're prepared to absolutely you
could do it at the same day. We do that all Sometimes we had
patients in and we removed in thesame day. Others they have different situations
and they need to come back anddo it another day. I try and
take care of my teeth, andwhat I'm confused about is that the wisdom

(12:56):
teeth never have it fought. Ihave problems with the other things, and
and these things stayed for am andthen all of a sudden, I'm having
problem with why don't we why arethere wisdom teeth in the first place?
And kids are all getting games.Well, that's another good question. Most
of the time, there isn't roomfor them to grow, to grow in
properly, and so they'll grow sideways, they'll grow backwards, they'll grow into

(13:22):
the other tooth in front of it, like I was saying earlier, causing
causing problems with that tooth, whetherit's decay or bone loss, and then
you end up with issues with theother one. Long term, some of
those teeth will form cysts as well, but that's again everybody should have them
evaluated to determine what is necessary forthem. This sounds like a mess.

(13:46):
Well, no, I think Clay, you've asked a lot of questions.
Actually, you took a lot ofmy questions for doctor Strawl about wisdom teeth.
Those were all of the questions Iwas gonna be asking him anyway.
And we want thank you for joiningour conversation tonight. We have Evan also
who had a question about his wisdomteeth. So, Evan, you're also

(14:07):
on with doctor Straw. Is ita question about your wisdom teeth as well?
Yes, thank you for having meon the call, doctor Greg.
And I have a question. Mywisdom teeths have never exposed themselves. They're
up in my jaw still and isthat a problem? I mean, well
that like, could they could theybe infected and hurt my bone? Or

(14:30):
should I just leave them alone whilethey're up there because they never come down,
They're just up there hanging out.Is that a problem? Well,
Evan, that's another good question.And again I think you should probably have
them checked to determine the status ofthem, because sometimes even though they're in
they're up in the bone. Asyou said, they can have cysts and

(14:50):
they can have problems with them againwith damage to the adjacent tooth. These
structures around that you should have themevaluated by in ord urgent or your dentist
someone at least to determine the statusof them and see if you do need
to have them out. Oftentimes,if you have not had problems with wisdom
teeth by the age of about thirtyfive, most of the time you're not

(15:11):
going to have problems with them.Oh I go to the Dennis regularly.
They check on them and they neversays a problem. But I just always
wonder if that's something just waiting tohappen. So okay, well, I
appreciate it, Thank you very much. So, Doctor Gregor's very welcome.
It sounds like not everybody ultimately hasto have their wisdom teeth out, is
that right? That is correct?Although ninety percent of people have at least

(15:35):
one wisdom tooth removed. They justneed to be checked to see the status
of them and how serious and whatissues, what issues a person might have
with them, whether it's infection,paradymal gum disease, cavities, cysts,
tumors damaged to adjacent teeth. Well, we I have a few remainder questions

(15:58):
about the wisdom teeth. We mightget back to by we have some other
callers. I want to I wantto be able to get to. Eugene
has been waiting to talk to you. He has a question about dentures.
So Eugene, you're on with doctorStraw. Yes, thank you for taking
my call. I had a badexperience with the dentists. I went to

(16:19):
the dentists. I had two insertsput in as a chow and they were
crooked. So anyway, the dentiststook all my top teeth out and never
seen me again. And then likea year and a half, I'd done
everything to try to find this person, but it left me kind of,

(16:44):
it left me really messed up.But I do I had dentres. I
went back somewhere else and got dentistin the top. But I can't even
eat a piece of bread or anything. It sticks to the top, and
I have all my bottom teeth.They took my wisdom teeth out in the
back, and I was just wondering, do you recommend somebody that can maybe

(17:11):
might do they do inserts with dentureswhere they put the pins in or whatever?
And that was my question because I'vebeen without my teeth for a while
and it's a challenge. So doctorGreg, so what are the kind of
options for more permanent denture replace yests. Well, it sounds like Eugene you

(17:37):
do have. You do have anissue there because if you can't eat and
you can't function, then that canbecome a problem. One of the options
that you have is sometimes you canhave a denture remade or refitted so that
it does fit better for you.Other times you can use dental implants,
which are titanium inserts that you placeinto the job to help support denture.

(18:00):
That can help support a denture andkeep it in place. It can keep
it and to keep it from movingaround and allow you to function better.
Other times you can use implants tosecure a denture in place so that you
don't have to take it in orout. Well, So those are a
couple of options that you do have. Okay, do you recommend someone or

(18:22):
do you have an office number andmaybe make an appointment get sing or that
is that is something we do inour practice. I have to figure out
how to get you the number.We can get your number, we could,
we'd be happy to get you intouch with doctor Strong. Okay,
and thank you so much for callingus. We do have one other caller

(18:45):
on the line. Jennifer wanted toask a question about mouth guards. Jennifer,
you're on with doctor Greg. Thankyou, Hi, doctor Greg.
This has been very informative. ButI have a question. I have a
science who played back a ball andhe has been elbowed on a rebound or
something and had a tooth that wasloose, so he was supposed to be

(19:07):
wearing a mouthguard. However, whenhe's playing an active sport, he says
it's very difficult to breathe and runwhen he's using these mouthguards. So are
there other give suggestions for how toprotect teeth and contact sports other than with
the mouthguard And what does he needto look for in the future going forward
to know if he needs to beseen again? Question Jennifer, Thank you.

(19:34):
There are different types of mouthguards andthe best way to play it safe
is with a mouthguard. And whetherit's football, basketball, baseball, hockey,
field, hockey, lacrosse, anysport athletes themselves are about sixty times
more likely to have injuries to theirteeth or their mouth without wearing Without wearing

(19:59):
a mouthguard, there are different typesthat you can make. You can make
a stock mouthguard that you buy atsupporting good store. It's preformed, it's
a bid bulky. You can alsoget the boil and bite type of mouthguards
that you can buy supporting good stores. They fit a little bit better.
But the best option would be toget a custom fitted mouthguard from your child's

(20:23):
dentist. They'll take an impression.I don't know if your child had orthodonics
or races, but it would bea similar situation like that, and they
would make a mouthguard that would formfit to the teeth, wouldn't be as
bulky, and would stay in bettersimilar to types of retainers that are made
in that fashion, and that wouldgive them that would certainly give them the

(20:45):
best protection for their teeth. Movingforward, Well, great, well,
doctor Gregg. One more quastion beforeI hang up. As the follow up,
if this happens again, is thissomething that has to be treated emergently
or is it something you wait forin my name earning and calling your dad
too, Because a lot of timein the game can be on a Friday
or Saturday. It depends on theinjury itself, but if it's a tooth

(21:08):
that is knocked out or displaced,it should be treated immediately. If it's
a tooth that is broken that isnot causing acute problems or acute pain,
that could wait till Monday. Butoftentimes those injuries that you're referring to,
especially in a basketball game, wouldbe a tooth that's knocked out which needs

(21:30):
to be replaced immediately, a tooththat is displaced that needs to be put
back into its position proper position immediately, some type of jaw fracture that would
need to be treated, as faras a tooth it's knocked out. In
that instance, if you had that, the best thing to do is just
pull that tooth just by the partof the tooth called the crown, which

(21:51):
is the piece which is the partof the tooth that you see in your
mouth. Don't rinse it, don'trub it, don't do anything to it.
Just put it into milk if youcan get some milk or salt water,
or even if you can't get anyof that, let your child keep
it in their mouth between their teethand dumbs and so that the tooth doesn't
dry out and get in touch withyour get in touch with your oral surgeon

(22:14):
as quickly as possible. Greg We'regonna need to take a quick break right
here. I hate to pull youaway from all these callers. You're giving
us such great information, but weare going to take a short break.
And I want to remind everyone thatyou're listening to Center on Health with Baptist
Health here on news radio eight fortyw eight. As Our phone number is
five oh two, five seven one, eight four eight four if you want

(22:36):
to call in and talk to tonight'sguests, which is doctor Gregory Straw,
Oral and Maxive Faithful thurs In talkingto us about wisdom teeth extractions, dental
implants and so much more. We'llsee you on the other side of this
break. Welcome that to Center onHell with Baptist Health here on news radio

(23:02):
eight forty w eight. As I'myour host, doctor Jeff Tublin, and
tonight we're talking with doctor Gregory Strawlabout the role of the oral surgeon,
from wisdom teeth extraction to dental implantsand beyond. Welcome back, doctor greg
We have another caller if he's stillon the line. We have Max who
is calling in to ask a questionabout jaw surgery. So Max, if

(23:26):
you are still with us, youare on with doctor Greg. Yes,
good evening, Doctor Tuve loved theshow Doctor Scrawl. Very excited to be
on the line. So my questionsregarding an upper jaw surgery I had recently
post surgery, I was a littlebit concerned about pain management. I was
prescribed liquid painkillers, but with alittle worried about over using them, Doctor

(23:52):
Straw, do you have a costefficient alternative that's also over the counter for
something I could use instead of theliquid pain killers. It's a great question,
Max, Greg. Yeah, Yes, that's a wonderful question. When
you said you had jaw surgery typeyou had upper jaw surgery, you said,

(24:14):
yes, and they gave you afterthe surgery, they gave you a
prescription for some medicine. You saidone of the one of the things that
we do with our patients with surgeryis to try and limit the amount of
the narcotic that they take. Soone of the things we do often most
surgeries is we tell patients to takea combination of a seat of medicine,

(24:38):
which is taile in all an ibewprofen, which is motrin or advill, and
we instruct them to take six hundredand fifty milligrams of the taile in all,
which would be two regular strength tailand All tablets, and four hundred
milligrams of ibewprofen, which would betwo Adville or motorn tablets at the same
time, four times a day forfirst two days of surgery. Studies have

(25:03):
shown that that combination works better thannarcotics do. Now we also will supplementations
with the narcotic that does not includetile and all or idioprofen as well.
It just has the narcotic itself andthey can take that as at their leisure.
Typically it's the first two days afterany type of surgery when the most

(25:26):
discomfort occurs. So that's what wedo. In our case. When you
had your jaw surgery, did youuse that regimen by chance? No?
I did not. I started usingit towards the end. I didn't use
two and two. I was reallyjust using some ad built towards the end
when pain wasn't necessarily as bad.But this is great insight, So this

(25:49):
is definitely something our keep in mindfor any sort of oil surgery. I
have in the future. Well,Max, we certainly hope you don't need
any in the future, but ifyou do, you were able to have
this, uh, this one onone with doctor Greg. So Max,
thank you for calling and being apart of Thank you, doctor tub,
thank you doctor Straw, Thank youguys very much. Have a great weekend.

(26:10):
Thank you, so doctor Straw.I'm gonna just piggyback on Max's question
because you know, we didn't reallyget a chance to hear like why he
needed surgery? But what are whatwhat is it under by? Why what
is it over by? Why arethose important in terms of needing correction and
when do they need correction? That'san excellent question. So the type of

(26:33):
surgery that the last caller was describingis something called corrective jaw surgery, also
known as or signatic surgery, andit's performed by oral and max will stacial
surgeries to realign their jaws and teeth. By doing so, it can help
with breathing and showing and speaking.Oftentimes, those patients that need correction,

(26:57):
they have what's called, as youask, an underbite, which means that
the party that the lower jaw protrudestoo much and that the upper teeth are
behind when you bite where the lowerteeth would be. There's also patients who
have a receiving lower jaw or aweak chin, or their upper jaws too

(27:21):
far forward of where it should beand you have a space and you can't
bite correctly. You also can havea condition what's called an open byte,
where your front teeth don't come togetherproperly. And you probably have noticed some
of those patients or some of thosepeople when their lips, their lips don't
close together, their teeth don't closetogether, and when you're looking at them,

(27:44):
oftentimes you can see into their intotheir mouth. These can create an
unbalanced facial appearance on someone looking athim from straight on or from the side.
You can get jaw joint pain,temporal mandibular jaw joint pain. That's
the area in front of your earwhen you open and close. That's your
jaw joint that I was referencing mosttimes, as I said earlier, the

(28:08):
lips don't come together. You canhave breathing problems such as sleep apnea.
You can have difficulty chewing and bibingfood, and these types of surgeries can
correct all of that. It's atype of surgery that is done in a
hospital setting, and it's done inconjunction with an orthodonist, because in order
to do this surgery, you haveto align the teeth in their proper arrangement

(28:32):
first, and then you move thejaws to meet where the teeth are supposed
to be. And then after thesurgery you have some fine movements and some
fine changes in the orthodonics just toalign the teeth properly to get your fight
locked in as best as you can. And I bet our previous caller Math
would have been able to answer thatthis for us. But what's a recovery

(28:56):
like from a surgery like that?Usually the initial healing is about six weeks
until the bones have fused and healed. And in the process of doing that
surgery, just like any other bonytype of surgeries, the jaw is separated,
the upper jaws separated from the skullbase, and it is moved forward

(29:19):
or from side to side, thelower jaws separated upon itself in a fashion
where the front part of the jawon the side and the back part slide
together, slide on one another,and then it's fixed in place. Whether
it's using bone plates, bone screwswires to prevent patient from having to have
their teeth wire together. It allowsyou, it allows you to get back

(29:42):
to quick, quicker function, butit does take about six weeks of initial
healing, takes about nine to twelvemonths for complete healing. Well, we
are going to take our final breakright now, and I want to remind
everyone you're listening to Center on Healthwith Baptist Health here on news radio eight
forty w HS. I'm your host, doctor Jeff Tublin. And if you've

(30:03):
missed any of tonight's show or wantto hear the entire excellent information that doctor
Greg is giving us in its entirety, please download the iHeart Radio app.
It is free, it's easy touse, and it gives you access tonight's
show and all of our previous recordedshows, as well as all the other
content on the app. We'll beright back after this. Welcome back to

(30:37):
here on news radio eight forty wh as I'm your host, doctor Jeff
Cublin. We're talking tonight with doctorGreg Stroll the role of a oral and
mes official surgeon. Lots of questionsand lots of great discussion. Dodgor Greg.
We do have another caller on theline, Stu has a question about
tooth extra teeth extraction. Stue,are you still on the line, and

(30:57):
if you are, you're on withdoctor Greg. Hey, now, this
is Stu from Georgia. First timecaller, longtime listener. Love the show,
Doctor Coblin. Well, we're happyto have you. Thanks for calling
all the way from Georgia. MayI call you Jeff? Of course,
absolutely so this this question pertains toI guess both of you guys. You

(31:18):
know what a fantastic guest that youhave tonight, such an intriguing topic with
so many different avenues to work under. My question is when are we gonna
get him on next? What agreat topic. Well we I feel like
I have a million questions we haven'tgotten to and I know we could do
it part two. So if doctorGreg is down for it, Center on
Health is down for it as well. Do you absolutely? Thank you,

(31:42):
Stu. I appreciate that. Yeah, you're welcome. Love the show,
guys, love the show. Keepat it all right, Well, I
guess glad we'll move on. SoGreg, I have some questions for you.
Stut. Thank you for calling inand sharing that excitement with us.
Doctor stroll. Could you let usknow a lot of times people have to
go to the dentist or I wouldimagine an oral surgeon, they need to

(32:07):
take antibiotics before they go. Thatis that common? Who needs to have
antibiotics? And why is that arecommendation? That's an excellent question because it
is. It is a common questionthat we get from patients. Patients take
antibiotics for a couple of reasons.One or for several reasons. One is

(32:28):
they have some type of infection andso they've been given antibiotics prior to having
having any type of surgery. Butone of the I think the more common
ones that you're discussing, and you'reasking about our antibiotic premedication for patients with
heart issues and with prosthetic joints.Over the years, there are very few

(32:52):
indications any longer for antibiotic premedication forprosthetic joints. What has been excuse me,
what has been studied in our literatureand the and the orthopedic literature is
joint sessis, and that one wayto prevent that is to give patients an
antibiotic prophylaxis an hour prior to anytype of surgery. It does not have

(33:15):
to be IV antibiotics except in asmall certain circumstances, but most patients are
able to take antibiotics by mouth anhour before surgery, typically if they've had
a joint replacement within the last twoyears. Anytime over that the literature says
it's not indicated any longer. Thereare only a few indications where you take

(33:37):
them. For for a heart condition, there's a prosthetic valves is. The
big is the biggest one prior historyof endocardiotis, but the more but the
more common reasons that patients took themyears ago really don't pertain anymore, and
it doesn't happen all that often.I see it more commonly in patient with
joint prosthesis than with heart than withheart issues. Thank you, And we

(34:02):
have just a couple of minutes left, so I want to do a couple
of kind of rapid fire your thoughtsabout different different a couple of different things.
I have a good friend who's anoral surgeon who always has gomen with
them everywhere we go. Is thatwhat's the story with gum and teeth?
What are your recommendations with that?Well, if you think back to when

(34:25):
we were younger. There was theold Trident ad. Four out of five
Dennists who recommend recommend gum to theirpatient recommend trident gum. One of the
things that gum does, is especiallysugarless gum, is that it prevent it
increases salivary flow, and for someonein a certain situation, increasing that salivary

(34:47):
flow can change the pH balance inthe mouth after you've had something to eat
or drink, and it balances thingsout and it cleanses your teeth in a
way. Does the American Demal Associationrecommend that. I don't believe so,
but I just know from my ownexperience that that seems to work and with

(35:08):
myself and with patients. And soif you're going to chew gum, that's
one one time to chew it.And what about mouthwash? Is there do
you recommend using mouthwash? How oftenis there a brand that you like or
what's the story with mouthwash? Therewas a study that came out several years

(35:30):
ago from the American Demo Association andit has to do with at the time,
listering mouthwash, in particular, listerinemouthwash comes in many different colors that
you see. There's the old goldcolor that we all remember that had that
Medicine EQ flavor when we were allyounger. But it's now some of us
might now that that's true, someof us depending on the age. Right,

(35:54):
there are more now that are havea fresher and a cleaner flavor.
They come with different essential oils,and the studies show that if you those
essential oils help to prevent the periodonalddisease that we discussed earlier, the ginger
items and phone loss. Swishing forthirty seconds twice a day with the listerine

(36:14):
mouthwash is typically what's indicated. Ido it myself and it works wonder I
tell my family they do it andit works great, and I tell my
all of my patients to do it, especially my implement patients. Well,
Greg, thank you so much andappreciate those last rapid fire questions taking in
sir, Well, that does itfor tonight's segment of Centered on Health with

(36:35):
Baptist Health. I am your host, doctor Jeff Publin, and I want
to thank our guest, doctor GregStroll. What a great topic. We
covered a lot of ground. There'sa lot more we'll have to have you
back. I want to thank allof our callers, Clay Eugene Evan,
Jennifer MAXs Do. Thank you forbeing a part of our conversation. Thank
you to our producer Jim benn.I hope everybody has a wonderful, great

(36:55):
weekend with great weather and everybody staysafe. Thank you for listening, and
we'll see you next Thursday here onCentered on Health with Baptist Health. Have
a great night. This program isfor informational purposes only and should not be
relied upon as medical advice. Thecontent of this program is not intended to

(37:16):
be a substitute for professional medical advice, diagnosis, or treatment. This show
is not designed to replace the physiciansmedical assessment and medical judgment. Always seek
the advice of your physician with anyquestions or concerns you may have related to
your personal health or regarding specific medicalconditions. To find a Baptist Health provider,

(37:37):
please visit Baptist Health dot com.