Bring More Oral Surgery Into Your Comfort Zone

By Genni Burkhart

Oral surgery remains one of the most underutilized yet valuable skill sets for general dentists. While many procedures are safely within the scope of general practice, they are often avoided due to a lack of training, confidence, or efficiency. Dr. Karl Koerner, a respected educator and longtime authority in oral surgery for general dentists, helps close this gap with practical, tested techniques that improve outcomes and reduce stress in the DOCS Home Study course, "Bring More Oral Surgery Into Your Comfort Zone."

His approach emphasizes smart preparation, appropriate case selection, and proven techniques that support better healing and safer procedures. Most importantly, his teaching is grounded in what works every day in real-world general practice.

The Value of Oral Surgery in General Practice

Incorporating oral surgery into a general dental practice offers consistent revenue with minimal costs. Procedures such as surgical extractions, frenectomies, and alveoloplasty can be completed efficiently in-office and provide high value to patients. With proper training and systems in place, these treatments can become routine.

It's no secret that efficiency improves with experience. The more extractions a dentist completes, the faster and more predictable they become. That consistency builds case acceptance, opens time for other procedures, and contributes to overall profitability.

Start With the Right Patients

Clinical success begins with good patient selection. Not all patients are ideal candidates for in-office surgical care. Those with uncontrolled chronic conditions, complex medical histories, or ASA III status may be better served in a specialty setting. Dr. Koerner emphasizes evaluating patient risk through vitals, medications, and oxygen saturation.

When determining which patient is appropriate for oral surgery, dentists should ask key questions, such as:

• Are there signs of recreational drug use or unmanaged medical issues?
• Is blood pressure within a safe range?
• Are any medications likely to increase bleeding or impact anesthesia?
• Does the patient show signs of anxiety that require sedation planning?

Before proceeding with treatment, baseline vitals, medication screening, and sedation protocols must be in place. Tools such as the Dental Drugs app support fast and accurate decision-making in these cases.

Improving Surgical Efficiency

A smooth surgical experience depends on preparation. Disorganized setups, missing instruments, or unrealistic scheduling increase procedure time and patient discomfort. Dr. Koerner advises preparing two complete surgical kits and blocking sufficient time for each case. A typical extraction should be scheduled for 30 minutes, even if the goal is to complete it in 15 minutes.

Tips for improving workflow:

• Eliminate individually bagged instruments and group them logically.
• Use a consistent surgical tray setup with all essential tools ready.
• Train assistants to anticipate the next steps and manage instrument flow.
• Use bite blocks and include tools for abscess management when needed.

Proper scheduling and setup improve both clinical performance and the overall patient experience.

Techniques That Minimize Complications

One of the most common causes of surgical complications is excessive force. This approach can lead to fractured roots, buccal plate damage, or tuberosity fractures. Dr. Koerner teaches alternative methods that focus on preservation and control. These include:

• Sectioning crowns and roots with a skinny bur.
• Creating vertical space with a luxator rather than using a side elevator.
• Removing bone between roots instead of buccal bone.
• Using mini flaps for better access with less tissue manipulation.

When anesthesia fails, dentists should move quickly to alternatives such as intraosseous injections or the Gow-Gates technique. Slow administration and the right anesthetic selection improve results and patient safety.

Real-World Case Application

Dr. Koerner’s instruction is rooted in practical experience. In one case, a student successfully completed a third molar extraction by following a step-by-step protocol. The patient experienced minimal swelling, no dry socket, and rapid recovery.

In another case, improper elevator use near a restored crown damaged it. Through review and correction, the dentist learned how to protect surrounding structures and improve technique. These teaching moments highlight the importance of mentorship and proper planning.

Choosing the Right Tools

Surgical success depends on having the correct instruments. Luxators must be thin, sharp, and used vertically. Elevators should be applied cautiously to avoid damaging adjacent teeth. In some cases, a slow-speed straight handpiece offers better control than high-speed options. A sterilized, slow-speed handpiece is often ideal for bone removal or tight access.

Tools such as osteogen plugs, PTFE membranes, and physics forceps are valuable in specific cases. However, foundational techniques should be mastered before incorporating advanced technology.

Education Fills the Gaps

Many surgical concepts are not taught in dental school and must be learned through continuing education. Topics such as luxator depth, flap design, socket preservation, and sinus management are essential for safe and predictable outcomes.

Dr. Koerner’s course helps to fill these gaps with clear demonstrations, clinical case reviews, and evidence-based protocols that general dentists can apply immediately. Following the course, participants have reported greater surgical confidence and reduced chair time.

View the course here: Bring More Oral Surgery Into Your Comfort Zone

Learning Objectives

• Discuss which surgery techniques elude many general dentists.
• Discover how to bring your surgery treatment more aligned with oral surgeon standards.
• Expand your surgical knowledge and treatment skills for faster and more predictable treatment.
• Learn how to avoid or manage several common surgery complications.

Note: Many dental boards require that a portion of CE credits be completed through in-person courses. Check your state’s CE requirements. The two-month trial membership offer is available to new users only and renews at $54.95 per month after 60 days.