Oro-Antral Communication Management – GF011

After the last group function where a juicy bit of dry socket has been tackled, I was again surprised by Dr. Chris Waith that managing OACs was such a simple matter of using your existing tools - there is some super real-world GDP-friendly advice in this episode. https://youtu.be/aHV15R0SNaw Check out this full episode on YouTube Need to Read it? Check out the Full Episode Transcript below! "If the OAC is bigger than 5mm, you really get into the point where I don't necessarily think we should be expecting GDPs to do something super courageous at that point." - Dr. Chris Waith In this group function we talked about: The Classic OAC regimen  1:31Oro-Antral Communication Management 6:37Medications for an OAC 8:55 If you loved this episode, be sure to check out the first part! Dry Sockets – How to Prevent and Manage Them? Click below for full episode transcript: Opening Snippet: Hello, Protruserati. I'm Jaz Gulati and welcome back to another group function again, Oral Surgery, we're doing a three part for surgery with Chris Waith, we already covered dry sockets. And his answer was very surprising to me. This one OACs was a bit more of what I expected to hear. And so we're gonna jump straight in, right? You are now very familiar with these group functions. So how do you prevent and manage an OAC? Shall we move on to now?... Main Interview: [Jaz]OACs. Okay, so, OACs, I was taught at dental school that a lot of times when we take tooth out, we probably make an OAC without even realizing. And it's a very common thing. And actually the probably heals up, especially when it's less than x millimeters, maybe that's four millimeters or whatever it might be. I was also taught and here's why I've been a little bit naughty. So let's play Zak's stuff 'Am I naughty, I get my, if I'm really not sure if there's an OAC and then I want to start them on the regimen, which we'll talk about shortly and see if our regimens are the same. But if I'm really not sure, then am I naughty if I get them to pinch their nose and try and blow out the nose aka the Valsalva maneuver, because I was taught not to but a few times, I'm really not sure whether I'm about to start this patient on the regimen. I have done it. What do you think? [Chris]I'd say yes, you are naughty. I mean, my logic is that I think we must close OACs all the time. But 99% plus they just heal. Some of the time will be because the membranes completely intact. And the whole, the communication is actually it's just a bony break. Sometimes the hole in the membrane will be so small that your body can heal it. If you've got a small hole, and you squeeze your nose and blow. Essentially, what we've just got them to do is what we're about to instruct them not to do for the next two weeks, because we know it might open up the OAC. So I would say if you got, if you're going to check and grab your suction off of your Nurse (so that she's not tempted to put it down to the bottom of the socket), just get your suction over the top of the socket, either get the light from your loupes or your chair light in a decent position. And just look. And I think if you can't see anything obvious, it's not to say it's not there. But if you can't see it, that's good. Because I usually teach five millimeters, I say less than five millimeters, I think you can kind of sit on that. Give them the instructions. And I try and make myself feel better - I put some collagen cubes in the coronal portion of the socket. [Jaz] So do I [Chris] If it's bigger than five millimeters, you really get into the point where I don't necessarily think we should be expecting GDPs to do something super courageous at that point. If you were thinking that that actually needs some kind of physical closure. I think if you're the GDP, the quickest, simplest thing you could do is just take an alginate, take an alginate send it to the lab, just say to the lab this needs to be kind of processed now.