8 Lessons AOX Surgeons Should Learn from Navy SEALs

In honor of the New Year and all the goal setting that surrounds it, I wanted to post a motivational article specific to All-On-X surgeons. It is my hope that this article can help inspire and shape how you handle your AOX surgeries in 2024. 

When looking for inspiration, the United States Navy SEALs showcase many traits to which surgeons can aspire. Known for being highly trained operators adaptable to any environment, extremely mentally tough, and working flawlessly as a team, these military personnel can teach us all a few things about being better All-On-X surgeons. 

Below are 8 Quotes reported to be attributed to the US Navy SEALs that can also have a profound impact on the thought process, mental toughness, and operational skill of the AOX surgeon. 

1. The only easy day was yesterday.

This quote reminds me that AOX surgery is incredibly rewarding, but also incredibly humbling. 

I’ve done enough arches to know, that the only easy arch…is the arch that’s already cut.

No matter how “straightforward” an X-ray appears, I realize that each and every case has the potential to be unknowingly, one of the most difficult surgeries I’ve ever completed. 

If you haven’t found this to be true, you haven’t cut enough arches. 

I treat every AOX case with respect, and I understand that the easiest arch on the schedule, is yesterday’s arch. 

2. Get comfortable being uncomfortable.

With the goal to load each and every AOX case we cut, we will find ourselves in stressful, uncomfortable situations. 

This is ok. Get comfortable being uncomfortable. 

We have to push through this mental block, so that we can focus on the surgery at hand and think clearly through difficult intraoperative situations. 

After nearly 1600 arches, I still get uncomfortable during surgery. While I’m not perfect, at this point in my career I am much better at being comfortable in these uncomfortable situations. 

3. No plan survives first contact with the enemy.

I always have a plan heading into surgery. However, it is not uncommon that once I start cutting, for one reason or another, that pre-surgical plan changes. 

There will always be the potential for surgical unknowns. This is why it is crucial to be highly adaptable and have more than one surgical pathway that will help you complete your mission objective: An immediately loaded full arch.

As AOX surgeons we must understand that our initial surgical plan may not always “survive first contact with the arch”. 

Plan for your plan to change. 

4. All in, all the time.

I am a true believer that while AOX surgery draws on many aspects of oral surgery and prosthodontics – it really is its own special skill set. 

If your goal is to be a great All-On-X surgeon, it is my opinion that this requires a strong focus on this procedure. Studying, collaborating, and operating frequently. 

Finding opportunities to consistently cut arches will push you forward in this field.

While not easy, finding a way to be “all in, all the time” will undoubtedly accelerate your AOX skillset. 

5. There are two ways to do something – the right way, and again.

Time after time, I’ve seen cases cut by surgeons with the attitude, “Well, that’s good enough…It will be ok”. 

Unfortunately, AOX surgery does not tend to be a forgiving procedure. 

Optimizing each and every surgery is critical.

This is first and foremost in the best interest of the patient. It is also in the best interest of the financial aspect of your practice. Poorly done surgeries will build up a plethora of “redo’s” over time. This is not ideal for the patient and is costly for your practice. 

In AOX surgery there really are only “two ways to operate – the right way, and again”. 

6. Under pressure, you don’t rise to the occasion, you sink to the level of your training.

When things get difficult in surgery, it’s wonderful to think that we will all magically rise to the occasion and overcome any surgical obstacle. 

However, the more realistic scenario is that we will revert to whatever our highest level of training is and use those known skills to manage the situation. 

This is why it is critical to never stop learning. The more training we have and the more tools we have in our toolbox, the more likely we can adapt to and handle the surgical situation at hand. 

While we should always strive to rise to the occasion, we should be prepared to sink to the level of our surgical training. 

7. Slow is smooth, smooth is fast.

A good goal for AOX surgeons is to be able, on average, to complete an arch an hour. 

You will never achieve this by trying to be “fast”. And if you do, it’s likely that your work is sloppy. 

You can however achieve this by being smooth. 

Efficiency is slow, smooth, calculated, unwasted movements repeated over and over. This is the key to consistently doing an arch an hour. 

Slow is smooth, and a smooth surgery is a fast surgery. 

8. Relax. Look around. Make a call.

It’s easy during All-On-X surgery to lose your cool. Believe me, I’ve been there.

When things aren’t going your way it’s tempting to lose focus, blame “the bone”, or take your frustrations out on your team.

In these scenarios, I actively try to remind myself of the following mantra SEALs use to “Prioritize and Execute”: 

Relax: I take a deep breath and keep my cool. My team is watching me. If they think I’m calm (even if I’m not on the inside) – they will remain calm and focused. 

Look around: I assess the surgical field and the issue at hand. I may even grab an over-glove and double check my CT scan if indicated.

Make a call: Even if I’m uncertain, I make a decision confidently. I want my team to know which direction we are headed surgically and have confidence in that decision. I also want to give myself direction…even if I’m uncertain on the inside. 

In the middle of that difficult surgery…Relax. Look Around. Make a call.

There are many attributes of the US Navy SEALs that would be wise for All-On-X surgeons to embrace. Their mental toughness, adaptability, focus, elite level of training, and emphasis on teamwork all have extreme value in the operating room.

While I am clearly not a Navy SEAL, it is my goal in 2024 to think more like one in the operating room. 

Here’s to being All In, All the Time. 

Matthew Krieger DMD