Questions Answered

After Surgery Questions

Dry Socket Questions

Dental Implant Questions

Home Care Instructions

After Surgery Questions

What should I do if food gets in the extraction site the day of surgery, since I shouldn’t rinse the first day?

Don’t be alarmed. Your active rinsing will begin tomorrow and this will help remove any food debris that might be present. Before bedtime you can brush your teeth and when you gently rinse out the toothpaste this will likely dislodge any food from the extraction areas.

Will I have stitches in my mouth, and will I have to return to your office to have them removed?

Not all patients will have sutures, or stitches, in their mouth after surgery. Once again, it depends on the surgery performed. If you do have sutures placed, you will not likely have to return to have them removed. Usually the doctor can use sutures that will dissolve on their own after a period of time.

What if I think I spit a stitch out a day or two after surgery?

Don’t be alarmed by this. Occasionally the stitches will loosen and be lost prematurely; however, if there is no active bleeding there is no need to replace it.

If I feel nauseated after surgery, what should I do?

Post-operative nausea and vomiting can occur due to the after effects of the general anesthesia as well as the prescribed medications. Treat the situation as though you have the flu, (e.g. start with sips of clear liquids like 7-Up, Ginger-Ale, apple juice). If those stay down then continue these fluids until the nausea has fully subsided. Also, it is best not to take any of the prescribed medications including the antibiotic until the nausea has passed. If after the first few sips the vomiting returns then wait two (2) hours and start the fluids again. Remember, no medications during this time. If the pain is quite intense it is OK to try Tylenol or Ibuprofen; these are much less likely to precipitate nausea. If this is not resolved within the next 12 to 24 hours please call us again.

How long does somebody have to stay with me after surgery?

We strongly recommend that the patient have someone with him/her throughout the day and night of the surgery. This is particularly true if the patient has had a general anesthetic. Until these medications are fully metabolized (12-24 hours) a patient may become nauseous, dizzy and even faint.

Should I still be swollen after the 3rd or 4th day?

Swelling is a common part of any surgery. The swelling of the mouth and face will generally be at its peak in the first two to three days. After that the swelling will slowly go down. Generally, the swelling will be 80% gone in five to seven days. Remember: keep using the ice packs for the first two (2) days and then you can apply moist heat. This is also covered in your home care instructions sheet.

Will I be able to eat after surgery?

Yes when you arrive home after surgery we encourage you to start drinking some clear liquids (e.g. 7-Up, Ginger Ale, apple juice, etc.) You will likely be tired especially if you had a general anesthetic however, try to drink or eat something before reclining. It is best to stay away from milk products until you are taking clear fluids well. Also, you will soon need some pain medication and it is preferable to have something in your stomach before taking medication to avoid nausea. You will probably want to have cool, softer foods for a day or so, and nothing hot, as hot foods or liquids can stimulate bleeding. You shouldn’t baby yourself, however. The sooner you return to a normal diet, the better off your nutritional and overall health will be. When you leave our office, our staff will provide you with a home care instructions sheet.

Can I drive myself home after surgery?

If you have only local anesthesia or local anesthesia with nitrous oxide, yes, you can drive yourself home after surgery. Some people still like to have someone with them just in case they are not feeling up to driving. If you have IV sedation or general anesthesia, no, you cannot drive for at least 12 hours after surgery. You will need a responsible escort to stay in the office during the procedure and take you home.

If I’m not in pain, why do I need to return for a follow-up appointment?

Not all patients require follow-up visits.Our doctors will determine if it is necessary for you to follow-up.We don’t expect our patients to have complications after an oral surgery procedure; however, a follow-up visit will ensure that healing is proceeding in the right direction.

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Dry Socket Questions

Q: How do I know if I am at risk of developing a dry socket?

A: Several known risk factors include difficult impactions, prolonged extractions, tobacco use immediately before and/or after extractions, menstruating patients, females, older patients, and patients on birth control.

Q: What does a dry socket feel like?

A: A dry socket is characterized by a sudden onset of a dull achy pain that usually occurs 3-4 days after a dental extraction, which cannot be relieved by pain medication. After a dental extraction, such as the removal of a wisdom tooth, a blood clot forms at the extraction site. This clot protects the surgical sites and facilitates healing. However, in some patients, the clot is lost prematurely and exposes the socket. This unprotected socket begins to experience pain and collects food, which often results in a foul odor and/or bad taste. Follow the post-operative instructions given to you to minimize possible complications.

Q: What do I do for a dry socket?

A: Please call our office to arrange a same day appointment at no-charge. Our doctors will evaluate the area and pack the socket with a special medicated dressing to relieve your discomfort. Additional follow-up appointments will be necessary to remove the dressing and insure an uneventful healing.

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Dental Implant Questions

What factors contribute to long-term success of Dental Implants?

Long-term success depends on multiple factors. First off, success will depend on the quality and quantity of bone. The better the bone and the more available, the greater the chance of long-term success. Secondly, the experience and ability of the dental surgeon will be a factor. As with any surgical procedure, there is no substitute for the experience and individual talent of the dentist. And finally, the quality of the restoration placed on top of the implant will play a big role in long-term success. If the design of the implant crowns or overdentures are poorly constructed, and biting forces are not balanced, even the best-placed dental implant will have a compromised survival rate.

Who will restore the teeth on the top of my dental implants?

Your general dentist will restore the teeth with crowns fabricated in a special offsite lab. The surgery and restoration are performed by two different clinicians. You will have your implant placed at our office and will then return to your general dentist for the final crown.

Can I bite on my implant after it’s placed?

Absolutely no direct pressure should be placed on the implant for the amount of healing time given by the doctor.

How long before I will have a functional tooth again?

This depends:

  1. If you already have an empty space, (an open area without a tooth) or the doctor has determined that it is safe to extract the tooth/teeth and place an immediate implant(s) in a single surgery then:
    1. You will need 6 weeks to 3 months of healing time (depending on many factors determined by the doctor).
    2. Once cleared by our doctor, you may proceed with the restorative treatment with you dentist either any time after being cleared OR a few weeks after.
    3. If the implant needs to be surgically exposed you will need a few weeks of healing time. Meaning your gum tissue has completely grown over the implant and will need to be uncovered for your dentist to have access to the implant post.
    4. Your final tooth/teeth can then be placed.
  2. If it is determined by the doctor that you will need to split the surgery into two phases (phase I-extraction(s), bone grafting, sinus lifts etc., phase II- placement of the implants) then:
    1. You will have phase I surgery which will require 6 weeks to 3 months of healing.
    2. Once cleared by our doctor, you will schedule phase II surgery. This will require 6 weeks to 3 months of healing time.
    3. Once cleared by our doctor, you may proceed with the restorative treatment with you dentist either any time after being cleared OR a few weeks after.
    4. If the implant needs to be surgically exposed you will need a few weeks of healing time. Meaning your gum tissue has completely grown over the implant and will need to be uncovered for your dentist to have access to the implant post.
    5. Your final tooth/teeth can then be placed.

Are there any options to fill the space I will have once the tooth is pulled?

Yes, there are a few options. You can have an Essix retainer, flipper, temporary crown, etc. These options need to be discussed with the doctor at the time of your consultation.

Are there any age limitations for dental implants?

No. Any person at any age can have dental implants as long as there is enough bone available in which to place the implants.

What might be some of the factors that would prevent me from being an implant candidate?

There are some medical factors that might prevent a person from being a good candidate for dental implants. Some of these may be uncontrolled diabetes, chemotherapy or radiation therapy, parathyroid disorders, blood disorders, rare bone disorders or bone marrow cancer. Some physical factors may include insufficient or poor quality bone, low sinuses or nerve bundles.

How often will I need to have my dental implants checked?

The success of your implants will depend greatly on how well you maintain them. They will need to be professionally cleaned by a hygienist and examined by your implant dentist every three to six months. This hygienist should be trained in the specific procedure of maintaining dental implants. Also, brushing and flossing daily is absolutely necessary for long-term success.

Is dental implant surgery painful?

No. An effective local anesthetic is used during the surgery so that you do not have any discomfort during the placement of the implants. The mild discomfort you might experience after surgery can be controlled with medications.

When can I return to work after implant surgery?

A: You can go to work the next day, unless some particular surgical circumstance arises. Your implant surgeon or staff will discuss all postoperative instructions with you.

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Home Care Instructions

Why should I go to an oral and maxillofacial surgeon?

While it is true that many general dentists will perform tooth extractions, many patients prefer the comfort and confidence of having these surgical procedures performed by an oral and maxillofacial surgeon. There is a wide range of variables and outcomes associated with surgical procedures. Oral and maxillofacial surgeons receive extensive training in anesthesia and pain control, and our clinical offices are equipped as outpatient surgical centers. Patients who prefer to be asleep or sedated for their extractions will be most comfortable under the care of an oral and maxillofacial surgeon.

Do I need to be hospitalized for my procedure?

The decision to stay overnight in the hospital is determined by your doctor and is based upon your need for continued management, medical monitoring, and nursing care after the operation. Most oral surgery procedures are performed safely on an outpatient basis, allowing the patient to return home following a brief recovery period when accompanied by an adult escort. Some procedures require a short hospital stay before the patient will feel comfortable resuming their activities of daily life in an independent fashion.

Why do I need jaw surgery AND braces?

Orthodontic appliances (braces) are an effective treatment for straightening teeth, but a misaligned bite can only be fixed through jaw surgery known as orthognathic surgery. Normally, an orthodontist and an oral and maxillofacial surgeon work together to plan a patient’s care, with orthognathic surgery taking place toward the end of the orthodontic treatment. Orthognathic treatment planning may involve the upper jaw (maxilla), the lower jaw (mandible), or both.

Am I a candidate for dental implants?

If you were told in the past that implants could not be used to replace certain teeth, you may be surprised to find that today’s implant technology can be used on almost every patient to replace almost any tooth. Dental implants are surgically implanted artificial roots that integrate with the bone to form a stable foundation for restoring missing teeth. A brief consultation with an oral and maxillofacial surgeon will help determine whether implants are a good solution for your tooth replacement and restoration needs.

Why do I need a panoramic x-ray at your office when I recently had x-rays taken from my dentist?

A panoramic x-ray provides surgical screening x-ray examination of the entire upper and lower jaw structures as well as the jaw joint structures, upper sinus cavities, nerves, and all related areas of the head and neck region. X-rays taken by your dental office often do not show the entire related root or bone structures. It is important to be able to view these structures when planning a surgery.

What types of anesthesia do you offer?

After the doctors review your medical history they will discuss an option that will be best for your situation. We offer local anesthesia , which numbs the area involved. Local anesthesia is always used whether it is used alone or in conjunction with other anesthesia types; nitrous oxide , with the common nickname “laughing gas” where you are awake but in a relaxed state; IV Sedation , where you will be somewhat awake, but have little or no recollection of the procedure being performed; and general anesthesia , where you are fully asleep.

Can I eat the night before?

Yes, you can eat the night before your surgery. If you are having IV sedation or general anesthesia, you may not have anything to eat or drink for a minimum of 6 hours prior to your surgery.

Can I brush my teeth?

You definitely should brush your teeth and have a very clean mouth prior to surgery.

What do I do about the medications I take for certain conditions?

There are some medical conditions where it is unadvisable to skip or delay taking what your physician has prescribed for you. You should contact your physician to let him or her know that you are having oral surgery to see if they have any concerns regarding general anesthesia. You need to make sure that our office is aware of any medications that you are taking when you schedule your appointment, especially if you have asthma, are diabetic, or are on any type of blood thinners or chemotherapy.

If I take medications can I still be asleep for my surgery?

Yes, unless your physician advises against it. Some medications may require you to follow special instructions prior to your surgery. If undergoing IV sedation or general anesthesia, you can take your pills with a tiny sip of water.

Can I drink alcohol before/after my surgery?

We strongly recommend that you do not consume alcoholic beverages the night before your surgery, and that you refrain from alcohol while you are taking prescription pain medication. Alcohol taken with prescription pain medication can cause adverse reactions.

How is the general anesthesia given, and will it hurt?

It is given intravenously (IV), usually in the arm and sometimes in the hand. All you will feel is a slight pinch. If you are nervous about that part, you can have some nitrous oxide, or laughing gas, before we start the IV to help you feel relaxed.

Why must I have an escort with me when I undergo IV sedation or general anesthesia?

Although you will be able to walk out of the office on your own after the surgical procedure, your reflexes and decision-making ability may still be hindered due to the anesthesia . Your escort will assist in your safe return home and aid in your care following the oral surgery.

I think I’m coming down with a cold and I have already scheduled my surgery. What should I do?

You should call our office and inform us of your condition. Usually, if a person is just getting a head cold and basically feels all right, they can go ahead with surgery as planned. If you feel it is going down into your chest or you cannot breathe freely through your nose, then you should probably postpone your surgery. You should still come in for an examination if you feel up to it; then the doctor can evaluate your condition and our staff can schedule you for a time when you will be feeling well enough for surgery. If you are nauseated, running a fever, or have a productive cough, you will need to give our office a call to reschedule your appointment.

Should I wear any kind of special clothes for surgery?

We recommend that our patients wear loose, comfortable fitting clothing for their surgery. Don’t wear anything tight or restrictive. If you wear something with long sleeves, make sure it fits you loosely. We also recommend that you do not wear any make up or jewelry for your surgery appointment. Please refrain from wearing nail polish if you are undergoing IV Sedation/General Anesthesia.

How do I know the instruments and materials used are sterile?

All instruments are cleaned and then sterilized after each use. Each instrument pack or bundle is tested with chemical indicators to confirm sterilization parameters have been achieved. We follow strict OSHA guidelines to assure sterility and safety for our patients and employees.

How soon will I recover from my oral surgery?

E veryone is different, and every surgery is individualized. Most people feel good enough to go back to work or school after a couple of days. Some people need a few days more for recovery. It really does depend on the individual and the type of surgery involved.

May I stay with my child during surgery?

Parents of small children may accompany their child prior to surgery to ask the doctor any questions. However, OSHA regulations and staff and patient safety do not permit bystanders during the surgical procedure.

The thought of oral surgery frightens me. Is this normal?

It is a natural response to be anxious about oral surgery. Our doctors and skilled staff make every effort so that your experience is as pleasant and comfortable as possible.

I’m a smoker. Does that matter?

Yes it does. You should refrain from smoking for 24 hours prior to your surgery, and you should plan on not smoking for 48 hours after surgery. Smokers can have delays in healing and other complications.

Do I have to be referred by a dentist to schedule an appointment?

You are not required to have a referral from a dentist; however, it is recommended. Unnecessary visits can be avoided if you first see a general dentist for a full evaluation, x-rays, and cleaning. Your dentist can develop a treatment plan for you and determine if a visit to our office is needed.

May I make an appointment for a cleaning?

No, we are a specialty office. Our doctors successfully completed a surgical residency in oral and maxillofacial surgery. Our doctors are board certified by the American Board of Oral and Maxillofacial Surgery and our practice is limited to oral and maxillofacial surgery care. No general dentistry is done.

What if I have an after-hours emergency?

We always have a doctor on call. If you are experiencing an emergency related to your treatment, Please call the office phone number and you will receive a call shortly after.

I am quite busy. How long will I be out after surgery?

Depending on the type of surgery, single tooth extractions and placement of dental implants require at least 24-48 hours before you will feel ready to resume your daily routine. Other more involved procedures will require additional healing time.

What is the typical recovery time after having a wisdom tooth extracted?

Although no two patients are the same, we expect a full recovery 3-5 days after a routine wisdom teeth or third molar extraction. For third molars that are more impacted, the recovery period is typically 5-7 days.

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