Examination & X-ray Questions
Q: If my dentist took x-rays recently, why do I need another x-ray at your office?
A: You are welcome to have your dentist forward their x-rays to our office; however our office takes either CT scan or a panoramic x-ray, different types of x-ray than a general dentist usually takes, so a new x-ray with our office may still be necessary. Both a CT and panoramic x-ray are more complete and comprehensive x-rays for examination of the entire upper and lower jaw structures as well as the jaw joint structures, upper sinus cavities, and all related areas of the head and neck region. Dental x-rays such as bitewings and periapicals are for the teeth only and often do not show all of the related root or bone structures. This is particularly important when planning oral surgery. If your dentist provides x-rays taken within the last year, there will be no charge for another x-ray with our office as long as your account is in good standing.
Q: Why do I need to schedule an examination when my dentist referred me to you? Why is there a charge for a separate examination?
A: We quite frequently will provide an exam and surgery the same day for shorter surgeries. However, for longer procedures an examination appointment provides the following: the doctors will be able to complete a thorough exam and overall evaluation of your specific dental/surgical needs; a treatment plan and approach (e.g. local anesthesia or general anesthesia) will be discussed and outlined in detail for you; our surgical assistants will spend additional time familiarizing you with preparation for surgery and your aftercare; finally, the business office will review the fees, insurance and payments with you. Overall, it guarantees a better experience for longer procedures because of the preparation and education provided at this appointment. As far as there being a charge for a separate examination with our office, the examination appointment has several components including a thorough evaluation by the doctor, discussion of the specific diagnosis, outlining the procedure and the anesthesia, review by a surgical assistant of the preparation for surgery and the aftercare, receipt of our comprehensive Care Information Pamphlet and finally, reviewing the proposed fees for the surgery in an effort to avoid any financial surprises for you and us. We feel the examination is a valuable tool for making your surgical experience a pleasant one.
Q: Do I have to be referred by a dentist to schedule an appointment?
A: 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.
Q: Can I be asleep for my surgery? A: Yes, that may be an option. Our doctors will review your medical history and discuss anesthesia options that will be the best for your situation. We also offer local anesthesia, which numbs the area involved, nitrous oxide (commonly called “laughing gas”) where you are awake but in a relaxed state, I.V. Sedation, which has been known as a “twilight sleep” 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. You will always have the area numbed no matter which anesthesia you choose.
Q: Can I have dinner the night before, and what about brushing my teeth in the morning?
A: Yes, you can have dinner the night before your surgery. If you are having general anesthesia, you may not have anything to eat or drink for a minimum of 6 hours prior to your surgery. No liquid or food of any kind. Basically, if it goes in your mouth, you cannot have it. You may, and definitely should, brush your teeth prior to surgery, as your mouth should be very clean, but be sure not to swallow any water or toothpaste.
Q: But I take medications for certain conditions. Does that mean I can’t be asleep for my surgery? How do I take my medications if I am fasting for 6 hours before surgery?
A: Taking certain medications does not mean that you cannot have general anesthesia, unless your physician advises against it. It just means that there could be special instructions you should follow prior to your surgery. 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 the surgery or the use of general anesthesia. If your physician advises you to continue your prescribed medication, you may take it with a tiny sip of water, just enough to get your pills down. In either case, 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 bloodthinners or chemotherapy.
Q: Can I have alcohol before and after my surgery?
A: We strongly recommend that you do not consume any 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.
Q: How is the general anesthesia given, and will it hurt?
A: It is given intravenously (IV), usually in the arm, and all you will feel is a slight pinch. If you are nervous about that part, we can give you some nitrous oxide, or laughing gas, before we start the IV to help you feel relaxed.
Q: Why must I have an escort with me when I undergo IV sedation or general anesthesia?
A: 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. Until the anesthetic medications are fully metabolized (12-24 hours) a patient may become nauseous, dizzy and even faint. Your escort will assist in your safe return home and aid in your care following the oral surgery. We strongly recommend that the patient have someone with him/her throughout the day and night of the surgery.
Q: I think I’m coming down with a cold and I have already scheduled my surgery. What should I do?
A: You should call our office and inform us of your condition. 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. 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 your surgery for a time when you will be feeling well enough for the procedure.
Q: Should I wear any kind of special clothes for surgery?
A: 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 enough that the sleeves may be rolled up. We also recommend that you do not wear any makeup for your surgery appointment.
Q: How do I know the instruments and materials used are sterile?
A: 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.
Q: May I stay with my child during surgery?
A: Parents of small children may accompany their child prior to surgery; however, OSHA safety regulations, HIPAA privacy laws, as well as staff and patient safety do not permit bystanders during the surgical procedure.
Q: My wisdom teeth are starting to really bother me, but I will be home from college for only one week. Can anything be done for me?
A: Absolutely. We commonly schedule x-rays, examination and surgery all in one appointment if at all possible. We at AOMS realize that everyone’s time is very important and it is not always convenient for patients to come in for an exam, and then return another day for surgery. We strive to accommodate the patient whenever possible. Q: I’m a smoker. Does that matter? A: Yes it does. You should refrain from smoking for 24 hours prior to your surgery, and you should plan on not smoking for at least 48 hours after surgery. Smoking can cause delays in healing as well other complications after surgery. Please ask our surgical staff about instructions regarding post-operative care if you are a smoker. Q: May I make an appointment for a cleaning? A: No, A.O.M.S is a specialty office limited to oral and maxillofacial surgery care; no general dentistry procedures are done. Our doctors successfully completed a surgical residency in oral and maxillofacial surgery and are board certified by the American Board of Oral and Maxillofacial Surgery. Q: What if I have an after-hours emergency? A: You will find it comforting to know that the AOMS staff is readily available by phone for their patients after hours. AOMS feels that no concern is too small. Please contact our office and a member of our surgical staff will promptly return your call.
Q: Will my insurance company cover my anesthesia?
A: Some insurance companies have specific guidelines within their policies regarding use of general anesthesia. At the time of the consultation appointment we attempt to obtain these requirements from your insurance company and review these with you. If your preference is to have the general anesthetic then you will assume that cost as there is no guarantee that the company will cover the anesthetic despite our best efforts.
Q: What insurance do you take?
A: We accept any insurance plan that allows patients to choose their own doctor; however, we are not a preferred provider or “in network” for any insurance company. If you wish to inquire about a specific insurance carrier, please contact our office.
Q: I have insurance. Do I have to make a payment the day of surgery?
A: For accounts in good standing, our office will file a claim to your insurance as a courtesy. Due to the length of time many insurance companies take to process claims, it is unfeasible to not require some form of payment the day surgery is performed. Our financial coordinator will contact your insurance company and inform you of your estimated portion. Payment of your estimated portion is due prior to surgery. If your insurance company takes more than 60 days to process your claim, you will be asked to pay the balance on your account. If insurance should eventually come through with payment, we will refund it to you.
Q: Do you accept Medicare?
A: No. As of July 1, 2004, Associates for Oral & Maxillofacial Surgery entered into an opt-out agreement with Medicare. This means we are no longer providers for Medicare, although the majority of procedures performed in our offices are considered dental in nature and are not covered by Medicare anyway. All patients who are Medicare recipients will be required to sign our Medicare contract informing them of the opt-out agreement and that we will not bill Medicare for any services, and agreeing that the patient themselves not bill Medicare for any services either. To answer any additional questions you may have, please review our full financial policy in the patient information section or contact us at one of our four offices.
Dry Socket Questions
Q: What puts me 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 therapy. Follow the post-operative instructions given to you at your appointment to minimize possible complications.
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.
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 medication to relieve your discomfort. Additional follow-up appointments will be necessary to insure further uneventful healing.
Q: How soon will I recover from my oral surgery?
A: That is a tough question to answer, as everyone is different and every surgery is individualized. Most people feel well enough to go back to work or school after a couple of days. Some people need a few days more for recovery. Typically, single tooth extractions and placement of dental implants require at least 24-48 hours before you will feel ready to resume your daily routine. For wisdom teeth extractions, we generally expect a full recovery 3-5 days after a routine wisdom tooth or third molar extraction. For third molars that are more impacted, the recovery period is typically 5-7 days. Other more involved procedures will require additional healing time. It really does depend on the individual and the type of surgery involved.
Q: How long will I be swollen after surgery?
A: 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% resolved in five to seven days. Remember: keep using the ice packs for the first 2 days and then you can apply heat. This is also covered in your post-operative care pamphlet.
Q: Will I be able to eat after surgery?
A: Yes, you will. You will likely be tired especially if you had a general anesthetic; however, try to drink or eat something before resting. You will soon need some pain medication and it is preferable to have something in your stomach before taking it to avoid nausea. When you arrive home after surgery we encourage you to start drinking some clear liquids (e.g. water, 7-Up, ginger ale, apple juice, etc.). It is best to stay away from milk products until you are taking clear fluids well. You will probably want to have 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. If you have any other questions, be sure to refer to your Care Information Pamphlet for instructions and advice.
Q: What should I do if food gets in the extraction site the day of surgery since I’m not supposed to rinse the first day?
A: 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.
Q: Will I have stitches in my mouth, and will I have to return to your office to have them removed?
A: 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 likely have to return to have them removed in seven to ten days. Sometimes the doctor can use sutures that will dissolve after a period of time.
Q: What if I think I spit a stitch out a day or two after surgery?
A: 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.
Q: If I feel nauseated after surgery, what should I do?
A: 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 water, 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, wait 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.
Q: How long does somebody have to stay with me after surgery?
A: 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, which takes 12-24 hours to become fully metabolized, during which time the patient may feel nauseous, dizzy and even faint.
Q: Can I drive myself home after surgery?
A: If you are receiving IV sedation or general anesthesia, you will need a responsible adult to drive you. Patients receiving local anesthetic or nitrous oxide can drive home or have a driver whichever is preferred. Some people still like to have someone with them just in case they are not feeling up to driving.
Q: If I’m not in pain, why do I need to return for a follow-up appointment?
A: A follow-up visit will ensure that healing is proceeding in the right direction. Not all patients require follow-up visits, and our doctors will determine if one is necessary for you at the time of your initial consultation. If you have any further questions or concerns please do not hesitate to contact one of our three offices. We will happily answer any questions you may have.