FREQUENTLY ASKED QUESTIONS

                    Examination & X-ray Questions

Q: If my dentist took x-rays recently, do I need a panoramic x-ray at your office?

A: A panoramic x-ray is a more complete and comprehensive x-ray 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 are for the teeth and often these do not show all of the related root or bone structures. This is particularly important when planning a surgery.

Q: Why do I need to schedule an examination when my dentist referred me to you?

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 payment plans with you. Overall, it guarantees a better experience for longer procedures because of the preparation and education provided at this appointment.

Q: Why is there a charge for an examination?

A: 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, including 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.

Anesthesia Questions

Q: Can I be asleep for my surgery?

A: Yes, that may be an option. Our doctors will review your medical history and discuss options that will be the best for your situation. We also offer local anesthesia, which numbs the area involved; nitrous oxide, which is 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.

Our doctors successfully completed hospital-based anesthesia training as part of their oral and maxillofacial surgery residency. They have performed general anesthesia for thousands of patients. Safety is of utmost importance. Your vital signs will be monitored with modern, high quality equipment that is regularly inspected. Our conscientious doctor and anesthesia assistants use the safest, proven intravenous medications for your anesthesia. We want your visit to our office to be as painless and anxiety-free as possible.

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.

Q: But I take medications for certain conditions. What about that?

A: 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.

Q: If I take medications does that mean I can’t be asleep for my surgery?

A: No, not at all, unless your physician advises against it. It just means that there could be special instructions you should follow prior to your surgery.  You may take your pills with a tiny sip of water, just enough to get your pills down.

Q: Can I have alcohol before and after my surgery?

A: We strongly recommend that you consume no 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. Your escort will assist in your safe return home and aid in your care following the oral surgery.

General Questions

Q: What is the difference between an Oral Surgeon and an Oral & Maxillofacial Surgeon?

A: Nothing. The field and scope of oral surgery is changing everyday. In dealing with the diseases of the oral cavity and its extensions outwards into the maxillofacial region, oral surgeons felt it was necessary to have a command of the adjacent extra oral structures to better serve our patients. As a result, the addition of maxillofacial in our title reflects the extended scope of our practice.

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. 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.

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.  We also recommend that you do not wear any make up 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: 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 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.

Q: May I stay with my child during surgery?

A: 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.

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

A: 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.

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 48 hours after surgery. Smokers can have delays in healing and other complications. Please ask our surgical staff about instructions regarding post-operative care if you are a smoker.

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: May I make an appointment for a cleaning?

A: No, A.O.M.S is 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.

Q: What if I have an after-hours emergency?

A: You will find it comforting to know that the AOMS staff is readily available 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: I am quite busy. How long will I be out after surgery?

A: 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.

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

A: 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.

 Insurance Questions

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 review these with you. If your preference is to have the general anesthetic then you will assume that cost. There is no guarantee that the company will cover the general anesthetic despite our 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 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: Insurance is filed as a courtesy. Due to the length of time many insurance companies take to process claims, it is unfeasible to not require payment the day surgery is performed. Our financial coordinator will contact your insurance company and inform you of your estimated portion due and collect payment following your examination.

Q:  Do you accept Medicare?

A: No.  As of July 1, 2004, Associates for Oral & Maxillofacial Surgery entered into our opt out period 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; that we will not bill Medicare for any services, and the patient agrees not to bill Medicare for any services as well.

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: 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 therapy.

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 medication to relieve your discomfort. Additional follow-up appointments will be necessary to insure an uneventful healing.

Post-Operative Questions

Q: How soon can I eat after an extraction?

A: 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. 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 shouldn't 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 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.

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. Until these medications are fully metabolized (12-24 hours) a patient may become nauseous, dizzy and even faint.

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

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% gone in five to seven days. Remember: keep using the ice packs for the first two (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. We highly recommend that right after you leave our office, you have something soft and cool in order for you to take your pain medication as soon as possible. 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. When you leave our office, our staff will provide you with a brochure on post-operative care.

Q: Can I drive myself home after surgery?

A:

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.

 Q: Do I need someone to drive me home after surgery or can I drive?

A: If you are receiving IV sedation or general anesthesia, you will need a responsible adult to drive you home and to remain with you for several hours following surgery. If you are having general anesthesia, under no circumstance can you drive home or anywhere else for at least 12 hours after surgery. Patients receiving local anesthetic or nitrous oxide can drive home or have a driver whichever is preferred.

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

A: Not all patients require follow-up visits. Our doctors will determine if it is necessary for you to follow-up at you initial consultation. 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.

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.