Frequently Asked Questions About Oral Surgery

Questions Answered by our Team at Winchester Oral Surgery Center

Q: What is an Oral and Maxillofacial Surgeon (OMS)?

A: An oral and maxillofacial surgeon is a specialist in the treatment of disease problems associated with the jaws, teeth, mouth and face. The type of problems that we see may be as simple as a tooth extraction or as complicated as reconstructive or tumor surgery. Educational requirements include graduation from dental school and completion of an approved internship and residency training program which is typically University and hospital based.

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Q: What is Board Certification and are our doctors Board Certified?

A: Board certification in oral surgery (also known as a Diplomate of the American Board of Oral and Maxillofacial Surgery) is the highest level of academic achievement. It is not a requirement to practice oral surgery however, those individuals who are board certified have demonstrated their capabilities and desires to obtain this level of achievement. To become board certified an applicant must have completed an approved internship and residency training program, applied to the board, be accepted, and pass a written and verbal exam. Many hospitals and insurance plans are now requiring board certification to participate as a provider. Both Dr. Coviello, Dr. Starley and Dr. Waise are board certified.

Q: What are the most common procedures performed by oral surgeons?

A: Oral surgeons commonly do the following procedures:

• Wisdom teeth removal
• Surgical tooth extraction
• Placement of dental implants
• Bone grafting
• Oral pathology
• Treatment of facial trauma or pain
• Correct problems with the bite
• Cosmetic facial surgery

Q: What is the difference between Oral Surgeons and General Dentist?

A: General dentists serve as primary care providers for dental medicine. At the general dentist’s office, you will receive teeth cleaning, X-rays, and a comprehensive screening for dental problems. General dentists most often provide gum care, dental fillings, root canals, veneers, bridges, and crowns. They also make recommendations for how to prevent common dental problems. Although a general dentist may perform simple tooth extractions, more complex surgeries may be outside the scope of a general dentist.

Oral and maxillofacial surgeons receive specialized training to treat a variety of conditions affecting the face, mouth, and jaw. Patients are typically referred to an oral surgeon when a problem is beyond the scope of a general dentist’s expertise. Oral surgeons perform simple and complex tooth extractions, including wisdom tooth extraction. They also provide care to accident victims who need reconstructive dental surgery. Oral surgeons may also perform soft tissue biopsies, tumor removal, jaw realignment surgery, soft tissue repair, or positioning of implants. Oral surgeons go through extra schooling and are certified to administer general anesthesia.

Q: Do I need a referral to make an appointment?

A: We do not require referrals to make appointments at our office. Some treatment plans require that you are established with a general dentist, but we can still see you for a consultation to start the process. We can also refer you to a dentist that participates with your insurance.

Q: How early should I arrive for my appointment?

A: You should arrive 15-20 minutes prior to your appointment time to fill out new patient paperwork, make your payment, and get settled in.

Q: Is oral surgery covered under medical insurance or dental insurance?

A: All insurance policies are different and have a wide variety of coverage. Depending on your insurance provider, policy and plan, as well as the type of oral surgery that you have, you may be eligible for partial or full coverage. Our insurance specialists will contact all your insurances to make sure that you are getting the most coverage for your insurance.

Q: Can you tell me how much my surgery will cost?

A: To be able to calculate an estimate we need your insurance information first. We accept most medical and dental insurances. Sometimes both insurances will cover procedures, other times only one insurance will cover. Our insurance specialists will let you know your out-of-pocket costs prior to any procedure.

Q: What types of anesthesia do we offer at our office?

A: We offer 4 different types of sedation, they are bulleted below with an explanation.

• Local Anesthesia: Local anesthetics are those that affect only a small portion of the body. They work locally to numb the area and ensure the patient doesn’t feel any pain. Lidocaine is a common numbing medication that is injected directly into the affected area and takes effect quickly. Patients are conscious and aware during local anesthesia, but should not feel any discomfort. It is typically used in simple tooth extractions or placement of dental implant(s). The patient is able to drive home after the procedure.
• Minimal Sedation: This method of anesthesia combines the localization of an anesthetic with the calming effects of nitrous oxide (also known as “laughing gas”). A mixture of nitrous oxide and oxygen is breathed through a mask or nosepiece, allowing a patient to be aware during the procedure while remaining relaxed. This method also may include a sedative agent. Patients with anxiety about dental care might prefer moderate or general sedation as you can still hear drills and removal of teeth. This type of anesthesia for simple procedures and you can drive yourself home.
• Moderate Sedation: Sometimes referred to as “twilight sedation,” intravenous (IV) moderate sedation places a patient in a state between awake and asleep, drifting in and out of consciousness. Although patients are partially conscious, few remember anything from the procedure other than feeling sleepy and relaxed. Moderate sedation often can be used instead of minimal sedation for procedures such as removal of impacted wisdom teeth. Moderate sedation may use the same types of medication as general anesthesia, and generally leads to a quick recovery from sedation and a minimization of anesthesia side effects. We require you to have someone drive you home after this type of sedation.
• General Anesthesia: The combination of medications used to put patients to “sleep” before surgery or another medical procedure is called general anesthesia. Under this type of anesthesia, patients are completely unconscious, though it will likely feel as if they are simply going to sleep. The key difference is the patient doesn’t respond to reflexes or pain signals. Patients with anxiety about dental care might prefer this type of anesthesia.

Q: How do I choose if I want to be sedated or not?

A: Most of the time it is a patient preference. We want to make you feel as comfortable as possible, so there are a few surgeries in which we encourage sedation such as wisdom teeth removal and multiple extractions. Other than that, we can do most surgeries under local anesthesia or under sedation, it is your choice!

Q: Can I eat or drink before my surgery?

A: If you are choosing local anesthesia (where you will be awake), you can eat or drink normally before you come in for surgery. If you are having General / IV sedation (where you will be asleep) you can NOT have food or drinks (including water) 6 hours before surgery. If you have pills that need to be taken, you can have a small amount of water to take those.

Q: Can I be sedated while pregnant or breastfeeding?

A: If pregnant you can NOT be sedated under general anesthesia, but if you are in your second trimester you can be awake and be locally numbed. If breastfeeding you will have to “pump and dump” for 24 hours after sedation but can breastfeed normally after local anesthesia.

Q: My sutures came out. What should I do?

A: We typically use dissolvable sutures (stitches). They begin to dissolve within 10 days. It’s ok for them to come out. If you notice any significant and persistent bleeding please let us know.

Q: Can I take Tylenol and Ibuprofen at the same time? What about with prescribed narcotics?

A: You can take ibuprofen and acetaminophen (Tylenol) at the same time. Just make sure to not take more than the recommended dose. Some people experience some stomach or abdominal pain when taking the two medications together. In this case, it’s better to alternate when you take each medication.

If your pain has increased and your doctor has prescribed a narcotic, you may take it with ibuprofen, but DO NOT take narcotics with Tylenol (acetaminophen) as it is already contained within the narcotic.

Q: How long do the holes in my jaw stay after extractions?

A: The “holes” or “extraction sockets” will generally close within 6 weeks. It will take several months for the sockets to actually fill with bone. If food gets trapped in the socket area, be sure to clean it with the Peridex prescribed to you or warm salt water.

Q: I have terrible bad breath after the surgery. Does this mean I have an infection?

A: No. The bad breath may be caused by food getting into the socket area. Be sure to keep the surgery site clean and this should resolve.

For more information about Dental Implants click here, to be taken to our Dental Implant Information Page.

For more information about Wisdom Teeth click here, to be taken to our Wisdom Teeth Information Page.

OMSNIC Informative Video

The video below covers the following topics: dental implants, wisdom teeth, orthognathic surgery, TMJ surgery, and postoperative care. If you have any further questions after watching these videos and reading about a specific procedure, please call our office. This video is also available in Spanish. (Este video también está disponible en español.)