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Anesthesia

The type of anesthesia used for your surgery is chosen to make you as comfortable as possible. While local anesthesia (such as is used by your dentist) will suffice in some cases, our office offers general anesthesia for more complicated procedures, such as wisdom tooth removal, implant treatment, removal of cysts or tumors, and patient management. If you are unsure as to which type of anesthesia you desire, we suggest you prepare for general anesthesia so you can keep your options open.

Instructions for general anesthesia:

1. Nothing to eat or drink for at least six hours before your appointment. If your appointment is in the morning, we suggest nothing after midnight the night before. If you have an afternoon appointment, a light breakfast is allowed, but no dairy products or breakfast meats.
2. If you are taking prescription medications, you may take them on your regular schedule with a small sip of water. Please consult with your medical doctor or our office as to which medicines must be stopped prior to surgery (e.g. blood thinners).
3. A responsible adult must bring you to the office, stay at the office during surgery, and drive you home.
4. Wear loose clothing and a short sleeve shirt. Do not wear sandals or flip flops. Do not wear contact lenses or dark nail polish.
5. It is helpful to take an over the counter acid reducer (Pepcid AC, Tagamet HB) one hour before surgery with a small sip of water. This will reduce post operative nausea.
6. Your mouth should be clean prior to surgery. Please brush and floss before your appointment.
   
    

Pain Management

Pain and swelling are to be expected following any surgery. You have most likely been prescribed one or more medicines to help manage the discomfort. Please follow the instructions carefully. Ibuprofen (i.e. Advil, Nuprin, Motrin IB, etc.) works very well for many patients following oral surgery, and can reduce the amount of narcotic pain medicine needed significantly. You may find taking 400-600mg (2 or 3 of the 200mg tablets) every six hours on a regular schedule for the first 2-3 days is all the pain medicine you will need. You may still take your prescription pain medicine as needed. Those who are allergic to aspirin or other NSAIDs obviously can not follow this regimen.

A Word About About Antibiotics

Antibiotics are strong medicines that can save lives in the face of infection. However, they are not needed in every situation. The Center for Disease Control and Prevention has issued several warnings on the consequences of inappropriate use of antibiotics. As surgeons dealing mostly with the head and neck, we have the luxury of a region that has a very rich blood supply, and a tremendous ability to resist infection. It is for that reason that not every surgery we perform necessitates the use of antibiotics afterward. There have been numerous studies published that show the use of antibiotics after most oral surgery procedures in healthy patients does not affect the infection rate. The general rule at our practice is: If you need antibiotics to fight an infection, or if you have a disease that lessens your body’s ability to fight infection, a prescription will be given. If you do not fall into one of these categories, no antibiotics will be required. That does not necessarily mean that you will not get an infection afterward- just that the use of antibiotics after surgery will not change the risk.

Implant Information

Dental implants are used to provide a foundation for replacement of missing teeth. The success of implant restoration depends largely on the quality and quantity of available bone and proper maintenance and cleaning of the restoration after placement. The patient must take an active role in treatment or a less than ideal result could occur. Instructions must be followed closely. Please do not hesitate to ask questions at any time during your treatment. Remember, above all, that implant treatment is a time consuming process and cannot be rushed.

An implant is a cylinder or screw made of a metal called titanium. The gum tissues are moved away from the underlying bone and special drills are used to create a space for the implant. A plastic guiding device is usually made to aid in positioning. The implant is tapped or screwed into place and the gums are repositioned and sutured. A healing period of three to six months is allowed. During this healing period, bone grows up to the implant and locks it into the bone, making it immobile.

A second surgery is sometimes needed to modify the gum tissue over the implant and place a healing abutment on the implant to allow the gum tissue to heal and form a barrier to protect the underlying bone and implant. After the second surgery, you will return to your dentist for construction of your new dentures, crowns or bridges.

On occasion, the existing bone or soft tissue is insufficient for proper implant placement. In this case, additional procedures may be necessary to improve the quantity or quality of bone or soft tissue in the area.

As with any surgery, there are known risks and complications associated with therapy. These include, but are not limited to:

• Failure of the implant to attach to the bone, necessitating removal
• Infection, pain, altered sensation of the lip, tongue, cheek, gums, or skin of the face that may last for several weeks or months. On rare occasion, the altered sensation may be permanent.
• Injury to adjacent teeth
• Fracture of the jaw
• Infection of the implant from the nose or sinuses
• Inability to use the implant due to its position in the jaw
• Bleeding
• Overgrowth of gum tissue, requiring additional surgery

The overwhelming majority of implant surgery is without complication. This information is provided in the hopes that it will help you make an educated decision as to having implants placed. With good professional care and proper maintenance and hygiene on your part, these procedures result in high quality restorations with many years of use. If an implant should fail during the first year, you may have it replaced, or receive one half the fee for that implant. Do not hesitate to ask questions at any time.

The fees quoted are for implant placement and uncovering only. Your dentist will provide you with fees for the prosthetic portion of the procedure. If we are to place any prosthetic components, there will be an additional charge.