General Questions

Consultation Questions

Do I need a consultation before treatment?

Some patients may think that consulting with their dentist and obtaining a referral is enough to undergo an oral surgery procedure. Dr. Maranon takes care of people, not just dental conditions. Every patient is unique, with each having their own needs and expectations. The purpose of the consultation is that a complete evaluation of the patient’s condition can be performed by Dr. Maranon. This gives Dr. Maranon the opportunity to see if he agrees with the diagnosis and the proposed treatment. Once his evaluation is complete, treatment recommendations and expected recovery can be discussed. This gives each patient the opportunity to fully understand why the procedure is being performed and allows them to prepare themselves for any recommended procedure.

Do I need a referral from my dentist to set an appointment with Dr. Maranon?

Your dentist knows you and your dental conditions the best. Some conditions do not require oral surgery services. Your dentist’s evaluation of your dental condition is the most appropriate way to determine if oral surgery is necessary. Having your dentist perform routine check-ups and teeth cleaning is important and may lessen your need for oral surgery.

Is it necessary to have an X-ray before oral surgery?

Depending on the condition, an x-ray of the entire or part of the mouth may be necessary to aid in making your diagnosis and recommending treatment. Inadequate imaging can lead to misdiagnosis and complications.

Does Dr. Maranon’s practice use the latest technologies in oral surgery?

Dr. Maranon offers exceptional care using state-of-the-art surgical facilities and equipment. These technologies are used to develop accurate diagnoses and treatment plans. He uses minimally invasive surgical techniques. Using those technologies, surgical treatments are less traumatic which leads to decreased pain and swelling, and a faster recovery.

What happens during the surgical procedure?

At your pre-surgical consultation, Dr. Maranon will develop your surgical plan. He will make clear to you the goals of the procedure, the nature of the procedure, and your expected recovery. During your procedure, Dr. Maranon will be assisted by at least three other staff members.

How long will it take for me to recover?

Recovery is a process. Recovery periods will vary depending on the procedure performed and each patient’s medical condition. Your body must devote energy to healing after surgery. Understanding your surgical procedure and your expected recovery is important to know. Prior to your procedure, Dr. Maranon will make it clear what your recovery expectations should be. This will allow you to prepare for that recovery should you need time off of work, school, or to make changes to your daily routine. Strenuous activity must be avoided immediately after surgery. Dr. Maranon will advise you when you should be able to return to your normal activities. During your recovery, if you note even the smallest deviation from your recovery expectations, contact Dr. Maranon immediately.

Is there a risk of infection?

Dr. Maranon and his staff follow strict infection control guidelines to ensure the safety of every patient. In every surgical procedure, there is a risk of infection. Dr. Maranon will provide you with instructions on how to minimize the risk of infection and management of surgical sites. He is available to you 24 hours a day should you have concerns about a possible infection after surgery.

Is there a risk of any complications?

Any time surgery is performed, there is a risk of complications. Patients have a role in communicating to Dr. Maranon all pertinent information about any illnesses, medical conditions, and dental considerations prior to surgery. All of this information will be used to develop a surgical plan that avoids complications. Dr. Maranon will advise you of potential complications prior to surgery.

After my surgery, will I be able to drive home?

If the procedure uses intravenous sedation or general anesthesia, you must be accompanied by a responsible adult who can take you home safely. That adult or another adult must be available to take care of you for a number of hours after you return home. If the procedure is performed under nitrous oxide and oxygen, or just local

anesthesia, then you may be allowed to drive home. Oral surgery is still surgery. It is advisable that you consider being accompanied by a responsible adult who can assist you after surgery.

What is a bone graft and why might I need it?

There are dental conditions that result in bone loss in the jaws. Bone grafting is sometimes necessary before placing dental implants. After a tooth is extracted, bone around the tooth can resorbed or dissolved away. Bone grafting at the time of extraction helps to regenerate the bone and make implant placement more predictable. There are other indications for bone grafting such as when there is insufficient bone below the sinus for implant placement or to restore bone width and height when the jawbone has resorbed after tooth extraction.

How do orthodontists and oral surgeons work together?

Frequently, orthodontists and oral surgeons collaborate on treatment crowding due to inadequate space, or some-times, excessive space. Treatments can involve a large array of procedures from extraction of teeth, exposure of teeth, surgical placement of anchorage devices, and up to including jaw surgery.

Why do baby teeth (deciduous teeth) need to be extracted?

There are many reasons for the extraction of deciduous teeth. Sometimes deciduous teeth can be decayed and cause pain and infection. Occasional deciduous teeth do not fall out normally. This may be due to the malposition of the permanent tooth that replaces that deciduous tooth. If the patient has orthodontic concerns, deciduous teeth are extracted in coordination with orthodontic treatment early (serial extraction) to shorten orthodontic treatment and create a more predictable orthodontic result.

What is an expose and bond procedure?

Any tooth can be impacted because of crowding of teeth or malposition. In some cases, the decision is made to extract those teeth out of functional considerations. Some teeth are particularly important to function. In those cases, the decision may be made to surgically expose the impacted tooth and bond an orthodontic bracket to it. The patient will then be referred back to the orthodontist who will slowly reposition the tooth back to its normal position.

Why should I have dental implants?

There are a lot of options to replace missing teeth. Making the decision to replace missing teeth can be overwhelming because of the many viable options. There are traditional replacements such as dentures, partial dentures, dental bridges, or dental implants if someone loses all their teeth. Dentures are removable but can be used to replace all the missing teeth. Partial dentures are used to replace a fewer number of teeth and are secured by wires or clasps to other teeth. Dental bridges are tooth replacements that are attached to adjacent teeth. While all of these are options, they are a compromise to a natural healthy natural tooth. This is what makes dental implants different. Dental implants replicate tooth roots. This makes them the most stable and comfortable option in tooth replacement.

There have been many advances in implant dentistry over the years. The advent of implant design, 3D imaging, virtual implant design, and guided implant placement makes the option of dental implants more accessible to more people. Dental implants are the most effective, functional, and aesthetic tooth replacement option. Dental implants can be used to replace individual teeth. They can be used to support bridges, eliminating the need for a denture. Implants and bridges more closely resemble the feel of real teeth. Dental implants may also be used to support dentures, offering more stability. There are many factors that need to be considered to determine if a person is a candidate for dental implants. Many of these factors are personal. Each person has unique needs and expectations. Some of those factors are related to the person’s presenting condition. At the consultation, Dr. Maranon reviews these factors. After that review, his patients will determine what are their best treatment alternatives.

What are tori and do they need to be removed?

Tori, or exostosis, are bony protuberances that are outside the normal structure of the bone. They occur in 25% of people. Tori can be found on the roof of the mouth, on the inside of the lower jaw, or even on the outside of the upper or lower jaws. Not all tori needs to be removed. Typically, they are removed when they are increasing in size and interfering with function. Frequently, patients say my dentist can’t take x-rays on me anymore because of these bony outgrowths. Some patients also complain that food gets caught underneath them or they are affecting their speech, displacing their tongue, and making it difficult to eat. It is Dr. Maranon’s opinion that when someone starts experiencing any of these conditions, they should be evaluated for removal. The recovery for tori removal is faster when they are removed when they are smaller.

Can oral surgery be performed when a patient is pregnant?

Elective oral surgical procedures are typically not performed on patients that are pregnant because of the potential risk to the baby. Urgent procedures will require consultation with the patient’s obstetrician. The safest time to have an oral surgical procedure performed is the second trimester (between the third and sixth weeks). A healthy dental condition is important especially during pregnancy. Routine care by a general dentist before and during pregnancy should be performed. Patients should ask their dentist and obstetrician about dental care and dental treatment.

Recovery Questions

What is Enhanced Recovery after Surgery (ERAS ®)?

Many surgical specialties have developed treatment protocols to help speed patient recovery. These protocols were developed to provide patients with information and expectations for their surgery, and were put in place to make the patient’s recovery as uncomplicated as possible. ERAS® was designed to achieve early recovery after surgical

procedures. The key elements of ERAS® protocols include pre-operative counseling, multimodal analgesia, optimization of nutrition, and early mobilization. Though treatment protocols have not been specifically developed for wisdom tooth surgery, Dr. Maranon has adapted many of those principles for his patients to help speed their recovery.

How long should I keep pressure on the gauze to control bleeding after surgery?

Try to keep gauze in place for the first hour after the procedure. It is important not to chew on the gauze but to keep constant light, but firm, biting pressure on the gauze. After about an hour, gently remove the gauze. It is common to have spotting on the gauze that is removed. A small amount of bleeding or blood-tinged saliva is common after oral surgery for the first 48 hours. If there are any questions about bleeding, replace the gauze with a new piece and contact the office for further instructions.

What kinds of foods can I eat after having oral surgery?

Dietary recommendations vary. At your consultation, you will receive dietary recommendations based on your procedure. Your diet should be advanced slowly. Clear liquids initially for the first hour or two. At that point, you could advance to full liquids such as ice cream and soups. On the evening of surgery, you can advance to a soft food diet – essentially foods that you can cut with a fork. Crunchy foods such as popcorn, nuts, sesame seeds, and granola must be avoided because these can get caught in the surgical sites.

Why can’t I use a straw for 24 hours?

The use of a straw, smoking, rinsing, or spitting out after surgery can prolong bleeding. These activities can also result in the loss of the blood clot at the extraction site leading to a very painful condition called alveolar osteitis or a dry socket. Carefully following the postoperative instructions will minimize the risk of this complication. Use of a straw and normal oral hygiene and rinsing can resume the day after surgery. Smoking should be discontinued for at least seven days after surgery.

I have a fever. Should I be concerned?

Low-grade fevers less than 100° are common for the first day or two after oral surgery. If fevers continue after the first two days or if they exceed 101°, contact the office. This is especially true if the fevers are associated with persistent or increased swelling and if you feel “sick”.

When will my swelling go down?

The amount of swelling a patient has after surgery is dependent on the difficulty of the procedure. Swelling usually increases on the night of surgery through the third postoperative day (72 hours after surgery). Using the jaw bra as recommended and maintaining an upright head position will help minimize swelling and help it resolve faster. Using ice after 72 hours can actually slow the resolution of swelling. If swelling continues to increase after the initial 72 hours, please contact Dr. Maranon.

How am I supposed to use the jaw bra?

The jaw bra is intended to be a pressure dressing to assist in the management of swelling. It should be worn for the first 36 hours after surgery. The ice packs should be used for 20 minutes on and 20 minutes off for those 36 hours while awake. When the ice packs are off, they should be placed in the freezer in between items that are already frozen. This will speed up the chilling of the ice packs. After 36 hours, the ice packs should no longer be used as they may slow the resolution of any swelling.

What does it mean if my lip or tongue feels numb?

Numbness in your mouth is common for a number of hours after oral surgery. This usually resolves itself by the morning after surgery. If it persists into the day after surgery, contact the office.

What do I do if my sutures come out?

Sutures are placed to assist with the initial control of bleeding and clot formation. The loss of a stitch is not considered an emergency. Generally, the most common type of sutures used dissolve on their own. Sutures typically last between three to five days before they fall out. If Dr. Maranon performs a procedure where your sutures should stay in longer, he will let you know. Should you have any questions concerning your sutures, contact the office.

How long does it take for the extraction site to heal?

If there are extraction sockets left behind after your surgery, these will typically close in about six weeks. Complete bone healing will take several months. Be sure to rinse the site well to keep food out of the extraction sites. There are occasions when you may be given a syringe to assist you in removing food debris from the surgical sites.

What does it mean if I have bad breath after an extraction?

This is usually the result of food debris around the extraction site. On the day after surgery, you should rinse vigorously after every time you eat with either warm salt water, dilute regular mouthwash, or tap water. If your bad breath is associated with increasing pain, fever, or swelling, you should contact the office.

Do You Have Missing Teeth or Serious Pain in Your Teeth or Jaw?

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