Oral-Maxillofacial Surgery Information

Jump to Pre and Post Operative instructions

Physician on staff
Robert A. Whittaker, DMD, MD

Background

Oral and Maxillofacial Surgery requires up to 6 additional years of hospital based surgical and anesthesia training. As an Oral and Maxillofacial Surgeon, Dr. Whittaker manages a wide variety of problems relating to the Mouth, Teeth and Facial Regions. He practices a full scope of Oral and Maxillofacial Surgery with expertise ranging from Reconstructive Jaw Surgery to Wisdom Tooth Removal. He can also diagnose and treat Facial Pain, Facial Injuries, Infections, and TMJ disorders, and performs a full range of Dental Implant procedures.

Dr. Whittaker’s staff is trained in assisting with Intravenous Anesthesia within our state-of-the art office setting. Patients are continuously monitored during and after surgery.

Surgical Staff

The surgical staff in Dr. Whittaker’s office are experienced surgical assistants who assist in the administration of anesthesia and surgery. We also have trained registered nurses (RN) to assist in surgery. Our nursing staff is CPR and ACLS (Advanced Cardiac Life Support) certified and our receptionists are well-informed administrative personnel, well versed in health and insurance policy issues.

Consultation

Your initial appointment will consist of a consultation with Dr. Whittaker whereby your diagnosis and treatment options are explained and any questions you might have are answered. A pre-operative consultation and examination is mandatory for patients undergoing IV anesthesia for surgery and surgery is generally scheduled for another day. If the procedure can be done with local anesthesia alone, Dr. Whittaker can often times do the procedure the same day as the consultation.

Please assist us by providing the following information at the time of your consultation:

• Your surgical referral slip and any X-rays, if applicable
• A list of medications you are presently taking
• If you have medical or dental insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.
• Please alert the office if you have a medical condition that may be of concern prior to surgery (i.e. diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are on any medication (i.e. heart medications, aspirin, anticoagulant therapy, etc.)

IMPORTANT: A parent or guardian must accompany all patients under the age of 18 years of age at the consultation visit.

X-Ray

If your dentist or physician has taken x-rays, you may request that they forward them to our office. If there is not enough time, please pick them up and bring them to our office. If additional films are necessary, they can be taken at our facility.

Day of Surgery

If IV Anesthesia is planned, please have nothing to eat or drink (this includes water) for 6 hours prior to your surgery. You will also need an adult to remain in the office and to drive you home.

Patient Billing

For your convenience we accept Visa and MasterCard. We deliver the finest care at the most reasonable cost to our patients, therefore payment is due at the time service is rendered unless other arrangements have been made in advance. If you have questions regarding your account, please contact us at (815) 632-5300. Many times, a simple telephone call will clear any misunderstandings.

Please remember you are fully responsible for all fees charged by this office regardless of your insurance coverage.

We will send you a monthly statement. Most insurance companies will respond within four to six weeks. Please call our office if your statement does not reflect your insurance payment within that time frame. Any remaining balance after your insurance has paid is your responsibility. Your prompt remittance is appreciated. We can make arrangements for a monthly payment plan but that must be done prior to the actual procedure.

Insurance Information

We make every effort to provide you with the finest surgical care and the most convenient financial options. To accomplish this we work hand in hand with you to maximize your insurance reimbursement for covered procedures.

If you have any problems or questions, please ask our staff. They are well informed and up-to-date. They can be reached by phone at (815) 632-5300. Please call if you have any questions or concerns regarding your initial visit.

Please bring your insurance information with you to the consultation so that we can expedite reimbursement.

Scheduling

The Oral and Maxillofacial Surgery Department is open Monday - Friday from 8 a.m. until 5 p.m. We will schedule your appointment as promptly as possible. If you have pain or an emergency situation, every attempt will be made to see you that day.

We try our best to stay on schedule to minimize your waiting. Because we provide surgical services, various circumstances may lengthen the time allocated for a procedure. Emergency cases can also arise and cause delays. We appreciate your understanding and patience.

Pre-Operative Instructions

I. PREOPERATIVE INSTRUCTIONS FOR PATIENTS UNDERGOING INTRAVENOUS ANESTHESIA

You may not have anything to eat or drink (including water) for six (6) hours prior to the surgery appointment (this does not apply to the consultation appointment).

A responsible adult must accompany the patient to the office, remain in the office during the procedure, and be able to drive the patient home.

The patient should not drive a vehicle or operate any machinery for 24 hours following the anesthesia experience.

Please wear loose fitting clothing with sleeves that can be rolled up past the elbow, and low-heeled shoes. Contact lenses, jewelry, and dentures must be removed at the time of surgery.

II. The removal of impacted wisdom teeth and surgical extraction of teeth is quite different from the extraction of erupted teeth. The following conditions may occur, all of which are considered normal:

• The surgical area will swell.
• Swelling peaks on the 2nd or 3rd post -operative day
• Trismus (stiffness) of the muscles may cause difficulty in opening your mouth for a period of days.
• You may have a slight earache.
• A sore throat may develop.
• Your other teeth may ache temporarily. This is referred pain and is a temporary condition.
• If the corners of the mouth are stretched out they may dry and crack. Your lips should be kept moist with cream or ointment.
• There will be a space where the tooth was removed. After 24 hours this area should be rinsed following meals with warm salt water until it is healed. This cavity will gradually fill in with new tissue.
• There may be a slight elevation of temperature for 24 to 48 hours. If temperature continues, notify us.
• It is not unusual to develop facial bruising in the area of an extraction.
• Please take all prescriptions as directed.
• Women please note: Some antibiotics may interfere with the effectiveness of your birth control pills. Please check with your pharmacist.

III. CARE OF MOUTH AFTER ORAL SURGERY

• Do not rinse or spit for 24 hours after surgery.
• Use ice packs on surgical area (side of face) for first 24 hours; apply ice 20 minutes on - 10 minutes off. Bags of frozen peas work well.
• For mild discomfort take Tylenol or Ibuprofen every three to four hours.
• For severe pain use the prescription given to you.
• Drink plenty of fluids. (Do not use a straw)
• If the muscles of the jaw become stiff, chewing gum at intervals will help relax the muscles, as well as the use of warm, moist heat to the outside of your face over these muscles.
• After the first post-operative day, use a warm salt-water rinse following meals for the first week to flush out particles of food and debris that may lodge in the surgical area. (1/2 teaspoon of salt in a glass of warm water. Mouthwash can be added for better taste.)
• Diet may consist of soft foods that can be easily chewed and swallowed. No seeds, nuts, rice, popcorn, etc.
• A certain amount of bleeding is to be expected following surgery. Applying pressure to the surgical area using small rolled gauze for 30 minutes controls bleeding. After that time remove the gauze and then you may eat or drink. If bleeding persists, a moist teabag should be placed in the area of bleeding and bite firmly for one hour straight. This will aid in clotting blood. Repeat if necessary. If bleeding still persists call our office.
• We suggest that you do not smoke for at least 5 days after surgery. Smoking may break down the blood clot and cause a "Dry-Socket".
• Feel free to contact us if any doubt arises as to your progress and recovery.

Post-Op Instructions

What you should do following extractions and other oral surgery procedures

A certain amount of bleeding, pain, and swelling is normal. Reduce your activity as much as possible for several hours. Avoid eating, drinking, and unnecessary talking. Do not rinse your mouth or brush your teeth for 24 hours. These activities may hinder formation of a blood clot that is necessary for proper healing.

Do not be alarmed if your vision is blurred for a time following anesthesia or if a "black and blue" bruise should appear at the site of an injection. The arm also may be "black and blue", swollen and tender to touch due to the IV.

Follow the simple instructions below to minimize complications and help ensure prompt recovery.

To control bleeding

Immediately following procedure . . .keep a steady pressure on the bleeding area by biting firmly on the gauze placed there by your doctor. Pressure helps reduce bleeding and permits formation of a clot in the tooth socket. Gently remove the compress after the local anesthesia has worn off and normal feeling has returned.

After 24 hours... some oozing of blood may persist. If necessary, resume use of moist tea bags. After bleeding has stopped, cautiously resume oral hygiene.

To relieve pain

Immediately following procedure... begin taking medication as directed by your doctor to minimize discomfort when the anesthesia wears off and feeling is back to normal. Application of an ice bag can also help relieve discomfort.

After 24 hours...continue to take your medication if pain persists, and use an ice bag if needed.

To minimize swelling

Immediately following procedure...apply an ice bag over the affected area. Use 20 minutes on and 20 minutes off for 24 hours to help prevent development of excessive swelling and discomfort. After 24 hours. . . it should not be necessary to continue with cold applications. You may expect swelling for 10 days to two weeks and a fever of 99 degrees F to 100 degrees F.

Special considerations following removal of impacted teeth:

• Removal of impacted teeth is a surgical procedure. Postoperative problems are not unusual, and extra care must be taken to avoid complications.
• Severity of postoperative pain will depend on the procedure and your physical condition. Take medication for pain precisely as directed.
• Healing of the surgical site is variable.
• Swelling can be expected. Be certain to apply ice bags as directed above.
• Difficulty in opening your mouth widely and discomfort upon swallowing should be anticipated.
• Numbness of lips and/or tongue on the affected side may be experienced for a variable period of time.

Oral hygiene is important

24 hours after surgery, rinse mouth gently with a solution of one-half teaspoonful of salt dissolved in a glass of water. Repeat after every meal or snack for seven days. Rinsing is important because it removes food particles and debris from the socket area and thus helps prevent infection and promote healing. Brush tongue with a dry toothbrush to keep bacteria growth down, but be careful not to touch the extraction site.

Resume your regular tooth brushing, but avoid disturbing the surgical site so as not to loosen or remove the blood clot.

Maintain a proper diet

Have your meals at the usual time. Eat soft, nutritious foods and drink plenty of liquids - with meals and in between. Have what you wish, but be careful not to disturb the blood clot. Add solid foods to your diet as soon as they are comfortable to chew.

In case of problems

You should experience no trouble if you follow the instructions and suggestions as outlined. But if you should have any problems such as excessive bleeding, pain, or difficulty in opening your mouth, call Dr. Whittaker immediately for further instructions or additional treatment.

Remember your follow-up visit

It is often advisable to return for a postoperative visit to make certain healing is progressing satisfactorily. A follow-up visit will be scheduled. In the meantime, maintain a healthful diet, observe rules for proper oral hygiene, and visit your dentist for regular checkups.