20 MountainGate Drive
Frederick, MD 21703
Oral & Maxillofacial Surgery
Oral and maxillofacial surgery corrects diseases, injuries, and defects in the hard and soft tissues of the oral and maxillofacial region.
They perform the following procedures:
Impacted wisdom teeth can cause structural damage to the jaw and other teeth. They can also provide a place for bacteria to gather since they are hard to reach and clean. These potential problems make it necessary to remove impacted wisdom teeth so that larger problems do not arise. Routine x-rays during a dental exam can reveal if you will need to have your wisdom teeth removed.
Platelet Rich Plasma (PRP)
As we only use innovative procedures in our offices and procedures, we routinely use platelet rich plasma (PRP) in oral surgeries that involve hard and soft tissues, derived from the patient. The plasma proteins are collected in the office in a short procedure which only takes a few minutes. The use of PRPs in surgery ensures that the patient has the best opportunity to successfully heal from their surgery. For patients who have a history of complications arising from hard and soft tissue regenerations, PRP is instrumental in surgical success.
Facial trauma causes a high degree of physical and emotional trauma to the patient. Correcting facial trauma requires special training and an in depth understanding of the long term functioning and appearance of the face. Oral and Maxillofacial surgeons take into consideration the patient’s prior appearance and any permanent damage that will affect the results.
When a wisdom tooth only emerges partially a flap of skin, called an operculum, may form over the tooth. This can make the tooth hard to clean, and pieces of food may be caught under the skin. This makes it easy for an infection, called pericoronitis, to develop. It will usually go away on its own, but it causes swelling and pain in the area.
Impacted teeth and wisdom teeth that can potentially cause problems, like infections, need to be removed. Extractions can range from a single tooth, to removing all four wisdom teeth at once. Based on the preference of the doctor and/or the patient, a local anesthetic could be used to numb the areas where the teeth will be extracted. Others will prefer to go under a general anesthetic so that they will be sedated during the procedure.
The gum tissue around the wisdom tooth is cut open to reveal the tooth. The tooth is loosened by gripping it tightly and wiggling it back and forth until it can be lifted out of the gums. Sometimes a tooth may be impacted so tightly that it cannot be simply lifted out of the gums. In cases like this the tooth will be broken up into pieces first before being removed. Depending on the incision and extraction site, sutures may be needed to close the area. Soluble sutures are the best option, which will dissolve on their own.
After the surgery you will need to rest. You need to be driven home by a friend or family member because of the anesthesia. You can expect for the extraction site to bleed for a little while after the surgery. Gauze will be applied at the completion of the surgery, and you will need to change it when it becomes soaked. If bleeding continues for longer than 24 hours you should call your dentist. Rest when you return home, but do not lie flat. This could prolong the bleeding. Prop your head up on a pillow when lying down. Your dentist will prescribe you pain medication, so if you become sore take as directed. You can also use an ice pack for the pain. Your dentist might also provide you with a cleaning solution to clean the extraction site.
You will be limited to soft foods for a few days after your surgery. Some recommended foods are:
- Mashed Potatoes
- Ice Cream
- Thin Soups
- …and other food you can eat without chewing.
When drinking, make sure you do not use a straw. The sucking motion can loosen your sutures and slow the clotting process. The same goes for smoking. If you have prolonged pain, bleeding, irritation, or don’t feel that the extraction site is healing properly call your dentist for a follow up.
Extraction Site Preservation
If you want to fill the space with a dental implant, a sturdy jaw bone is necessary to install the implant. If you opt for a dental bridge, the bridge must be molded and placed before the teeth shift.
Your dentist is always open to a conversation on what you would like to do with your extraction site before removing a tooth. They will be able to make a recommendation and layout a treatment plan. Make sure to schedule follow up appointments to properly care for your extraction site.
1) Continue to Bite Firmly on this cotton for ____ hours (until _____________).
2) Change to Bite Firmly on new cotton for ____ hours (until _____________).
3) DURING THESE ABOVE _______ HOURS that you are biting on cotton, HOLD ICE against the extraction(s) side of your face – Use only ___ ice cube(s) in plastic bag; when ice melts dispose of water and get new ice.
IMPORTANT – IF YOU GET A JAW MUSCLE SPASM/PAIN, DO THE NEXT 2 ITEMS:
a) Every 15 minute cycles – Use Ice for 10 minutes and Moist Heat for 5 minutes.
b) Repeat “Slowly Stretching Mouth Wide Open” every 5 minutes and as needed.
4) AFTER THESE ABOVE _______ HOURS:
a) Remove and throw away the cotton – No More is normally needed.
b) Remove the ice against your face – No More is normally needed.
c) EAT Ice Cream, Milk Shakes, Sherbet, or Yogurt (something cold).
5) TODAY PLUS THE NEXT 2 DAYS:
a) No Rinsing out – This is Aggressive and Harmful to healing tissue.
b) No Spitting out – Swallowing is OK and normal.
c) Brush your teeth using only water so you can swallow the water.
d) No Smoking or use of any tobacco products in any form.
6) IF YOU HAVE PAIN TODAY OR THE NEXT 2 DAYS:
a) Take “ONE ASPIRIN” Tablet together with “ONE TYLENOL” Tablet starting today at _______________ when you change the cotton in your mouth, and repeat every 4 – 6 hours as needed for your pain.
b) IF this does not take care of your pain, it is important to Telephone me at (301) 662-0100 – If Voice Mail answers, very clearly leave BOTH your name and telephone number so that I can return your telephone call. REMEMBER TO CALL ME IF YOU NEED TO.
7) STARTING TOMORROW – FOR MINOR PAIN AND SWELLING:
Use only Moist Heat on these tender areas – (Do Not Use Ice). For 2 days have warm food, soups, and tea – (Do Not Use Cold Food/Drink).
I, UNDERSIGNING PATIENT, HAVE HAD THESE INSTRUCTIONS READ AND EXPLAINED TO ME, AND A COPY GIVEN TO ME TO TAKE HOME TODAY. I UNDERSTAND THAT I NEED TO DO EACH OF THESE INSTRUCTIONS FOR PROPER AND TIMELY HEALING TO TAKE PLACE.
1) Continue mordiendo firmemente sobre este algodon por ____ horas (hasta ___________).
2) Cambie a morder firmemente sobre un nuevo algodon por ____ horas (hasta __________).
3) DURANTE ESTAS ______ HORAS que usted esta mordiendo el algodon, SOSTENGA HIELO sobre el lado de la cara donde le hicieron la extracción. Ponga cubitos de hielo ___ sólo en una bolsa de plástico, cuando el hielo se derrite disponer de agua y obtener cubitos de hielo nuevo.
IMPORTANTE – SI TIENE ESPASMO MUSCULAR O DOLOR, INCLUYA LOS DOS SIGUIENTES DETALLES:
a) Cada ciclo de 15 minutos – Use hielo por 10 minutos y calor humedo por 5 minutos.
b) Repita “Poco a poco extiende la boca abierta” cada 5 minutos y cuando sea necesario.
4) DESPUES DE LAS ________ HORAS ANTES INDICADAS:
a) Remueva el algodon y botelo – Normalmente no es necesario mas algodon.
b) Remueva el hielo de su cara – Normalmente no es necesario aplicar mas hielo.
c) COMA helado, batido de leche, sorbete o yogurt (algo frio).
5) HOY Y LOS DOS DIAS SIGUIENTES:
a) No enjuague su boca – Es Agresivo y dañino a la curación del tejido.
b) No escupa – deglución es correcto y normal.
c) Cepille sus dientes usando agua que usted pueda tragar.
d) No fume ni use productos de tabaco de ninguna clase.
6) SI TIENE DOLOR HOY O EN LOS PROXIMOS DOS DIAS:
a) Tomese UNA PASTILLA DE ASPIRINA junto con UNA PASTILLA DE TYLENOL
Comenzando hoy a ____________ cuando cambie el algodon de la boca, y repita esto cada 4 – 6 horas como sea necesario para el dolor.
b) Si esto no le alivia el dolor, es importante que me llame por telefono al (301) 662-0100 – Si le, sale la maquina contestadora, deje AMBOS su nombre y numero de telefono para que yo pueda devolverle su llamada. RECUERDE LLAMARME SI ES NECESARIO.
7) EMPEZANDO MANANA – PARA DOLORES E INFLAMACION MENORES:
Use Calor Humedo solo en las partes adoloridas – (No use hielo). Durante 2 días tienen comida caliente, las sopas y el té – (No utilice la comida fría o bebida).
YO, EL PACIENTE QUE FIRMA DEBAJO, HE RECIBIDO ESTAS INSTRUCCIONES LEIDAS Y EXPLICADAS, Y UNA COPIA DE LAS MISMAS ME HA SIDO ENTREGADA PARA LLEVAR A MI CASA HOY. YO ENTIENDO QUE TENGO QUE SEGUIR CADA UNA DE ESTAS INSTRUCCIONES PARA QUE UNA CURACION APROPIADA Y A TIEMPO TENGA LUGAR.