Oral Surgery FAQs

With many state-of-the-art dental treatments and prevention options available in dentistry today, there are fewer reasons for having to extract (remove) teeth. When something does go wrong with a tooth, we try to do everything possible to restore the tooth to its original function. Removing a tooth is the last option because we know that removal may lead to severe and costly dental and cosmetic problems if the tooth is not replaced.

Losing a tooth can be a very traumatic experience and it’s very unfortunate when it does happen. Injury, accident, fracture, severe dental decay, and gum disease are the major reasons for having to remove a tooth. If teeth are lost due to injury or have to be removed, it is imperative that they be replaced to avoid cosmetic and dental problems in the future.

When a tooth is lost, the jaw bone that helped to support that tooth begins to atrophy, causing the teeth on either side to shift or tip into the open space of the lost tooth. Also, the tooth above or below the open space will start to move towards the open space because there is no opposing tooth to bite on. These movements may create problems such as decay, gum disease, excessive wear on certain teeth, and TMJ (jaw joint) problems. These problems and movements do not result immediately, but will eventually appear, compromising your chewing abilities, the health of your bite, and the beauty of your smile.

Options for replacement of missing teeth:

Removable bridges – This type of bridge is a good solution for replacing one or more missing teeth, especially in complex dental situations where other replacement options are not possible. They are usually made of tooth-colored, artificial teeth combined with metal clasps that hook onto adjacent natural teeth. Removable bridges are the most economical option for replacing missing teeth, but may be the least aesthetically pleasing. This is because the metal clasps on the appliances are often impossible to completely conceal.

Fixed bridges – This type of bridge is generally made of porcelain or composite material and is anchored (cemented) permanently to a natural teeth adjacent to the missing tooth site. The benefit of this type of bridge is that it is fixed (not removable) and it is very sturdy. The disadvantage is that in order to create a fixed appliance, two healthy, natural teeth will have to be crowned (capped) to hold the bridge in place.

Dentures – This type of tooth replacement is used when most or all of the natural teeth are missing in one dental arch. Dentures are removable artificial teeth that are made to closely resemble the patients’ original teeth.

Implants – Are a great way to replace one or more missing teeth. They may also be great to support ill fitting dentures. A dental implant is an artificial root that is surgically placed into the jaw bone to replace a missing tooth. An artificial tooth is placed on the implant, giving the appearance and feel of a natural tooth. Implants are very stable, durable, and are the most aesthetically pleasing tooth replacement option.

If you are missing teeth, ask us if they need replacement and what options are available to you. Together we will select the best replacement option for your particular case. Prevention and early treatment is always less involved and less costly than delaying treatment and allowing a serious problem to develop.

Dentistry is finally able to “give back” in a way that we never could before. Even with the very best of talent and materials, dentists were always cutting away teeth, filling, extracting, restoring. Patients had to accept that a fair to poorly fitting denture was the best dentistry could do. So they lived and persevered with it.

Today we can do better. Dr. Mike feels fortunate to be able to provide this to you. With dental implants, we can give back form and function. We can restore a patient to a level of comfort, function, and esthetics that we never could before.

What is even more exciting is that every year, advances in implant technology are enabling higher levels of success. Dr. Mike is dedicated to maintaining the most current technology and surgical “know-how” in implant dentistry.

Q: I am afraid of dentists, physicians, needles, and pain!

A: It is an unfortunate fact that surgical procedures often produce pain. It is never our intent to produce pain. Rather we anticipate it, then take the appropriate measures to remove it, then minimize it.

These measures begin at our consultation visit by meeting Dr. Mike Dachowski, discussing the case, understanding the expectations of everyone involved in the patient’s care. Appropriate anesthesia is used for the case. That could be as simple as a local anesthetic or as involved as an intravenous anesthetic. Then the appropriate postoperative measures to minimize postoperative pain are implemented.

Our mission regarding pain is to minimize it!

The consultation is the most important part of your care and involves more than just looking. It allows our doctor to acquire all of the information necessary for a complete medical and dental evaluation of your treatment requirements. The information required may include the appropriate X-rays, drug allergies, and other data that allow us to assess the pertinent risks and benefits. Once the doctor has this information we can then discuss it with you and then agree on a treatment plan.

With non-complicated situations such as a standard extraction or biopsy on a healthy patient, consultations may not be required.

Remember, the informed patient is a partner in his/her own care. Also remember, as important as your surgery is to you, we also attach a high level of priority. Our first aim is excellent, patient-centered care. Delivering that high level of specialized care requires a plan that includes the surgery, the anesthesia, and all other relevant medical and dental data.

Certain procedures that we provide are covered by many medical and/or dental insurances. This can be very confusing since policies and levels of coverage may change, without notice to you or us.

For example, a wisdom tooth that is impacted in the bone is many times covered by the medical carrier and a non-impacted tooth is covered by the dental carrier. Sometimes one or the other carrier covers the anesthesia fees. Sometimes there is coordination between the two carriers to partially cover each service. Sometimes a specific surgery that was always covered by a company is suddenly not covered.

One thing our patients need to know: the insurance companies are not always “doctor friendly” when it comes to phone calls. Almost every time, a call to your insurance company requires at least 15 minutes of on hold waiting time, voice mails, call routing, and difficulty talking to a “provider relations representative” who can readily solve an issue without more time on hold.

If you have a question on the necessity for a referral, please read your insurance policy. We will be happy to advise you to the best of our knowledge.

Absolutely. Appropriate pain medicine is always prescribed in a dose and amount that will enable the patient to safely and effectively manage any pain. Many times, parents will be concerned as to the strength of the pain medicine for their teenage son or daughter. Many times, there is the requirement for “adult strength medicine” for “adult type pain”.

Post surgical diets after surgery vary with the extent of the surgery. In most cases, such as after wisdom teeth extractions, multiple extractions, or dental implants, it is safe to say: the softer the better for the first several days.

Soups, high caloric milk shakes and breakfast drinks are a good start. Blenderized foods are also a safe bet. After the first two days, the diet can advance to a true soft diet such as pasta, scrambled eggs, and foods with a mashed potato consistency. After 4-5 days, one can advance to well cooked meats and vegetables.

One of the most important dietary considerations is hydration. Maintaining fluids after surgery is very important. The more “good stuff” is in the drink, the better. A good example is Gatorade.

As you may have learned in basic first aid, direct pressure is the best way to control most bleeding. Many times, sutures (stitches) are placed to close the oral wound. But to stop bleeding, pressure is still necessary. Gauze may be placed after surgery and biting pressure should remain on the wound. The gauze should be replaced every 15 – 20 minutes until the bleeding stops. Sometimes it may take 1-2 hours for bleeding to completely stop. Even after that, some occasional oozing may occur from the wound for 1 – 3 days.

If bleeding restarts, gently rinse out the mouth and replace the bite gauze. Repeat the cycle until the bleeding stops.

A mistake that a lot of patients make is leaving the office in no pain (because of the anesthetic) and disregarding these important instructions. As bleeding continues, and is swallowed, nausea occurs, and that is about the time when there is some post-operative pain. It becomes quite difficult to tolerate pain medications, important fluids to drink, or any food at that point.

We do everything we can to ensure that there are no long wait times to get an appointment with one of our doctors at one our four locations.

Many people are unaware that having periodontal disease (the destruction of gum tissue and bone that hold our teeth in place) can affect your overall health. Periodontal disease is one of the most common infections; often more prevalent than the common cold! Periodontal disease is not only the number one reason people lose teeth; it can also affect the health of your body!

Periodontal disease is a bacterial infection, and in its earliest stages, it’s called gingivitis. It starts when an accumulation of plaque (a colony of bacteria, food debris, and saliva) is NOT regularly removed from the gums and teeth. The bacteria in plaque produce toxins/acids that irritate and infect the gums and eventually destroy the jaw bone that supports the teeth. When periodontal disease is not treated it can eventually lead to tooth loss!

There are numerous studies that have looked into the correlation between gum disease and major medical conditions. These studies suggest people with periodontal disease are at a greater risk of systemic disease and indicate that periodontal disease may cause oral bacteria to enter the bloodstream and travel to major organs and begin new infections. Research suggests that periodontal bacteria in the blood stream may:

Contribute to the development of heart disease

Increase the risk of stroke

Compromise the health of those that have diabetes or respiratory diseases

Increase a woman’s risk of having a preterm, low-birth weight baby

Researchers conclude there is still much research to be done to understand the link between periodontal disease and systemic diseases, but enough research has been done to support that infections in the mouth can play havoc elsewhere in the body.

To ensure a healthy, disease-free mouth, we recommend the importance of regular dental check-ups and cleanings, which include a periodontal evaluation. Also, diligent home care and a proper diet can help reduce the plaque and bacteria in the mouth.

Remember to take care of your oral health! It contributes to your overall medical health!