New Oral Surgery Patient Information – Houston, TX

Appointments

Because we realize that your time is valuable, we make every effort to see patients at appointed times. However, if an emergency situation arises that causes a delay or necessitates rescheduling your appointment, we will keep you well informed. If you find it necessary to change your appointments, we would appreciate as much advance notice as possible. In general, most of our patients, even if referred to our Houston oral surgery office for a specific surgical service, will be seen for a comprehensive consultation visit before the date of surgery. The purpose of this visit is to allow you to meet your oral surgeon and discuss your diagnosis and oral treatment in a pleasant, stress-free environment. It is our experience that trying to have both the exchange of information that is the essence of the consultation visit as well as the surgery on the same day may make it difficult for some to make careful and considered decisions about their care. There are, of course, exceptions to this, and some patients who are hurting or require urgent oral care will naturally be seen and treated on the same day. This is a decision best left up to the patient and oral surgeon. If you have concerns or comments about, feel free to discuss them at the time your appointment is made, or you may email us. We welcome your feedback.

It would greatly assist us if, at the time of your initial consultation, you provide us with any or all of the following:

• Your referral slip and any x-rays from your dentist
• A list of your current medications, including dosages
• Insurance information to assist us in filing your claim
• Medical records, especially if you have a complex history

It will also assist us if you have a medical condition which may affect your care (artificial heart valves or a history of rheumatic fever, heart murmurs requiring premedication, diabetes, hypertension, or heart disease) for you to share this information with the surgical office staff while scheduling your consultation.

If your referring dentist has taken x-rays, you might request that these films be forwarded to our oral surgery office in order to expedite your care. Additional films, if needed, may be taken at our surgical office.

Patient Registration Forms 

The below forms will need to be read and completed before you can have your first consultation with one of our oral surgeons. Instead of trying to hastily get everything done on the day of your appointment, you can print the necessary forms along with important information right here and review it on your own time. Then, when you walk into our oral surgery office for the first time, you can just hand us the completed paperwork.

Patient Registration View our Notice of Privacy Practices Acknowledgement of Receipt of Notice of Privacy Practices

Your Consultation

Our oral surgeons will examine and evaluate your situation and discuss your oral surgery options. This is your time to become familiar with your surgeon and the staff and to voice your needs and concerns. Your health history and X- rays will also be reviewed. Please bring all medication you are taking and any X-rays that were given to you. Fees for surgical services will be explained to you at this time. Our oral surgery office staff will evaluate any dental and medical insurance you have and discuss financial arrangements. If you are under 18 years of age, you must be accompanied by a parent or legal guardian. If you cannot keep your scheduled appointment, please call us as soon as possible. Every effort will be made to see you at the appointed time. If emergencies should arise which make it impossible for us to do so, we will notify you of any unexpected delays. Your efforts to keep us informed and arrive when scheduled will be appreciated.

Oral Surgical Fees & Payment

Our goal is to provide our patients with the highest quality of oral and maxillofacial surgical care. We endeavor to do this in a professional and businesslike environment, at a cost that is both fair and reasonable. Sending frequent statements and following up on delinquent accounts can be costly. Therefore, to avoid rising costs, we ask that all fees be paid at the time of service. If special arrangements are necessary, please contact our oral surgery office as soon as possible. For your convenience, we also accept Visa, MasterCard, Discover, and American Express credit cards. Additionally, we may be able to offer a third-party financing option for major elective surgeries that can ease the financial burden for these procedures.

We realize that medical and dental care is expensive. Our fees, by design, are within the usual and customary range for our specialty in this geographical area. We also understand that sometimes it can be a sobering experience to discuss the costs of surgical care. Please try to understand that we strive to deliver care in the safest, most comfortable fashion. For many patients, this includes general anesthesia or IV sedation techniques to further enhance their comfort during the oral procedure. The oral care is delivered in a manner that is analogous to and as safe as that delivered in a hospital operating suite but at a fraction of the cost. The costs of your care underwrite this provision of comfort, safety, and expertise.

Medical & Dental Insurance Information

Many oral and maxillofacial procedures are covered by dental and/or medical insurance. It is very likely that you are insured under an individual or group policy that partially covers the type of advanced dental and oral surgery services provided in our Houston surgical office. It is, however, extremely rare that a policy covers 100% of all charges incurred. There may be deductibles, and frequently, insurance companies make payment on what they consider "usual and customary" fees for various oral and maxillofacial services. These payments may actually be lower than the fee charged. We do participate in many managed oral care (PPO's, HMO's, POS) programs. If you are a member of such a plan, please discuss this with our patient coordinator.

We will assist you in every way we can to see that you receive the maximum benefit allowable under your policy and expedite claims in a timely fashion. A standard "attending physician's" or "attending dentist's" statement will be provided and a form for predetermining benefits prior to the oral surgery will be supplied upon request. However, please remember that the patient is fully responsible for all fees charged by this oral surgery office regardless of medical or dental insurance coverage.

Pre-Op Instructions

• Your mouth and teeth should be well cleaned immediately before your appointment.
• It is essential that you bring a responsible adult with you who can drive you home. We ask that this person be present in the oral surgery office prior to surgery and remain until the patient is dismissed from the oral surgery office.
• If the surgery is in the morning, you should have nothing by mouth after midnight the night before surgery. If the surgery is to be in the afternoon, you may have liquids for breakfast and then nothing by mouth until after the surgery. YOU SHOULD NOT HAVE ANYTHING TO EAT OR DRINK FOR AT LEAST SIX HOURS PRIOR TO SURGERY. If the doctor has given you medication to take one or two hours before surgery, it should be taken with only a sip of water.
• If the patient is a child or legally a minor, it is essential for at least one parent or legal guardian to be with the patient.
• You should wear loose fitting clothing, preferably with short sleeves. Do not wear a tight collar or necktie. No jewelry should be worn during surgery.
• The profound effects of the sedation will wear off 30 to 45 minutes following surgery, after which you will be discharged from the oral surgery office. However, because of the residual effects of the medication, you should plan to go home and remain in bed for the remainder of the day.

Post-Op Instructions

Fractured Jaw & Osteotomy Surgery Care Instructions

Bleeding

Keep pressure over extraction (surgery) site with gauze for forty-five minutes. If bleeding continues, place a fresh gauze pad over extraction (surgery) site and bite hard, applying pressure to the area at forty-five-minute intervals until the bleeding stops. It is not unusual for saliva to be slightly blood-tinged for several days following surgery.

Medication

Take pain medication as instructed by the doctor. The first dose should be taken with a clear liquid such as tea or Seven-up. After the initial dose, do not take pain medication with just water on an empty stomach. Take the second dose as soon as you feel discomfort after you have had something substantial to drink (soup, milkshake, etc.).

Smoking

Avoid smoking for at least forty-eight hours following surgery.

Oral Rinsing

Avoid all rinsing for at least six hours after surgery. Beginning the day after surgery you should rinse gently with mouthwash (Chloraseptic, Cepacol) several times daily, especially after eating.

Diet

You should have a LIQUID DIET ONLY on the day of surgery and the day following surgery. It is important that you maintain a high fluid intake (malts, juices, soup, etc.) for several days following surgery. Liquids may be taken beginning three hours after surgery. Beginning forty-eight hours after surgery, you may eat soft foods. After that, you may progress to anything that you feel you can eat unless given other specific instructions by the doctor. No alcoholic beverages should be consumed for at least twenty-four hours following surgery, or as long as you are taking pain medications.

Ice Packs

Ice packs should be used for the first forty-eight hours following surgery. It is not unusual to have more swelling on the second postoperative day than was present on the first postoperative day. Beginning seventy-two hours after surgery (the third day), a heating pad or moist heat should be used for relief of swelling, bruising, and stiffness. Heat should be continued for thirty-minute intervals, three or four times daily until the symptoms subside.

Dental Emergencies

If any unusual symptoms should occur, you may reach the doctor twenty-four hours a day at by contacting our surgical office. Proper care following oral surgery will hasten recovery and prevent complications. You should experience progressive improvement in symptoms three to four days after surgery, although tenderness for several days is not unusual. If severe throbbing pain or pain unrelieved by medication persists beyond the third or fourth postoperative day, please notify our oral surgery office. You should also return to this surgical office for your postoperative follow-up visit five to ten days following surgery.

Postoperative Care - Day of Molar Surgery

Bleeding

To control bleeding following surgery, firm, consistent pressure should be applied to the surgical site(s) for one hour. This is accomplished by biting down on the sterile gauze sponges that were placed over the site(s) during surgery. These gauze sponges may be removed after one hour. If bleeding continues, the sterile gauze should be re-applied for one-hour periods until the bleeding has been controlled. However, it is not necessary to continue using the gauze for slightly blood-tinged saliva which may continue for several days.

Medications

• Antibiotics: Antibiotics should be started 4 hours after surgery following the first liquid meal and continued until the entire prescription has been taken.
• Anti-inflammatory: If an anti-inflammatory medication (i.e., NSAID, Motrin) has been prescribed, it should also be started 4 hours after surgery following the first liquid meal. It should be taken every 8 hours for 3 days and may be continued after the third day to control mild pain as necessary. Anti-inflammatory medications reduce swelling and pain without causing drowsiness. If adequate pain control is achieved with the anti-inflammatory medication, narcotic pain medication may not be necessary. However, the anti-inflammatory medication and the pain medication may be taken at the same time, if necessary, to control discomfort.
• Oral Pain: Medication for pain control may have been administered by the doctor following the surgical procedure. Therefore, narcotic pain medication should not be given unless pain is experienced. This may not occur until several hours after surgery. If necessary, the pain medication may be taken every 3 to 4 hours. These medications may cause drowsiness, so driving or use of hazardous equipment should be avoided.

Smoking

Smoking should be avoided for at least 48 hours after surgery.

Ice Packs

Ice packs should be used continuously for 36 hours following surgery.

Diet

A liquid diet may be started 3 hours after surgery and should be continued for 48 hours. It is important to maintain a high fluid intake (juice, soup, malts, etc.) for several days following surgery.

Oral Rinsing

You may begin rinsing 6 hours after surgery with a half Chloraseptic and half water rinse. Rinse after meals and before bedtime.

First Day After Oral Surgery

Medications

Antibiotics and anti-inflammatory medications should be continued as directed and pain medication taken as needed.

Ice Packs

Ice packs should be continued throughout the day and may be discontinued at bedtime. It is not unusual to have increased swelling on the first day after surgery.

Diet

A full liquid diet should be continued throughout the day.

Brushing

You may begin brushing your teeth in front the first day after surgery, avoiding the surgical sites until after your postoperative checkup.

Second Day After Oral Surgery

Medications

Antibiotics and anti-inflammatory medications should be continued as directed and pain medication taken as needed.

Ice Packs

Ice packs should not be used the second day after surgery.

Diet

A soft food diet may be started including scrambled eggs, mashed potatoes, and items of similar consistency.

Third Day After Oral Surgery

Medications

Antibiotics should be continued until the entire prescription has been taken. Anti-inflammatory medication may be discontinued unless needed for relief of discomfort. Pain medication should be taken only if full relief of discomfort is not achieved with the anti-inflammatory medication.

Heat

If symptoms of swelling, bruising, or stiffness are present, apply a heating pad or moist heat to the affected area 3 or 4 times daily for approximately 20 to 30 minutes each time. Heat should be continued until the symptoms subside, which may take several days.

Diet

A regular diet may be resumed although sharp or chewy items should be avoided for a few more days.

Emergencies

If any unusual symptoms occur, you may reach the doctor 24 hours a day by calling our oral surgery office.

Proper care following oral surgery will hasten recovery and prevent complication. Although tenderness is not unusual for several days, the patient should feel progressively better every day starting 3 to 4 days after surgery. If severe throbbing pain or pain unrelieved by medication persists, please notify the oral surgery office.

Regular postoperative visits are scheduled 5 to 10 days following surgical procedures. This is an important part of comprehensive care. If you are unable to keep this appointment, please contact our surgical office to reschedule as soon as possible.

Fractured Jaw & Osteotomy Surgery Care Instructions

1. Just as a cast immobilizes other bones for healing, immobilization of the jaw bones is necessary when it is broken and surgically repositioned. Wiring of the teeth and immobilization with splints and rubber band traction may be used to position the jawbones for healing. If internal rigid fixation with screws and plates are utilized, movement of the jaw is allowed.

2. The usual healing time is 6-8 weeks. Appliances are removed shortly thereafter.

3. Initially, you may have pain. Take prescribed medications as needed. The pain will gradually diminish. Do not attempt to move or open your jaws. This action only increases the pain, may delay healing, and may cause muscle spasms in your jaw muscles.

4. Adequate nourishment is important during this period. Your diet will consist of milkshakes, soups, and juices. Many liquid food supplements are also available such as Sego, Metrecal, Sustagen, Boost, and others. A blender or food processor is useful to puree solid food for intake. Five or six small feedings each day are usually easier than three larger ones. Your oral intake should be at least 8-10 cups of fluid each day. A general rule is to maintain a minimum of 2,000 calories per day to avoid losing weight. It is important to keep well hydrated as well.

5. Oral cleanliness is of the utmost importance while the teeth are wired together. Rinsing the mouth 4-5 times each day, especially after eating, is a necessity. A small child's toothbrush is also handy for cleaning. An oral irrigation device (Water Pic) is extremely useful following meals. The following mouthwashes should be used separately at each cleansing period:

• Hydrogen peroxide, 3% - 1/2 strength
• Chloraseptic, Listerine, or Cepacol mouthwash
• Peridex oral rinses

6. If severe nausea or vomiting occurs, cut the rubber bands or wires between the upper and lower teeth. If your jaws are fixed together, have a pair of scissors or wire cutters on your person at all times. Call the oral surgery office for replacement immediately.

7. Frequent oral surgery office visits and periodic postoperative x-rays are necessary.

8. Following initial recovery (1-2 weeks), a moderate schedule may be resumed. No swimming or contact sports are allowed. You may bathe and wash your hair.

9. If wires begin to irritate cheeks or lips, wax can be placed over these sharp areas temporarily. Vaseline or other lip lubricants will aid in comfort. If any problem arises such as a shifting of your bite, fever, excessive swelling or bleeding, call the oral surgery office.