Background

Oral and maxillofacial surgery requires up to 6 additional years of hospital based surgical and anesthesia training after graduating from dental school. As an oral and maxillofacial surgeon, Dr. Nijhawan, is extensively trained in maxillofacial trauma, facial reconstruction, orthognathic surgery, preprosthetic surgery, temporomandibular joint surgery, aesthetic maxillofacial surgery, craniofacial surgery, exodontia and other surgery as it pertains to the specialty.

Consultation

Before surgery the doctor will examine your mouth and discuss the findings with you. This examination will include x-rays and a complete health/medical history with particular attention to allergies, medications or health problems that might affect surgery and/or the administration of anesthesia. The doctor will examine your mouth for any signs of swelling or infection, and check your blood pressure and other vital signs. It is important that you provide complete information, including the names and dosage of all medications you are taking, so an accurate assessment of your health can be established prior to recommending surgery.

Anesthesia

Modern anesthesia technology now makes it possible to perform even complex surgery in the oral and maxillofacial surgery office with little or no discomfort. During surgery, one or more of the following is used to control pain and anxiety: Local anesthesia that numbs the surgical area; nitrous oxide-oxygen (sometimes called "laughing gas") for analgesia to relax you; intravenous sedation for increased relaxation; and general anesthesia that puts you to sleep. The surgeon will discuss the available anesthetic options and will recommend the most appropriate choice to ensure your comfort during the procedure. In addition, practicing Oral and Maxillofacial Surgeons must comply with individual state rules and regulations on anesthesia administration. As a member of AAOMS, our doctors must periodically undergo an onsite anesthesia inspection and reevaluation as part of association's office anesthesia evaluation program. AAOMS requirements are strict and often exceed those mandated by the state law.

Financial Info

We prefer not to send bills because the cost of paperwork and postage affects our fees. If you have insurance, we file your forms promptly, and request that you pay your portion when services are rendered. You may pay by Visa, Master Card, Discover and American Express.  For your convenience we also accept Care Credit. (http://www.carecredit.com)

Insurance Information

We request that you bring your insurance card and forms with you. Insurance plans vary and may cover from zero to 100 percent of your dental, medical, and surgical costs. You are responsible for any amount not covered by your plan. If your insurance plan pays you directly, please know that payment may take up to three months. We will be happy to help you complete and submit your forms, but you should address any questions or complaints regarding your coverage to your insurance carrier.

Scheduling for general anesthesia or sedation

 

THE EVENING BEFORE SURGERY:

1.  Eat a light dinner.

2.  Get a good night’s rest

3. DO NOT EAT OR DRINK AFTER MIDNIGHT

THE DAY OF SURGERY:

1.  DO NOT EAT OR DRINK ANYTHING

2.  A RELATIVE OR FRIEND MUST ACCOMPANY YOU HOME. Do not plan on driving a car or returning to work after intravenous anesthesia.

3.  Wear short sleeve clothing.

4.  Minors MUST be accompanied by an adult or legal guardian.

5.  REFRAIN FROM ALCOHOL AND SMOKING.

6.  Please remove ALL nail polish from fingernails.

NOTE:  Please notify the office of any change in health: i.e.: stomach upset, cough, cold, or post nasal drainage prior to surgery appointment.

Instruction For Care Of Mouth After Extraction

1.  DO NOT RINSE MOUTH TODAY.  Tomorrow rinse mouth gently, especially after meals.  Use one-quarter teaspoon of salt to a glass of warm water.  Continue rinses for several days.  Brush and floss as usual the day after.  Do not use mouthwash!

2.  BLEEDING.  Some bleeding is to be expected.  Bite firmly on gauze for 45 minutes.  If persistent bleeding occurs, a dampen tea bag, place on extraction site, bite firmly for 30 minutes.  Repeat if necessary.  If bleeding continues, contact the office.

3.  SWELLING.  Ice packs, double zip lock baggies with crushed ice, frozen peas, frozen corn, wrapped in a soft cloth or cotton tee shirt should be applied to the face, 20 minutes on and 20 minutes off, as much as possible for the first 48 hours.  Warm moist heat may be applied after 48 hours to relieve muscle soreness and stiffness.

4.  PAIN.  Take medication as directed.  An over-the-counter medication can be supplemented between doses. For example, Ibuprofen or Tylenol.  Do not take prescription pain medication on an empty stomach.

5.  FOOD.  Modify diet as necessary.  DO NOT USE STRAWS!!!

6.  BONY EDGES.  Small bone fragments may work up through the gums during healing.  These are not roots.  If annoying, return to this office for their simple removal.

7.  SMOKING. DON’T.  (Smoking is an irritant).

8.  If any unusual symptoms occur, call the office at once.

9. The proper care following oral surgery procedures will hasten recovery and prevent complications.

10. If wearing a retainer, resume use the next day, if it does not irritate the surgical site.