Frequently Asked Questions
Frequently Asked Questions Jump Menu:
- Oral and Maxillofacial Surgeons
- Wisdom Teeth
- Dental Implants
- Corrective Jaw (Orthognathic) Surgery
- Facial Cosmetic Surgery
Oral and maxillofacial surgeons are dental specialists who treat conditions, defects, injuries, and esthetic aspects of the mouth, teeth, jaws, and face.
Oral and Maxillofacial Surgery training includes a four-year graduate degree in dentistry and an additional completion of a four-year or six-year hospital surgical residency program. Dr. Reynolds completed a six-year program and has his medical degree in addition to his dental degree.
Oral and maxillofacial surgeons care for patients who experience such conditions as problem wisdom teeth, facial pain, and misaligned jaws. He treat accident victims suffering facial injuries, offer reconstructive and dental implant surgery, and care for patients with tumors and cysts of the jaws. Dr. Reynolds is specially trained to treat functional and esthetic conditions of the maxillofacial areas.
With specialized knowledge in pain control and advanced training in anesthesia, the oral and maxillofacial surgeon is able to provide quality care with maximum patient comfort and safety in the office setting.
Please visit the following pages to view answers to Frequently Asked Questions (FAQ) About Wisdom Teeth
- Why Do We Have Wisdom Teeth?
- Why Should I Have My Wisdom Teeth Removed?
- When Should I Have My Wisdom Teeth Removed?
Although the best time for removal of wisdom teeth is about 16 years old, there is a wide age range for patients who require wisdom teeth removal. Determining when to remove the wisdom teeth is based off of three factors:
- Age of Patient: The younger the better. Younger patients typically have less chances of wisdom teeth complications. It is recommended to have your wisdom teeth removed sooner than later if your dentist or our doctors have indicated that conditions are not optimal for keeping your wisdom teeth.
- Root Formation: If your wisdom teeth’s roots have about 1/3rd of formation, this is a good time to consider getting your teeth removed. If you have over 2/3rds root formation on your wisdom teeth, there is an increased chance of complications with wisdom teeth removal.
- Position of the Tooth: Another important factor in determining when to remove your wisdom teeth is where the wisdom teeth are positioned relative to other anatomical structures such as the sinuses and adjacent teeth. If the wisdom tooth cannot attain a healthy position then problems can occur such as cavities, infections, or complications with roots.
What can I expect to pay for the removal of wisdom teeth?
Each patient’s needs are different. When you come in, our team will determine the specifics of your case and will estimate the cost for your treatment. Although each case requires different individual surgical needs and the difficulty of removal of each tooth may vary, on average, the cost for wisdom teeth removal is approximately $1,400.00. However, the cost could be as low as $500 for four erupted wisdom teeth with only local anesthesia.
How long is recovery?
For the first two days, it is recommended to limit your activity to allow your mouth to recover; no strenuous activity is allowed. Most people don’t feel like going back to their regular daily activities until approximately four days or 96 hours after surgery. The patient will still experience swelling and tenderness until around day 7 to day 10. Rinses are continued until day 30; however, from day 10 to day 30 there is typically no pain.
Why did my dentist send me to an oral surgeon just to pull a tooth? Can’t he do that?
Yes, but your dentist feels it is in your best interest to be treated by someone trained in advanced surgical and anesthetic procedures in a fully equipped surgical and anesthesia setting.
I don’t like dentists, is there anything you can do to make this easier on me?
We do our best to help you through this sometimes scary process by providing friendly staff in a comfortable setting. Our team can also use multiple anesthesia techniques including preoperative anti-anxiety medicines (similar to valium).
What are dental implants?
Dental implants are substitute tooth roots used to replace natural tooth roots in areas of the mouth where teeth are missing. Crowns, bridges, or other replacement teeth are then connected to the implants to replace missing dentition.
The reason it is so important to replace the tooth root as well as the visible part of the tooth is so that natural tooth roots are embedded in the bone, stimulating bone growth and providing the stable foundation necessary to bite and chew.
When teeth are missing, the bone that previously supported those teeth deteriorates in a process called bone resorption. However, the bone can be preserved by replacing missing tooth roots with dental implants. Since the bone actually forms a strong bond to the implants, they can serve the same functions as natural tooth roots.
What are some of the benefits of dental implants?
- Overall quality of life is enhanced with replacement teeth that look, feel and function like natural teeth. With implant-supported replacement teeth, the appearance of the smile is more natural and the teeth function more like natural teeth. The result is increased comfort and confidence when smiling, speaking and eating.
- Integrity of facial structures is preserved. By preventing the bone resorption that would normally occur with the loss of teeth, the facial structures remain intact. This is particularly important when all of the teeth are missing, as the lower one-third of the face collapses if implants are not placed to preserve the bone.
- Adjacent teeth are not compromised to replace missing teeth. Tooth replacement with traditional tooth-supported bridges requires grinding down the teeth adjacent to the missing tooth/teeth, so that the bridge can be cemented onto them. This tooth structure can never be replaced and the long-term health of these teeth is compromised. The teeth are then made to do the work they were intended for plus the work of the missing tooth. Partial dentures have clasps that hook onto adjacent teeth, putting pressure and unnatural torquing forces on them as the partial rocks back and forth. Eventually these teeth can loosen and come out as a result of this pressure. Replacing missing teeth with implant-supported crowns/bridges does not involve the adjacent natural teeth, so they are not compromised or damaged.
- The mouth is restored as closely as possible to its natural state. By replacing the entire tooth, including the root, it is possible to replicate the function of natural teeth, with a strong, stable foundation that allows comfortable biting and chewing. In addition, nothing in the mouth looks or feels artificial.
- Increased stability and a sense of security that teeth will not fall out when eating, laughing or sneezing. People who wear dentures often worry that their dentures will fall out when they laugh, sneeze and sometimes even when they eat. Since the bone bonds to the implants, replacement teeth have a stable foundation and are securely attached to the implants, so there is no fear that teeth will fall out.
- Improved health due to improved nutrition and proper digestion. People with dentures usually have problems eating certain foods, such as fresh vegetables and fruits, which can compromise their nutrition. Additionally, since it is difficult to chew properly with dentures, digestion is often compromised.
- Improved appearance. Since implants preserve bone, preventing deterioration of the facial structures, appearance is improved. Collapse of the lower one-third of the face caused by complete tooth loss can be visually corrected and the remaining bone preserved. The appearance of wrinkles around the mouth caused by posterior bite collapse or complete facial structure collapse, are virtually eliminated. The smile is improved when replacement teeth look more like natural teeth. Even when only one tooth is missing, long term esthetics are usually much better with an implant-supported replacement tooth than with a traditional tooth-supported bridge. This is particularly important in the front of the mouth, where preventing a visible bone defect is critical for natural appearance.
- Improved ability to taste foods. Wearing an upper denture can prevent someone from really tasting food, as the roof of the mouth is covered. With implant-supported replacement teeth, it is not necessary to cover the roof of the mouth, so it is possible to enjoy the taste of foods.
- Increased convenience of hygiene. It is much easier to care for an implant-supported crown, which can be cleaned like a natural tooth, as opposed to a tooth-supported bridge, which requires the use of a flossthreader for proper cleaning. It is also easier to clean implant-supported replacement teeth than a removable partial.
- Elimination of denture adhesives. Since implant-supported teeth are securely attached to the implants, there is no need for messy denture adhesives, which are often needed to keep dentures from falling out.
- Restored self esteem and renewed self confidence. Many of the people who now enjoy the benefits of implant-supported replacement teeth state that their self esteem and self confidence have been restored as a result of improved appearance, function, comfort and health.
Who is a candidate for dental implant treatment?
Nearly everyone who is missing one or more teeth and in general good health is a candidate for dental implant treatment. There are a few medical conditions that can undermine the success of implant treatment, such as uncontrolled diabetes and smoking. However, there are very few conditions that would keep someone from having implant treatment altogether.
Quality and quantity of available bone for implant placement is more often a factor in qualifying for dental implants than medical conditions. However, even people who have lost a significant amount of bone can qualify for dental implant treatment with additional procedures to add bone or create new bone. Advances in this type of treatment have made it possible for thousands of patients who would not previously have been considered candidates to have successful implant treatment.
What is involved with dental implant procedures?
- Consultation. The first step is an examination and consultation to determine whether or not you are a candidate for implant treatment. This usually involves x-rays and may include taking impressions for models of your teeth. If you have already lost a significant amount of bone, additional x-rays taken at another facility that specializes in this type of x-ray may also be recommended. During the examination, Dr. Reynolds will be evaluating the area(s) of your mouth where teeth are missing, including the amount of bone available to support the placement of implants. He will also be evaluating the type of replacement teeth that will best meet your needs. A review of your health history will indicate whether there are any medical conditions that could prevent you from being a candidate for implant treatment.
- Implant Placement Procedure. The implants are placed in the bone using a standard surgical technique. Following the implant placement procedure, the implants may be left undisturbed for a period of 3-9 months so that the bone can bond with the implants, or the implants may be placed and immediately “loaded” with replacement teeth. Your surgeon and dentist will select the procedure that is best for you. In any case, you will always have the option of some type of temporary replacement teeth, so that you never have to be without teeth during treatment.
- Abutment Attachment Procedure. Following the appropriate healing period, a small connector, or extension, called an abutment, is attached to each implant. Sometimes this is a temporary part used to help shape the gingival (gum) tissue and sometimes this is the “final” abutment. The permanent replacement teeth will eventually be attached to the abutments.
- Fabrication of Replacement Teeth. A series of appointments with your dentist will be needed to take impressions of your teeth and the implant abutments, to place temporary replacement teeth, to select the appropriate shade for your replacement teeth, and to try them for proper fit. In between these appointments, the laboratory technician will fabricate your replacement teeth and the underlying structures that will be attached to the implants.
How Long Does It Take to Complete Treatment?
Dental implants preserve bone because they function like tooth roots, firmly embedded in the bone. In order for the implants to become embedded in the bone, the bone must bond to the implants. This process takes anywhere from 3 to 9 months, depending upon the quality of the bone into which the implants are placed. In selected cases, dental implants can be immediately loaded after placement.
Thus, the time to complete this treatment plan is minimal. Your restorative dentist and/or oral surgeon will evaluate your options for immediate loading.
There are other treatment options that do not include dental implants that do not take as long to complete; however, none of these traditional methods of tooth replacement preserve bone. And, in fact, dentures and partials actually accelerate the bone resorption process.
Is the Surgical Procedure Painful?
Most implant patients report that the discomfort is far less than they expected, and is much like having a tooth extracted. And although everyone is different with regard to pain tolerance, most patients are very comfortable simply taking Ibuprofen afterward.
What Is Involved With Taking Care of Dental Implants?
The home care recommended varies depending upon the type of implant-supported replacement teeth. For example, a single implant-supported crown is cleaned like a natural tooth, with regular brushing and flossing. Implant-supported bridges that replace a few teeth are cleaned like tooth-supported bridges, brushing and flossing with a floss threader.
Home care is a little different for people who are missing all of their teeth. Special brushes and floss are often recommended. With overdentures, it is necessary to clean the implant attachments, as well as the overdenture. Permanently fixed implant supported replacement teeth are cleaned like all other bridges.
In all cases, it is recommended that patients see their regular dentist and hygienist at least twice each year unless they routinely see the periodontist, in which case they would continue to alternate visits. If a surgical specialist placed the implants, it is usually recommended that the patient see the specialist at least once each year as well. These visits, combined with proper home care, are essential to the long term success of implant treatment.
How Long Do Implants Last?
Documented clinical research demonstrates that implant-supported replacement teeth have been successful for over 35 years. These were some of the first root-form implant cases ever completed and they have been closely monitored from the beginning. It is highly likely that these cases will be successful throughout the lifetime of those patients.
Dental implants are designed to be permanent; however many factors contribute to the long term success of implant treatment, such as home care and regular maintenance visits to the dentist or dental specialist.
By comparison, research demonstrates that the typical tooth-supported bridge lasts from 7-10 years and that partials and dentures are functional for approximately 5 years. Insurance statistics indicate that bridges, partials and dentures last 5 years and they generally pay for replacements every 5 years.
Do Dental Implants Ever Fail?
Dental implant treatment is one of the most successful procedures in the medical/dental field, with documented success rates over 95%. Although successful treatment is very predictable, there are rare occasions where the bone does not completely bond to the implants. When this occurs, new implants are placed. Smoking or putting too much pressure on newly placed implants, as with excessive grinding of the teeth, can cause problems with the bone bonding to the implants, and should be avoided.
Is Dental Implant Treatment Covered by Dental Insurance?
Insurance coverage of implant treatment depends on the individual policy. The benefit coverage is determined strictly by the amount the employer wants to spend on the policy, and how much the insurance companies want to preserve their profit margins. In addition, there are major limitations on most dental insurance plans. In reality, the plans are only designed to cover routine maintenance, emergencies and basic care.
The insurance companies use statistical data to determine the most common procedures submitted on claims, then set their own “usual and customary fee” schedule for these procedures. They then determine the specific restrictions and limitations for each plan. Because the plans are only intended to cover the basics, there is an annual maximum allowable benefit of $1,000-$1,500 on most plans.
Some companies exclude dental implants as a covered benefit, many of them will pay the same benefit they would cover for the lowest cost alternative treatment option (partials and dentures) and some of the diagnostic records, if a specific request is made for “alternative benefits.” Even if an individual policy includes implants as a covered benefit, the amount of coverage is still limited to the annual maximum allowable.
What Is the Cost of Implant Treatment?
A little more than the cost of a bridge. An investment in dental implant treatment is an investment in overall health, appearance and well being, as it involves preserving the integrity of facial structures, as well as replacing missing teeth.
The actual cost of implant treatment is based on a number of factors, such as the number of missing teeth being replaced, the type of implant-supported teeth (treatment option) recommended and whether additional procedures are necessary to achieve the proper esthetic and functional result.
There is often a misconception that there is a set cost for each implant. The fees are calculated based on the amount of time the dentist or dental specialist anticipates spending to complete treatment (implant placement, other surgical procedures, fabrication of replacement teeth) as well as the estimated cost of implants, other components and materials necessary to complete treatment and dental laboratory fees.
The only way to accurately estimate the cost for an individual patient is to have an examination and consultation with a dentist or dental specialist. If a dentist and dental specialist work together on a patient’s treatment, there is a separate fee for each of the doctors.
Does Medical Insurance Cover Implant Treatment?
There are a few cases where medical insurance is available for people who are missing all of their teeth, and as a result, have medical complications.
This type of coverage depends solely on the individual policy. Work-related injuries and other types of accidents are the other cases that are sometimes covered by insurance. Other than these situations, medical coverage is very rare. Medicare does not cover implant treatment.
MANY OF THE IMPLANT COMMONLY ASKED QUESTIONS ARE COURTESY OF NOBEL BIOCARE
How do you say orthognathic?
Orthognathic has been pronounced both orthõ-nathic and orthög-nathic. ( õr-thõ-nath’ ik, õr-thog’ nãth’ ik)
What does orthognathic mean?
Ortho is of Greek origins, it means straight, true or correct. Gnathic is Greek meaning related to the jaws. It therefore means correct jaws or essentially to make or have jaws that are correct in size, function and relation to each other and the facial skeleton.
Who needs orthognathic surgery?
Patients whose teeth don’t bite correctly, underbites (class III malocclusion), overbites (class II malocclusion), open bite (where the front teeth don’t touch and can’t cut food or any teeth don’t touch when the teeth are biting together) and other bad bites (malocclusions) such as cross bites. Orthognathic surgery is also done to move the bones of the face to correct skeletal deformities which may be causing problems. One such problem is obstructive sleep apnea. Moving the jaws can open the airway and help the patient breath. It can also correct facial disharmonies such as lip incompetence or unaesthetic smiles.
What are the benefits?
Improvement in the occlusion (bite) of the teeth and function of the jaws is the most common benefit. But other benefits include improved airway, lip function, overall oral health, correction of obstructive sleep apnea, and improved facial appearance and speech.
What if I need it but don’t want to have it done?
There may be some orthodontic (tooth movements) that could compensate for the malocclusion partially. These changes may produce undesirable effects, such as, periodontal recession, improper tooth wear and unattractive facial changes. Careful consideration of the entire dento-facial complex is important in reaching a decision.
What is involved?
Evaluation by our team consists of history, physical exam, special x-rays and cephalometric work-up (measurement of the face and jaw bone). Also, evaluation by an orthodontist is needed because braces are part of the treatment.
Who can’t have it done?
Almost anyone. Some serious medical conditions may make the risk outweigh the benefits. Our team can give you a complete risk assessment at the time of consultation.
How long is surgery?
The surgery can range from 1 1/2 to 6 hours depending on the various type of surgical procedures involved. There may be several types of procedures involved in the surgery.
How long is the whole process?
About 2 years. The first step is 6 months to a year of pre-surgical orthodontics to set up the jaw and teeth for the surgery. Next the surgery takes place with approximately 3 months of healing along with post-surgical orthodontics which is completed over 3 months to a year.
Is it painful?
Post surgical pain is significant but it is well controlled by strong pain medicines, however, pain medicine is rarely needed after 10 days.
How long do you have to take off from work or school etc?
Two weeks of free time is needed for post-surgical recovery. Some patients are able to return to semi-normal activities in only one week.
Does it ever relapse?
Yes. There is a chance that a type of arthritis in the joint can cause loss of bone that will change the bite. Carefully following post-operative instructions and regular follow-up is important.
What if it doesn’t turn out right?
If the planned surgical goals are not met then the patient may be taken back to surgery early in the post-operative period to improve the outcome. Our doctors and staff have the most advanced and modern imaging equipment and models to determine the patient’s needs prior to surgery so that the best results possible can be performed. Countless orthognathic patients have experienced exceptional results with their surgeries performed at Reynolds Oral & Facial Surgery.
What are the restrictions of my activities after surgery?
Each patient varies depending on the surgery that was performed, however, after six months prior to surgery, there are few restrictions and the bones will be fully mature at the two year mark. Typically with our patients, there are no restrictions after six months.
How much does it cost?
Depending on the complexity of the case, it can cost from $7,000.00 to $60,000.00 which includes all costs (hospital, surgical, hardware, and orthodontic). We try our best to give you an accurate estimate of all the costs (several of which are not under our control).
Does medical insurance cover it?
Depending on the case, medical insurance will sometimes cover costs of orthognathic surgery. We make exceptional efforts to help the patient retrieve insurance benefits.
What types of doctors perform cosmetic surgery?
There are many qualified doctors from various specialties that perform cosmetic surgery. Plastic Surgeons, Dermatologists, Oral and Maxillofacial Surgeons, Ear, Nose and Throat (ENT), Facial Plastic Surgeons, Ophthalmologists and other types of surgeons perform cosmetic procedures. Some specialties can mislead the public by indicating that their particular area of practice is the most qualified to perform cosmetic surgery. Again, all the specialties mentioned above have contributed significant advancements to the field of cosmetic surgery. There are excellent doctors all over the world in all the above specialized fields who have the experience and patient results to support their qualifications. Although any doctor can legally perform cosmetic facial surgery, it is not the degree that is the qualification. You would not let your pediatrician or psychiatrist perform a facelift even though they are a doctor. It is the training of the doctor. For instance, Dermatologists have added much progress to cosmetic surgery with the development of tumescent liposuction and lasers. Oral and maxillofacial surgeons pioneered and developed many head and neck cosmetic procedures as did ENT doctors. Ophthalmologists have defined the anatomy and techniques for many cosmetic eye procedures. To say that these doctors are not qualified is simply untrue. See the AAOMS’ document on Comparative Training of Surgical Specialties.
What is the difference between cosmetic and plastic surgery?
Essentially nothing. Cosmetic surgery is defined as surgery to correct defects especially of the face. Plastic surgery originally meant to deal with soft tissue but now the term encompasses many modalities including hard tissue surgeries. The term plastic surgery is defined as surgery concerned with the restoration, construction, reconstruction, or improvement in the shape and appearance of body structures that are missing, defective, damaged or misshapen.
Does an oral surgeon have the same training as a plastic surgeon?
In some areas yes. Oral and plastic surgeons are both trained in cosmetic facial surgery. They both do a year of General Surgery internship. In other areas the focus of training is different. The oral surgeon spends the vast majority of his training on the head and neck while the plastic surgeon only spends a small part of his training in that area.
What is BOTOX® Cosmetic?
BOTOX® is Botulinum Toxin in extremely small doses and very tightly controlled form.
How can I look younger?
Some of the signs of aging can be reversed by relatively simple procedures.
I always look tired. What can I do?
Usually a tired look is because of eyelid (see Blepharoplasty [eyelid surgery]) or brow problems (see Brow Lift) but can be due to general wrinkles (see Juvederm) or drooping of the facial tissues (see face lift procedures).
What are Chemical Peels?
Chemical peel is helpful for wrinkles, light acne scarring and irregular pigmentation such as freckles and age spots. Pre-cancerous conditions such as keratoses (thick, rough, reddish growths) also respond well to this procedure.
What areas can be treated through laser resurfacing?
The laser is used to reduce tiny wrinkles, acne scars and other minor skin imperfections, especially around the mouth and eyes. Laser Skin Resurfacing can improve sun-damaged and acne scarred skin problems that often cause concern to both men and women. It can also be used to treat scars from trauma.
What is Obagi?
Obagi® is a cosmeseutical line that is designed for aging and sundamaged skin.
What is Dermabrasion?
Facial Dermabrasion is the removal of imperfections of the skin, as acne and other scarring, by abrading the superficial layer with a diamond wheel or fraise instrument.