FREQUENTLY ASKED QUESTIONS
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. Lebsack 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.
What is an Oral & Maxillofacial Surgeon?
Oral and maxillofacial surgeons are dental specialists who treat conditions, defects, injuries, and esthetic aspects of the mouth, teeth, jaws, and face.
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 floss threader 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 imaging and may include taking impressions for models of your teeth. If you have already lost a significant amount of bone, additional imaging taken at another facility that specializes in this type of imaging may also be recommended. During the examination, Dr. Lebsack 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?
Thus, the time to complete this treatment plan is minimal. Your restorative dentist and/or oral surgeon will evaluate your options for immediate loading.
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. 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?
Home care is a little different for people who are missing all of their teeth. Special brushes and floss are often recommended. With over-dentures, it is necessary to clean the implant attachments, as well as the over-denture. Permanently fixed implant supported replacement teeth are cleaned like all other bridges.
How Long Do Implants Last?
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.
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?
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. Plans are only intended to cover the basics, there is an annual maximum allowable benefit of $1,000-$1,500 on most plans.
What Is the Cost of Implant Treatment?
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.
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?
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.
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 surgeon 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 Washington Oral & Maxillofacial 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.