Procedures

At Washington Oral & Maxillofacial Surgery, we offer a full scope of oral maxillofacial procedures. Dr. Jon Lebsack’s surgical expertise and thorough understanding of both aesthetics and function uniquely qualify him to diagnose, treat and manage the conditions, defects, injuries, and aesthetic aspects of the mouth, teeth, jaws, and face. Oral maxillofacial procedures include dentoalveolar surgery, wisdom tooth removal, dental implant, bone grafting, diagnosing and treat facial pain, and facial injuries.

Find out more about a procedure you may need. If you don’t see the specific procedure you need, contact our office today (636) 239-7150. Renee Hodge, Office Manager, will be happy to tell you about the other services we offer.

Dental Implants

What Are Dental Implants?

A natural tooth consists of a root and a crown. If you compare natural teeth to implant-supported replacement teeth, you’ll see they have the same basic parts. Both have a crown (the visible part used to chew food). Both have a root that holds the tooth securely under the gum anchored into the jaw.

The difference is that the implant is made of titanium – the same time-tested material used by surgeons for artificial joints. When you lose a tooth, you lose both the root and the crown. To replace the tooth, the surgeon first replaces the root with a dental implant.

Time is allowed for bone to heal and grow around the dental implant. The bone bonds with the titanium, creating a strong foundation for artificial teeth. A support post (abutment) is then placed on the implant and a new replacement tooth (crown) is placed on top of the abutment.

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In some cases, a temporary replacement tooth can be attached to the implant immediately after it is placed. If all of your teeth are missing, a variety of treatment options are available to support the replacement teeth.

Missing teeth over a period of time can cause your jaw bone to atrophy, or resorb. This often results in poor quality and quantity of bone suitable for the placement of dental implants as well as long term shifting of remaining teeth and changes to facial structure. Most patients, in these situations, are not candidates for dental implants.

Fortunately, today we have the ability to grow bone where it is needed. This not only gives us the opportunity to place implants of proper length and width, but it also gives us a chance to restore functionality and aesthetic appearance.

Dentoalveolar Surgery

Dentoalveolar surgery includes teeth extractions, bone contouring, exposure of teeth for orthodontic purposes, and denture preparation(pre-prosthetic surgery). This treatment can be done under local anesthesia (numbing medicine), conscious sedation or general anesthesia. Recent x-rays from your dentist may be used, or a panoramic x-ray may be indicated to identify vital structures in the area of the surgery.

Depending on the nature of the procedure and level of post-operative discomfort will dictate when the patient resumes normal activity. Post-operative pain medicine and antibiotics (if indicated) will be prescribed after treatment is complete. Post-operative instructions will be provided as a guideline to your home recovery.

The Extraction Process

At the time of extraction, the doctor will need to numb your tooth, jawbone, and gums that surround the area with a local anesthetic.

During the extraction process, you will feel a lot of pressure. This is from the process of firmly rocking the tooth in order to widen the socket for removal.

You feel the pressure without pain as the anesthetic has numbed the nerves stopping the transference of pain, yet the nerves that transmit pressure are not profoundly affected.

If you do feel pain at any time during the extraction please let us know right away.

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Oral Biopsy

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The inside of the mouth is normally lined with a special type of skin (mucosa) that is smooth and coral pink in color. Any alteration in this appearance could be a warning sign for a pathological process. The most serious of these is oral cancer. The following can be signs at the beginning of a pathological process or cancerous growth:

  • Reddish patches (erythroplasia) or whitish patches (leukoplakia) in the mouth
  • A sore that fails to heal and bleeds easily
  • A lump or thickening on the skin lining the inside of the mouth
  • Chronic sore throat or hoarseness and/or difficulty in chewing or swallowing

These changes can be detected on the lips, cheeks, palate, and gum tissue around the teeth, tongue, face, and/or neck. Pain does not always occur with pathology, and curiously, is not often associated with oral cancer. However, any patient with facial and/or oral pain without an obvious cause or reason may also be at risk for oral cancer.

Remember that your mouth is one of your body’s most important warning systems. Do not ignore suspicious lumps or sores. Please contact us so we can assist you with any questions or concerns.

Patient Information

Information

Would you like to know what to expect before your initial appointment? Find out with all of our information and instructions below.

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Get a head start for your appointment, fill out our patient forms online and save time before your appointment.

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OUR PRACTICE PHILOSOPHY

“Patient safety is our first priority. We provide oral and maxillofacial surgery procedures with attention to detail that yields long-lasting results and improves the quality of our patients’ lives.”

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POST-OPERATIVE INSTRUCTIONS

PLEASE READ THESE INSTRUCTIONS CAREFULLY

Oral surgery involves not only the removal of teeth. There are incisions often accompanied with bone removal and placement of sutures. After having surgery, it is important to realize that a time of recovery is to be expected. The first day of surgery is usually the most uncomfortable. You may experience nausea, swelling, or stiffness. If multiple extractions were done, one side may be worse than the other.

The second day will most likely be for more comfortable and although still swollen, you can usually begin a more substantial diet.

From the third day on you should expect to see gradual, steady improvement for the remainder of your postoperative recovery. If you do not see steady improvement, call the office and report symptoms so you can be seen as soon as possible. Common sense will often dictate what you should do. However, when in doubt, follow these guidelines or call our office anytime for clarification.

First Hour

  • Bite down firmly on the gauze pocks that have been placed over the surgical area, making sure they remain in place.
  • Change them at 30-minute intervals keeping pressure on the packing.
  • If active bleeding persists after one hour, place enough new gauze to obtain pressure over the surgical site for another 30-60 minutes.
  • The gauze may be changed as necessary and may be dampened and/or fluffed for more comfortable positioning.
  • The gauze may be removed when there is minimal oozing and should not be left in overnight.

Exercise Care

  • Do not disturb the surgical area today.
  • Do not rinse vigorously or probe the area with any object or your finger.
  • Abstain from anything forceful (examples: spitting or sucking through a straw) that may dislodge the blood clot in the extraction site.
  • SMOKERS: DO NOT smoke for at least 48 hours. Smoking is very detrimental to healing and may make your recovery time longer more painful.

Bleeding

  • Intermittent bleeding or oozing is normal, and drainage from the surgical site is to be expected during the healing process.
  • Bleeding should never be severe. It usually means that the pocks are being clenched between your teeth rather than exerting pressure on the surgical areas.
  • Try repositioning fresh pocks directly over the surgical site and apply pressure for 30-60 minutes. If bleeding remains uncontrolled, please call our office.

Swelling

  • Often there is some swelling associated with oral surgery.
  • You can minimize this by using a cold pack or ice bag wrapped in a towel and applied firmly to face or cheek adjacent to the surgical area.
  • This should be applied 20 minutes on and 20 minutes off during the first 12 to 48 hours after surgery.
  • You can expect swelling to be of a maximum 48 hours after surgery.
  • Thereafter, each day should show steady gradual improvement.

Instructions for the Second & Third Days After Surgery

Mouth Rinses

Keeping your mouth clean after surgery is essential. Use one capful of hydrogen peroxide in on eight-ounce glass of warm water and gently rinse with portions of the solution. Repeat as often as you like, but at least 2 or 3 times daily for the next five days.

 

Brushing

Begin your normal oral hygiene routine as soon as possible after surgery along with brushing over the gum areas of extraction sites. Soreness and swelling may not permit vigorous brushing. Some bleeding may be evident during brushing. This is normal. Do not allow this to interfere with appropriate hygiene.

 

Hot Applications

You may apply warm compresses to the skin overlying areas of stiffness and discomfort. Hot water bottles, moist hot towels, or heating pods for 20 minutes on and 20 minutes off will help soothe those tender areas. This will not reduce swelling.

Pain Management

Nausea is not an uncommon event after surgery. It is sometimes caused by stronger pain medicines. Nausea may be reduced by preceding each pill with food, then taking the pill with a large volume of water. If nausea occurs, try to keep taking clear fluids and minimize the pain medication. Change to on over the counter pain analgesic until nausea is under control. Call us if you do not feel better or if repeated vomiting is a problem.

 

Nausea

Nausea is not an uncommon event after surgery. It is sometimes caused by stronger pain medicines. Nausea may be reduced by preceding each pill with food, then taking the pill with a large volume of water. If nausea occurs, try to keep taking clear fluids and minimize the pain medication. Change to on over the counter pain analgesic until nausea is under control. Call us if you do not feel better or if repeated vomiting is a problem.

 

Diet

Eat any nourishing food that can be taken with comfort. It is important not to skip meals! If you take nourishment regularly, you will feel better, gain strength, have less discomfort and heal faster.

 

The temperature of the food doesn’t matter, but avoid extremely hot foods. Some suggestions include creamed soups, puddings, yogurt, milkshakes, oatmeal, cottage cheese, applesauce, scrambled eggs, pastas, etc.

 

Avoid foods like nuts, sunflower ·seeds, popcorn, etc. that may get lodged in the socket areas. II you are diabetic, maintain your normal eating habits as much as possible and follow instructions from Dr. Lebsack or your physician regarding your insulin schedule.

 

Sharp Edges

If you feel sharp edges in the surgical areas with your tongue it is probably the bony walls which originally supported the teeth. Occasionally, small slivers of bone may work themselves out during the first week or two after surgery. They are not pieces of tooth and if necessary we will remove them. Please call the office if you are concerned.

Several methods of anesthesia are available. The method of anesthesia that is chosen for or by a patient depends upon the nature of the surgical procedure and the patient’s level of apprehension. The following table illustrates the choices of anesthesia, a description of the anesthetic technique, and the usual indications for that technique.

  • Local Anesthetic: The patient remains totally conscious throughout the procedure. A local anesthetic (e.g. lidocaine) is administered in the area where the surgery is to be performed. Local anesthetic is used in conjunction with the other methods of anesthesia in all oral surgery procedures.
  • Nitrous Oxide Sedation with Local Anesthetic: A mixture of nitrous oxide (laughing gas) and oxygen is administered through a nasal breathing apparatus. The patient remains conscious in a relaxed condition. Nitrous oxide has a sedative and analgesic (pain-controlling) effect.
  • Intravenous Sedation: Monitored anesthesia care or “twilight sleep”, is a type of anesthesia that relaxes a patient through an IV placed in a vein.