4175 N Hanson Ct, Ste #200, Bowie, MD 20716 301-383-9883

Oral surgeon bowie, MD

The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and swelling as well as the risk of infection and other unwarranted outcomes can be minimized if the instructions are followed carefully.

IMMEDIATELY FOLLOWING SURGERY

  • The gauze pad placed under pressure over the surgical areas should be kept in place for a 30- 60 minutes. During this time talking should be minimized. After the recommended time, the gauze pad should be removed and discarded.
  • Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
  • Take the prescribed pain medications preemptively, ideally you should attempt to take the first dose with some food within 1 hr of leaving the office. This allows the medication adequate time to become effective prior to the wearing off of the local anesthetic.
  • Restrict your activities the day of and 24 hrs following surgery. You may resume normal activity when you feel comfortable.
  • Place ice packs to the sides (outside) of your face where surgery was performed. Refer to the section on Swelling for an explanation.

BLEEDING

A certain amount of bleeding is to be expected and anticipated following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first gently wiping any old clots from your mouth, then placing a moistened gauze pad over the area and biting firmly for 30 minutes. Repeat if necessary. If bleeding persists, bite on a moistened tea bag for 30 minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. 

To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call our office immediately for further instructions. Avoid the use of straws for 2 – 3 days after surgery.

SWELLING

The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and is to be expected. The swelling will not become apparent until the day following surgery and will not reach its maximum until two to three days after surgery. However, the swelling may be minimized by the immediate use of ice packs following surgery. 

Ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake for the first 24 hours following surgery. After 24 hours, ice has little beneficial effect at this point you may switch to using a warm compress or warm wet rag against the face to further minimize swelling. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm, it is common for swelling to last up to 5 days following surgery. 

This is a normal reaction to surgery. However, please call us at 301-383-9883 if persistent swelling is associated with fever, severe pain or purulent discharge from the surgical wounds.

PAIN

Take your pain medications as directed. Some prescription pain medicines can cause drowsiness and slow your reflexes. For this reason, you should not drive a car or operate heavy machinery while you are taking these medications. You should also avoid combining alcoholic beverages with these medicines.

The pain medicine given to you by the doctor can be supplemented with over-the-counter medicines. Tylenol can be taken as directed by the instructions on the bottle. Up to four 200mg tablets of ibuprofen (Motrin, Advil) can be taken at one time as needed for pain, but should be taken (6) six hours apart.

Please be aware that the prescription given to you by your doctor may already contain Tylenol or ibuprofen. Taking additional medicine could cause an overdose. If there are any questions about your medications please call our office at (301) 383-9883.

Do not take any of the above medications if you have an allergy or have been instructed by your oral surgeon or your physician not to take it. If your pain medicine does not seem to be working please call the office. Pain or discomfort from the surgery should subside gradually however pain will normally peak at 48hrs – 72hrs after surgery. If severe pain persists beyond 72 hrs, it may require attention and you should notify our office immediately.

DIET

Soft non-chew foods and liquids are recommended after most oral surgical procedures. Do not use straws for up to 3 days following surgery. The sucking forces can cause more bleeding by dislodging the blood clot or potentially lead to a dry socket. You may eat anything soft by chewing away from the surgical site(s). High calorie, high protein intake is very important for a speedy recovery. Try to maintain as close to normal a caloric intake as possible. 

You should prevent dehydration by drinking fluids regularly. Your food intake will be limited for the first few days due to discomfort and lack of appetite. You should compensate for this by increasing your fluid intake. At least five to six glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat regularly.

CAUTION: If you suddenly sit up or stand from a lying position, you may become dizzy. If you are lying down following surgery, make sure you sit for 30 seconds to one minute before standing.

KEEP THE MOUTH CLEAN

No rinsing or brushing of any kind should be performed until the day following surgery. The day after surgery you should begin rinsing gently at least 3 times a day with a cup of warm water mixed with a teaspoon of salt especially after eating. You should also begin brushing gently with a soft bristle brush, taking care to avoid contact with the surgical sites.

DISCOLORATION

In some cases, discoloration of the skin of the face follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal postoperative occurrence, which may occur two to three days after surgery and resolves over the next few days. Moist heat applied to the area may s peed up resolution of the discoloration.

ANTIBIOTICS

Antibiotics are not always required following surgery but rather they are prescribed only when deemed necessary by your doctor to treat or prevent infection. If you have been placed on antibiotics, take the tablets or liquid as directed to completion. Discontinue antibiotic use in the event of a rash or other unfavorable reaction and call the office immediately.

NAUSEA & VOMITING

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including prescribed medications. You should then sip on coke, tea, or ginger ale. You should sip slowly over a 15-minute period. When the nausea subsides, you can begin taking solid foods and the prescribed medicines. In the rare event that nausea/vomiting persists, call our office immediately.

OTHER COMPLICATIONS

  • If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful. Call the office if you have any questions.
  • A slight elevation of temperature immediately following surgery is not uncommon. If the elevated temperature persists longer than 48 hrs, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
  • You should be careful going from the lying down position to standing as you may feel light headed/dizzy. Before standing up, you should sit up for 30 secs to one minute.
  • Occasionally, patients may feel hard or sharp projections in the mouth with their tongue. They are usually not tooth or remnants of teeth; they are the usually the bony walls that supported the extracted tooth. These projections usually smooth out spontaneously as healing occurs. If they cause severe discomfort or ulceration they can be surgically removed by the doctor.
  • If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline.
  • Sore throats and pain when swallowing are not uncommon as the muscles may become swollen. The normal act of swallowing can then become painful. This will usually subside in two to three days.
  • Stiffness (trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event that will resolve with time. You should perform jaw stretching exercises as well as apply heat to the face to help improve symptoms of stiffness in the jaw muscles.

FINALLY

  • Sutures are sometimes placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures will normally dissolve 7- 10 days after surgery unless otherwise specified by the doctor.
  • The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur, call the office for instructions.
  • There will be a cavity or hole where the tooth was removed. The cavity will gradually fill in with new tissue over the next month. In the meantime, the area should be kept clean especially after meals with salt-water rinses or medicated mouth rinse which is sometimes prescribed.
  • If you are given sinus precaution instructions please adhere strictly to them.
  • Your case is individual. No two mouths are alike. Do not accept well-intended advice from friends. Discuss your problem with the persons best able to effectively help you: your oral surgeon and staff.
  • Brushing your teeth is okay beginning the day after surgery just be gentle at the surgical sites.
  • A dry socket is when the blood clot gets dislodged prematurely from the extraction socket. A dry socket manifests as symptoms of severe, exacerbating pain at the surgical site and even pain radiating to the ear may occur usually starting three days following surgery. Call the office if this occurs.
  • If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you or in some cases induce bleeding at the surgical sites. If you feel light headed, stop exercising.

In any case, you should avoid strenuous activities for two (2) days following surgery.

SMOKING

Smoking not only disturbs and delays the normal wound healing but it also increases risk of excessive post surgical bleeding as well as infection hence should be avoided for 3-4 days after surgery.

Oral Surgeon Bowie, MD

Impacted Wisdom Teeth Bowie, MD

What Are Wisdom Teeth?

Third molars are commonly referred to as wisdom teeth. They are usually the last teeth to develop and are located in the back of your mouth, behind your second molars. Their development is usually completed between the middle teenage years and early twenties, a time traditionally associated with the onset of maturity and the attainment of wisdom.

What is an Impacted Tooth?

Although most people develop and grow 32 permanent adult teeth, many times their jaws are too small to accommodate the four wisdom teeth. When inadequate space prevents the teeth from erupting they are called impacted. This indicates their inability to erupt into the proper position for chewing and cleaning.

Types of Impactions

We will need to see you for a consultation to determine if you will benefit from wisdom tooth removal. A special x-ray of your mouth and jaws (panorex) will be taken to determine if your wisdom teeth are impacted, if there is room for them to erupt, and how difficult it will be to have them removed.

  • Soft Tissue Impaction: There is not enough room to allow the gum tissue to retract for adequate cleaning of the tooth.
  • Partial Bony Impaction: There is enough space to allow the wisdom tooth to partially erupt. However, the tooth cannot function properly in the chewing process, and creates cleaning problems, among others.
  • Complete Bony Impaction: There is NO space for the tooth to erupt, usually because the jaw is too small or the teeth are toot large in size. It remains embedded in the jaw bone or if even partially visible requires complex surgical techniques for removal. The impacted wisdom tooth may also be in an unusual position and difficult to remove.

Oral Surgeon Bowie, MD

  • With an oral examination and x-rays of the mouth, Dr. Egolum can evaluate the position of the wisdom teeth and predict if there are present or future potential problems. Studies have shown that early evaluation and treatment result in a superior outcome for the patient. Patients are generally first evaluated in the mid-teenage years by their dentist, orthodontist, or by an oral surgeon.
  • All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. Our doctors are trained, licensed, and highly experienced in providing various types of anesthesia for patients.
  • To schedule a consultation for your wisdom teeth evaluation please call our office.

WHY SHOULD I HAVE MY WISDOM TEETH REMOVED?

Not all wisdom teeth require removal. If you do not have enough room in your mouth for your third molars (wisdom teeth) to fully erupt, a number of problems can occur. Impacted wisdom teeth should be removed before their root structure is fully developed. In some patients it is as early as age 12 or 13, and in others it may not be until the early twenties. Problems tend to occur with increasing frequency after the age of 30. Some of the possible problems related to not removing your wisdom teeth include:

Infection:

● The most frequent clinical problem we see is pericoronitis, (a localized gum infection). Without enough room for total eruption, the gum tissue around the wisdom tooth can become irritated and infected, resulting in recurrent pain, swelling, and problems with chewing and/or swallowing.

Cyst Formation:

● Non-infectious diseases may also arise in association with an impacted wisdom tooth. Cysts are fluid-filled “balloons” inside the jawbone that develop as a result of impacted teeth and slowly expand destroying adjacent jawbone and occasionally teeth. They can be very difficult to treat if your wisdom teeth are not removed in your teenage years. Although rare, tumors can be associated with the delayed removal of wisdom teeth.

Possible Crowding:

● Impacted wisdom teeth may contribute to crowding of your teeth. This is most noticeable with the front teeth, primarily the lower front teeth and is most commonly seen after a patient has had braces. There are a number of factors that cause teeth to crowd after braces or in early adulthood. Retained, impacted wisdom teeth may be a contributing factor. Unless you have an active problem when you see the oral surgeon, the reason for removal is primarily to prevent long-term damage to your teeth, gums and jawbone.

Damage to Adjacent Teeth:

● If there is inadequate room to clean around the wisdom tooth, the tooth directly in front, the second molar, can be adversely affected resulting in gum disease, bone loss around the tooth, and/or decay.

WHAT IF I DON’T HAVE MY WISDOM TEETH REMOVED AS A TEENAGER OR YOUNG ADULT?

As wisdom teeth develop, the roots become longer and the jawbone more dense.When it is necessary to remove impacted wisdom teeth in your thirties, forties or beyond, the post-operative course can be prolonged and there is a higher complication rate. Treating these complications is often more difficult and less predictable than with a younger patient. Healing may be slower and the chance of infection can be increased. If your impacted wisdom teeth are not removed in your teenage years or early in your twenties and they are completely impacted in bone, it may be advisable to not have them removed unless a localized problem (such as cyst formation or localized gum disease and bone loss) develops due to high risk of complications at this point. In general, you will heal faster, more predictably and have fewer complications if treated in your teens or early twenties.

WHAT HAPPENS ON THE DAY WISDOM TEETH ARE REMOVED?

Most people prefer to be unaware of the experience when they have their wisdom teeth removed and usually decide to be sedated. You will be provided with appropriate anesthesia options at your consultation. All outpatient surgery is performed under appropriate anesthesia to maximize your comfort. Our office staff has the training, licensing, and experience to provide the various types of anesthesia. These services are provided in an environment of optimum safety, utilizing modern monitoring equipment and a well trained experienced staff. The Surgical Care Team, the office facilities, and the doctors are inspected on behalf of the Board of Dental Examiners on a regular basis.

On the day of your procedure, you will take medications to help minimize post-operative pain and swelling. We ask that a parent (for those under the age of 18) or responsible adult accompanies you to the office and plans to stay with you the rest of the day. The procedure will take about 30 to 45 minutes and you will probably be in the office for 1 hour. Recent advances in medicine and technology allow patients to undergo wisdom tooth removal in a manner, which promotes rapid healing and minimal post-operative discomfort. State of the art sterilization and infection control techniques are used at all times in our office.

On the morning or afternoon of your surgery, it is essential that you have nothing to eat or drink (excluding prescription medications with a sip of water) for at least 8 hours. This does not mean you should try to fit in one “last meal” exactly eight hours before your surgery. Having anything in your stomach can increase the risk for serious anesthetic complications, including nausea and vomiting. Your procedure will be rescheduled if you have not heeded these guidelines. We may provide you with a prescription for pain medication at your consultation appointment, which for your convenience, can be filled in advance. When you are seated in the surgical room, we will make every effort to make you as comfortable as possible. If you are going to be sedated, we usually will place an IV in your right or left arm. This is a quick and nearly painless procedure that ensures optimal delivery of your medication. Local anesthesia is given to you afterwards to ensure comfort, and allow adequate time to travel home and rest. You will be sleepy for a significant portion of the day.

The Day of Treatment

Be sure to have an adult with you at the time of surgery. Make plans to have a parent or responsible adult stay with you for the rest of the day, following wisdom tooth removal.

If your surgery requires stitches, these are usually the type that dissolve in 5 to 10 days and do not require removal. You may also notice a sensation of your gums feeling swollen and pulling away from your teeth. This is all part of the normal recovery, and will subside in several days.

Once the local anesthesia wears off, you may require prescription pain medication. Please try non-narcotic anti-inflammatory medications such as ibuprofen (Advil®) first, to see if that adequately treats your pain. If not, begin your other prescription pain medication. The local anesthesia may last until the following day, and should not be confused with an injury to your nerve. We recommend starting your post-operative diet with clear liquids such as jello and broths, gradually increasing in substance as your body permits.

We do not recommend using dairy products such as yogurt, ice cream or milkshakes on the day of surgery, as nausea and vomiting may develop in conjunction with the anesthetic and pain medication. If you are given antibiotics and you take birth control pills, please be aware that the birth control pills might become ineffective and take appropriate precautions.

WHAT DOES WISDOM TOOTH REMOVAL COST AND IS IT COVERED BY INSURANCE?

The fee for your treatment is determined by a number of factors. These may include the difficulty involved in removing your teeth and which type of anesthesia is best for you. During your consultation appointment, the surgeon will need to review your x-rays, complete an examination and determine the best option for anesthesia, before an accurate estimate can be provided. Every insurance company has a different policy regarding the extent of coverage for a given surgical procedure. Our office staff will assist you in obtaining the maximum insurance coverage for your treatment.

WHAT IF I HAVE QUESTIONS BEFORE SURGERY?

At the time of your consultation, your specific situation will be discussed in greater detail. We encourage you to ask any questions you may have at this time. If new questions arise after your consultation, please call our office to speak to one of our patient care coordinators.

The Day of Treatment

Please do not eat or drink anything prior to your surgery. Having anything in your stomach can increase the risk for serious anesthetic complications.

Wisdom Teeth Removal by Oral Surgeon Bowie, MD

  • With an oral examination and x-rays of the mouth, Dr. Egolum can evaluate the position of the wisdom teeth and predict if there are present or future potential problems. Studies have shown that early evaluation and treatment result in a superior outcome for the patient. Patients are generally first evaluated in the mid-teenage years by their dentist, orthodontist, or by an oral surgeon.
  • All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. Our doctors are trained, licensed, and highly experienced in providing various types of anesthesia for patients.
  • To schedule a consultation for your wisdom teeth evaluation please call our office.

Why Should I Have My Wisdom Teeth be Removed?

Not all wisdom teeth require removal. If you do not have enough room in your mouth for your third molars (wisdom teeth) to fully erupt, a number of problems can occur. Impacted wisdom teeth should be removed before their root structure is fully developed. In some patients it is as early as age 12 or 13, and in others it may not be until the early twenties. Problems tend to occur with increasing frequency after the age of 30. Some of the possible problems related to not removing your wisdom teeth include:

Infection:
The most frequent clinical problem we see is pericoronitis, (a localized gum infection). Without enough room for total eruption, the gum tissue around the wisdom tooth can become irritated and infected, resulting in recurrent pain, swelling, and problems with chewing and/or swallowing.

Cyst Formation:
Non-infectious diseases may also arise in association with an impacted wisdom tooth. Cysts are fluid-filled “balloons” inside the jawbone that develop as a result of impacted teeth and slowly expand destroying adjacent jawbone and occasionally teeth. They can be very difficult to treat if your wisdom teeth are not removed in your teenage years. Although rare, tumors can be associated with the delayed removal of wisdom teeth.

Possible Crowding:
Impacted wisdom teeth may contribute to crowding of your teeth. This is most noticeable with the front teeth, primarily the lower front teeth and is most commonly seen after a patient has had braces. There are a number of factors that cause teeth to crowd after braces or in early adulthood. Retained, impacted wisdom teeth may be a contributing factor. Unless you have an active problem when you see the oral surgeon, the reason for removal is primarily to prevent long-term damage to your teeth, gums and jawbone.

Damage to Adjacent Teeth:
If there is inadequate room to clean around the wisdom tooth, the tooth directly in front, the second molar, can be adversely affected resulting in gum disease, bone loss around the tooth, and/or decay.

What If I Don’t Have My Wisdom Teeth Removed as a Teenager Or Young Adult? 

As wisdom teeth develop, the roots become longer and the jawbone more dense.When it is necessary to remove impacted wisdom teeth in your thirties, forties or beyond, the post-operative course can be prolonged and there is a higher complication rate. Treating these complications is often more difficult and less predictable than with a younger patient. Healing may be slower and the chance of infection can be increased. If your impacted wisdom teeth are not removed in your teenage years or early in your twenties and they are completely impacted in bone, it may be advisable to not have them removed unless a localized problem (such as cyst formation or localized gum disease and bone loss) develops due to high risk of complications at this point. In general, you will heal faster, more predictably and have fewer complications if treated in your teens or early twenties.

What Happens on the Day Wisdom Teeth are Removed?

Most people prefer to be unaware of the experience when they have their wisdom teeth removed and usually decide to be sedated. You will be provided with appropriate anesthesia options at your consultation. All outpatient surgery is performed under appropriate anesthesia to maximize your comfort. Our office staff has the training, licensing, and experience to provide the various types of anesthesia. These services are provided in an environment of optimum safety, utilizing modern monitoring equipment and a well trained experienced staff. The Surgical Care Team, the office facilities, and the doctors are inspected on behalf of the Board of Dental Examiners on a regular basis.

On the day of your procedure, you will take medications to help minimize post-operative pain and swelling. We ask that a parent (for those under the age of 18) or responsible adult accompanies you to the office and plans to stay with you the rest of the day. The procedure will take about 30 to 45 minutes and you will probably be in the office for 1 hour. Recent advances in medicine and technology allow patients to undergo wisdom tooth removal in a manner, which promotes rapid healing and minimal post-operative discomfort. State of the art sterilization and infection control techniques are used at all times in our office.

On the morning or afternoon of your surgery, it is essential that you have nothing to eat or drink (excluding prescription medications with a sip of water) for at least 8 hours. This does not mean you should try to fit in one “last meal” exactly eight hours before your surgery. Having anything in your stomach can increase the risk for serious anesthetic complications, including nausea and vomiting. Your procedure will be rescheduled if you have not heeded these guidelines. We may provide you with a prescription for pain medication at your consultation appointment, which for your convenience, can be filled in advance. When you are seated in the surgical room, we will make every effort to make you as comfortable as possible. If you are going to be sedated, we usually will place an IV in your right or left arm. This is a quick and nearly painless procedure that ensures optimal delivery of your medication. Local anesthesia is given to you afterwards to ensure comfort, and allow adequate time to travel home and rest. You will be sleepy for a significant portion of the day.

The Day of Treatment

Be sure to have an adult with you at the time of surgery. Make plans to have a parent or responsible adult stay with you for the rest of the day, following wisdom tooth removal.

If your surgery requires stitches, these are usually the type that dissolve in 5 to 10 days and do not require removal. You may also notice a sensation of your gums feeling swollen and pulling away from your teeth. This is all part of the normal recovery, and will subside in several days. Once the local anesthesia wears off, you may require prescription pain medication. Please try non-narcotic anti-inflammatory medications such as ibuprofen (Advil®) first, to see if that adequately treats your pain. If not, begin your other prescription pain medication. The local anesthesia may last until the following day, and should not be confused with an injury to your nerve. We recommend starting your post-operative diet with clear liquids such as jello and broths, gradually increasing in substance as your body permits.

We do not recommend using dairy products such as yogurt, ice cream or milkshakes on the day of surgery, as nausea and vomiting may develop in conjunction with the anesthetic and pain medication. If you are given antibiotics and you take birth control pills, please be aware that the birth control pills might become ineffective and take appropriate precautions.

What Does Wisdom Tooth Removal Cost and is it Covered by Insurance?

The fee for your treatment is determined by a number of factors. These may include the difficulty involved in removing your teeth and which type of anesthesia is best for you. During your consultation appointment, the surgeon will need to review your x-rays, complete an examination and determine the best option for anesthesia, before an accurate estimate can be provided. Every insurance company has a different policy regarding the extent of coverage for a given surgical procedure. Our office staff will assist you in obtaining the maximum insurance coverage for your treatment.

What If I Have Questions Before Surgery?

At the time of your consultation, your specific situation will be discussed in greater detail. We encourage you to ask any questions you may have at this time. If new questions arise after your consultation, please call our office to speak to one of our patient care coordinators.

The Day of Treatment
Please do not eat or drink anything prior to your surgery. Having anything in your stomach can increase the risk for serious anesthetic complications.

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