Examination & X-ray Questions

Q: Why do I need another x-ray at your office if my dentist recently took x-rays?

A:  We encourage you to have your dentist forward their x-rays to our office, but please remember a new x-ray in our office may still be necessary.  We often take a CT x-ray for our implant patients and a panoramic x-ray for our wisdom teeth and multi-extract patients.  Both a CT and panoramic x-ray are more complete and comprehensive x-rays for examination of the entire upper and lower jaw structures as well as the jaw joint structures, upper sinus cavities, and all related areas of the head and neck region.  X-rays from your family dentist such as bitewings and periapicals are for the teeth only and often do not show all of the related root or bone structures.  If your dentist has a panoramic x-ray taken within the last year that clearly shows everything we need to see, there will be no charge for another x-ray with our office.

QWhy do I need to schedule an examination when my dentist referred me to you? I don’t understand why there is a charge for a separate examination.  

A:  An examination appointment allows our doctors to complete a thorough exam and overall evaluation of your specific dental/surgical needs and  a treatment plan and approach (i.e. local anesthesia or general anesthesia) will be discussed and outlined in detail for you.  A complete medical history and oral examination will be provided.  Our surgical assistants will spend  additional time familiarizing you with preparation for surgery and your aftercare.  Finally, our financial coordinator will review the fees, insurance (if applicable) and your estimated out-of-pocket expenses.  This guarantees a better experience for longer procedures because of the preparation and education provided at this initial appointment. We feel the examination is a valuable tool for making your surgical experience a pleasant one.  

Q: Do I have to be referred by a dentist to schedule an appointment?

A: You are not required to have a referral from a dentist, however, it is recommended.  Your general dentist will often develop a treatment plan for you and will look to our office to complete various aspects of this plan.  If you are not established with a family dentist, we would be more than happy to see you for an initial evaluation and x-ray.  We would then assist you in finding a dentist you feel comfortable with. 

 Anesthesia Questions

Q: Can I be asleep for my surgery?

A: Yes, this may be an option.  Our doctors will review your medical history and discuss anesthesia options that will be best for you.  We offer local anesthesia, which numbs the area involved, but where you remain awake during the procedure; I.V. Sedation (often known as a “twilight sleep”) where you will be somewhat awake, but have little or no recollection of the procedure being performed; and General Anesthesia, where you are fully asleep.  You will always have the area numbed no matter which anesthesia you choose. 

Q: I take medications for certain conditions.  Does that mean I can’t be asleep for my surgery?  How do I take my medications if I am fasting before being put to sleep?

A: Taking medications does not mean that you cannot be put to sleep for your oral surgery procedure.  It means that there could be special instructions you will have to follow prior to your surgery.  Our doctors will discuss this with you at your consultation visit.  It is important that you make sure our office is aware of all prescription and over-the-counter medications and supplements that you are taking when we first see you, especially if you are on any type of blood thinners or chemotherapy, or are diabetic or have asthma.  Most medications will continue to be taken as per your normal routine with a tiny sip of water (enough to get your pills down).  There may also be incidences in which we will be in direct contact with your physician. 

Q: Can I have dinner the night before?  What about brushing my teeth in the morning?

A: Yes, you can have dinner the night before your surgery.  If you are being put to sleep for your procedure, you may not have anything to eat or drink after midnight prior to your surgery.  No liquid or food of any kind.  Basically, if it goes in your mouth – excluding prescribed medications – you cannot have it.  We encourage you to brush your teeth prior to your surgery, as your mouth should be clean, however you should refrain from swallowing any water or toothpaste. 

Q: Can I have alcohol before and after my surgery?

A: We strongly recommend that you do not consume any alcoholic beverages the night before your surgery.  Alcohol is dehydrating and can make it difficult to start your IV if you are being put to sleep for the procedure.  You should also refrain from alcohol while you are taking prescription pain medications.  Alcohol taken with prescription pain medications can cause adverse reactions.

Q: Why must I have an escort with me when I am put to sleep for my procedure?

A: Even though you will be able to walk out of our office on your own after your procedure, your reflexes and decision-making abilities will still be hindered due to the anesthesia.  Until the anesthetic medications are fully metabolized, you may become dizzy and/or nauseous. Under no circumstances should you drive a motor vehicle or make important decisions. Your escort will assist in your safe return home and aid in your care following your surgery.  We strongly recommend that you have someone with you throughout the day and night of your surgery to monitor you and assist you in taking your pain medication. 

Insurance Questions

Q: What insurance do you take?

A: We are contracted with a variety of insurance carriers; please contact our office to inquire about a specific carrier.  We also see patients that have an insurance policy that allows them to choose their own doctor; we are not HMO providers for any insurance company.  We file claims as a courtesy to our patients, however, we do look to you for payment if a claim has not been paid within 60 days of submission. 

Q: Do you accept Medicare?

A: No.  Edmonds Oral Surgery entered into an Opt-out Agreement with Medicare in July of 2004.  This means we are not providers for Medicare.  All patients who are Medicare recipients will be required to sign our Medicare contract informing them of our opt-out agreement.  This agreement simply states that EOS will not bill Medicare for any services performed and that the patient will also not bill Medicare either.  The majority of services performed in our office are considered dental in nature and are therefore not covered by Medicare anyway.

Q: Will my insurance company cover the cost for me to be put to sleep for my procedure?

A: Most insurance companies have specific guidelines regarding the use of general anesthesia.  Although we do our best to obtain these guidelines prior to your consultation appointment, we can make no guarantee of payment by your insurance carrier.  It is important to remember that verification of benefits is not a guarantee of payment.  You will be responsible for all costs incurred in our office whether covered by insurance or not. 

Q: Am I required to make a payment the day of surgery?

A: Yes.  We will provide you with your estimated portion due at the time of your consultation appointment.  Most carriers pay claims within 35 business days of receiving the claim.  If your insurance company takes more than 60 days to pay your claim, you will be sent a statement to pay the balance on your account.  If payment is eventually received from your insurance carrier, we will send you a refund.  In addition, if your insurance company pays more than anticipated, we will send you a refund within two weeks.  Conversely, if your insurance company pays less than anticipated (due to outstanding claims or non-covered services), we will send you a statement for this amount.    

Q:  I had a biopsy done and paid my estimated portion.  I just received a bill from the pathology lab.  Why?

A:  Biopsy specimens are sent to the University of Washington Pathology Lab for reading and diagnosis.  As discussed at your consultation appointment, charges for reading the pathology are separate from the surgical charges of our office and are billed directly to you from the University.  As a courtesy to you, we forward all insurance information to the University but we are not involved with any billing procedures from the lab.   

Post-operative Questions

Q: If I swell after surgery, how long will it last?

A: Unfortunately, swelling is a common part of surgery. Swelling of the mouth and face will generally reach a peak in the first two to three days, after which the swelling will gradually go down. Ice compacts to the face for the first two days aid in the reduction of swelling; switch to heat compresses after this.  Longer use of the ice compacts will only prolong the swelling, however, if this makes you feel better it is fine to use.   Sleeping with your head elevated will also help reduce the effects of swelling. 

Q: Will I have stitches in my mouth?

A: Not every patient has sutures, or stitches, placed after surgery.  This depends on your particular surgery.  If you do have sutures placed, our doctors usually place a dissolvable kind that will come out on their own.  If you have the type that must be removed by the doctor, this will be done at your post-operative follow-up appointment.

Q: What if I spit a stitch out a day or two after surgery?

A: Don’t be alarmed if this happens.  Occasionally the stitches will loosen and be lost prematurely; if there is no active bleeding there is no need to replace it.  Never hesitate to call our office if you have any questions or concerns. 

Q: Why do I have to return for a follow-up appointment?  I’m not in any pain.

A: Not all patients require follow-up visits; this depends on your surgery.  If an appointment has been made, the doctor wants to make sure that healing is proceeding in the right direction.  This is usually a quick visit.  There is also no charge for this, as it is included in the cost of your surgery.  

Q: What does a dry socket feel like?

A: After a tooth extraction, a blood clot forms at the extraction site. This clot protects the surgical site and helps facilitate healing.  In some patients, the clot is lost prematurely and exposes the socket; this is called a “dry” socket. A dry socket is typically characterized by the sudden onset of a dull achy pain, usually three to four days after an extraction, which cannot be relieved by pain medication. This unprotected socket begins to experience pain and collects food, which often results in a foul odor and/or bad taste in the mouth.  Symptoms vary from patient to patient, with some patients never realizing they have a dry socket. 

Q: What do I do for a dry socket?

A: Please call our office to arrange for a complimentary re-evaluation appointment.  Our doctors will evaluate the area, possibly rinsing the socket out.  The socket can be packed with a special medication to relieve your discomfort; it is important to remember that prescription medications will not take away the pain of a dry socket. Additional follow-up appointments will be necessary to ensure further uneventful healing.  

General Questions

Q: What should I wear for surgery?

A: We recommend that you wear loose, comfortable clothing; tight/restrictive clothing is discouraged.  If you wear something with long sleeves, be sure that the sleeves may be rolled up past your elbow (so that your IV may be started easily).  We also encourage you to wear flat, close-toed shoes.

Q: May I stay with my child/spouse during surgery?

A: OSHA safety regulations, in addition to staff and patient safety, do not permit bystanders during the surgical procedure.  Once the surgery is complete and the patient is in recovery, however, you will be able to sit with them prior to discharge. 

Q: I don’t feel well but I have already scheduled my surgery.  Should I cancel my appointment?

A: Please call our office to discuss your condition.  If you are running a fever, have a stuffy nose or productive cough, or are feeling nauseated, you should probably postpone your surgery.  We want you feeling your best, as this could impact your recovery.

Q: Can I drive myself home after surgery?

A: Patients who elect to have their surgery performed with local anesthesia only can drive themselves home.  Patients who are being put to sleep for their surgery must have a responsible adult accompany them to the office and who will then be able to drive the patient home afterwards. 

Q:  Can I use a taxi or bus as a means of transportation if I am being put to sleep?

A:  No.  You may not use a cab or bus unless you have a responsible person over the age of 18 riding with you.  This person may need to assist you as you may be a little unsteady on your feet.  Tri-County Cabulance is a medically approved cab you may use if needed.  They may be reached at (425)775-8358.