FAQ

Below are some of the most frequently asked questions that our patients have about dentistry and oral health issues. If you have any other questions, please feel free to contact us. Click on a question below to see the answer.

Click on a question below to see the answer.

What does maxillofacial mean?

Maxillofacial refers to the face and jaws, which along with the mouth comprise the areas of expertise of an oral and maxillofacial surgeon.

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What is oral surgery?

Oral and maxillofacial surgery is the specialty of dental practice that deals with the diagnosis and surgical treatment of diseases, injuries and defects of the mouth, jaws, face and related structures. This includes the removal of impacted and decayed teeth, placement of dental implants, biopsy and removal of cysts and tumors of the mouth and jaws, treatment of facial trauma and reconstructive jaw surgery.

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What does it mean to be Board Certified in Oral and Maxillofacial Surgery?

Dr Sullivan is a Board Certified Oral Surgeon. This means that he graduated from an accredited dental school and completed an oral and maxillofacial surgery residency program approved by the American Dental Association Commission in Dental Accreditation. This requires thirteen years of post-high school education and training. The American Board of Oral and Maxillofacial Surgery is recognized by the American Dental Association as the specialty board for oral and maxillofacial surgery. The board is responsible for reviewing all applicants for board certification, as well as administering the examination involved in the certification process. One must pass both a thorough written qualifying examination and a rigorous oral certifying examination to become board certified as a Diplomate of the American Board of Oral and Maxillofacial Surgery. Diplomates are encouraged to maintain current competence by ongoing continuing education.

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Do I need a referral from a dentist to schedule an appointment?

In most instances, a referral from a general dentist or physician is required for care at Warren Oral & Maxillofacial Surgery Center.

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Do I need to have X-rays taken?

X-rays are necessary for any problems involving the teeth or bones. If your dentist does not have current X-rays to forward to us with the referral, we can take the films at our office.

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What is digital radiography?

Oral Surgery Care is now utilizing digital radiography, which is an outgrowth of the space industry that reduces radiation to the patient by approximately 50% from conventional radiography. In addition to reduced radiation, digital radiography eliminates the environmentally hazardous waste products typically produced by radiograph processing, such as developer, fixer, film and processor cleaning agents.
In digital radiography, a sensor connected to a computer is used instead of film. This sensor needs approximately 50% less radiation to be properly exposed than does conventional x-ray film, and the image is available immediately on a computer monitor, instead of waiting for film processing. Dr’s Sullivan and Maguire can enlarge, zoom and colorize the image so that a problem is much easier to both diagnose and to illustrate to you. The images are stored electronically and can instantly be copied or sent by e-mail to an insurance company or to your dentist or another specialist for a second opinion.
We feel that this digital technology provides substantial benefits to both you and our staff as well as being more environmentally friendly. Time that used to be wasted in the dark room by our staff can now be spent with you, discussing your care and answering your questions.

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What should I know about general anesthesia?

This applies to General Anesthesia, Sleep Sedation (IV Sedation).

Restrictions

  • You may not have anything to eat or drink (including water) for eight (8) hours prior to the appointment.
  • A responsible adult must accompany the patient to the office and drive the patient home.
  • The patient should not drive a vehicle or operate any machinery for 24 hours following general anesthesia (sleep sedation).
  • Please wear loose fitting clothing with sleeves which can be rolled up past the elbow, and low-heeled shoes do not wear white clothing.
  • Contact lenses, jewelry, and dentures must be removed at the time of surgery.
  • Do not wear lipstick, excessive makeup, or nail polish on the day of surgery.
  • If you have an illness such as a cold, sore throat, stomach or bowel upset, please notify the office.
  • If you take routine oral medications, please check with the surgeon prior to your surgical date for instructions

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May I sleep through the surgical procedure?

Yes, our doctors are trained in anesthesia techniques and are licensed by the state of New Jersey to provide a variety of anesthetic techniques.

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Do I need someone to drive me home after surgery?

If our doctor has scheduled you to be sedated, you will need someone to drive you home. Patients receiving local anesthetic can drive home themselves.

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Can I eat before I come in for surgery?

If our doctor has scheduled you to be sedated for your procedure, you should not eat or drink anything at least eight (8) hours before your surgery. If you intend to complete you surgery with local anesthetic, you may eat normally prior to your appointment.

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How do I know the instruments you use are sterile?

We clean and sterilize all instruments after each use. We maintain a surveillance program to assure all equipment and instruments are cleaned and sterile.

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When should I have my wisdom teeth removed?

It isn’t wise to wait until your wisdom teeth start to bother you. In general, earlier removal of wisdom teeth results in a less complicated healing process.The AAOMS/OMSF study strongly recommends that wisdom teeth be removed by the time the patient is a young adult in order to prevent future problems and to ensure optimal healing.The researchers found that older patients may be at greater risk for disease, including periodontitis, in the tissues surrounding the third molars and adjacent teeth. Periodontal infections, such as those observed in this study, may affect your general health.

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Do any of my wisdom teeth have to come out if they haven’t caused any problems?

Not all problems related to third molars are painful or visible. Damage can occur without your being aware of it.

As wisdom teeth grow, their roots become longer, the teeth become more difficult to remove and complications become more likely. In addition, impacted wisdom teeth are more likely to cause problems as patients age.

No one can predict when third molar complications will occur, but when they do, the circumstances can be much more painful and the teeth more difficult to treat. It is estimated that about 85% of third molars will eventually need to be removed.

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Following surgery, what will I experience after my wisdom teeth are removed?

Following surgery, you may experience some swelling and mild discomfort, which are part of the normal healing process. Cold compresses may help decrease the swelling, and medication prescribed by your Oral and Maxillofacial Surgeon can help manage the discomfort. You may be instructed to modify your diet following surgery and later progress to more normal foods.

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What is an impacted tooth?

A tooth becomes impacted when there is a lack of space in the dental arch and its growth and eruption are prevented by overlying gum, bone or another tooth.

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How serious is an impacted tooth?

Impacted teeth can be painful and lead to infection.They may also crowd or damage adjacent teeth or roots.

More serious problems may occur if the sac surrounding the impacted tooth becomes filled with fluid and enlarges to form a cyst. As the cyst grows it may hollow out the jaw and permanently damage adjacent teeth, the surrounding bone and nerves. Rarely, if a cyst is not treated, a tumor may develop from its walls and a more serious surgical procedure may be required to remove it.
Despite the considerable concern regarding impacted third molars, a recent study sponsored by the American Association of Oral and Maxillofacial Surgeons and the Oral and Maxillofacial Surgery Foundation finds that third molars which have broken through the tissue and erupted into the mouth in a normal, upright position may be as prone to disease as those third molars that remain impacted.

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What is dry socket?

Dry socket is the most common complication of an extraction. It develops in about 5% of tooth extractions. It is very painful condition that is easily treated.

A dry socket is: 

Any socket in which a patient is having pain due to the loss of the blood clot thus exposing the bone to air, food, and fluids along with an offensive odor.  This often occurs two or more days after an extraction and can last about 5-6 days.  It is normal to have soreness and discomfort following an extraction.

However, pain should be lessening by the second day.
 
This condition exist when a blood clot is dislodged from the surgery site thus exposing the bone and fine nerve endings. The blood clot helps in the stopping of bleeding and lays the foundation or framework for new tissue and bone to develop over a two-month healing process.  This condition is more common in the mandibular area and in back teeth due to poorer circulation in this area, with wisdom teeth being the most common site.  Dry socket delays the healing process.

It usually takes gum tissue about 3-4 weeks to heal where as the bone can take up to six months to heal.

This condition is most often found:

  1. In individuals who smoke before their recommended time.  Smoking: decreases healing, decrease blood supply to the protective blood clot, brings toxic products to the area, injuries the gum tissue and the negative pressure of sucking removes the blood clot from the surgery site.

  2. If you do not administer the proper care for your extraction site as instructed by staff.  

  3. Not following your home care instructions.

  4. Sucking action from smoking, sneezing, coughing, spitting or sucking, within the first 24 hours.  

  5. Women taking oral contraceptives are more susceptible.

Prevention of dry socket:

  • Avoid drinking through a straw.
  • Avoid smoking, it contaminates the extraction site.
  • Avoid excessive mouth rinsing, it interferes with blood clotting.
  • Keep food from impacting in this area. Chew on the other side of your mouth and gently rinse your mouth with warm salt water after the first 24 hours
  • Women who use birth control pills or have their teeth removed in the first 22 days of the menstrual cycle are twice as likely to develop dry socket after an extraction.  Schedule extractions during the last week of your menstrual cycle(days 23 through 28)when estrogen levels are low or inactive.

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How is dry socket treated?

Treatment could include the following:

  • Medication applied to the site
  • Clove oil technique
  • Gauze with medication
  • Additional home care instructions
  • Applying topical anesthetic
  • Alvogyl by Septodon


Patients usually notice pain relief in about 5-10 minutes after the dressing is applied.

We have experienced fewer cases of dry socket since every patient is asked to rinse with an antimicrobial mouthwash and each patient is instructed on how to care for their extraction site through our website, verbal instruction and home care instruction handouts. We highly recommend patients use Breath RX  in their daily oral hygiene routine to help control oral bacterial.

Continue these instructions for the next 3-4 days:

  • Good oral health care
  • Avoid food with any residuals i.e. popcorn, peanuts and pasta
  • Eat soft foods i.e. mashed potatoes, clear or cream soups, pudding

News Updates on Dry Socket

Oral contraceptive may increase pain after wisdom tooth extraction

That tests on 267 women showed that those on the birth control pill were more susceptible than non-users to both postoperative pain and a condition known as “dry socket.” In this condition, normal healing of the vacant tooth socket is delayed by the failure of a blood clot to form. Infection instead causes the socket to remain empty. In the study, pain on the day after the operation was experienced by 30 percent of pill takers compared to just 11 percent of non-users. Five days after the operation the difference was 14 percent compared to 5 percent. The researchers said these results suggest that the pill may reduce the pain threshold. The differential was similar when the development of dry socket was compared. Here, 11 percent of pill users were affected compared to 4 percent of non-pill users. 
SOURCE: British Dental Journal 2003;194:453-455.

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What should I know about dental implants?

Replacing missing teeth has always been a challenge for dentists, but fortunately we have added another way to replace teeth that offers many advantages over conventional methods. Dental implants allow a missing tooth to be replaced without altering or trimming down neighboring teeth that would serve as anchors for a bridge, or without relying on neighboring teeth that are not strong enough to support a bridge. Partial dentures and full dentures can be supported or retained by implants so that the function of the denture is greatly improved. The problem of a lower full denture that moves around when talking or eating can often be corrected by placing two implants in the lower jaw that hold the denture in place. Once dental implants are placed, the gradual deterioration that takes place in your jawbone where teeth are missing is slowed or eliminated.

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What are dental implants?

A dental implant is a natural tooth replacement which is implanted in the jaw. They can be used to support a crown, bridge or denture.

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Why are dental implants so popular?

Implants offer tooth replacements that attach to the jaw and can have many advantages over conventional methods. They are both functional and esthetic.

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Who is a candidate for dental implants?

Anyone in reasonable health who wants to replace missing teeth. You must have enough bone in the area of the missing teeth to provide adequate anchorage for the implants. Most people today are potential candidates for dental implants to replace a single missing tooth, small bridges or removable partial and full dentures.

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What is the success rate of dental implants?

This depends on where the implants are placed and their function, as well as how well they are cleaned at home after they are completed. Most studies show success rates of at least 95%.

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Does it hurt to have dental implants placed?

Most people experience minimal discomfort following dental implant placement. Most describe the implant as less painful afterward than having a tooth extracted. The procedure can be done either under local anesthetic or intravenous sedation.

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If I have insurance how much do I pay at my initial visit?

Most insurance plans pay a portion of your bill. The noncovered copayment and deductible amount is expected on the day of your procedure. We file claims promptly and we serve as your advocate.

*Please be aware that with most insurance plans have a deductible, copay and or coinsurance.
We will file your insurance as a courtesy to you. However, insurance benefits vary from plan to plan and rarely do they cover 100% of the surgical fee for services. We require that you pay your deductible (if not already met) and co-payment on the day of the surgery.

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What insurance plans do you participate with?

*As of December 1, 2008, we participate (in network) with the following insurances:

MEDICAL INSURANCES

Aetna HMO & PPO
Cigna PPO
NJ Carpenters Fund
Qualicare
Horizon Medical PPO, HMO, NJ Plus & Traditional
United HealthCare
Oxford PPO
Amerihealth

 

 DENTAL INSURANCES

Aetna PPO
Cigna DMO & PPO
Careington Discount Plan
Delta Dental
DeltaCare
Guardian PPO & Managed DentalGuard
GHI Dental
Healthplex PPO
Metlife Dental
Northeast Discount Plan
NJ Carpenters Fund
Qualident
United Concordia
Principal
Protective Dental Discount Plan

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Do you verify insurance benefits?

Yes!

Please be aware that insurance coverage can ONLY be verified during normal business hours Monday through Friday from 9:00am until 5:00pm . Hence during the aforementioned times we will accept payment in full until insurance coverage is verified. Insurance benefits will be reimbursed to the patient.

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How do you file your insurance claims?

Most of our claims are sent electronically. There are still some insurance companies that only take paper claims.

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Do you accept payment plans?

Yes! We utilize 3rd party financial institutions Care Credit & Citihealth These companies offer flexible payment plans that allow you to get the treatments you need right now.

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