Steve Bureau, DDS

Visiting an oral surgery office can bring on nerves for some. We fully understand this, and we want you
to know that there is nothing wrong with that. You are not alone! A lot of our patients come to us
apprehensive about the process and what to expect. So, we thought it would be a great idea to give you
some insight!

 

Unless otherwise discussed, when you come for your first visit, you will have an initial consultation. Your
procedure will not be performed at this appointment. Instead, you will meet with Dr. Bureau and one of
our dental assistants to go over the reason for your referral/visit and how we can help you. You will be
able to ask any questions you might have about the procedure, anesthesia, or dental care that you may
have.

Once we have a treatment plan outlined, we will provide you with all of the information you will need
before, during, and after your procedure. These will include information on what to expect on surgery
day, the days after, and how to care for yourself and manage any discomfort or emergencies should
they arise.

Upon check out from this appointment, you will meet with one of our administrative team members to
schedule your surgery. If you have any financial and insurance questions, there will be answered at this
time.

We try to keep the process as simple and streamlined as possible for you, and we want you to enjoy
your experience knowing you will be well taken care of with us.

As always, please call the office if you have any questions!

Let’s talk insurance!

Depending on what you need to have done, oral surgery can be costly. Most of the most common questions we get are surrounding insurance. So, we have created a quick cheat sheet for you.

1. A pre-authorization is always sent to your insurance before surgery by our office. Not all insurance companies will get back to us with coverage information, so make sure to keep an eye out for their response because they will always send a response to you.
2. Oral surgery often falls under the “basic dental coverage” category. Ensure you know if you have any insurance maximums, this could affect the amount of insurance coverage you get.
3. Once your pre-authorization for surgery has been submitted and a response received, any other dental appointments completed before you have your surgery could take away from the total allowed/available for surgery.
4. You will be required to pay your consultation fee in full at the time of consult, and we will submit it to your insurance to reimburse you, except you have social assistance or NIHB insurance coverage. We offer direct billing when moving forward with surgery as a courtesy to our patients.
5. Not all procedures are eligible for direct billing. We will advise regarding this during the consultation.
6. While we are happy to offer direct billing for convenience, the insurance contract is ultimately between you and your insurance company. If your insurance fails to remit payment, you are responsible for any balance left owing.
7. Every insurance company is different, and so is every policy within that company. Until we receive a written approval from your insurance company, we cannot assume that your procedure will be covered by them. We will do our absolute best to make your patient portion manageable for you.

Insurance can be complex. We are here to help! Please feel free to call us with any questions or concerns you may have.

After having oral surgery, it is important to ensure you are getting adequate nutrition. Soft and easy to chew food options are recommended and are necessary for proper healing, there also cause minimal irritation to surgery sites compared to hard and crunchy food options. It is also very important to keep yourself hydrated and nourished during the healing process. Depending on the nature of your surgery, it can take a week or two before you can go back to eating your regular meals.

For most people, we recommend eating cool and warm soft foods, soups and drinks for the first few days to allow the sites to heal. Very hot foods and drinks should be avoided after oral surgery to prevent irritation of the gum and surgery sites. 

Some great food options are:

• Applesauce
• Yogurt
• Scrambled Eggs
• Mashed Potatoes
• Mac and Cheese/Pasta
• Oatmeal
• Cooled or Warm Soups
• Bananas
• Pudding
• Cottage Cheese
• Jello
• Smoothies or Milkshakes
• Ice Cream 
• Popsicles

Our team will give you all the aftercare instructions tailored to your treatment type and individual needs at your consultation and after your surgery. We are also available at the office by phone for any additional questions or clarification you may need. It may be uncomfortable to eat at first, but your health depends on your body being nourished, hydrated and strong!

When having an oral surgery procedure done, knowing what NOT to eat is just as important as knowing what you should eat.

For a couple of hours after surgery, your mouth will still feel frozen due to the Local anesthetic, so you won’t feel how hot some foods are. You’ll want to be extra careful with Hot meals and drinks such as coffee, soup, or tea immediately, afterwards, as these could cause burns without you knowing.

 

Here are some foods you should avoid for about a week after surgery:

• Spicy Foods (salsa, hot sauce, spicy chilli)
• Hard or Crunchy Foods (bread crust, carrots, apples, nuts, potato chips, popcorn, granola)
• Acidic foods (orange juice, lemonade)
• Seeds (raspberries, strawberries)

Keep in mind that you will have wounds in your mouth that need time to heal. You wouldn’t want something spicy or full of citrus to get into a cut on your arm. Think of your mouth in that context when deciding what would be good to eat.

We will ensure that you have all of the information you need before and after having oral surgery in our office. We will also ensure that you know exactly how to care for yourself after surgery. We are always available by phone for any questions or clarification you may need.

Is it safe for me to receive an anesthetic?

If you are healthy, receiving an anesthetic is generally safe. If you have any special conditions or complicated medical history, please inform us, and we will advise you of your options and any risks.

Will I be in pain for my procedure?

You will not feel pain during your procedure. You may feel pressure with a local anesthetic while your procedure is underway, but ideally, you will not feel pain. The numbing agents are effective in keeping you comfortable.

What kind of preparations do I need for a general anesthetic?

We want you to have an empty stomach when you are administered a general anesthetic. After midnight the day before surgery, you are not to eat or drink anything, including water. We also recommend no smoking, vaping, or drinking alcohol use 24 hours prior. 

Will I remember my surgery?

With a local anesthetic, you are fully conscious. You will remember your entire procedure. IV sedation does not affect your consciousness, but most patients do not recall their procedure due to being so relaxed. With a general anesthetic, you will not recall your surgery at all.

How long is the surgery?

The surgery itself typically does not take long, but that depends on what you are having done. Expect to be in the office for 2 to 3 hours to complete check-in, surgery, and post-operative care.

What are the side effects of anesthetic?

Some pain or discomfort after the numbing from surgery wears off is normal. You will be prescribed pain management medication to help with that. You may experience nausea or vomiting from the anesthetic and a sore throat, dizziness, and headaches. These side effects only occur in a very small percentage of cases and do not last long.

What are the risks?

Individual risks vary based on medical history. During your consultation appointment, we will review any possible risks with you.

What happens after surgery?

Our team of registered nurses or registered dental assistants will take care of you after surgery, depending on the type of anesthetic you have had. After which, they will review post-operative care instructions with you and your responsible party following surgery. You will be given resources and advice to help alleviate any pain, discomfort, or nausea. You may feel drowsy immediately after surgery, but this will wear off as the day progresses. 

We offer three different types of anesthesia in our office:

1. Local Anesthetic
2. Intravenous IV Sedation
3. General Anesthetic

Dr. Bureau will tell you which anesthetic is best for you during your consultation. Here are some facts about each one to help you better understand and prepare for your oral surgery.

Local Anesthetic

You will remain completely conscious during your procedure. A local anesthetic will cause numbing for the area being treated so that you will not feel pain. It will not affect your awareness of the pressure or vibrations of the drills associated with your procedure. The numbing typically lasts a few hours. During this time, we recommend staying away from any foods that are hot to prevent burns, given that you will not be able to feel the heat and being careful not to bite your cheek/lip. Local anesthetic is often used for less invasive oral surgeries or medically compromised patients who may be at greater risk of complications if other anesthetic options are used.

Intravenous (IV) Sedation

This type of sedation is administered through an intravenous line by one of our medical anesthesiologists, and it helps to relax you and prevent you from feeling pain. It can also be referred to as “deep sedation.” During your procedure, you may fall asleep but you will not completely lose consciousness and will still be able to maintain your breathing. Many patients say that having IV sedation makes them completely unaware of what is happening, and they do not remember their procedures.

General Anesthetic

For this anesthetic, you are completely unaware of the surgery and do not feel any pain. Typically, you are “put to sleep” by inhaling a gas. One of our medical anesthesiologists administers the gas and other medications and maintains your breathing and airway during the surgery. Specific instructions need to be followed before receiving a general anesthetic to ensure a smooth and safe procedure. In addition, a local anesthetic is administered to numb the area so that you are unaware of your procedure and feel no pain upon waking up after the surgery. 

They are a great, permanent alternative to replace a missing tooth, and they are not nearly as invasive as you may think. The chances of failure are small. Some factors that could cause an implant to fail include infection, poor oral hygiene, excessive occlusion load, and general health status.

Implants are a great option because they help you return to normal function with eating, speaking, and aesthetics. Not to mention we have come a long way from the days of the ancient Mayans when seashells were reshaped, contoured, and used as implants/tooth replacements. Nowadays, small titanium tooth form posts are used and put in your jawbone. After-which a crown can then be placed and anchored on it to achieve the natural tooth look and feel.

Implants can sometimes be placed immediately after a tooth extraction or in an already existing space. The surgical placement of an implant can often be done in-office, with one procedure. Although sometimes it does take two. Implant placement can be done, under local anesthesia, deep sedation or general anesthesia, depending on your needs.

After the implant placement, It can take up to 6 months for your bone and the implant to integrate. After-which, you can have a crown placed on top by your dentist. The healing/integration process allows the implant to bond properly into your bone. During this time, you may have a denture temporarily so that you aren’t living everyday life with an open space in your mouth.

Dr. Bureau will do one final check once you are fully healed, to make sure you are ready for a crown placement from your dentist. Your smile and function will then be fully restored, and the implant process is complete!

You may know you need oral surgery or have heard the term before, but what on earth does that mean?

Oral surgery is also known as Oral & Maxillofacial surgery. It is a branch of dentistry that covers the diagnosis and treatment of orofacial defects, diseases, or injuries. This means that to become an oral surgeon, you have to become a dentist first, then do even more schooling to specialize and obtain the title of Oral & Maxillofacial Surgeon. Oral surgeons can provide patients with unique expertise in facial reconstruction, dental implants, tooth removal, and bone grafts, among others.

The reasons why people require oral surgery can range from tooth extractions, facial trauma, cyst or tumour removal to correcting birth-defects such as unequal jaw growth or a cleft palate. Surgery time can be as quick as 10 to 20 minutes or can take a few hours, depending on what is needed. For your typical wisdom tooth extraction, you can expect to be in the office for 2 to 3 hours. These include the time for check-in, a consult if needed that day, surgery time, and recovery (if the surgery was under General Anesthesia).

Proper preparation for oral surgery appointments is very important. When you have your consultation with Dr. Bureau and his team, you will be given preoperative instructions to follow depending on the type of anesthesia you will require. This may include having no alcohol or smoking for 24 hours prior, no eating or drinking (not even water) after midnight the night before the surgery if general anesthetic or IV sedation is required and may include a premed antibiotic. Once your procedure is complete, our lovely nurses will go over post-operative care instructions. Always remember that when having general anesthetic or IV sedation, you are considered legally impaired for 24 hours after surgery. You will need a ride to and from our office, as well as care at home afterwards.

In the following days and weeks, it is important to keep the surgical area clean and free from any debris. This is important to minimize your risk of infection. We always call to check on you the next business day after your procedure just to follow up and make sure there are no concerns. We want to make sure that you are healing as quickly and seamlessly as possible. While you will be provided with an aftercare booklet and our website also has more information, we encourage you to call with any questions that you may have. We are more than happy to address your individual needs as we know that each and every case is different.

We are always happy to answer any additional questions and we encourage you to contact our office during business hours at (403) 286-2551.

References:
https://www.cdc.gov/mmwr/PDF/rr/rr5116.pdf
https://www.mclainsurgicalarts.com/preparing-for-oral-surgery
https://www.verywellhealth.com/how-to-prepare-for-oral-surgery-1059320
https://www.webmd.com/oral-health/prepare-oral-surgery
https://www.academia.edu/37335792/Oral_Surgery_pdf
https://www.caoms.com/procedures

One of the most common things that patients are referred to us for is wisdom teeth extractions.

Having your wisdom teeth taken out can seem scary for some but we are here to tell you that it doesn’t have to be! With Dr. Steve Bureau, you can rest assured that you are in fantastic and very capable hands.

While wisdom teeth used to be useful, they now serve no purpose in our mouths. In fact, they are more harmful than good! They are so far back in our mouths that we couldn’t use them to chew food even if they have erupted. It also makes cleaning them a challenge because they are hard to reach –this can lead to decay, cavities, and abscess. Furthermore, wisdom teeth don’t properly fit in our mouths so they can cause crowding and problems for neighboring teeth, especially if they are growing in at an abnormal angle.

Most people choose to have their wisdom teeth taken out with sedation or general anesthetic so that they don’t have to experience the extraction process. Unlike a regular tooth extraction, wisdom teeth are often below your gumline so they are more invasive to take out. Choosing to have sedation or general anesthetic over a local anesthetic makes the procedure a total breeze. Most patients are in and out of the office within 2-3 hours – that includes check-in time, a brief wait while we get your room setup, surgery, recovery, and reviewing post-operative care instructions before sending you on your way!

Having removed thousands of wisdom teeth from patient’s mouths, Dr. Bureau is an expert on how to make the process as seamless and painless as possible. Our team understands the anxiety that can come along with putting your health care needs in our hands and as a result, we are sensitive to all situations and any specific needs that you may have.

We are always happy to answer any additional questions and we encourage you to contact our office during business hours at (403) 286-2551.