Please assist us by providing the following information at the time of your consultation:

• Your surgical referral slip and any X-rays if applicable
• A list of medications you are presently taking
• If you have medical or dental insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.
• If you are a member of a managed care Medical or Dental plan, make sure we have on record a referral authorization for your consultation in advance of your appointment.
• If you are taking any herbal or nutritional supplements, please make sure you list them on your health questionaire.

IMPORTANT:

A pre-operative consultation and physical examination is mandatory for patients undergoing IV anesthesia for surgery. Please have nothing to eat or drink 8 hours prior to your surgery. You will also need a responsible adult to drive you home.

Please alert the office if you have a medical condition that may be of concern prior to surgery (i.e. diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are on any medication (i.e. heart medications, aspirin, anticoagulant therapy (warfarin, coumadin or plavix, etc.)

If your dentist or physician has taken x-rays, you may request that they forward them to our office. The films must be recent and of good quality otherwise new films will have to be taken at the time of your visit.

For patients who are being referred for treatment of their Temporomandibular joints, the following will occur on your first office visit.  

You will be evaluated and examined by doctor. A scout radiograph called a Panorex will be taken. Measurements of your jaw opening and side movements will be made and a record of your pain grade made. This grade is on a 0 to 10 scale with 10 being the worse pain imaginable. Once you have been evaluated, recommendations if indicated will be for obtaining MRI’s of your TMJ’s as well a request for splint fabrication (oral orthotic device) and physical therapy will be requested.  If an oral orthotic device is recommended, impressions of your teeth will be made. Molds will be fabricated of your teeth and then they are sent out for the device to be made.  This usually takes 7 to 10 working days.  If an MRI is recommended, you will be given a prescription for the radiographic exam.  You will be referred to an approved MRI center for the scan to be performed. Once the scan is completed, you must have the MRI center duplicate the films and give your the copies or have them give you the scan on a CD. You are then to bring the CD or films to us at your next office visit.  All this information will be reviewed at your second office visit. 

After physical therapy and conservative treatment is performed for a few weeks, you will than be re-evaluated. If TMJ arthroscopy is indicated, it will be recommended at that time. The procedure is performed as an aout patient procedure in a hospital or our office under general anesthesia. It involves making a small puncture in front of your ear and a small probe inserted into your joint. When finished, a band-aid is applied. Usually there are no stitches involved.  Following the procedure, it is required and is mandatory that post operative physical therapy begin within 24-48 hours after the procedure. 

An oral rehabilitation device may be recommended for you following your surgery.  We usually recommend either a Therabyte or Dyna-Surg splint. These devices require pre approval from most insurance companies and must be done so in advance of your surgery. 

Post operative appointments are usually at 1 and 2 weeks following arthroscopy. At those visits, measurements will be made of your jaw opening and side movements. Additionally you will be asked to once again grade your pain on a 0 to 10 scale.

Most patients are concerned about popping.  This is a function of your disc within your Temporomandibular joint.  Not all noises are eliminated with surgery.  Occasionally some popping persists.  

If you have any further questions regarding this visit and treatment, please write your questions down. Remember to bring those questions to your office visit and do not hesitate to ask those questions to your treating doctor at the time of your visit.

For patients who are being referred for the removal of their wisdom teeth, the following will occur on your first office visit.

You will be evaluated and examined by doctor. A scout radiograph called a Panorex will be taken. This radiograph shows your wisdom teeth in relation to your entire jaw. It also shows the relationship of the roots of the teeth in question with regard to the nerve to the lower lip.  This radiograph is required and mandatory.  If your referring doctor has taken a recent (within the last month) Panorex and it is of good quality, a repeat radiograph will not be necessary. 

Once evaluated, your treating doctor will go over your proposed surgery, discussing the risks and benefits of the removal of the teeth in question. In some situations, removal of the teeth may not be necessary due to the possibility or risk of injury to the neurovascular canal which could result in either temporary or permanent loss of feeling to your lower lip. In any case, your doctor will go over all of this at your visit. 

If you are considering the removal of the teeth immediately after the consultation, please refrain from eating or drinking anything for 6 hours prior to your surgery. You must make sure our office fully understands that you would like to have the teeth removed at that time. The appropriate time will be allocated to your visit.  Additionally you must understand that not all wisdom teeth are authorized for removal from your managed care provider. If this is the case, either prior determination will be needed and your surgery delayed until this authorization is received or you will be responsible for all surgical costs at the time of your visit. 

Remember insurance coverage is your responsibility. Our staff with be happy to assist you in obtaining proper prior determinations for treatment.

Please go the Informed consents section of our web site and down load the consent "Removal of Impacted Wisdom Teeth". Please read the consent. Your doctor will go over the consent at your consultation office visit.

For patients who are being referred for reconstructive jaw surgery, the following will occur on your first office visit.

You will be evaluated and examined by doctor. Two radiograph will be taken, one is called a Panorex, the other a Cephalometic radiograph. These films may be given you to by your Orthodontist along with study models of your teeth and photographs of your face. If this is the case and the films are of good quality, they will not have to be repeated. Study models and photographs will be taken if not provided to us by your Orthodontist.

Your doctor will discuss your jaw problem and discuss with you the different procedures that can be done to correct your jaw alignments. He will take measurement of your face and ask you may questions. This visit is usually just a preliminary office visit. Its purpose is to familiarize you with what your problem is and how we go about fixing the problem. Requests will than be made to your primary care physician for proper referrals so that a full Orthognathic workup can be performed. Letters of support will also be requested from your orthodontist.

Once we have obtained all the  necessary information required to fully work up your case, we will than complete your work up and do computer tracings and drawings of your proposed surgery. We will than prior determine with your insurance company your proposed surgery. Once approval is received, you will than begin your orthodontic pre surgical treatment.  Please understand that pre determination and approval does not mean full insurance coverage. All financial responsibilities will be discussed with you at that time.

For more information on Orthognathic surgery, click Surgical Services link above and scroll to Surgical Orthodontics.