Welcome Background Information Our Goal What is Oral and Maxillofacial Surgery ? Can I be Sedated For My Procedure ? X-Rays

Bethesda Health City

Our Goal

Our goal is to provide our patients with the best possible oral surgical care, utilizing surgical and anesthetic techniques designed to make your surgical experience as smooth and comfortable as possible.

What is Oral and Maxillofacial Surgery?

Oral and Maxillofacial Surgeryis the specialty of Dentistry which deals with the surgical and adjunctive treatment of diseases, injuries, and malformations of the jaws and face. The term "Maxillofacial" refers to the upper jaw and facial structures. Oral and Maxillofacial Surgery is a unique specialty in that it functions in the realm of both Medicine and Dentistry. An Oral and Maxillofacial Surgeon is a surgical specialist who following completion of four years of college and four years of Dental School, completes an additional 4-6 years of intensive medical and surgical training. In addition to comprehensive training in all aspects of our particular surgical discipline, this training also includes rotations in Anesthesiology, Internal Medicine, Emergency Medicine, General Surgery, Trauma Surgery, Cardiology, and Neurosurgery, and may include additional rotations in such areas as Pulmonary Medicine, Pediatrics, Otolaryngology, and Plastic Surgery. Our Anesthesiology training is extensive, and provides our specialty with unique qualifications so that we may safely administer sedatives and anesthetics to our patients during office surgical procedures. Most of our activity in the hospital setting relates to the care of trauma patients (i.e facial lacerations, repair of facial fractures, etc.), but we often see inpatients for other problems such as major facial infections, and oral pathological conditions. Most of our elective facial reconstruction or major bone graft surgery is also performed in a hospital setting. We do however, spend most of our time treating patients in the office for such things as routine dental extractions, wisdom tooth extractions, implants, biopsies, etc.

Can I Be Sedated For My Procedure ?

As might be expected given the nature of our specialty, many of our patients report considerable trepidation and anxiety, when confronted with the need for an oral surgical procedure. This is a natural human response, and is often worsened by misconceptions about the procedure, or by advice provided by well-meaning, but misinformed friends or relatives. It has been our experience over the years that patients who undergo a minor oral surgical procedure under local anesthesia had often grossly overestimated the associated difficulty and discomfort, and find that the experience was significantly less stressful than they had anticipated. Despite this however, we still see a large number of patients who express extreme fear and apprehension about the proposed procedure, and request that they be sedated or "put to sleep" for their surgery. Conversely, there are certain more difficult procedures, which patients may initially wish to consider having performed under local anesthesia, for which we would highly recommend some form of sedation.

If there are no medical contraindications to intravenous sedation (and there are very few patients who are too medically compromised to benefit from some form of sedation), patients can be sedated safely and comfortably in the office, even for relatively minor procedures. The technique normally employed is that of Intravenous (or I.V.) Sedation. This involves the slow and careful administration of sedative medications through a small butterfly intravenous needle, which can normally be placed easily and painlessly in the arm. This is not the same as the full general anesthetic in the hospital setting, which requires breathing tubes, ventilators, etc. Instead, our patients breathe in a normal fashion throughout the anesthetic (just as if one were sleeping at night), remain numb throughout the procedure (as the local anesthetic is given after the patient is "asleep"), and have no recall of anything during the procedure itself. Please click on the Anesthesia link on this web site for more information regarding anesthetic procedures.

If you wish to consider being sedated for your surgery, it will be necessary to see you in the office for a brief consultation before the surgery can be scheduled, so that Dr. Digney can review your medical history, discuss the surgery with you, and explain the anesthetic procedures and considerations. In addition, it is not usually possible to sedate a patient on the first visit, as it is necessary to make special arrangements with the office schedule, because it is not possible to treat other scheduled patients at the same time that Dr. Digney is sedating a patient. If you are a new patient, and are considering being sedated for your procedure, please notify the receptionist that you are interested in this possibility, and she will schedule a brief consultation with Dr. Digney prior to scheduling the surgery.

X-rays

Panorex X-ray machine

For the majority of procedures performed in the office, a satisfactory x-ray is necessary, to adequately diagnose and treat your condition. Patients are often given x-rays by their referring Dentist, and these are often perfectly adequate for us to use. There are times however, where the x-ray that has been supplied is not adequate to properly visualize the area in question. In this case, it may be necessary to take another similar film, or in many cases, a larger more comprehensive x-ray called a Panorex, may be necessary to visualize all necessary structures. Please remember to bring any x-ray films that your Dentist has supplied with you at the time of your appointment

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