Frequently Asked Questions
Will it hurt?
We will be as gentle as possible. Normally the periodontal examination can be completed with little or no discomfort.
Do I need X-Rays?
We will need current periodontal x-rays in order to see disease not otherwise visible. If your referring dentist has taken x-rays, you may request that they be forwarded to us.
What will it cost?
Since all patients are different, Dr. Johnson must complete your examination before establishing your treatment plan and the fees for your care. The fee for periodontal treatment can vary considerably depending on the type of problems and the complexity and length of treatment. An approximate fee can usually be determined at the initial visit: but on occasion, some initial treatment or further diagnostics must be completed before the final treatment plan can be established. "Our philosophy of practice is to provide a range of treatments to fit within your budget, condition, desires. and esthetic wishes
Will my Insurance cover the cost?
Dental insurance policies often cover periodontal treatment. Please bring all medical and dental benefit information and cards to your examination appointment. Upon request, we will submit a claim to obtain a pre-estimate of your insurance benefits: however, this is not required by most plans.
"I am often told not to eat or drink anything before any kind of surgery, why is this surgery different?"
You will be given a local, not general. anesthetic â€” so eating is OK. If you have been prescribed sedative medicines, a light meal shortly before the appointment is still OK. If you happen to be diabetic then it is essential that you have normal meals
My normal meal includes several cups of coffee followed by a cigarette, is that OK too?
Sorry, but that is not a good idea! Coffee will only make you more nervous and uncomfortable, especially because -bathroom breaks" will be very inconvenient. Tobacco in any form should not be used at all on the day of surgery and for as long afterwards as possible! Nicotine is a potent constrictor of blood vessels, shutting off blood supply that is critical for wound healing. If you cannot resist the cravings, then use a dermal patch (not nicotine gum!) to sustain your addiction.
Can I use the mouthwash more than twice a day?
Not a good idea. The active ingredient in the rinse stays in your mouth for 12-14 hours, so "twice-a-day" means just that. Using the mouthwash more often does not increase its effectiveness, but it does increase the side-effects of staining and sometimes "canker sore-like" ulcerations.
"I was given antibiotics, when should I start taking them?"
Antibiotics do the most good if they are already in your system, 'just waiting for the germs' ! It is especially important for the success of any graft for your blood to be "full of antibiotic" Once sutured and clotted. antibiotics cannot get to the wound until new blood vessels form a few days later.
I don't like taking pills, so can I stop taking the antibiotic if I feel OK?
Not a good idea. Antibiotics kill the susceptible bacteria (the "weak bugs") quickly but some (the "strong bugs") will be somewhat resistant and won't be killed for several days. If you stop taking the antibiotic early, the resistant bacteria will multiply uncontested and the resulting infection will be more difficult to treat.
Why can't I just take my sedative pills and then quickly drive to my appointment?
You could hurt yourself or others or get a DUI! Besides, you should be relaxing, not stressing over the drive here. Also, since you will not be driving home (right?!!), you won't have to worry about getting your car back.
Can't I just take the bus or call a Cab for the ride home?
Sorry, but even just walking down the steps outside the office you cold fall and hurt yourself. You must be accompanied by a responsible adult. (No offense intended to cab drivers...!)
When the numbness wears off what do I do?!!
It is easier to prevent pain than relieve it. You will feel pain after the surgery, so start taking the prescription pain-reliever before the numbness is gone. If you followed the pre-operative instructions to start taking Ibuprofen before your appointment, then you are already well on your way to a comfortable recovery. Remember, "Don't wait for it to get bad' and "Stay ahead of the pain". Also, take it easy and treat yourself as if you have just had an operation.
I was feeling better a few days after my surgery, but now my teeth feel high and tender when I bite, my jaws ache and even my ear hurts. What's happening?
A normal part of wound healing is swelling, so when the tissues around your teeth swell it will move the teeth slightly out of position. This usually starts 2 or 3 days after the surgery and lasts for about 2 weeks. Your "bite reflex" will sense this and you may unconsciously clench to reposition your teeth. If you already have the habit of clenching or grinding your teeth, this can become especially uncomfortable. It pushes your teeth back into swollen/tender "sockets". further bruising the surrounding tissue and creating a vicious cycle.
This creates the feeling of a "bone bruise", a dull throbbing ache in the jaw above and below the wound. Muscle spasms may occur. especially overnight, in the area of your cheek, ear, temple and even the back of your head. These aches are not easily relieved by any pain-relieving medicine (narcotic or not). Cramps are relieved by relaxation, stretching, massage and applying heat to stimulate circulation. Try these remedies before taking more pills!
I've had Codeine, Vicodin, Percocet and Demerol before and they all make me sick to my stomach. What else can I take to relieve pain?
This is a problem. All oral narcotics will cause some nausea, especially if taken on an empty stomach. So always take prescription pain-relievers with plenty of liquid and/or some food. Also, the larger the dose of narcotic the more nausea, so try a smaller dose more frequently. You can even grind up the pill (two spoons work well) and put it in yogurt or applesauce, then eat this mix slowly over a period of half-an-hour. This problem is also why you should be taking Ibuprofen as your "basic" pain reliever. It is very good at relieving dental pain and can be taken at the same time as your prescription pain reliever.
I had a gum graft and thought all of the recession would be gone. What happened?
The main purpose of the graft is to thicken and widen the gum to protect the underlying bone. Getting new soft tissue to survive on a tooth root where there is no blood supply is not a "natural act". Think of trying to get your lawn to grow over and completely cover your driveway! But we "gum-gardeners" are clever and in some special situations (for instance a very narrow defect) we can "fool mother nature".
I had surgery to get rid of my gum pockets. Will my gums grow back?
If gum tissue were to grow all the way back to its original position where gum pockets were present. the pockets would be back. So. we don't want the gums to "grow back' that far.
Why are there now black triangles between my teeth?
Now you can see where your periodontal disease had caused bone decay' There is now space where there were pockets before the operation. We do not want the pockets to reform so these spaces should remain. Look at it another way, if a tooth had been lost there would be a huge 'black rectangle'!
How can we get rid of the black line around all of my porcelain crowns?
The black line is the metal that seals the crown to the tooth and upon which the porcelain is built. Only a new crown will alter this appearance. Attempting to cover it with a filling is not a good idea.
Why is my tongue black?!!
An occasional side-effect of the disinfectant mouthwash, it will go away when you are able to perform normal oral hygiene again, usually 2-3 weeks after the operation. It is not an infection or anything that needs treatment.
Where did this brown stain on my teeth come from?
A more common side-effect of the disinfectant mouthwash, it can be removed from most areas by polishing during your post-operative visits. But if your plastic fillings are old and porous, the stain cannot be removed. Look at it as a good way to have found a leaky filling before it caused a toothache!