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Oral and Maxillofacial Surgery Website copy March 2011 Table of Contents Oral and Maxillofacial Surgery: Why choose us? ............................................................................... 3 Welcome ............................................................................................................................................................ 3 Making Your Appointment ......................................................................................................................... 3 Your First Consultation................................................................................................................................ 3 Referrals and Medicare Rebates .............................................................................................................. 4 Affordable Fees and Charges ..................................................................................................................... 4 Hospital and Anaesthetist Fees ................................................................................................................ 5 Affordable Payment Plan ............................................................................................................................ 5 Pre-Operative Instructions......................................................................................................................... 6 Post-Operative Instructions ....................................................................................................................... 7 Bleeding ........................................................................................................................................................ 7 Nausea/ Vomiting ..................................................................................................................................... 7 Swelling ......................................................................................................................................................... 7 Pain ................................................................................................................................................................. 7 Eating ............................................................................................................................................................. 7 Oral Hygiene ................................................................................................................................................ 8 Sutures........................................................................................................................................................... 8 Surgeon Profile: Dr [first name] Anura ................................................................................................. 8 Contact Us ......................................................................................................................................................... 9 Phone ............................................................................................................................................................. 9 Fax ................................................................................................................................................................... 9 Mailing Address ......................................................................................................................................... 9 Office Hours ................................................................................................................................................. 9 Locations....................................................................................................................................................... 9 Oral and Maxillofacial Surgery: Why choose us? Oral and maxillofacial surgery is a specialty that diagnoses and treats a wide variety of diseases of the teeth, mouth, face and neck. These problems are often of a traumatic, pathologic or cosmetic nature. A typical oral and maxillofacial surgeon is trained in both the medical and dental professions, along with additional maxillofacial training. This extensive training guarantees that the surgeon is experienced and qualified, ensuring you’re in safe hands. (Read about our surgeon, Dr Anura, by clicking here.) Established in 2004, our company Wisdom Teeth and Implant Services was built with an emphasis on quality care and patient satisfaction. By combining several years of professional experience with up-to-date knowledge, advanced technology and excellence in technique, we are committed to providing optimum care and service. Welcome Thank you for looking into our oral surgery practice and services. At Wisdom Teeth and Implant Services understand that your time is valuable, so when you book an appointment with us we take care to accommodate your needs. With consulting rooms in Sydney City, Strathfield, Liverpool and Dubbo, we strive to provide you with affordable and first-rate solutions to your oral surgery needs. Making Your Appointment When you call us, we will try to book your appointment as soon as possible to ensure you're not left waiting too long. We understand that you have a busy schedule and we'll work within the times that suit you to make an appointment. Please note that we appreciate 48hours notice if you need to cancel or change your appointment. Your First Consultation At Wisdom Teeth and Implant Services we are committed to providing you with an oral and maxillofacial surgery evaluation in a pleasant and professional environment. To ensure your initial consultation is as convenient and efficient as possible we ask that you please bring the following: Your Referral letter from your dentist or GP (if you are unsure of what this is or whether you are eligible for a Medicare rebate please see the Referrals and Medicare Rebates section) OPG X-RAY, or any other relevant x-rays A list of your current medications Your Medicare and Health Fund details When you arrive for your consultation you’ll be asked to complete a consent form as well as a patient history form. If convenient, you can download these forms online and fill them out before you arrive. To do this you’ll need your Medicare and Health Fund details. Please click on the links below to download the forms: Patient history form Consent Form At your consultation we will ask you to describe your oral and maxillofacial problem as well as review your medical history, current medications and discuss allergies. Our specialist will discuss with you the diagnosis and treatment options. We will then propose a possible treatment plan and answer all of your questions. It is important to us that our patients are 100% comfortable with the course of action and oral surgical treatment required, so we are happy to discuss the treatment needed in great detail until you are at ease. We will also discuss with you any alternative treatment options, pre- and post-operative care, surgical fees and any potential complications. We hope to make this initial visit as informative and helpful as possible. Whether it be wisdom teeth, facial swelling, tooth pain or any number of oral and maxillofacial problems, we are here to help in an affordable and professional manner. Referrals and Medicare Rebates Usually, our patients have been referred by their family doctor, general dentists or orthodontists. If this is the case, you should bring your referral letter with you to your consultation, or you can ask your doctor to send it to us directly. With a referral you will be eligible for a Medicare rebate for the cost of your consultation. However a referral is not compulsory and we accept patients without them as well. Affordable Fees and Charges Dr Anura is a Medicare approved oral surgeon and some of the procedures, including some surgical procedures with Medicare item numbers, may be eligible for a Medicare rebate. If you have a referral letter from your dentist, GP or orthodontist, you may be able to claim a Medicare rebate. For more information please see the patient information section or contact us. Dental treatment or removal of Wisdom teeth is not usually covered by Medicare. However health funds will generally provide a rebate for this kind of surgery depending on your level of cover. During your consultation Dr Anura will discuss the fees and provide a quote including relevant item numbers and cost. It is wise to enquire with your health fund if you will need to pay a gap for your treatment. Generally the exact cost of a surgical procedure is not known until the procedure is carried out; however Dr Anura will give you an estimate. It is the policy of this oral surgery practice, to keep the fees at the bare minimum. We believe in competitive pricing and quality care. For maximum efficiency, we must ask that patients undergoing general anaesthesia pay the surgery cost in full, prior to the surgery. The fees for separate procedures carried out in the surgery under local anesthesia or sedation will need to be settled on the day of the surgery. In addition the patients undergoing general anaesthesia also have to pay hospital and anaesthetist fees. Hospital and Anaesthetist Fees If your surgery is to be carried out in the hospital, both the hospital cost and the anesthetist will have separate fees. Generally, the hospital will expect you to finalise your payment on the day of admission. If you have private health fund cover it is wise to contact the fund before surgery to arrange payment. If you are uninsured, a special rate applies which must be settled on the same day. The cost of the general anaesthesia will vary depending on the length of the surgery and other factors that you should discuss with the anaesthetist. Usually, after the surgery, the anesthetist will send you a bill which is partly covered by Medicare. It should be noted that this is the only part of the procedure that includes a Medicare rebate. However, some anesthetists may request their fee is paid up front. If this is the case, they will contact you prior to your oral surgery. Affordable Payment Plan We understand that it’s not always easy to pay for medical treatment, so to ease the financial burden we offer payment plans of a maximum of three to four fortnightly installments for eligible patients. Please inquire about this if you’re interested. As always, our goal is to offer you professional surgical treatment on an affordable basis. Pre-Operative Instructions For your safety and to ensure a smooth recovery from your oral surgery, you will need to follow several simple instructions prior to the surgery. These will also be discussed at your initial consultation. 1. If general anesthesia is required: You must not eat or drink for six hours prior to surgery You must not drive after the surgery for 24 hours A family member or friend should accompany you to and from the surgery 2. If local anesthesia AND oral sedation is required: You can eat and drink as usual prior to the surgery You must not drive after the surgery for 24 hours A family member or friend should accompany you to and from the surgery 3. If only local anesthesia is required: You can eat and drink as usual prior to surgery Post-Operative Instructions After oral surgery, patients may experience several side effects. It’s important to note that the following side effects are generally normal post operative symptoms and you should not be alarmed. However if they become more serious contact us as soon as possible or attend the emergency department at the hospital. Post operative symptoms include the following: Bleeding If bleeding occurs, please apply pressure on the wound site by biting gently on some gauze or using your fingers to apply gentle pressure with a piece of cotton gauze. This should help stop bleeding and may take anywhere between 15 and 30 minutes. If the bleeding doesn't stop or you examine the wound and there is heavy bleeding directly at the wound site, please contact our office or attend the emergency department at the hospital. Nausea/ Vomiting Some patients may vomit after recovering from general anaesthesia or sedation, or as a result of taking medication such as ‘Panadine Forte’, or ‘Metronidazole’, on an empty stomach. Vomiting once or twice after surgery is not uncommon. If vomiting is due to taking a medication, please stop taking the medication. If vomiting continues for more than 24 hours after surgery, contact our office or attend the emergency department at the hospital. Anti-vomiting medication and IV fluids may be necessary to prevent dehydration. Swelling Swelling occurs after surgery due to tissue trauma, or an infection and can vary from mild to severe for two to five days after oral surgery. Ensure you are well rested and relaxed with your head elevated on two pillows or sitting up. You can use ice packs applied on the face near the extraction site for up to 24 hours to help to reduce the swelling. Pain Your oral surgeon will use local anesthesia, which will numb the mouth for between two and six hours. When the local anesthesia wears off you will experience pain. Take your prescribed medication as soon as you get home. Pain or discomfort when opening the mouth is common for up to two weeks after removal of a wisdom tooth. Simple jaw exercises, such as using chewing gum, may help. Use ‘Panadine forte’ as prescribed (2 tablets every 4 hours for the first 24 to 48 hours). When pain reduces, change to Panadol. If your pain does not seem to get better as the days go on, inform your doctor. Eating After surgery, it's important to start eating and drinking slowly. Start with clear liquids such as water, apple juice or a flat lemonade. Once you can keep fluids down without vomiting, you can move onto other food and drinks. Start with easy-to-digest foods such as brothbased soups or soft foods that don't require much chewing if you have a sore jaw. Note: Do not drink beer, wine, spirits or other alcoholic drinks while you are taking antibiotics. Oral Hygiene Use ‘Savacol’ alcohol free mouthwash, half diluted with water (10ml bottle capful) three times a day. Start the mouth wash from day two after tooth removal, then continue for two weeks. You can also use warm salt water (1/2 tea spoon of salt per 125mL of warm water). Avoid vigorous rinsing and spitting as this may remove the blood clots and elicit a dry socket. Brush your teeth at least two times per day, keeping away from the suture sites. Sutures Usually dissolving sutures are used during the surgery. These become loose and will fall out between one and three weeks. But occasionally non-dissolving sutures are used, these may need to be removed during your post operative check up. A post–operative appointment is needed two weeks after surgery to check the wound. Your follow-up appointments are important and help to ensure your comfort and health during recovery from your oral and maxillofacial surgery. Surgeon Profile: Dr [first name] Anura Dr V Anura MBChB BDS MDS (OMFS) FRACDS Consultant Oral and Maxillofacial Surgeon Dr Anura received his dental degree in 1992. Then in 1996, at the Royal Australasian College of Dental Surgeons Part I FRACDS examinations he achieved marks which placed him within the first five in the merit list. He has completed training in 1998 for a period of two years under Professor John E de B Norman, an internationally renowned, Oral and Maxillofacial Surgeon. From 2002 to 2010, Dr Anura undertook a combined Medical degree and Oral and Maxillofacial training at the University of Otago, Dunedin and Middlemore Hospital Auckland, New Zealand. In addition to his dental, medical and oral and maxillofacial training, Dr Anura has completed a Masters degree at University of Otago. His major research thesis was entitled Tumours of the Minor Salivary Glands. He has worked in the past as Clinical Associate Lecturer in the Oral and Maxillofacial Surgery department at the University of Sydney. He has presented his findings and research at international meetings including The Royal Australasian College of Dental Surgeons Convocation, 2002 and The Australia New Zealand Oral and Maxillofacial Surgeons’ annual meetings 2009, 2010. Dr Anura is a Fellow and member of several renowned organisations, including: Fellow of the Royal Australasian College of Dental Surgeons, Sydney Member of the American Association of Oral and Maxillofacial Surgeons Member of the British Association of Oral and Maxillofacial Surgeons Member of the International Association of Oral and Maxillofacial Surgeons Member of the International Team of Implantology Contact Us We are here to answer any questions you may have about our services, the procedures we provide, post operative care or anything else. Please don't hesitate to call. Phone 1300 30 60 84 Mobile 0439 39 0483 Fax 02 99802153 Mailing Address PO Box 561 Pennant Hills NSW 1715 Australia Office Hours Monday to Friday 8.30am – 5.30pm Emergency calls answered on Saturday, Sunday and after hours. Locations 1. Sydney South West Private Hospital consulting rooms 40, Bigge Street, Liverpool, NSW 2170 (Insert Google map here) 2. Strathfield Private Hospital consulting rooms (Insert Google map here) 3. Castle Hill Private Hospital consulting rooms (Insert Google map here) 4. Sussex Day Surgery consulting rooms (Insert Google map here)