Information: Frequently Asked Questions
What does an Oral and Maxillofacial Surgeon do?
Where will I have my procedure?
Get contact information.......
Learn about facial infection ..........
Learn about oral pathology .....
Learn about Third Molar (Wisdom Tooth) Surgery........
Learn about Anesthesia for dentistry.......
Learn about reconstructive surgery.......
Frequently asked questions about Platelet Rich Plasma technology..........
Frequently asked questions about The Pillar Procedure.....
THE ORAL AND MAXILLOFACIAL SURGEON
Patients who present to the primary care provider with complaints of pain or dysfunction in the oral and maxillofacial region are often candidates for referral to an oral and maxillofacial surgeon. The following information will provide helpful guidelines for establishing a working relationship with an oral and maxillofacial surgeon in your area.
Training and Scope of Practice
After four years of post-graduate dental education, an oral and maxillofacial surgeon completes four or more years of intensive, postdoctoral, hospital-based surgical residency training. Oral and maxillofacial surgery residents spend significant time rotating through related medical fields such as internal medicine, general surgery, anesthesiology, otolaryngology, plastic surgery, and emergency medicine. Some may also subsequently complete fellowships in subspecialty areas. Dr. Caplash chose to partake of a separate residency in anesthesiology.
The scope of oral and maxillofacial surgery encompasses diagnosis and surgical and related management of diseases, injuries, and defects that involve both the functional and esthetic aspects of the oral and maxillofacial regions. This includes preventive, reconstructive, or emergency care for the teeth, mouth, jaws, and facial structures.
It is a fact that outpatient ambulatory surgery and anesthesia as we know it today was pioneered and developed by Oral and Maxillofacial surgeons after World War II. Oral and maxillofacial surgeons can perform a wide variety of procedures in an office setting as well as in a hospital environment. Local anesthesia, nitrous oxide, intravenous sedation, and general anesthesia are options available in the oral and maxillofacial surgery office for the appropriate patient and treatment. Office surgery can be the most efficient and cost-effective way to perform many procedures while maintaining maximum patient comfort and safety.
Because of their dental background and hospital-based training, oral and maxillofacial surgeons are uniquely qualified to deal with injuries to the face, jaws, mouth and teeth. Dental occlusion is the most important piece of the puzzle in dealing with complex facial fractures. Oral and maxillofacial surgeons have extensive training in repairing traumatic injuries, including fractures of the mandible, maxilla and orbits as well as closure of extraoral lacerations. Childhood injuries resulting from skateboarding, sports or bicycle accidents often involve dental of maxillofacial trauma. Younger children often sustain damage to teeth or supporting structures from falls. Such traumatic injuries can usually be effectively treated in the oral and maxillofacial surgery office, avoiding costly emergency room visits.
Infections in the maxillofacial region can develop into life-threatening emergencies if not treated promptly and effectively. Pain and swelling in the face, jaws or neck may indicate an infection of dental or related origin. If the infection is severe, an oral and maxillofacial surgeon is able to work within the hospital setting to diagnose and treat the problem. Appropriate imaging studies and culture and antibiotic sensitivity tests are routinely done. Surgical treatment may include intraoral or extraoral incision and drainage as well as extraction of involved teeth. For less severe infections, evaluation and treatment may be done in the office setting. Depending on the diagnosis and severity of the case, oral and maxillofacial surgeons may work with other specialists to provide comprehensive patient care.
Differential diagnosis of pathology in the maxillofacial region is an important part of the practice of oral and maxillofacial surgery. If indicated, biopsies and/or other tests can be performed to arrive at a definitive diagnosis and appropriate treatment plan. Early detection and treatment of oral lesions greatly improve the patient’s prognosis.
Orofacial Deformities ( Orthognathic Surgery)
Discrepancies in skeletal growth between the upper and lower jaws may lead to both functional and psychological difficulties. Functionally, this may involve problems with chewing, swallowing, speech, or temporomandibular joint (TMJ) function. Patients may also exhibit psychological difficulties stemming from esthetic and social concerns.
Some abnormalities may involve only misaligned teeth and can be corrected orthodontically with braces or other appliances. Serious growth disturbances require surgery to realign the upper and/or lower jaw into a more normal relationship. Common dentofacial deformities, including under- or overdevelopment of the jaws (prognathism, micrognathia, retrognathia) or misaligned teeth (over-bite or under-bite), can cause difficulty in eating, swallowing, speaking, and breathing. Surgical correction of these problems (orthognathic surgery) is often performed in conjunction with treatment by an orthodontist and restorative dentist. Through careful diagnosis and surgical treatment planning, the outcome may be reasonably predicted. Orthognathic surgery is usually performed in a hospital or ambulatory surgical center under general anesthesia. The end result is a more balanced, functional skeletal relationship.
A tooth that fails to emerge or fully break through the gum tissue is by definition “impacted.” This is a common problem associated with third molars, or wisdom teeth, as they are the last teeth to develop and erupt into the mouth. Other teeth, however, such as cuspids and bicuspids, can also become impacted. The usual symptoms associated with impacted teeth are pain, swelling, and signs of infection in the surrounding tissues. An impacted tooth has the potential to cause permanent damage to adjacent teeth, gum tissue, and supporting bone structure. Impacted teeth are also associated with the development of cysts and tumors that can destroy large portions of the jaw. Many times impacted teeth are not addressed until symptoms are present, but early removal may be indicated if radiographs predict potential problems.
Inadequate bone structure in the upper and/or lower jaws can be a result of injury, ablative tumor surgery, or long-term denture wearing. Osseous grafts using either autologous bone or bone substitutes can be performed to improve both the quantity and quality of the hard tissue. Skin grafts and soft tissue corrections can be utilized to improve the architecture of the intraoral soft tissues. Through oral reconstructive surgery, a solid foundation can be provided for dental rehabilitation, which in turn aids nutrition and speech. If the patient is a good candidate, dental implants may be used to replace lost teeth and improve function. Implants can also be used to anchor intraoral and extraoral prostheses.
An Important Link
Oral and maxillofacial surgeons are an important link in the referral network for primary care providers. Through appropriate referrals, patients can be provided with expedient and cost-effective health care for conditions relating to the specialty of oral and maxillofacial surgery.
Source: American Association of Oral and Maxillofacial Surgeons
We can give the apprehensive patient a safe and
comfortable sleep while a restorative dentist performs the necessary dental
treatment.
back to top
Platelet Rich Plasma technology (PRP)
1. Is PRP safe? Yes. During the outpatient
surgical procedure a small amount of the patients own blood is drawn out via
the IV. This blood is then placed into the PRP centrifuge and spun down.
In less than fifteen minutes PRP is formed and ready to use.
2. Should PRP be used in all bone-grafting cases? Not always. In some
cases there is no need for PRP. However, in the majority of cases,
application of PRP to the graft will increase the final amount of bone
present in addition to making the wound heal faster and more efficiently.
3. Will my insurance cover the costs? At this time, probably not.
The Pillar® Procedure
for Mild to Moderate Obstructive Sleep Apnea
Frequently Asked Questions
What is the Pillar Procedure?
The Pillar Procedure is a
simple, effective, first-line treatment for obstructive sleep apnea (OSA)
and socially disruptive snoring. Known by the medical term “palatal
restoration,” the procedure only takes a single, brief visit to Dr.
Caplash's office. After first numbing the area with a local anesthetic,
he embeds three tiny inserts in your soft palate using a specially
designed delivery tool. The inserts cause a stiffening effect in the
palate tissue to prevent vibration (snoring) and obstruction (OSA) of
the airway during sleep.
How does the treatment work?
As throat muscles relax during
sleep, unsupported tissues in the back of the mouth and the throat may
stretch and collapse. This reduces the size of the airway and obstructs
breathing. It can also cause the soft palate to vibrate or undulate,
causing snoring sounds. (Studies estimate that nearly 80% of all sleep
apnea and snoring may be caused either entirely or in part by the soft
palate.) The inserts stiffen the soft palate, reducing its vibration and
ability to obstruct the airway during sleep.
Is it painful?
Because tissue is not removed
or damaged, discomfort is minimal. Some patients use an over-the-counter
pain reliever after the procedure and most are able to resume normal
activities and diet the same day.
How long does the procedure take?
The procedure takes one,
short visit to Dr. Caplash's office.
How does the Pillar Procedure
differ from other treatments?
There are several key differences:
-
Simple treatment. The treatment is done in one brief office visit. Some other treatments require a series of visits or an operating room procedure.
-
Minimal discomfort. Palatal restoration does not require chemical agents, heating or removing tissue. Therefore the procedure causes minimal discomfort and most patients resume normal diet and activities the same day.
-
Results. Most patients report a noticeable improvement within 4 to 6 weeks, and because the implant is designed to be permanent they have the potential of experiencing a lasting effect.
How do I know if the Pillar
Procedure will work for me?
Success with the Pillar
Procedure can be influenced by tongue position, tonsil size and other
factors. Dr. Caplashwill do a physical exam to determine if your palate
is the likely cause of your sleep apnea or snoring and if you are a good
candidate
for the Pillar Procedure.
What kind of results can I expect?
Short-term results show
that most patients experience an improvement within 4 to 6 weeks. Most
patients report a noticeable and lasting reduction in snoring. In nearly
80% of patients in a clinical study, the severity of sleep apnea was
reduced. More than 80% of sleep apnea patients—and their bed
partners—would recommend the Pillar Procedure.
How long does the effect last? Is
it permanent?
The inserts are designed to
be permanent and the effect of the treatment is designed to be
long-lasting because of the effect of fibrosis. This natural tissue
response stiffens the palate and changes its response to airflow. Our
clinical studies show that patient and sleep partner satisfaction with
the procedure remain
high after one year.
How are the inserts placed in the
soft palate?
Each patient receives three
Pillar inserts. The inserts are preloaded into a specially designed
delivery tool. Each insert and its delivery tool are provided in a
sterile package to the physician. To place each insert, Dr. Caplash
inserts the delivery tool into the soft palate. The Pillar insert is
left embedded in the soft palate tissue and the delivery tool is
removed. The palate tissue is not cut or removed.
How big is the insert? What does
it look like?
Each highly engineered,
tiny woven Pillar insert is approximately 18 mm (0.7 inches) in length
and has an outer diameter of approximately 2 mm (0.08 inches). The
inserts are woven from a polyester material that has been used for more
than 50 years in implantable medical products.
Will I notice the inserts in my
palate?
You will not see the
inserts in your palate. A small percentage of patients report feeling a
minor foreign body sensation after the procedure. This sensation is
temporary and subsides after a short time.
Will there be any change in my
voice or will I have any difficulty swallowing?
Physicians have not
reported that patients have experienced any long-term changes in voice
or difficulty swallowing.
What kind of complications have
you seen?
Since the procedure does not involve removing or
damaging tissue, the risk of complication is extremely low. There have
been no reported major adverse events.
Minor complications have consisted of partial extrusions that have been
readily resolved by the physician simply removing the insert. A partial
extrusion occurs when the tip of the insert can be felt or seen through
the surface of the palate tissue. Most patients request to have the
insert replaced because they were pleased with the results. Since
launching the product in the US, there have been fewer than 1% reported
partial extrusions.
Can the inserts be removed?
Yes. An insert can be
removed in Dr. Caplash's office with a simple procedure with no special
surgical tools. A patient can also have a new insert placed at the time
of removal.
What is the reimbursement for the
procedure?
The diagnosis and treatment
of sleep apnea is traditionally reimbursed. Restore Medical, the
manufacturer of the Pillar Procedure, is actively working with both
government and private payers (insurance companies and others) to secure
coding for the Pillar Procedure. Currently, insurers will make a
case-by-case decision whether or not to cover the procedure.
How many people are affected by
sleep apnea and disruptive snoring?
It is estimated that more
than 40 million Americans suffer from some form of sleep-disordered
breathing. Of these, more than 12 million suffer from some form of sleep
apnea.
What are the risks if I choose not
to have my sleep apnea treated?
Because of the serious
disturbances in their normal sleep patterns, people with sleep apnea
often feel very sleepy during the day and their concentration and
daytime performance suffer. The consequences of untreated sleep apnea
range from annoying to life-threatening. They include symptoms
suggesting depression,
irritability, sexual dysfunction, learning and memory difficulties, and
falling asleep while at work, on the phone, or driving. Untreated sleep
apnea patients are at least 3 times more likely to have automobile
accidents. Additionally, it has been estimated that up to 50% of sleep
apnea patients have high blood pressure. Also, risk for heart attack and
stroke may also increase in those with sleep apnea.
We endorse CareCredit Patient Payment Plans. To learn more about this option click here.
The Linden Oaks Medical Campus
Surgery Center
10 Hagen Drive,. Suite 230
Rochester, NY 14625 directions and map
Contact Information
Office: 585-442-1492
Fax: 585-442-7825
Answering Service: 585-723-6564
email: jcaplash@rochester.rr.com
Home / About Our Practice / Meet Dr. Caplash / Meet Our Staff / Procedures / Typical Postoperative Instructions / Questions / CareCredit Patient Payment Plans / Office Policies / Office Hours / Map & Directions / Contact Us
Copyright 2004 Dr. Jolly Caplash. All rights reserved.
Web Design by M.Panessa
Hosting by Precisehosting.net
