WELCOME to Southwest Oral & Maxillofacial Surgery, PA

It is our pleasure to WELCOME you to our practice! Dr. Marshall and his staff are committed to excellence and making your surgical experience as pleasurable as possible. We treat every patient as we would a family member and have earned our outstanding reputation, one patient at a time, on that fundamental principle.

Background Information

Oral & Maxillofacial Surgery requires up to 6 additional years of hospital based surgical and anesthesia training. As an Oral and Maxillofacial Surgeon, Dr. Marshall manages a wide variety of problems relating to the mouth, teeth and facial areas. Dr. Marshall practices a full scope of Oral & Maxillofacial Surgery with expertise ranging from wisdom teeth removal to corrective jaw surgery and dental implants. He can also diagnose and treat facial trauma and tmj disorders, and performs a full range of advance bone grafting procedures for implant site development.

Surgical Staff

The surgical staff at Dr. Marshall’s office are experienced Oral & Maxillofacial Surgery Assistants. They are trained in assisting with IV anesthesia within the facility. Dr. Marshall and staff continuously monitor patients during and after surgery.

Initial Consultation

Your initial appointment will consist of a consultation explaining your diagnosis and treatment options. Occasionally, surgery can be done the same day as the consultation. However, a complex medical history or treatment plan will require an evaluation and a second appointment to provide treatment on another day.

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

  • Your surgical referral slip from your referring dentist and any current x-rays if applicable
  • A list of medications you are presently taking, and any medication allergies
  • If you have medical or dental insurance, bring the necessary completed forms and insurance cards. This will save time and allow us to help you process any claims.

IMPORTANT: All patients under 18 years of age must be accompanied by a parent or guardian before any procedure can be performed.

A pre-operative consultation and physical examination is mandatory for patients undergoing IV anesthesia for surgery. Please have nothing to eat or drink 6 hours prior to your surgery. You will also need an adult to drive you home. That driver must accompany you and remain in our facility to drive the patient home after the procedure. Most procedures are accomplished within approximately one hour. During this time the driver will receive important post-operative care instructions. This responsible adult must also stay with the patient at home while recovering from anesthesia.

Please alert the office if you have medical conditions 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, etc.) Pre-medication or a change in medications may be required prior to surgery.

X-rays

If your dentist or physician has taken x-rays within the past year, you may request that they forward them to our office. If there is not enough time, please pick them up and bring them to our office. If additional films are necessary, they can be taken at our facility.

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Scheduling

Dr. Marshall is open Monday - Friday 8am – 5pm. We will schedule your appointment as promptly as possible. If you have pain or an emergency situation, every attempt will be made to see you that day.

We try our best to stay on schedule to minimize your waiting. Due to the fact that Dr. Marshall provides surgical services, various circumstances may lengthen the time allotted for a procedure. Occasionally, we experience emergency scheduling of patients involved in accidents and other emergencies. We do try to stay on schedule; however, there are instances when even the best plans cannot control your waiting room time. In case of a long wait or unanticipated emergency, we will be happy to reschedule another convenient time for you.

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Insurance Information

Our insurance coordinators deal with many different insurance companies. Some companies offer many different dental and medical plans. Some companies combine dental and medical coverage. This insurance alphabet soup changes polices and guidelines weekly. At times, it is almost impossible to accurately estimate our patient’s insurance co-payment. Many insurance companies will not give out fees until after the treatment is completed. Dealing with these companies can be difficult and time consuming. As a courtesy, we ask that you keep us informed of any changes to your insurance. It is important that all information about you and your insurance be current. Many times a pre-determination / pre-authorization in writing is required prior to treatment.

Co-Payment - co-payments are payable at the time of service.

HMO Patients – If a patient comes to us with a problem that they expect to be covered by medical insurance, (biopsies, tumors, TMJ, infections, jaw deformities) they must have a referral from their primary care physician. A referral from a dentist is not adequate for medical insurance coverage. Obtaining a medical referral is the patient’s responsibility. We cannot obtain the referral for you, and the referral cannot be obtained retroactively. If you do not have a referral, we will be happy to see you on a cash basis, but your medical insurance company will not pay for your treatment.

Medicare Patients – Medicare pays us directly for your care. You are responsible for any deductibles and co-insurance. Dental procedures (extractions, implants) are not covered by Medicare. If Medicare denies your procedure, you are responsible for the charges.

Private and Group Insurance – As a courtesy, we will file your insurance claims for you. Upon receipt of an insurance payment, any balance due will be billed to you. If you have deposited a co-payment, the difference will be refunded to you.

If you have any problems or questions, please ask our staff. They are well informed and up-to-date. Please call if you have any questions or concerns regarding your initial visit.

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Financial Options

For your convenience we accept Cash, Check, Visa, MasterCard, American Express, and Discover. We deliver the finest care at the most reasonable cost to our patients, therefore payment is due at the time service is rendered unless other arrangements have been made in advance. If you have a question regarding your account, please contact us at 972-566-7622. Many times, a simple telephone call will clear any misunderstandings.

Please remember you are fully responsible for all fees charged by this office regardless of your insurance coverage.

We will send you a monthly statement. Most insurance companies will respond within four to six weeks. Please call our office if your statement does not reflect your insurance payment within that time frame. Any remaining balance after your insurance has been paid is your responsibility. Your prompt remittance is appreciated.

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SURGICAL INSTRUCTIONS


Pre-operative Instructions for Patients undergoing Intravenous Anesthesia.

  • You may not have anything to eat or drink (including water) for six (6) hours prior to the appointment. Ask your doctor if you should take your regular medications.
  • A responsible adult must accompany the patient to the office, remain in the office during the procedure, and drive the patient home.
  • The patient should not drive a vehicle or operate any machinery for 24 hours following the anesthesia experience.
  • Please wear loose fitting clothing with sleeves which can be rolled up past the elbow, and low-heeled shoes. Contact lenses, jewelry, and dentures must be removed at the time of surgery.
  • The removal of impacted wisdom teeth and surgical extraction of teeth is quite different from the extraction of erupted teeth.
  • The following conditions may occur, all of which are considered normal:
    • The surgical area will swell
    • Swelling peaks on the 2nd or 3rd post-operative day
    • Trismus (stiffness) of the muscle may cause difficulty in opening your mouth for a few days.
    • You may have a slight earache
    • A sore throat may develop
    • Your other teeth may ache temporarily. This is referred pain and is a temporary condition
    • If the corners of the mouth are stretched out they may dry and crack. Your lips should be kept moist with cream or ointment.
    • There will be a space where the tooth was removed. After 24 hours this should be rinsed following meals with warm salt water until it is healed. The cavity will gradually fill with new tissue.
    • There may be a slight elevation of temperature for 24 to 48 hours. If temperature continues, call our office.
    • It is not unusual to develop discoloration in the area of an extraction.
    • Please take all prescriptions as directed.


Women please note: Antibiotics may interfere with the effectiveness of your birth control pill (please check with your pharmacist).


Care of Mouth After Surgery

  • Keep fingers and tongue away from socket or surgical site.
  • Use ice packs on surgical area (side of face) for first 48 hours.
  • For mild discomfort take Ibuprofen up to 400mg every 6 hours.
  • For severe pain use the medication prescribed to you.
  • Drink plenty of fluids. (Do no use a straw).
  • Beginning the third or fourth day after surgery, if the muscles of the jaw become stiff, the use of warm, moist heat to the outside of your face over these muscles will help relieve this.
  • After the first post-operative day, use a warm salt-water rinse following meals for the first week to plush particles of food and debris which may lodge in the surgical area, (1/2 teaspoon of salt in a glass of warm water). Diet may consist of soft food which can be easily chewed and swallowed. No seeds, nuts, rice, popcorn, etc.
  • Diet may consist of soft foods which can be easily chewed and swallowed. (NO SEEDS, NUTS, RICE, POPCORN, ETC.)
  • A certain amount of bleeding is to be expected following surgery. Bleeding is controlled by applying pressure to the surgical area using small rolled gauze for 90 minutes. After that time remove the gauze and then you may eat or drink. If bleeding persists, a moist teabag should be placed in the area of bleeding and you should bite firmly for one hour. This will aid in stopping the oozing. Repeat if necessary. If bleeding still persists call our office.


If the muscle of the jaw becomes stiff, chewing gum at intervals will help to relax the muscles, as well as the use of warm moist heat to the outside of your face over these muscles.

We suggest that you do not smoke for at least 5 days after surgery. Nicotine may break down the blood clot and cause a “dry-socket”.

Feel free to contact us if any doubt arises as to your progress and recovery. Life threatening emergencies - CALL 911.

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Post-operative Instructions

What you should do following extractions and other oral surgery procedures?

A certain amount of bleeding, pain, and swelling is normal. Reduce your activity as much as possible for 48 hours. Physical activity may hinder formation of a blood clot which is necessary for proper healing.

Do not be alarmed if your vision is blurred for a time following anesthesia or if “black and blue” bruise should appear at the site of an injection. The arm also may be bruised, swollen and tender to touch due to the IV.

Follow the simple below to minimize complications and help insure prompt recovery.


To Control Bleeding

  • Immediately following procedure: keep steady pressure on the extraction site by biting firmly on the gauze. Pressure helps reduce bleeding and permits formation of a clot in the tooth socket. Gently remove the compress after the local anesthesia has worn off and normal feeling has returned.
  • After 24 hours: some oozing of blood may persist. If necessary, resume use of moist tea bags. After bleeding has stopped, cautiously resume oral hygiene.


To Relieve Pain

  • Immediately following procedure: begin taking medication as directed by Dr. Marshall or the Surgical Staff to minimize discomfit when the anesthesia wears off and feeling is back to normal. Application of ice bag can also help relieve discomfort.
  • After 24 hours: continue to take your medication if pain persists, use ice if needed.


To Minimize Swelling

  • Immediately following procedure: apply an ice bag over the affected area. Use 20 minutes on and 20 minutes off for 48 hours to help prevent excessive swelling and discomfort. If an ice bag is unavailable, simply fill a heavy plastic bag with crushed ice. Tie end securely and cover with a soft cloth to avoid skin irritation.
  • After 48 hours: it should not be necessary to continue with cold applications. You may expect swelling for 10 days to two weeks and a fever of 99 to 100 degrees Fahrenheit.


Special Consideration following Removal of Impacted Teeth

  • Removal of impacted teeth is a surgical procedure. Postoperative problems are not unusual, and extra care must be taken to avoid complications.
  • Severity of postoperative pain will depend on the procedure and your physical condition. Take medication for pain precisely as directed.
  • Healing of the surgical site is variable.
  • Swelling can be expected. Be certain to apply ice bags as directed above.
  • Difficulty in opening your mouth widely and discomfort upon swallowing should be anticipated.
  • Numbness of lips and/or tongue on the affected side may be experienced for a variable period of time.


ORAL HYGIENE IS IMPORTANT

Twenty-four hours after surgery, rinse mouth gently with a solution of one-half teaspoonful of salt dissolved in a glass of water. Repeat every meal or snack for seven days. Rinsing is important because it removes food particles and debris from the socket area and thus helps prevent infection and promote healing. Brush tongue with a dry tooth brush to keep bacteria growth down, but be careful not to touch the extraction site.

Resume your regular tooth brushing, but avoid disturbing the surgical site so as not to loosen or remove blood clot.

IN CASE OF PROBLEMS

If you should have any problems such as excessive bleeding, pain or difficulty in opening your mouth call our office immediately our phones are answered 24 hours a day - for further instructions or additional treatment.

REMEMBER YOUR FOLLOW-UP VISIT

It is often advisable to return for a post-operative visit to make certain healing is progressing satisfactorily. A follow-up visit will be schedule. There still may be sutures (stitches) that have not re-sorbed, these may be removed at your followup visit. In the meantime, maintain a healthful diet, observe rules for proper oral hygiene and visit your dentist for regular checkups.

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Register Online

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Please Note:

Our online forms use the Adobe Acrobat 5 Plugin to allow patients the convenience of completing their health history and registration forms from home or work. Please download the free plugin from Adobe's web site if it is not already installed on your system. It is important that you have at least version 5 of the plugin, in order to successfully use our forms.


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