Why do I need a consultation?

Dental Implants Dental Surgery Oral Surgery TMJ

When making appointments at our practice whether it is for extraction of wisdom teeth, dental implants, TMJ or tooth extractions and other dentoalveolar procedures the front office staff is almost always told/asked “I don’t need a consultation I just need the procedure done.”  In the back of my mind I always wonder if the same patient would feel the same if they were having a leg amputated or open heart surgery.  To say, “it’s no big deal”, or “it’s just a tooth”, shows a lack of understanding of how an individual’s medical history and the procedure to be done work together.  The answer that is typically received with an aggravated sigh is that the timing of the procedure will be determined by the doctor at the time of the procedure.  Because this conversation is inherent in our business we know that most people would like their procedure done in a timely fashion if not the same day and we make every effort to accommodate our patient’s wishes.  There are, however, many times when we have to have patients come back for their procedure.  The following is a list of reasons why we may have to delay dental surgery for another day:

  1. Anesthesia- this is a very broad category. If the patient had ANYTHING to eat or drink that day surgery would need to be delayed.  That’s the most common cause of delay.  In addition however, sedation or general anesthesia requires 3-4 devoted staff members and the doctor to safely monitor and recover from the procedure.  The schedule that day may limit the number of available personnel and make performing the procedure impossible.
  2. Difficult procedures- Third molar surgery, bone grafting, TMJ procedures, multiple tooth extractions and many other procedures may not be possible in the allotted time. The time necessary for any particular surgery cannot accurately be determined until the doctor reviews the x-rays and does an examination.  I think most patients would agree it would be better to have the surgeon’s undivided attention during any procedure that requires more than just a few minutes.
  3. Medical problems- some patients have medical issues that interfere with the normal healing process that may cause a delay. Patient’s on blood thinners, steroid medications, bone medications (bisphosphonate medicines) may need adjustments to the medications prior to surgery to prevent complications.  In addition patients with uncontrolled blood pressure, diabetes, COPD or other illness may not be able to undergo elective surgeries of any kind due to unnecessary risk.
  4. Office schedule/emergencies- as a surgical practice and specifically with our practice where we handle emergencies in the hospital and regional area we encounter situations that may be an absolute emergency. These occasional interferences in our normal practice schedule are unable to be planned for and take away time that would have been used to perform elective unscheduled surgery at our office.

Keep in mind that this list of reasons why surgery may be delayed to another day is brief and nowhere near complete.  Many other reasons exist for delaying surgery including allowing patients to reasonably consider surgical complications, financial and insurance issues and other daily nuances of our specialty which may not result in everyone getting what they want on any given day.  And although we try to provide a place where your needs are always taken care of we appreciate your understanding when things don’t go as expected.