Resource Center

Please contact us to schedule an initial consultation with Dr.
McGann.You’ll need to fill out this form online before you come in.

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.

Your initial appointment will consist of a consultation explaining your diagnosis and treatment options. Occasionally, surgery can be performed 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 and any x-rays if applicable.
  • A list of medications you are presently taking.
  • A copy of your current medical or dental insurance.

 

IMPORTANT: All patients under the age of 18 years of age must be accompanied by a parent or guardian at the consultation visit

For years, McGann Facial Design has been serving the specific needs of patients visiting San Diego for their care. We make every attempt to make your visit to our office before, during, and after your procedure as seamless and convenient as possible. During your initial consultation with Dr. McGann, we take your full history and recommend a tailored treatment plan. In order to ensure all details are covered, we schedule a final workup or pre-op visit anywhere from 3 weeks before your scheduled surgery. You can expect to stay in San Diego for at least 2 weeks after surgery for post-op visits and to make sure you are healing appropriately. Typically, Dr. McGann will not need to see you after this week and you can continue your care with your home-town dental professional.

At McGann Facial Design, we make every effort to provide you with the finest surgical care and the most convenient financial options. To accomplish this goal, we work hand-in-hand with you to maximize your insurance reimbursement for covered procedures. As always, if you have any questions, please ask our staff.

For your convenience, we accept Visa, MasterCard, Discover, debit, and cash. We deliver the finest care at the most reasonable cost to our patients; therefore, insurance co-payment is due at the time of service. If you have questions regarding your account, please contact us at (858)874-8181. Many times, a simple telephone call will clear any misunderstandings. Please remember that you are fully responsible for all fees charged by this office regardless of your insurance coverage.

Pre-Operative Care

Pre-Operative Examination

Anywhere from one week before your surgery to the day of surgery, Dr. McGann will perform a medical history and physical examination to make sure there are no potential medical problems for your surgery. These tests may include laboratory blood and urine tests, a chest x-ray, and an electrocardiogram.

Hospitalization and Surgery

Diet

To aid your recovery, you will need to do the following:

1. Acquire a Blender

Before you go into the hospital, you should purchase or borrow a blender or food juicer. Any food that you normally eat can be blended into a meal you can eat while you are recovering from your surgery. Your favorite foods may look different, but they will still taste the same.

2. Eat Healthy Foods

Eating plenty of fresh fruits and vegetables helps your body get all of the vitamins, minerals, and fluids it needs in order to recover from your surgery. To make sure all of your dietary needs are met, you will want to purchase dietary supplements such as multivitamins that include iron and calcium. In addition to eating enough fresh fruits and vegetables, make sure that you eat enough protein, carbohydrates, and calories to help your body recover. While your jaws are held in place with elastics, you will eat about six times per day, but you will consume smaller meals.

3. Do Not Eat Prior to Surgery

You will be asked not to eat or drink anything past midnight on the day prior to your surgery. This will ensure that you have an empty stomach for your procedure, which helps ensure a safe procedure.

Anesthesia

A member of the hospital anesthesia department will discuss your surgical anesthesia with you, including its benefits, risks, side effects, and potential complications. This person will be happy to answer any questions you may have about your anesthesia.

Possible Side Effects and Complications

Swelling

After your procedure, you can expect to see significant facial swelling. During the second and third weeks, swelling should reduce significantly. To minimize swelling, you will be given steroids to accompany the use of ice packs. Getting out of bed and keeping your head elevated will assist with keeping the swelling at a minimum.

Nausea, Vomiting, and Bleeding

Nausea, vomiting, and bleeding may occur. In addition, if you feel nauseous and need to vomit, remember to stay calm and turn your head to the side to ensure that any fluids clear your mouth easily. Vomiting is not a life threatening situation after your procedure, since your stomach will be empty. It is common to vomit once after surgery to clear the blood in your stomach.

It is not uncommon to experience some minor bleeding and increased salivation after surgery. If you had upper jaw surgery, you may experience some oozing of blood and mucous from your nose. If you do, nurses will have access to a suction device at your bedside that will remove any blood that accumulates.

Post-Operative Discomfort

Discomfort is not uncommon after surgery. However, in most cases it is mild. Dr. McGann will prescribe medications as needed to help you manage your discomfort. If bone is taken from your hip for a bone graft, you may experience pain after your procedure. According to many patients, the discomfort experienced after jaw surgery is no worse than the discomfort of having wisdom teeth removed. Please remember that every attempt will be made to keep you as comfortable as possible.

Nasal Congestion and/or Stuffiness

The placement of tubes in the nose and surgery on the upper jaw can sometimes lead to nasal congestion or stuffiness. This can be managed with nasal sprays and regular cleaning of the nostrils. It is suggested that you clean your nostrils with q-tips and a 3:1 solution of water (3 parts) and hydrogen peroxide (1 part).

Splint

A plastic splint has been constructed from the impressions taken during your examinations. This splint will be used during your surgery to ensure an accurate and aesthetically pleasing result. Sometimes this splint will be left attached to your upper jaw, much like a mouth guard, in order to ensure a quality result. The splint will be removed at a later time. Whether or not the splint will be used after your surgery is usually dependent upon the type of surgery that is being performed.

Jaw Wiring

While jaw wiring was once prevalent in jaw surgery, it is now a very rare occurrence. On very rare occasions, jaws will be wired shut after surgery to ensure a quality result from your procedure. The length of time that jaw wiring may be necessary is dependent upon the type of surgery performed.

Post-Surgical Care and Home Care

After your surgery, there are a few things that you can do to improve your recovery period. You will be asked to do the following:

1. Don’t Chew Hard Foods

Your jaws are held together with plates and screws. Chewing on food can cause them to get infected and need additional surgery to be removed. Chewing can also move the jaws and teeth, and can cause the need for surgery to be redone, or have extended orthodontic time to finish your case.

2. Take Your Medications

You will be prescribed medications to be taken during your hospital stay. These medications may include antibiotics, pain medications, nasal sprays, medicated cream for your lips, or Peridex oral rinse. You will likely continue these medications after you are released form the hospital. Remember to take your medications as directed.

3. Maintain Good Oral Hygiene

After your surgery, it is important that you keep your mouth clean to minimize the chance of infection and to maintain dental health. Use a soft-bristled (baby) toothbrush and Peridex. Be sure to keep the brush in contact with your teeth as you brush them. Brush 5 times a day to keep teeth clean.

4. Walk as Soon as Possible

After your surgery, you are encouraged to try to walk as soon as it is determined safe. Getting back on your feet and walking is very healthy and will aid your recovery. The better you prepare yourself mentally, physically, and nutritionally to get back to your routine, the quicker your recovery will be.

5. Practice Speaking to Others

After your surgery, speech may be difficult. However, you can improve your recovery and your ability to speak through practice. Remember, the best way to be understood is to speak slowly, concentrate on each word, and calmly try to be understood if you have to repeat what you have said.

6. Avoid Smoking

Smoking may delay healing as well as stain your teeth. Not smoking during your recover will improve the smile you have at the end of your treatment.

7. Take Care of Your Jaw

Remember that pressure changes can be painful and can compromise your results. Avoid situations like changing altitudes, blowing your nose, sneezing through your nose, and intense exercise, as these things can cause significant changes in intraoral pressure. Don’t lift heavy weights or do anything that causes you to clench your teeth together.

When and what can I eat?
You can eat and drink as soon as you leave our office, however it may be difficult while you are numb. Most people prefer to eat soft and cool foods. Avoid hot and chewy foods while you’re numb so you won’t bite your tongue, lower lip, or burn your mouth. The numbness of the upper jaw lasts for up to 4 hours, while the lower jaw stays numb for as long as 6-8 hours. You will have gauze in your mouth throughout most of the day of your surgery. Take the gauze out to eat and drink, then place a new piece when you’re finished until it stops bleeding . STRAWS – Do not use a straw for 1 week if you had upper molars or upper wisdom teeth taken out, or if the doctor tells you that the sinus was visible upon extraction.

How long do I keep the gauze in my mouth?|
You need to change the gauze every hour (you are sent home with enough gauze to last you all day). It is normal to ooze blood for the rest of the day, sometimes up until bed time. You do not need to sleep with the gauze in your mouth, however we recommend sleeping with a towel on your pillow due to possible oozing that may occur overnight. If you have excessive bleeding moisten a tea bag (regular black tea) and bite on it for 30 minutes in place of gauze. The tannic acid in the tea bag helps to form a clot.

Most patients find that biting on the gauze is a very uncomfortable part of the recovery – don’t get discouraged. You may change the gauze every 30 minutes if it becomes bothersome.

Should I use ice or heating pads right after the surgery?
You should start icing as soon as you get home – 20 minutes on, 20 minutes off (if you had teeth extracted on both sides, switch the ice pack from side to side every 20 minutes) for about 1 hour. Take a break for an hour, and then go back to icing, continuing this routine throughout the day. This will significantly reduce the swelling that may appear the morning after your surgery, and can last for 3-4 days. DO NOT apply heat to the area.

To manage your pain effectively after surgery, follow this guideline:

  1. Start with 600-800mg of Ibuprofen OR 500-650mg of Tylenol if you cannot take NSAIDs (ex. Naproxen/Aleve, Advil, Aspirin) Still in pain?
  2. Take 1 Tylenol 8-Hour (650mg) if you haven’t done so already. Still in pain?
  3. Take 1 tablet of Oxycodone/Percocet OR Hydrocodone/Lortab OR Tylenol #3 with Codeine every 4-6 hrs. Still in pain?
  4. Continue taking 600-800mg of Ibuprofen together with 1 tablet of Oxycodone/Percocet OR Hydrocodone/Lortab OR Tylenol #3 with Codeine every 4-6 hrs. Severe pain?
  5. Take 600-800mg of Ibuprofen with 2 tablets of Oxycodone/Percocet OR Hydrocodone/Lortab OR Tylenol #3 with Codeineevery 4-6 hrs. (DO NOT exceed 12 tablets OR 4000mg of acetaminophen/ Tylenol in 24 hours)

DO NOT mix Tylenol with Oxycodone/Percocet OR Hydrocodone/Lortab OR Tylenol #3 with Codeine as they all have acetaminophen.

If you are taking Oxycodone/Percocet OR Hydrocodone/Lortab OR Tylenol #3 with Codeine you should not be driving nor doing anything that requires concentration as these are strong pain medications that may cause drowsiness.

The 3rd day after the surgery is usually the most painful but you should start to feel better after the 3rd day, however it is not unusual to have soreness for 7-10 days. If it’s been 1 week and you have more pain, swelling, or a fever, give us a call for further evaluation.

Do I have a dry socket?
After a tooth is extracted, a blood clot forms in the tooth socket which starts the healing process. When the clot is dislodged or it doesn’t form, it leaves a bony hole that throbs and hurts beyond the help of the strongest pain medication. If after the 4th day you are experiencing extreme, unbearable pain (10 on a scale of 1-10) that does not seem to subside with any combination of prescribed medication, there is a possibility of a dry socket. Contact our office.

*The most common causes of dry socket can be smoking, or debris left in the extraction socket from improper rinsing.

Why can’t I open my mouth very wide?
Stiffness of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is normal and will resolve in time. Stretching the jaw during the day will help with the feeling of tightness.

When can I resume my daily activities?
We recommend that you refrain from physical activities (e.g. working out, running, playing sports) for 2 days after your surgery. The more active you are, the more swelling and bleeding you may have.

You can go back to work or school the next day. After extraction of all 4 wisdom teeth, most people prefer to have 2 days off to recover.

You can brush your teeth as normal; just don’t brush right over the extractions sites to avoid irritating your gums.

*If you were asleep for the procedure, you should not be driving until the next morning.  The medications used during sedation make you sleepy, dizzy and forgetful.

How do I take care of my mouth after the surgery?
It is very important to keep your mouth clean. You need to start rinsing your mouth after you eat with warm salt water (1 cup of warm water and 1 teaspoon of salt or Peridex rinse if you were prescribed it) the next day after your surgery. If you had an extraction on your lower jaw, you will have an irrigating syringe in your post-op bag to start using the next day on the bottom only. Continue rinsing with salt water or using the syringe until the hole from the extraction site closes, which can take up to 1 month. When using the syringe, be sure to place the curved tip inside the hole to ensure adequate cleaning. This is crucial in preventing infections. Don’t be alarmed if there is a little bit of blood mixed with the saliva. You do not need to use the syringe after extraction of upper teeth. If you were prescribed Peridex mouth wash use it only for 1 week after surgery, then switch to salt water until the extraction sites close.

Do I need to have my sutures removed?
After surgery, the recovery assistant will inform you and your escort if sutures have been placed and all needed instructions for aftercare. All sutures will dissolve unless noted in your directions.

I feel something sharp/ hard on my gums. Is there still a piece of tooth left?
During your extraction we ensure that all of the tooth is removed, and the extraction socket is flushed and cleaned. What you may be feeling is what is called a bone spicule. It is not uncommon and can be painful and irritating while it is present. They will usually surface and resolve on their own but sometimes they do not and become quite bothersome. If you feel that you have a bone spicule and it is causing you irritation, please call our office to schedule a post op visit. Removal of the bone spicule can be done with just a little bit of numbing medicine.

Do I need to take antibiotics after my extraction?
Most extraction cases do not require post op antibiotics. Once the tooth is removed any infection caused by the tooth is generally resolved. If you feel like you are developing a post op infection, call our office for a post op visit and we will evaluate the extraction site and determine if antibiotics are needed.

What do I do about my missing tooth?
If the tooth you had extracted is not a wisdom tooth, you may be able to replace it with a dental implant. Please call our office and we will schedule your consultation for 3 months after the extraction site has healed.