Eon Clinics:
Medically related questions that you may have.

In order to keep you well informed, we have gathered relevant medically related queries, as asked by our patients and answered by our team of clinicians and board of directors. In addition, below are published interconnected inquiries on insurance issues, medications, pre, post and day of surgery procedures, and other such topics.

Kerry Voit, dental implant doctor

Typical, yet different

The following questions are typical; however your particular case should be fully discussed with your own medical doctor(s). In addition, all cases are individual and unique, and we at EON Clinics have an entire team dedicated to address your specific concerns.

Presurgical

Will antibiotics be prescribed prior to surgery? What kind? For how long?
Most oral surgeons do not prescribe preoperative antibiotics, however antibiotics given at the time of surgery via IV may be indicated. We will commonly use antibiotics such as clindamycin and amoxicillin that kill bacteria found in the mouth known as oral flora (an oral bacterium). The specific drug used will depend on the operation and the allergy profile of the patient. A short post operative course of antibiotics is almost always prescribed.

Are there any medications and/or vitamins that need to be avoided? If so, for how long?
Prior to surgery you will discuss your medications with your surgeon. Aspirin, and other types of blood thinners such as Coumadin, should be stopped a week before the operation as it can increase bleeding. Most other medications should be continued. Again, it is very important to discuss these and other medications with both your primary care doctor and your oral surgeon before the implant procedure.

Are there food and drink restrictions prior to surgery?
Only if the patient is being sedated. In this case, the patient should not consume anything, including water, 6 - 8 hours prior to the procedure.

Surgery

What anesthesia will be used? How will it be administered?
The patient and surgeon will discuss anesthesia options. It is our goal to provide state of the art care with minimal discomfort. Local anesthesia (a drug such as lidocaine) can be injected at the surgical site. If the operation is more involved, sedation will be used via an IV placed in the arm or hand.

Will vital signs be monitored?
Yes, with sedation the oral surgeon and surgical assistants will continuously monitor the vital signs.

Will sedatives and/or anti-anxiety medication be used? Which one(s)?
With IV sedation all of the drugs have anxiolytic (anti-anxiety) and sedative properties designed to relax you. These include propofol, Versed, and possibly a narcotic such as fentanyl. A preoperative oral sedative can be prescribed in some cases.

What type of pain management will be administered?
During the procedure a local anesthetic to help block pain, such as lidocaine, will be given. Following the procedure, a combination of adequate pain medications mixed with a non steroidal anti-inflammatory such as ibuprofen will be prescribed.

What is estimated length of surgery?
Single tooth implants can be placed in less than 30 minutes, multiple tooth implants can be up to an hour, while a full jaw could be 2-3 hours.

Are implants placed within gum line so natural gums are visible/grow over implants? Or are implants constructed with artificial gums and placed over natural gums (similar to traditional dentures)?
Placement of the implants depends on many factors, with outstanding results. The surgeon and prosthodontist, along with the patient's input, will decide which option is best.

Is there much blood loss?
It would be very very rare to have significant blood loss.

If jaw bone density was evaluated and found appropriate prior to surgery, is it possible to find inadequate bone density during surgery and further exploration, resulting in inability to complete the procedure? What alternatives are available if this should occur?
In these rare occasions, either immediate bone grafting or staged bone grafting can correct the problem. The key is to hold off on implant placement if the chance of osseointegration (the implant fusing to the bone) is poor.

How many implant procedures has your team placed?
EON Clinics' clinicians have placed and restored thousands of implants, all with success rates greater than 97%.

Post-Surgical

How long do I need to stay at your office following surgery? What criteria must be met before I will be released to go home?
If sedation is used we will have you stay approximately 20 minutes. The patient must be alert and oriented prior to leaving by assessing vital signs and mental status at regular intervals. Basically, you can be tired when you leave but you should be alert.

What pain medication will be prescribed? Which one(s) and for how long?
Most prescribed drugs include Percocet or Vicodin for 3-5 days post operative.

Will antibiotics be prescribed following surgery? Which one(s) and for how long?
In most cases, depending on the procedure itself, amoxicillin or clindamycin is prescribed for 7 days post operative. We also recommend an antimicrobial mouth rinse called Peridex for 1 week.

Recovery

How long will I need to be off work?
Depending on the extent of the procedure and what you do for work, anywhere from a matter of hours to 4 days.

Is there likely to be any facial bruising?
There can be some bruising, particularly if many teeth are removed and numerous implants placed. Women and light skinned individuals may bruise more.

When can I resume fluid intake? Food - soft, normal?
Clear liquids can be started immediately. Patient's diet will be determined based on the extent of the surgery and recovery protocol.

Are there restrictions for activities? Driving?
With sedation there should be NO driving until the following day. Depending on the extent of surgery, and in the most severe cases, curb strenuous activities for 7 days.

How soon do I need to return to office for post-surgical follow-up?
Within one week, depending on the case. Your implant coordinator will determine your recall visits and our post operative staff will keep you informed of your appointments.

Insurance

Are any surgical procedures covered under medical benefits? My dental benefits are limited to $1,500.00 per calendar year.
Typically, medical insurance will cover implant/tooth replacement procedures related to the following types of conditions: 1) trauma, say you lose your front teeth after a car accident, 2) loss of teeth due to a medical condition, 3) if teeth are lost in the course of tumor treatment, 4) a congenitally missing tooth.

Are anesthesiologist's fees billable to medical insurance?
At EON Clinics the oral surgeon administers the anesthesia, which is included in the fee.

General

I am sure that the best post-operative care will depend on giving up smoking. Do you have any comments with regard to drugs to assist in accomplishing this, Chantix in particular?
Chantix has the best rate of success with regards to quitting. It should be started with physician monitoring prior to the operative date.

What type of cleaning is required? At home? Professional?
Both at home and professional cleaning are required. The tissue surrounding an implant can become chronically inflamed as a result of poor hygiene and lead to peri-implantitis. This can cause the implant to fail. Single unit implants should be flossed and brushed, where as an implant supported bridge should be brushed as per protocol.

How often do I need to return for maintenance, cleanings?
Regardless of the number of implants placed, we prescribe 6 month recall visits for maintenance and cleaning.

Will xrays/CT scans be used to assess for potential problems?
CT scans are used throughout the procedure to assure proper healing.

Will the implants need replacing (outside of extreme circumstances i.e. physical injury)?
Under normal conditions, implants will last a lifetime and in the rare case of failure, EON Clinics will replace the implant and associated bridge work at no charge to the patient for life. A lifetime guarantee.

How long can the temporary bridge remain? When is permanent bridge placed? Is this a surgical procedure?
The provisional bridge (referred to as the provisional implant supported bridge) is designed to last 6 months under normal wear. At that point, the final bridge (referred to as the definitive implant supported bridge) will be placed and is designed, under normal wear and following a maintenance and checkup routine, to last a lifetime.

Are there any additional costs/fees to expect?
All fees will be discussed prior to surgery, during the consultation appointment. You will be given a thorough examination to help determine your immediate needs, concerns, and to give you enough information to make an informed decision regarding the best possible treatment for the best possible outcome. One cost will be presented, and that is the cost.

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