Carson Valley Oral Surgery
Edward Gray, D.M.D., M.D.


Welcome to Our Website

Introduction

Dr. Edward Gray completed a dual-degree Oral and Maxillofacial Surgery program. His training includes; degrees in Pharmacy, Dentistry, Medicine, and completion of a surgical residency in Oral and Maxillofacial Surgery, including one year of General Surgery. Oral and Maxillofacial Surgery requires up to 6 additional years of hospital-based surgical and anesthesia training, after graduation from college and Dental School. As an Oral and Maxillofacial Surgeon, Edward Gray DMD, MD manages a wide variety of problems relating to the Mouth, Teeth and Facial Regions. Edward Gray DMD, MD practices a full scope of Oral and Maxillofacial Surgery with expertise in; Implant surgery, Bone Grafting, Facial Trauma, Corrective Jaw Surgery, Wisdom Tooth Removal, and a wide variety of Oral Surgical procedures.

Edward Gray DMD, MD's staff is trained in assisting with Surgery, IV Sedation, and General Anesthesia within a state-of-the-art office setting. Patients are continuously monitored during and after surgery.

Surgical Staff

The surgical staff at; Carson Valley Oral Surgery are experienced, certified, oral and maxillofacial surgical assistants, who assist in administration of IV sedation and surgery. All staff are CPR certified and our administrative personnel are well-versed in health and insurance policy issues.

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 and any X-rays if applicable
  • A list of medications you are presently taking
  • If you have medical or dental insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.
  • If you have access to the internet you can utilize our website: www.carsonvalleyoralsurgery.com and fill out your patient health and financial information on our secure server.

IMPORTANT REMINDER: All patients under 18 years of age must be accompanied by a parent or guardian.

A pre-operative consultation and physical examination is mandatory for patients undergoing IV anesthesia for surgery. Please have nothing to eat or drink for 8 hours prior to your surgery, if you are an adult, or as Dr. Gray directs, for pediatric patients. You will need to be accompanied by an adult who will remain in the office during the procedure, and who will drive you home after the procedure.

Please alert the office if you have a medical condition that may be of concern prior to surgery (i.e. diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.), if you are on any medication (i.e. heart medications, aspirin, anticoagulant therapy, etc.), or if you have any allergies to medicines.

X-Ray

If your dentist or physician has taken x-rays, 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.

Scheduling Information

Carson Valley Oral Surgery is open Monday, Tuesday, Thursday, and Friday from 8 am until 4:30 pm. 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 Carson Valley Oral Surgery is a provider of surgical services, various circumstances may lengthen the time allocated for a procedure. Emergency cases can also arise and cause delays. We appreciate your understanding and patience.

Our office is located across the street from Carson Valley Hospital.

Please call 775-782-6491 with any questions or to schedule an appointment.

Financial Information

Patient Billing

For your convenience we accept Visa, and MasterCard. We deliver the finest care at the most reasonable cost to our patients, therefore payment is due at the time service is rendered. If you have questions regarding your account, please contact us at 775-782-6491. 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. Your insurance policy is an agreement you or your employer has made for payment of your care, it generally has little to do with the treatment you may need, or the cost of that treatment.

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 paid is your responsibility. Your prompt remittance is appreciated.

Insurance Information

At Carson Valley Oral Surgery we make every effort to provide you with the finest surgical care and the most convenient financial options. To accomplish this we work hand in hand with you to maximize your insurance reimbursement for covered procedures. If you have any problems or questions, please ask our staff. They are well informed and up-to-date. They can be reached by phone at 775-782-6491. Please call if you have any questions or concerns regarding your initial visit. Please bring your insurance information with you to the consultation so that we can expedite reimbursement.



Surgical Instructions

Preoperative Instructions for Patients Undergoing Intravenous Sedation

  • You may not have anything to eat or drink (including water) for eight (8) hours prior to the appointment, if you are an adult, or as Dr. Gray directed if the patient is a child.
  • 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. A least one finger needs to be free of fingernail polish.

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 muscles 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 area should be rinsed following meals with warm salt water until it is healed. This cavity will gradually fill in with new tissue.
  • There may be a slight elevation of temperature for 24 to 48 hours. If temperature continues, notify us.
  • It is not unusual to develop bruising in the area of an extraction.

Please take all prescriptions as directed.

Women please note: Some antibiotics may interfere with the effectiveness of your birth control pills. Please check with your pharmacist.

Care of Mouth After Oral Surgery

  • Do not rinse or spit for 24 hours after surgery.
  • Keep fingers and tongue away from socket or surgical area.
  • Use ice packs on surgical area (side of face) for first 48 hours, apply ice 20 minutes on and 10 minutes off. ( Note:Bags of frozen peas work well.)
  • For mild discomfort take Tylenol or Ibuprofen every three to four hours.
  • For severe pain use the medication prescribed to you.
  • Drink plenty of fluids. (Do not use a straw)
  • If the muscles of the jaw become stiff, chewing gum at intervals will help relax the muscles, as well as the use of warm, moist heat to the outside of your face over these muscles.
  • After the first post-operative day, use a warm salt-water rinse following meals for the first week to flush out particles of food, and debris which may lodge in the surgical area. (1/2 teaspoon of salt in a glass of warm water. Mouthwash can be added for better taste.)
  • 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, by mild to moderate bite force, using a small rolled gauze for a 90 minute period. 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 bite firmly for one hour straight. This will aid in clotting blood. Repeat if necessary. If bleeding still persists call our office. Herbal teas will not be effective for this purpose, please use a English style tea in a teabag.
  • 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". Dry-socket, or “alveolitis sicca” will cause a prolonged period of discomfort usually extending from day 3 to day 7 following your procedure.

Feel free to contact us if any doubt arises as to your progress and recovery.

Post-Op 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 several hours. Avoid eating, drinking, and unnecessary talking. Do not rinse your mouth or brush your teeth for 24 hours. These activities 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 a "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 instructions below to minimize complications and help ensure prompt recovery.

To control bleeding

Immediately following the procedure keep a steady pressure on the bleeding area by biting firmly on the gauze placed there by your doctor. 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, you may bite with moderate pressure on a tea bag, which has been placed over the oral surgical site. After bleeding has stopped, cautiously resume oral hygiene.

To relieve pain

Immediately following your procedure... begin taking medication as directed by Dr. Gray to minimize discomfort when the anesthesia wears off and feeling is back to normal. Application of an ice bag can also help relieve discomfort.

After 24 hours, continue to take your medication if pain persists, and use an ice bag if needed.

To minimize swelling

Immediately following your procedure apply an ice bag over the affected area. Use 20 minutes on and 20 minutes off for 24 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 24 hours after your procedure 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 considerations 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 after 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 toothbrush 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 the blood clot.

Maintain a proper diet

Have your meals at the usual time. Eat soft, nutritious foods and drink plenty of liquids — with meals and in between. Have what you wish, but be careful not to disturb the blood clot. Add solid foods to your diet as soon as they are comfortable to chew.

In case of problems

You should experience no trouble if you follow the instructions and suggestions as outlined. But if you should have any problems such as excessive bleeding, pain, or difficulty in opening your mouth, call our office immediately for further instructions or additional treatment.

Remember your follow-up visit

It is often advisable to return for a postoperative visit to make certain healing is progressing satisfactorily. A follow-up visit will be scheduled. In the meantime, maintain a healthful diet, observe rules for proper oral hygiene, and visit your dentist for regular checkups.



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