It is an unfortunate fact that surgical procedures often produce pain. It is never our intent to produce pain. Rather we anticipate it, then take the appropriate measures to remove it, then minimize it.

     These measures begin at our consultation visit by meeting Dr. Mike Dachowski, discussing the case, understanding the expectations of everyone involved in the patient's care. Appropriate anesthesia is used for the case. That could be as simple as a local anesthetic or as involved as an intravenous anesthetic. Then the appropriate postoperative measures to minimize postoperative pain are implemented.

     Our mission regarding pain is to minimize it!

     The consultation is a most important part of your care and involves more than just looking. It allows Dr. Dachowski to evaluate all of the medical, dental, and patient concerns, obtain appropriate X-rays and other data, present the pertinent risks and benefits, and then agree on a plan.

     With non complicated situations such as a standard extraction or biopsy on a healthy patient, consultations are usually not required.

     Remember, the informed patient is a partner in his/her own care. Also remember, as important as your surgery is to you, we also attach a high level of priority. Our first aim is excellent, patient centered care. Delivering that high level of specialized care requires a plan that includes the surgery, the anesthesia, and all other concerns.

     Certain procedures that we provide are covered by many medical and/or dental insurances. This can sometimes be very confusing as policies and levels of coverage continue to change, unknown to any of us.

     For example, a wisdom tooth that is impacted in the bone is many times covered by the medical carrier and a non-impacted tooth is covered by the dental carrier. Sometimes one or the other carrier covers the anesthesia fees. Sometimes there is coordination between the two carriers to partially cover each service. Sometimes a specific surgery that was always covered by a company is suddenly not covered.

     How about this? Certain insurance companies have been known to change the code they use to process payment for a procedure, and then deny the procedure, without any explanation for the change.

     One thing our patients need to know. The insurance companies are not always doctor friendly when it comes to phone calls. Almost every time, a call to your insurance company requires no less than 15 minutes of on hold waiting time, voice mails, call routing, and almost never talking to someone who can readily solve an issue without more time on hold.

     If you have a question on the necessity for a referral, read your insurance booklet. We will be happy to advise you to the best of our knowledge.

     Absolutely. Appropriate pain medicine is always prescribed in a dose and amount that will enable the patient to safely and effectively manage any pain. Many times, parents will be concerned as to the strength of the pain medicine for their teenage son or daughter. Many times, there is the requirement for “adult strength medicine” for “adult type pain”.

     Dentistry is finally able to “give back” in a way that we never could before. Even with the very best of talent and materials, dentists were always cutting away teeth, filling, extracting, restoring. Patients had to accept that a fair to poorly fitting denture was the best dentistry could do. So they lived and persevered with it.

     Today we can do better. Dr. Mike feels fortunate to be able to provide this to you. With the dental implants, we can give back form and function. We can restore a patient to a level of comfort, function, and esthetics that we never could before.

     What is even more exciting is that every year, advances in implant technology are enabling higher levels of success. Dr. Mike is dedicated to maintaining the most current technology and surgical “know how” in implant dentistry.

     Post surgical diets after surgery vary with the extent of the surgery. In most cases such as after wisdom teeth extractions, multiple extractions, or dental implants, it is safe to say, The softer the better for the first several days.

     Soups, high caloric milk shakes and breakfast drinks are a good start. Blenderized foods are also a safe bet. After the first 2 days, the diet can advance to a true soft diet such as pasta, scrambled eggs, mashed potato consistency. After 4-5 days, one can advance to well cooked meats and vegetables.

     One of the most important dietary considerations is hydration. Maintaining fluids after surgery are very important. The more “good stuff” is in the drink, the better. A good example is Gatorade.

     As we all learned in basic first aid, direct pressure is the best way to control most bleeding. Many times, sutures (stitches) are placed to close the oral wound. But to stop bleeding, pressure is still necessary. Gauze are placed after surgery and biting pressure should remain on the wound. These gauze should be replaced every 15 - 20 minutes until the bleeding stops. Sometimes it may take 1-2 hours for bleeding to completely stop. Even after that, some occasional oozing may occur from the wound for 1 - 3 days.

     If bleeding restarts, gently rinse out the mouth and replace the bite gauze. Repeat the cycle until the bleeding stops.

     A mistake that a lot of patients make is leaving the office in no pain and disregarding these important instructions. As bleeding continues, and is swallowed, nausea occurs, and that is about the time when there is some post operative pain, so it becomes quite difficult to tolerate pain medications, important fluids to drink, or any food.

     One thing we can all agree upon is that advances in technology in healthcare has allowed all of us to live healthier and longer quality lives.

     Just 30 years ago, a CT scan was a special test that was difficult and timely to obtain. Today, it is a standard study that is readily available and can be scheduled at a patient's convenience.

     In oral and maxillofacial surgery, we can now reconstruct one or both jaws that might not have grown correctly, and the patient no longer requires 6 - 8 weeks of their jaws being wired together. With rigid fixation, the jaws are securely fixed in place and the patient can return to near normal daily function and return to work or school in about 1 week.

     Dental implants allow one to recapture the joys of eating, laughing, or even kissing without the fear of their own teeth falling out of the mouth.

     These and other advances come at a cost to all of us. Costs in research, development, laboratory fees, maintaining stock of materials, qualified staffing, maintaining precision machinery and instrumentation all add up.

     Patients are seen by appointment only. We will do our best to accommodate you in a timely fashion.

     Our office usually runs on schedule. Given that unpredictable situations arise from time to time in any health care delivery, there may be a wait for your appointment. We are usually complemented on our minimal to no wait times and prompt processing. Many doctors’ offices habitually “run late”. We do not.

     We are not in the habit of “squeezing someone in”. We are providing surgical care. This cannot be rushed or squeezed in. We ask that you respect the same importance to the surgery and care of others that you expect for yourself.

     Please remember a few things: Dr. Dachowski gives everyone the appropriate time they require for their care. We do not base our care on the schedule, rather the schedule is set by the care anticipated. Finally, when patients are significantly late for their appointment, it impacts everyone for the day. For example, a patient who arrives 20-30 minutes late for their 9 AM appointment will throw off a schedule for the rest of the workday, so that the patient with the 1:30 PM appointment might have to “wait” 30 or more minutes.

     Please extend us the courtesy to call the office at least 24 hours in advance of any cancellation or reschedule.

     Emergency patients are seen on a priority basis. Priority is weighted on the dental and medical severity of the situation.

     Philadelphia was once world known as a center for excellence in healthcare. Today, the area has become a “hotbed” of healthcare malpractice. It is unlikely that with so many excellent hospitals, doctors and nurses, medical and dental schools, that the quality of care is any less here than anywhere else in the country. In fact, Philadelphia maintains what is legally known as a very high “standard of care” as compared to the rest of the country.

     Much, not all, of this medical-legal circus has been brought on by a variety of people trying to “make some money” out of a medical outcome that might not be desirable. Other times, it is a simple opportunity to make some money by “making a case”.

     Please understand that again, the cost of healthcare will become more prohibitive as this situation continues to escalate. We will all pay more. If left unchecked, the system as it is today will choke the quality and the initiative for excellence right out of our backyard.

     We maintain our commitment to excellent care.

     Dr. Dachowski and staff are available to our patients.

     If you need to contact us, just call the office.

     If necessary, Dr. Dachowski can be reached by pager when away from the office.