Bill Klaproth (host): This is OMS Voices an AAMOS Podcast. I'm Bill Klaproth. And with me is Dr. Ehlie Bruno, who is here to discuss wisdom teeth. How should my teen prepare for wisdom teeth surgery, Dr. Bruno, Thank you. for being here.

Ehlie Bruno: Thank you I appreciate being here.

Bill Klaproth (host): Yeah, it's great to see you. So, thank you for your time. So, let's start here. What are the beginning steps to having wisdom teeth evaluated?

Ehlie Bruno: Great question. So, typically patients undergoing removal of impacted wisdom teeth have been referred to our practice by either a physician or a dentist. Sometimes if X-rays have been taken at the dental office, they can be forwarded to the OMS office for review. The OMS will then go over the current state of the patient's wisdom teeth and what if any treatment would be indicated?

Bill Klaproth (host): Yeah, that's great. So, for a parent listening to this podcast, what else should they bring to the consultation? What should they prepare for?

Ehlie Bruno: The consultation can be a very, very important part of the entire surgical process. So, you definitely want to optimize that time spent with the surgeon. So, some basic things. it'd be very important to be aware of your past medical history. including a current list of medications and any supplements you might be taking, along with your allergy history and any kind of prior reactions to anesthesia. It's also a great idea to bring a list of questions to ask your surgeon.

And also take notes, especially if you're a little bit unfamiliar with the procedure that would be taking place. Also, that would be the time to just kind of share any concerns and ask specific questions about your situation and if you are a good candidate to proceed with surgery.

Bill Klaproth (host): Yeah, that makes I think that's really good too, about writing the questions down because I think a lot of times people go, oh yeah, I'm going to ask. And then they forget and walk in and go, oh, I forgot. I was going to ask them. I forgot it. Gosh, darn it. So, surgery is coming up. How should my team prepare on the days before surgery? What should we do? What do we need to know?

Ehlie Bruno: So, depending on how far out the surgery date is, there's probably minimal changes right before surgery. Occasionally, you may need to follow your OMS instructions about certain medications or how to best prepare, but generally, as long as you're abstaining from alcohol tobacco right before the surgery, you should be fairly well-prepared. Then when the time comes for actually the surgery visit, you're going to want to make sure that you follow those instructions, so you're ultimately prepared. So, hopefully, at the consultation, you're aware of what medications either need to be taken or avoided and also prepare dietarily. So, it would be a great idea to take a trip to the grocery store and make sure you have all your soft foods on hand to make the recovery time pretty seamless for you.

Bill Klaproth (host): Yeah. Speaking of soft foods after the surgery, is there a list of things a child should stay away from before the surgery?

Ehlie Bruno: So, depending on the type of anesthetic, especially if IV sedation is going to be used, you definitely need to strictly follow your OMSs instructions. Generally, there is a period with IV sedation that you cannot eat or drink prior to the surgery. But if you're undergoing a simple procedure, perhaps just under local anesthesia, those instructions may be a little bit different.

Bill Klaproth (host): So, let's talk about anesthesia for a minute. Do you counsel the parent or give them instructions like "Hey, here's, what's going to happen, just so you know how this works?"

Ehlie Bruno: Definitely. So that is what the importance of the consultation is. So that both the surgeon can educate patients and parents regarding what the upcoming procedure will be. That includes not only the surgical procedure, but also the anesthesia that will be used. We can best prepare you at the consultation for what's to take place. But overall, all of the options that your surgeon would present you for anesthesia choices are very safe.

Bill Klaproth (host): Right. Absolutely. And during this consultation you want to have your teen or young child with you, right? So they have the opportunity to ask questions too?

Ehlie Bruno: Ask questions and also to have the physical exam performed. So, it's usually best for a teen if both the teen is present, but also either a parent or legal guardian, just someone else that can also hear these answers and ask questions and make sure that everyone's comfortable.

Bill Klaproth (host): And get to know the OMS as well, that's got to be important too. "Okay, I know Dr. Smith, or I know Dr. Bruno cause she's going to take care of me. I got to ask her all of these questions." Is that right?

Ehlie Bruno: Exactly. Exactly.

Bill Klaproth (host): Yeah, that makes sense. So let's talk about post-surgery, "It's over. Yay. Oh, my God, it wasn't that big of a deal." What type of post-surgery instruction should we know about?

Ehlie Bruno: So with specifically wisdom to the surgery, most surgeons will counsel you and educate you about what the appropriate diet should be. We're going to gear patients towards softer foods, Avoiding really hard and crunchy foods. Most surgeons always recommend placement of ice on the side of the face that does help with swelling in the first 24 hours. You definitely want to strictly follow your surgeon's instructions about dental care afterwards. Hygiene is actually a very important component of your recovery period. While we typically do recommend maintaining good dental hygiene, you may want to switch from an electric toothbrush to a manual brush while you're in that recovery period.

We also would typically recommend that you avoid your standard over the counter mouth rinses, but there are many surgeons who will prescribe you a prescription rinse following wisdom to surgery, and you certainly should use that. Also avoiding drinking from straws as that sucking motion can also increase bleeding and then obviously we would like you to take all prescriptions both home medications, prescriptions and over the counter medications as prescribed and directed by your surgeon.

Bill Klaproth (host): Right. Absolutely. So we're talking teens here. They are probably like, "Hey mom, I'm going to go out and play baseball or I'm going to go ride my bike or I'm doing this." Probably need to slow down a little bit. and actually have a recovery period instead of jumping right back in. Is that a challenge?

Ehlie Bruno: It is a surgical procedure. Most recommendations would include taking some time off of school, perhaps work and certainly physical activities, sports, recreational activities, just so that you can give your body enough time to bounce back from it.

Bill Klaproth (host): Dr. Bruno, this has really been fascinating. Is there anything else you want to add?

Ehlie Bruno: I think just one of the most important parts is that you have all your questions answered. You have just an open, honest discussion with your surgeon and you share any potential concerns. Generally, we can make this a very smooth, safe, comfortable process. And lots of teens get this procedure done every single day. Every single day, and they do great.

Bill Klaproth (host): Well hearing you, I'm sure the parent listening to this podcast right now has been put at ease and has learned a lot. So, thank you for the education and the information Dr. Bruno. We appreciate it.

Ehlie Bruno: It's my pleasure.

Bill Klaproth (host): And once again, Dr. Ehlie Bruno. And for more information in the full podcast library, please visit MYOMS.org. And if you found this podcast interesting, please share it on social media and don't forget to subscribe. Thanks for listening.