Oral Surgery
Surgical care, gentle hands
Oral surgery covers a range of procedures that involve removing teeth, treating jaw issues, or addressing problems that cannot be solved through restoration alone. While 'surgery' is a word that makes most patients nervous, the vast majority of oral surgical procedures performed in a general dentistry office are routine, predictable, and well-tolerated with modern anesthesia.
At Gateway Smiles, our approach to surgical care is conservative — we recommend extraction only when a tooth cannot be saved, and we always explore restorative alternatives first. When surgery is the right choice, we walk you through exactly what will happen, what to expect during recovery, and how to make the process as smooth as possible.
For complex cases — including impacted wisdom teeth, advanced bone grafting, or cases requiring deeper sedation — we partner with trusted oral and maxillofacial surgeons in the Fredericksburg area. You will never have to coordinate that handoff yourself; we manage every step of your care.
Oral Surgery Procedures
The Gateway Smiles approach
Conservative recommendations
We never recommend extraction or surgery unless it is the best option for your long-term oral health. When restoration is possible, we explain those options first.
Comfort-focused technique
Modern anesthesia, careful surgical technique, and clear pre- and post-operative instructions make most procedures more comfortable than patients expect.
Coordinated care for complex cases
For impacted wisdom teeth, advanced bone grafting, or cases requiring IV sedation, we partner with experienced oral surgeons and coordinate every step so you do not have to.
Recovery support
Detailed written instructions, follow-up calls, and clear guidance on what is normal during healing — and what warrants a call back to the office.
At your appointment.
Every patient gets the same thoughtful, unhurried care. Here is the typical flow of a surgery appointment at Gateway Smiles.
- 1
A thorough evaluation including X-rays or 3D imaging to plan the procedure
- 2
A clear explanation of the procedure, anesthesia options, and recovery timeline
- 3
A discussion of any alternatives, including doing nothing, if applicable
- 4
Detailed written pre- and post-operative instructions
- 5
A follow-up call or visit to confirm healing is progressing as expected
Insurance and cost
Many oral surgical procedures — including medically necessary extractions and wisdom teeth removal — are partially covered by dental insurance, typically at 50–80% after your deductible. Some procedures may also be billable to medical insurance. Our team will verify your benefits and provide a clear estimate before any procedure is scheduled.
Frequently asked questions
Modern anesthesia makes most oral surgical procedures comfortable. You will feel pressure and movement but no sharp pain. We offer local anesthesia, nitrous oxide ('laughing gas'), and oral sedation depending on the procedure and your comfort level. For cases requiring IV sedation, we partner with oral surgeons who specialize in those techniques.
Recovery varies by procedure. A simple extraction typically heals in 7–10 days, with most patients returning to normal activities the next day. Wisdom teeth removal usually involves 3–5 days of reduced activity. We provide detailed written instructions and remain available throughout your recovery for any questions or concerns.
After procedures with local anesthesia only, yes — you can drive yourself home. After nitrous oxide, you can typically drive after a short recovery period. After oral or IV sedation, you must have someone drive you home and stay with you for several hours. We will discuss this in advance.
Some surgical procedures require stitches and others do not. When stitches are needed, we typically use dissolving sutures that disappear on their own within 7–14 days. Non-dissolving stitches are removed at a follow-up visit.
Some discomfort and minor bleeding are normal for 24–48 hours after surgery. However, if you experience severe pain, heavy bleeding that does not respond to pressure, fever, or worsening swelling, call our office immediately at (540) 299-5721. After hours, we provide guidance on next steps.
Not always. Bone grafts are typically recommended when you plan to replace the extracted tooth with a dental implant, or when significant bone loss is expected. We will discuss whether a graft is appropriate for your situation before the extraction.