Questions to Ask Your Oral Surgeon

This page exists to be printed, screenshotted or read off a phone in a waiting room. It was written for a wisdom tooth consultation and for the anaesthesia that usually goes with one, because that is the surgery this practice does. Take it to whichever office you are sitting in. Nothing on it is designed so that only one practice can answer it well; every question below has a plain, verifiable answer that any competently run oral surgery office can give in under a minute.

Two habits make the list work. The first is to write the answers down while you are still in the chair — not because anyone is trying to deceive you, but because a consultation is a high-information conversation and most people retain a fraction of it. The second is to ask for the important answers on paper. A surgeon who tells you the anaesthesia plan will also put the anaesthesia plan in the consent document, and a document is something you can read again at home, show to a family member, or hand to a second surgeon.

You are allowed to ask all of it. None of these questions is rude, none of them implies distrust, and a surgeon who is irritated by them has told you something useful. Consent is not a signature; under Florida's informed consent standard it is a conversation in which the risks, the alternatives and the identity of the operator are disclosed to you before anything is done. The questions below are simply that conversation, written out in advance so you do not have to invent it under fluorescent light with a swollen jaw.

The person who performs your wisdom tooth surgery should be named to you before you consent, and that name should appear on the consent form you sign. In some offices the surgeon you meet at the consultation is the surgeon who operates. In others, cases are distributed among several clinicians, or a resident or an associate performs part of the procedure under supervision. All of those arrangements can be entirely appropriate. What is not appropriate is finding out on the day of surgery, or never finding out at all.

Ask the question directly: will you be the one removing these teeth, and if not, who will? Then ask the follow-up that most people forget — what happens if that person is unavailable on the day. Illness, emergencies and hospital call all move surgeons around. An office with a clear answer has thought about it; the honest answer is often "we would reschedule you rather than substitute without telling you," and that is a good answer.

Credentials are worth asking about in the same breath, and they are public. In Florida you can look up any dentist's licence on the Department of Health's practitioner search and see the licence number, its status, the issue date, and whether there is disciplinary history attached. An oral and maxillofacial surgeon holds a dental licence plus four to six years of hospital-based residency training in surgery and anaesthesia. A general dentist may also remove third molars, lawfully and often well, particularly straightforward erupted ones. The distinction is not a ranking; it is a description of training, and it matters most as cases get harder.

So the useful version of the credentials question is not "are you a specialist" but "given what you see on my imaging, is this a case you do routinely?" A surgeon who removes deeply impacted lower third molars every week and one who does a handful a year are describing different amounts of practice, and both can tell you honestly which they are.

• Will you personally perform the surgery, and will your name be on the consent form?
• If you are unavailable that day, does the case move to another clinician or does it get rescheduled?
• What is your licence number, so I can look it up?
• How often do you remove teeth positioned like mine?
• Will anyone else be operating or assisting in a way that requires my consent?

A Florida dental office must hold a permit from the Board of Dentistry for the depth of anaesthesia it provides, and the permit tiers are separate: nitrous oxide, minimal sedation, moderate sedation, paediatric conscious sedation, and general anaesthesia. Each tier carries its own training requirements, its own equipment and monitoring rules, its own staffing floor, and its own periodic office inspection. An office permitted for one tier may not lawfully work at a deeper one.

That structure is why the anaesthesia question has two halves that people usually collapse into one. The first half is clinical: what do you plan to give me? The second half is regulatory: what is this office permitted to give? Ask both. The answers should match, and if the plan is deep sedation or general anaesthesia, the office should be able to tell you plainly that it holds the general anaesthesia permit and that the permit is current.

It also helps to understand what the tiers actually describe, because the marketing vocabulary in dentistry is much vaguer than the regulatory vocabulary. The tiers are defined by your responsiveness and by whether you can keep your own airway open and your own breathing going — not by which drug is used or by how the office describes the experience. A patient under minimal sedation responds normally to speech. Under moderate sedation, a patient responds purposefully to speech or light touch and keeps breathing without help. Under deep sedation, a patient responds only to repeated or painful stimulation and may need airway support. Under general anaesthesia, a patient cannot be roused at all and airway support is routinely required.

Depth is a continuum, not a set of boxes, and any patient can drift a level deeper than intended. That is precisely why the permit is written the way it is: an office must be equipped and staffed to rescue a patient from one level deeper than the level it intends to produce. So the sharpest question in this whole article is the rescue question — if I go deeper than you planned, is this office set up to bring me back? An office permitted at general anaesthesia has already answered that for the deepest tier.

• What level of anaesthesia are you planning for me, and why that level for this case?
• Which permit tier does this office hold, and is it current?
• Who administers the anaesthesia — you, or a separate anaesthesia provider?
• If I drift deeper than planned, what is the rescue plan?
• What are my fasting instructions, and when exactly do they start?
• Is there a version of this operation I could have under local anaesthetic alone?

For general anaesthesia and deep sedation, Florida rule requires at least three trained individuals present at the chair: the dentist administering the anaesthesia, a second person whose sole responsibility is monitoring the patient, and an assistant. The word that carries the weight is sole. The monitoring person is not also passing instruments, not also answering the phone, and not also charting. Their entire job for the length of the case is watching you and the numbers.

Ask how many people will be in the room and what each of them is doing. Then ask what is being monitored. For deeper anaesthesia you should expect continuous pulse oximetry, blood pressure, electrocardiogram, and capnography — the measurement of exhaled carbon dioxide, which shows that you are actually ventilating rather than merely appearing to. Capnography is worth naming specifically, because it detects a problem earlier than oxygen saturation does. Saturation falls after breathing has stopped; end-tidal carbon dioxide changes as it stops.

The second half of this question is about training that is current rather than historic. Ask who in the room holds Advanced Cardiac Life Support certification, and when the team last rehearsed an emergency together. Certification cards expire on a two-year cycle and offices are inspected, but a rehearsed team is a different thing from a certified one. An office that runs periodic emergency drills will tell you so without hesitation, and will usually tell you what they drilled.

Ask, too, who watches you after the operation ends. Recovery is not the same room and not the same task, and the period immediately after the last stimulus stops is when patients can quietly become obstructed. There should be someone observing you until documented discharge criteria are met, and there should be written criteria rather than a general impression that you seem fine.

An office providing deeper anaesthesia is required to keep specific emergency drugs and equipment on site and to know how to use them: oxygen with positive pressure delivery, suction, airway adjuncts, a defibrillator, and reversal agents for the drug classes being used. Ask to be told what is on the cart. Ask when it was last checked, because emergency equipment is only useful if someone opens the case on a schedule and replaces what has expired.

Then ask the question that reveals whether the office has actually thought this through: what is the transfer plan? Every anaesthesia office should have a written relationship with emergency services and a named receiving hospital, and should be able to describe the physical route out of the building — which door a stretcher comes through, whether the gurney fits in the lift, how the ambulance is directed. Offices that have rehearsed this describe it concretely. Offices that have not describe it vaguely.

Ask also about the cases that never reach the office in the first place. Some patients should not have office-based anaesthesia at all, and a surgeon who cannot name a category of patient they send elsewhere has probably not drawn the line anywhere. Severe obstructive airway disease, poorly controlled cardiac disease, significant obesity with a difficult airway, some pregnancies, and certain complex medical histories are all reasons to move a case to a hospital or surgical centre. The correct answer to "who do you not treat here?" is a list, not a reassurance.

Finally, ask what happens afterwards if something goes wrong slowly rather than suddenly — persistent numbness, an opening into the sinus, an infection at day five, bleeding at midnight. Who do you call at two in the morning? Is it the surgeon, a service, or an answering machine? Does the surgeon see complications personally, and is there a charge structure for follow-up visits that you should know about before you consent? These are cash-practice questions as much as clinical ones, and they belong in the same conversation.

• What emergency drugs and equipment are on site, and when were they last checked?
• Which hospital do you transfer to, and what is the physical route out of this building?
• Which patients do you decline to treat in the office and send elsewhere?
• Who answers the phone at 2am on a Saturday, and how quickly do I hear back?
• If I develop a complication, who sees me for it, and what will that visit involve?

Every consent conversation is legally required to include the alternatives, and for third molars the alternative that gets skipped most often is the simplest one: leave the teeth in and watch them. Ask what the monitoring alternative actually looks like in practice, and make the surgeon describe it in the same detail they described the surgery. Vagueness here is informative.

A real monitoring plan has a shape. It has an interval — how often you are seen, typically annually or at your regular dental recall. It has a look — clinical examination plus a defined imaging schedule, rather than repeat imaging with no stated reason. And it has triggers: the specific findings that would change the recommendation. Recurrent pericoronitis, a widening follicular space suggesting cyst formation, decay on the back of the second molar caused by the third molar sitting against it, progressive bone loss behind the second molar, or resorption of the adjacent root are the usual ones.

Monitoring is not a passive choice and it is not the same as ignoring the teeth. It has costs of its own, and an honest surgeon will name them: the difficulty of surgery increases with age as roots complete and bone becomes less elastic, recovery tends to be longer in a patient in their forties than in a patient in their twenties, and a tooth that becomes symptomatic often becomes symptomatic inconveniently — during a pregnancy, on a trip, or the week before an examination. None of that makes removal automatic. It makes the timing a real decision with real trade-offs, which is exactly what you want it to be.

The corresponding question in the other direction is equally important: what specifically about my case makes you recommend removal? Answers grounded in a finding you can see on your own imaging — a tooth angled into the second molar, decay, a radiolucency, repeated infections you can remember having — are different in kind from answers grounded in age or in the general proposition that third molars cause trouble. Ask to see the imaging on the screen and have the finding pointed out.

You have a right to a copy of your dental records and your imaging, and you should ask how to exercise it before you need to rather than after. Under Florida law a dentist must furnish records on written request from the patient or a legal representative, and under HIPAA you are entitled to receive them in the electronic form you ask for where the practice can readily produce it. A practice may charge a reasonable, cost-based amount for producing copies. Ask how the request is made, what format you receive, and how long it takes.

Format matters more than people expect, particularly with imaging. A screenshot of a panoramic radiograph pasted into a PDF is a picture of your scan, not your scan. What another surgeon needs is the original DICOM data, which preserves the geometry and lets them measure, adjust and reslice — and for cone beam scans, lets them look at the relationship between a root and the inferior alveolar nerve canal in the plane that actually answers the question. Ask specifically whether you can receive DICOM files, and whether they come on a disc, a drive, or a download link.

Ask who reads the scan as well. A cone beam volume covers anatomy beyond the teeth, and there is a real question in every practice about whether the whole volume is reviewed and by whom. Some practices have every scan formally reported by a radiologist; others have the surgeon read the region of interest. Both approaches exist. What you want is a clear statement of which one applies to you and whether a written report will exist in your file.

Two more record questions are worth adding if you are considering a second opinion, which you are entitled to seek at any point and which no reasonable surgeon will take badly. First, will the office release the imaging without requiring you to explain why you want it — the answer should be yes. Second, what does the office send back to your general dentist after surgery, and will you get a copy of that letter? The letter is often the clearest single summary of what was done, and it is much easier to obtain by asking for it up front.

Here is the whole list in a form you can hold in one hand. The third column is not a script anyone should recite back to you — it is a description of the shape a solid answer takes, so you can tell the difference between an answer that contains information and an answer that contains reassurance.

If you only have time for two of them, ask who is monitoring you during anaesthesia and what the transfer plan is. Those two questions between them describe how an office behaves on the worst day it will ever have, and an office that has thought carefully about the worst day has usually thought carefully about the ordinary ones.

None of the following means an office is unsafe. Each one means the conversation is not finished, and that you should ask again, ask for it in writing, or take the imaging and get a second opinion before scheduling anything.

• You cannot get a straight answer to who will be holding the handpiece.
• The anaesthesia is described only in comfort language, with no tier named, when the plan is clearly deeper than local anaesthetic.
• Nobody can tell you how many people will be at the chair, or the monitoring person also has another job during the case.
• The emergency plan is described as "we would call 911" with nothing after it — no receiving hospital, no route, no drill.
• You are asked to sign consent on the day of surgery, after fasting, without having read it beforehand.
• Removal is recommended without a specific finding on your imaging being shown to you.
• Your imaging is described as belonging to the office, or is offered only as a printed picture.
• You are pressed to decide before you leave, or told the arrangement changes if you go away and think about it.

Pressure is the one to weigh most heavily. Third molar surgery is elective in the overwhelming majority of cases, and elective means you have time. The exceptions are genuine and worth knowing — spreading infection, swelling that involves the eye or the floor of the mouth, difficulty swallowing or breathing, fever with facial swelling — and those are emergency room problems, not consultation problems. Absent those, a week to think, read and consult a second surgeon costs you very little and buys you a decision you actually made.