Dear patients.

We are happy to say that we are planning to reopen our office for patient treatment on Monday, May 4th. Initially we will be open from 8am til 2pm though we will expand those hours as needed.

COVID-19 has been a very difficult time for all of us. Many of you have been forced to wait for dental care, and we deeply appreciate your understanding while we kept our office closed to help control the spread of the coronavirus.

Your health and well-being continue to be our highest priority, and we are ONLY opening because we have carefully planned and revised our office procedures to greatly minimize the risk of infection for our patients and our team members. Our own families are also patients here, so you can be assured that we’ll be taking care of you just as well as we’ll be taking care of them.

For your peace of mind, the measures we will be taking to provide a safe dental treatment experience include, but are not limited to, the following:

Upon Your Arrival at the Office

●     Patients will be screened BEFORE treatment and temperatures will be checked. Any patients showing signs of a fever or other symptoms of illness will be asked to reschedule their appointment.

●     ONLY patients will be allowed entry into the office. Parents and other family members will be asked to wait outside whenever possible.

●     Patients are asked to wait in their cars or outside the office until their scheduled appointment time.

●     The waiting area chairs will be spaced apart to allow for 6 feet of distancing.

●     We will ask that you continue to practice social distancing measures in common areas of the office, including the front desk.

●     The front door and the door between the waiting area and operatories will be propped open all day.

●     There will be no physical contact with patients with the exception of treatment.

During Treatment

●     All rooms will be COMPLETELY sterilized before each patient is seated, and public areas, including restrooms, will be cleaned and sterilized frequently throughout the day.

●     All operatories have high-volume air filtration and we have installed a whole office purification system. This system will kill the Covid virus along with other contaminates

●     Our team will STRICTLY follow guidelines set forth by the CDC, OSHA, and ADA in regards to personal protective equipment (PPE) and office sterilization.

●     During patient care, goggles or face shields will be worn by everyone and changed between patients.

●     All surfaces that came in contact with the patient will be wiped with disinfectant including the patient chair.

Checking Out After Your Appointment

●    We will be requesting prepayments when we know the amount of payment which will expidite your visit 

●     All efforts will be made to complete scheduling in the back of the office so you can leave without stopping at the front desk

We are proceeding with an abundance of caution, but we want you to feel as confident as we do that any visit you make to our office will be a safe one.

We also realize that many of you have been impacted financially during this outbreak, and we have solutions to keep dental care affordable for you and your family.

To discuss these payment options, schedule an appointment, or ask us any questions you may have about your next visit, please don’t hesitate to contact us at 757-473-8482

We look forward to seeing you soon!

Dr. Parr, Dr. Frey and the Smile Center Team

Nerve Repositioning

In order to safely place dental implants, the structures surrounding the treatment area must be carefully evaluated. The inferior alveolar nerve, which runs along the lower jaw, controls sensation in the patient’s lower lip and chin. In rare cases, nerve repositioning, or nerve lateralization, is necessary to avoid serious complications. This includes patients who have inadequate bone or the space between the bone and nerve is too narrow. The purposes of this procedure are to protect the inferior alveolar nerve, avoid potential complications, and allow the patient to maintain feeling in the lower lip and chin.

Candidates for the Procedure

Before recommending a patient for dental implant surgery, an oral surgeon or dentist must evaluate whether there is adequate bone present to support the implant post. Once teeth are lost or extracted, the bone naturally resorbs into the body. This can significantly weaken the jaw. If socket preservation (a type of bone grafting) was performed at the time of extraction, the bone may have retained its integrity. However, insufficient bone quality or density will require grafting prior to implant placement.

Nerve repositioning can help implant patients avoid potential complications, as well as maintain proper sensation in the lower lip and chin.

If the patient requires an implant in the back of the lower jaw and bone grafting is not an option, the surgeon must determine if there is sufficient space surrounding the inferior alveolar nerve to proceed with treatment. If a dental implant comes into contact with the nerve, the patient may experience pain, numbness, or other serious issues. Nerve repositioning may be beneficial for patients who are found to lack sufficient space.

Illustration of projected implant placement with or without nerve repositioning surgery
Without nerve repositioning surgery, certain patients could experience complications during dental implant placement.

Nerve Repositioning Surgery

Computed tomography (CT) scans, an advanced type of 3-D imaging, will be used to evaluate the amount and quality of bone present, as well as the position of the inferior alveolar nerve. This information can also be combined with computer modeling techniques to create a precise surgical plan.

Traditional Surgery

Nerve repositioning surgery is typically performed as an outpatient procedure. Prior to beginning, the surgeon will administer local anesthesia to numb the area. Sedation may also be available to further ensure patients' comfort.

To begin, an incision will be made in the outer portion of the cheek to gain access to the underlying tissue. Next, the doctor will create a small window in the lower jawbone to reach the inferior alveolar nerve. The nerve bundle is then carefully pulled aside. The doctor will place the implant in the jaw while avoiding contact with the nerve bundle. Following placement of the implant, the nerve bundle can be moved back into place. The space that was created in the jawbone is then filled bone grafting material, and the incision is closed.

In most cases, nerve repositioning surgery can be performed in conjunction with dental implant surgery, but sometimes the procedures may need to take place separately. 

Piezosurgery

Although most nerve repositioning surgery is performed using traditional methods, some dentists and oral surgeons use a newer technique called piezosurgery. During surgery, a specialized instrument uses high-frequency vibrations to incise bone while sparing the surrounding soft tissues, including skin, gums, and nerves. Piezosurgery is often preferable to traditional nerve repositioning surgery because it causes less trauma, which results in reduced bleeding and expedited healing. The most notable drawbacks of piezosurgery are the higher treatment cost and the fact that the doctor must also have received special training in the technique.

Weighing Your Options

Any kind of surgery carries some degree of risk. Nerve repositioning typically results in at least some degree of numbness in the lower lip, cheeks, and jaw. This should be temporary, and the majority of patients will see improvement in a few weeks to a few months. For a small number of patients, nerve damage may be permanent, and numbness may persist indefinitely. Due to the potential for permanent damage, nerve repositioning surgery is usually recommended only as a last resort. Your dentist can help you decide whether the surgery is right for you or whether an alternative, such as a traditional bridge or denture, is advisable. 

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Virginia Beach Office

200 Grayson Rd
Ste 100
Virginia Beach, VA 23462

Open Today 8:00am - 5:00pm

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