Virginia Oral & Facial Surgery

The Importance of Oral & Maxillofacial Surgerons

Dr. Mark Gardner

It is not widely known outside of our industry, what exactly oral surgeons do. An Oral & Maxillofacial surgeon is uniquely trained to perform surgery on anything from the neck up. This includes not only the mouth, teeth & jaws, but also cheek bones, eye sockets, ears, noses and more! An Oral & Maxillofacial surgeon is just a fancy name for “facial surgeon”. Your face is the first thing the world sees, make sure to trust it with a surgeon who specializes in reconstruction of your most precious asset!

Dr. Mark Gardner had the privilege to work with this patient during his residency at Virginia Commonwealth University. See below on what she had to say about working with an Oral & Maxillofacial surgeon.

“My oral & facial surgery journey is COMPLETE!! I have a newly constructed jaw with screw implants and missing 5 front teeth. Next up, dental prostheses.
My smile has always been my strongest tool. After the accident, I lost a big part of me as my jaw and teeth shattered. Dr. Mark Gardner made it possible again. He operated on me multiple times & reconstructed my jaw. Prior to Dr. Gardner, I saw 2 surgeons and it was a complete disappointment. They didn’t take the time to learn about my trauma to better assist me. They only wanted the $$$. I needed someone to listen to me since this would essentially be my permanent smile. I believe that’s what makes Dr. Gardner a great surgeon. He has cared for me and held my hand each step of the way, explaining everything even when I had ‘stupid’ questions (because who at the tender age of 25 knows anything about dental implants???). His patience is what I admire the most. With a brain injury/short term memory loss, I found myself panicking all the time from the stress of my recovery yet I was always assured by Dr. Gardner’s immediate response. He provided his personal number from the beginning and was always responsive when I was met with multiple adversities. His quality of work is impeccable and I am very glad I chose him to trust to help me retrieve my smile & identity back. Thank you, Dr. Gardner.” – Tara R.

Learn more about Dr. Mark Gardner>>

Schedule your appointment with us, today!>>

Irrigation of Wisdom Tooth Sockets

It is common and inevitable that food and other debris will begin to accumulate in your extraction sites. This is even more common on the lower extraction sites. We have provided a curved-tip irrigation syringe that you should begin using on DAY 5 after your surgery to aid in the removal of debris.

We recommend you use either a lukewarm saline solution or tapwater to irrigate your sockets as follows:

  1. With the plunger pressed all the way down into the syringe, place the tip of the syringe in a clean cup containing saline or tapwater.
  2. Pull up on the plunger to fill the syringe. In rare instances, if you find it difficult to draw through the tip, you may cut a small amount of the tip off with clean scissors to enlarge the opening.
  3. While standing in front of a mirror or with the assistance of another person, open your mouth and pull your cheek out with your finger, a toothbrush, or a tongue depressor. Pulling the cheek outwards will allow you to see the extraction site and may open the incision up a bit to facilitate insertion of the syringe.
  4. Advance the tip of the syringe just inside the socket and flush it with the water in the syringe.
  5. Spit and repeat until fluid comes out clear.
  6. Repeat on the other side if applicable.
  7. Sockets should be irrigated at least twice daily, preferably after meals, until sockets have fully healed. In some cases this may take several weeks.


  • Do not start irrigating earlier than day 5 after your surgery unless instructed to do so by your surgeon.
  • It is not uncommon for a small amount of bleeding to occur when first irrigating. Biting on gauze for a few minutes after irrigating generally stops any minor bleeding.
  • It is not uncommon for a bad odor or taste to be present. Keep in mind that the socket initially contains a blood clot and several days of food debris. A small amount of listerine mouth rinse mixed with the water in the syringe (half and half) is typically effective in eliminating the odor.
  • Keep your syringe in a clean place, ideally with your toothpaste and other oral hygiene products.

More after care instructions for Wisdom Tooth Removal >> 

More after care instructions for Tooth Extraction(s) >> 

Please do not hesitate to call our office if you have any questions! 

After Care: Dental Implants

Are you considering dental implants but are worried about the recovery time?
Don’t worry, we’re here to give you the facts!

The recovery time following dental implant surgery tends to vary but is usually based on the amount of teeth being implanted, whether or not a bone graft was needed and how well the individual manages his or her recovery. The science and technology behind dental implants have improved drastically over the last few years, improving post-surgery pain and comfort for patients.

Recovery Time
Typically, you will have the fastest recovery time if you had a standard, single dental implant placed with no bone grafting. With a simple procedure like this one, there is very little discomfort or pain after the surgery. Mild bruising and soreness can occur, but this can typically be managed with over the counter pain relievers. In more severe implant cases, such as those where multiple teeth are implanted or severe bone grafts are needed in order to accomplish the implant, the recovery time tends to be longer and the discomfort can be more intense.

It is important to keep your mouth clean after surgery, which can be done by rinsing your mouth gently with saltwater beginning the day after surgery. You may begin brushing your teeth the night after the surgery, but make sure to be extremely gentle around the surgery area as to not disrupt the healing process. Remember that in the week following your surgery, there should be no smoking and no sucking through a straw, as this can seriously inhibit your healing process. Stick to a diet primarily consisting of soft foods for the first 7-10 days following your surgery before beginning to return to your normal diet.

As you can see, the recovery process after receiving a dental implant is fairly predictable and comfortable. It is important to follow the instructions that we give you, and always remember that if you have any questions or concerns regarding a procedure or following your surgery, you can always give us a call.

History of Wisdom Teeth

Most people need their wisdom teeth removed, so why do we have them in the first place? Here’s a quick history lesson of wisdom teeth and the important role they once played!

Wisdom teeth were once an extremely valuable asset to our ancestors. When a typical diet consisted of chewy plants and uncooked meat, third molars (wisdom teeth), which fit easily into our ancestors’ larger jaws, were absolutely necessary. Wisdom teeth were the evolutionary answer to the need for chewing power to combat excessive wear.

Today, our diets are not as rough as those of our ancestors. With modern marvels like forks, spoons, and knives, as well as softer food, the need for wisdom teeth is virtually nonexistent. And yet, on average, about 65% of the human population is born with wisdom teeth which usually erupt between the ages 17 and 25.

Although wisdom teeth were incredibly advantageous for our ancestors, they pose a bit of a problem for the modern mouth. Humans have evolved to have smaller jaws, and so wisdom teeth are often either too big for the jaw or the jaws themselves are just too small. Either way, third molars crowd the mouth. Because of this lack of space, molars often grow sideways, only partially emerging from the gums, or actually get trapped inside the gums and jawbone.

These impacted wisdom teeth can be chronically contaminated with bacteria associated with infection, tooth decay, inflammation, and gum disease. And because they’re so far back in the mouth or trapped underneath gums, it’s difficult and sometimes impossible to keep them clean. Even when wisdom teeth come in fully, they are so far back in the mouth that it’s just too easy for food to get trapped, leading to plaque, cavities, and gum disease.

Although wisdom teeth were very important to our ancestors, nowadays, they pose a serious problem to oral health. Are you worried that your child may need wisdom teeth removal? Call our office at Brandermill Office Phone Number 804-608-3200 to find out more.

Oral Surgery FAQs

You have questions and we have answers! For more information, check out the procedures portion of our website or call/click to make a consultation.

Why do I need to get my wisdom teeth out?

Wisdom teeth are a third set of molars that under ideal conditions would erupt into the mouth and serve as another set of chewing teeth.  However, most people do not have enough space in their mouth for functional eruption. In such cases, the wisdom teeth only partially erupt or fail to erupt and become impacted.  This can lead to:

  • Chronic food trapping and subsequent inflammation
  • Caries (cavities) and periodontal disease on both the wisdom teeth and neighboring teeth
  • Exacerbate dental crowding and/or interfere with orthodontic correction
  • Infection of the head and neck
  • Development of cysts and tumors associated with impacted teeth, which can weaken the jaw

Extraction of wisdom teeth is a very routine procedure with minimal risk in adolescence.  When the above conditions develop later in life, the procedure becomes more complicated due to the development of the tooth roots and maturation of the surrounding bone, and other factors that may be present.

My dentist sent me to get a biopsy.  Do I really need one?

Yes.  Most people see their dentist every 6 months, so their dentist is pretty adept at finding abnormalities and monitoring such findings over time.  By the time a patient is referred to our office there is a reasonable need for a biopsy. In some instances, if both the dentist and the surgeon believe that the lesion is benign, we may develop a plan of observation with regular follow ups.  However, the only way to truly identify a lesion, and to predict its behavior and consequences, is with a biopsy.

Are implants really expensive?

The answer to this question is relative to each individual patient.  Implants are no longer considered strictly cosmetic by insurance companies, so usually there is some degree of coverage.  For patients without insurance, the cost of an implant restoration is comparable to the cost of a bridge. From a value perspective, the possibility of having a potentially lifelong replacement of a tooth, restoration of aesthetics and function, and boosted confidence, is immeasurable.

How much will this cost?

We understand this part can get tricky with insurance. To make matters worse, many of the procedures that we perform can fall under medical or dental insurance, or both.  Thankfully, we have very knowledgeable and dedicated staff who can answer this question after they have reviewed your treatment plan and your particular insurance policies.

How long is recovery?

Generally, inflammation, pain, and swelling may take up to 72 hours to peak.  I would take time off from work/school/life during this period to avoid over-taxing the body.  Simple things like lifting, bending over, straining, or eating the wrong foods can prolong recovery.  Most importantly, dietary restrictions placed by the surgeon are key to optimal outcomes. Eating the wrong food can tear the incision, loosen sutures, compromise dressings, or weaken provisional restorations.  Depending on the procedure, a soft, no chew diet may be required for a week, sometimes more, after surgery 

How much pain should I expect after surgery?

This depends on the patient and the procedure(s).  Generally, procedures of the upper jaw cause less pain than those on the lower jaw.  Extractions hurt more than implants. Impacted teeth cause more soreness after surgery than erupted teeth.  Most of our patients find that prescription strength ibuprofen, possibly taken with Extra Strength Tylenol, provide adequate pain relief.  We recommend that patients avoid narcotic medications if possible. We also offer Exparel which is a long-lasting local anesthetic which will keep the site numb for about 3 days. 

When can I smoke?

Both the smoke and the actual nicotine itself have a detrimental effect on healing.  Smoking with gauze over the socket, vaping, or using other methods of nicotine delivery do not lessen the risk.  However, because smoking is an addiction that cannot easily be stopped, we recommend that patients refrain from smoking for as long as they can stand it.  A good start would be to refrain from smoking for 48 hours, if possible.

Oral Health: Get Your Oral Cancer Screening

Did you know that mouth cancer is the sixth most common cancer worldwide? The sad truth is that oral cancers are more than twice as common in men as in women, and the fastest growing group of oral cancer patients are young, healthy, nonsmoking individuals. Now is the time to be proactive and get yourself checked for oral cancer.

Remember—early detection saves lives! It is more important than ever for young adults, as well as older men and women, to get regular screenings whether they think they’re at risk or not.

What are the risks?
Knowing the risks can help you make educated decisions about your health. There are several risks that increase your chances of developing oral cancer:
• Smoking and using tobacco products are a known long-term historic cause of oral cancer.
• Heavy alcohol usage also makes you more susceptible to develop oral cancer.
• The HPV virus, a sexually-transmitted disease, is the leading cause of oropharyngeal (the back part of the mouth) cancer.

What are the signs and symptoms?
The mouth is one of the body’s most crucial early warning signs in the fight against oral cancer. In between regular dental visits, it’s important to be aware of the mouth’s signs and symptoms. Remember, if you see any of these signs or symptoms, schedule an appointment at the office if you don’t see improvement within two-three weeks:
• Hoarseness, chronic sore throat, or change in voice
• The development of white, red, or speckled (white and red) patches in the mouth
• Lumps, thickening tissues, rough spots, crusty or eroded areas
• Difficulty chewing or swallowing, speaking, or moving the jaw or tongue
• A change in the way your teeth or dentures fit together when you close your mouth
• Dramatic weight loss
• Unexplained numbness, loss of feeling, or pain/tenderness in any area of the face, mouth, or neck
• Unexplained bleeding in the mouth

Don’t wait any longer. Be proactive about your oral health, and get checked today!

Wisdom Teeth Aftercare

Having your impacted wisdom teeth removed is a serious surgical procedure, and post-operative care is extremely important! Read on for instructions on how to care for your sore mouth, and how to minimize unnecessary pain and complications.

Immediately Following Surgery:
Keep a firm, yet gentle, bite on the gauze packs that have been placed in your mouth to keep them in place. You can remove them after an hour if the bleeding is controlled. If the surgical area continues to bleed, place new gauze for another 30 to 45 minutes.

Do Not:
• Rinse vigorously
• Probe the area
• Smoke (hopefully you don’t!!)
• Participate in strenuous activities

You Can:
• Brush gently (but not the area)
• Begin saltwater rinses 24 hours after surgery (mix 1 tbs of salt with 1 cup of water).
• Make sure to swish gently. These rinses should be done 2-3 times a day, especially after eating.

Enjoy some down-time! Keep activity level to a minimum! Enjoy a day of couch or bed-rest, as being active could result in increased bleeding. Avoid exercise for 3-4 days, and when you do begin exercising again, keep in mind your caloric intake has been reduced so you may feel weaker. There are also some diet restrictions to keep in mind!

• Extremely hot foods
• Straws (for the first few days)
• Chewing (until tongue sensation has returned)
• Smaller foods that can become stuck in the socket area
• Skipping meals—while eating may seem like a lot of work, you need your nourishment to be able to heal and feel better!

Swelling is a completely normal occurrence. Keep in mind, swelling will usually be at it’s worst in the 2-3 days after surgery. You can minimize swelling by applying a cold compress (covered with a towel) firmly to the cheek next to the surgical area. Apply the pack with 20 minutes on, and 20 minutes off for the first 24-48 hours.

Since no two mouths are alike, do not take advice from friends (even well-intended advice could cause a healing set-back). The advice given to you from your doctor and team are tailored to fit your needs. Please call us if you have any questions or concerns about your recovery. Happy healing!

Flossing: Absolutely Necessary!

Yes, You Still Have to Floss. No, the dance move “flossing” does not count. The AP recently released an article making the claim that “there’s little proof that flossing works”. Their review cited a series of studies that found flossing does little or nothing to improve oral health. Here’s the problem: the studies were flawed. The AP concluded that floss does little for oral health, but it’s important to note that the evidence they cited was very weak at best. In fact, they said so themselves.

As acknowledged by the AP, many of these studies were extremely short. “Some lasted only two weeks, far too brief for a cavity or dental disease to develop” (Associated Press). They also say that “One tested 25 people after only a single use of floss” (Associated Press).

Of course, the evidence is unreliable. You don’t simply develop gum disease because you forgot to floss yesterday. Cavities and gum disease do not happen overnight. Gum disease is preventable by maintain great oral health habits for a long period of time. Lets put it this way: If a study claims drinking milk does nothing for bone health, but draws conclusions after only three glasses of milk, is it a reliable study?

The fact of the matter is floss removes gunk from teeth. You can see it. Gunk feeds bacteria which leads to plaque, cavities, poor gum health, and eventually gum disease. Floss has the ability to reach the food particles that your brush can’t get to. Using a sawing motion instead of moving up and around the teeth to clean the cracks. Positive results come from correct use and it’s critical that people learn to use a tool properly before discarding it as useless.

That’s just what floss is: a tool. Just like your toothbrush, it is designed to keep your mouth clean, and therefore keep your body safe from infection. Both your toothbrush and floss are designed to do what the other can’t, and both successfully remove bacteria from your mouth. Just like proper brushing technique, it is important that you know how to use floss properly, so that you can reap the long-term health benefits of good oral hygiene.

Oral hygiene is a long-term process and requires long term observations to make worthwhile conclusions. In the meantime, it’s obvious that you should continue to do everything you can to protect your well-being, and floss is one of many tools that can help you do that. If you would like a refresher on the best, most efficient techniques for floss use feel free to call our office today

How to Take Care of Your Dental Implant


Cleaning and taking care of your implant is just as important as cleaning your natural teeth. Here are some things you should know about caring for your implant.

Your implant and your natural teeth are similar because they both rely on healthy tissue for support! Just like with real teeth, plaque buildup can be harmful. It’s important to remove that plaque because it can develop into an infection. If the infection isn’t properly treated, it can result in a loss of bone around the implant which could progress to the loss of the implant itself.

It’s important to get your teeth cleaned on a regular basis so your dental hygienist can get biofilm off your teeth and keep your teeth infection-free. As always, you should be brushing your teeth and flossing twice a day.

Dental implants are the closest thing you can get to real and natural teeth. They don’t require any special products or treatment, just a simple brush and floss will do the job! If they are properly cared for, they can last a lifetime, avoiding any further dental work down the road.

With a dental implant, you can still enjoy all your favorite foods. It will not loosen or fall out if you are chewing something hard.

Overall, dental implants are meant to make life better and easier! You don’t have to go out of your way to take care of them – a simple brush and floss will ensure that they improve your overall quality of life for many years to come.

If you think a dental implant may be right for you, call Virginia Oral & Facial Surgery at 804-608-3200 to schedule a consultation!

Wisdom Teeth: Questions Answered

If you or your child are getting your wisdom teeth removed, you must have questions! We are here to make you feel as comfortable as possible. As always, if you have other questions feel free to contact us. We are more than happy to help you understand more on your upcoming procedure. Read on for some frequently asked questions:

1. Why do we have Wisdom Teeth?
Centuries ago our human ancestors used wisdom teeth to help them grind up tough food, like leaves and roots. Their jaws were larger and had more room for extra molars. As we evolved, our diets changed to include softer foods. The third molars became unnecessary as our jaws became smaller.

2. Why do I need to have my wisdom teeth removed?
There are several reasons why you would need your wisdom teeth extracted, as they can cause a variety of complications.
• Impaction: If there is not enough room in your mouth, your wisdom teeth will become impacted and grow at an angle. This can cause problems such as pain and discomfort while eating.
• Damage to other teeth: Your impacted tooth can begin pushing against your second molars, causing potential tooth decay.
• Disease: Spaces between the impacted tooth and your molars allows room for bacteria to grow, putting you at risk for inflammation, cysts, and periodontal (gum) disease.

3. When should I get my wisdom teeth removed?
Wisdom teeth usually come out between the ages of 17- 25, and are typically removed during your high school years. The longer you wait, the more complications that may arise. The root will continue growing and can cause potential permanent nerve damage.

4. When are wisdom teeth okay to keep?
If there is enough room for them to erupt correctly without causing any damage, then they are safe to keep. It is also important to note that not everyone is born with all four wisdom teeth, as evolution has been removing them for generations.

We hope this article has helped you, and if you have any other questions please contact us. Everyone’s teeth are different, and we want to make sure we take the right course of action for your wisdom teeth.