EXPERT
David Ludwig
Oral and Maxillofacial Surgeon | Oral and Maxillofacial Surgery
Dr. David Ludwig is an oral and maxillofacial surgeon practicing in Tacoma, WA. Dr. Ludwig specializes in the treatment of problems related to the face, mouth and jaws. As an oral and maxillofacial surgeon, Dr. Ludwig is a unique dental specialist who can provide emergency medicine, perform general surgery and give anesthesia. These medical doctors are the only type of medical care specialist who can administer anesthesia, besides anesthesiologists. Typical procedures performed by Dr. Ludwig are tooth extractions, especially wisdom teeth, corrective jaw surgery, cleft palate surgery and reconstructive surgery after an injury. Oral and maxillofacial surgeons can also perform dental work including placing dental implants. These surgeons might also deal with conditions of sleep apnea, oral cancers and more.
6 years
Experience
David Ludwig
- Tacoma, WA
- University of Washington
- Accepting new patients
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Do you get CT scan before implant surgery?
The standard of care for implant surgery at this time is to obtain three-dimensional imaging of the region of interest. Dentists, oral surgeons, or other dental professionals trained READ MORE
The standard of care for implant surgery at this time is to obtain three-dimensional imaging of the region of interest. Dentists, oral surgeons, or other dental professionals trained in implant surgery will often get a CBCT as part of implant planning at your consultation appointment. This will allow them to see the three-dimensional volume of bone and any adjacent structures (teeth, sinus, nerve) in order to reduce risks and improve outcomes.
Do you get general anesthesia for jaw alignment surgery?
Your surgeon will generally perform the surgery under general anesthesia in an operating room or surgical center. For lower jaw surgery your surgeon may instead perform the surgery READ MORE
Your surgeon will generally perform the surgery under general anesthesia in an operating room or surgical center. For lower jaw surgery your surgeon may instead perform the surgery in an office setting under intravenous sedation.
Does corrective jaw surgery leave scars?
Depending on the specific surgical technique, corrective jaw surgery may leave scars. Some surgeons perform the surgery through incisions only within the oral cavity, while others READ MORE
Depending on the specific surgical technique, corrective jaw surgery may leave scars.
Some surgeons perform the surgery through incisions only within the oral cavity, while others utilize ~1 cm incisions at the angle of the jaw (mandible) to assist in the placement of fixation screws. The latter may lead to scar formation at the site of incision.
Both techniques yield good results. I would speak to your surgeon about which technique they utilize and inform them if you have any history of adverse scarring, keloids, or systemic illness.
Some surgeons perform the surgery through incisions only within the oral cavity, while others utilize ~1 cm incisions at the angle of the jaw (mandible) to assist in the placement of fixation screws. The latter may lead to scar formation at the site of incision.
Both techniques yield good results. I would speak to your surgeon about which technique they utilize and inform them if you have any history of adverse scarring, keloids, or systemic illness.
What antibiotics are used after oral surgery?
The choice for antibiotics and their duration will depend on the nature of infection, type of procedure, history of antibiotic use, allergies, patient or surgeon preferences. Often READ MORE
The choice for antibiotics and their duration will depend on the nature of infection, type of procedure, history of antibiotic use, allergies, patient or surgeon preferences.
Often times an antibiotic like penicillin, amoxicillin or Augmentin will be used for routine oral surgery procedures or oral infections in the absence of any allergies. Other antibiotics used may include Clindamycin, Azithromycin, Metronidazole, Cephalexin.
Often times an antibiotic like penicillin, amoxicillin or Augmentin will be used for routine oral surgery procedures or oral infections in the absence of any allergies. Other antibiotics used may include Clindamycin, Azithromycin, Metronidazole, Cephalexin.
How can I prevent infection after jaw surgery?
The risks of infection after jaw surgery are low. Talk with your surgeon about how to minimize your risk in anticipation of your upcoming jaw surgery. They may recommend antibiotics READ MORE
The risks of infection after jaw surgery are low. Talk with your surgeon about how to minimize your risk in anticipation of your upcoming jaw surgery.
They may recommend antibiotics prior or during the surgery, or a postoperative course depending on their preference and your allergies.
In order to prevent infection, there are things you can do, too. Focus on your oral hygiene (tooth brushing, mouth-rinse, flossing/water-flossing). Make sure you are getting adequate nutrition. Stay on schedule with any medications you may be prescribed (anti-inflammatory, pain medication, antibiotic). Reduce swelling with a cold compress in the first days after surgery. Avoid any tobacco use. Follow any instructions you were given by the surgeon or their clinic.
They may recommend antibiotics prior or during the surgery, or a postoperative course depending on their preference and your allergies.
In order to prevent infection, there are things you can do, too. Focus on your oral hygiene (tooth brushing, mouth-rinse, flossing/water-flossing). Make sure you are getting adequate nutrition. Stay on schedule with any medications you may be prescribed (anti-inflammatory, pain medication, antibiotic). Reduce swelling with a cold compress in the first days after surgery. Avoid any tobacco use. Follow any instructions you were given by the surgeon or their clinic.
What helps with pain after tooth extraction?
Pain after tooth extractions can be multi-factorial, so an approach that addresses each contributor is important. Using an ice-pack the first ~3 days will help to reduce the READ MORE
Pain after tooth extractions can be multi-factorial, so an approach that addresses each contributor is important.
Using an ice-pack the first ~3 days will help to reduce the effect of swelling which can contribute to discomfort. You may be placed on an antibiotic for an underlying infection, which, when treated, will improve symptoms of pain. Anti-inflammatories (i.e. Ibuprofen) and Tylenol, if you don't have any allergies or contraindications to those medications, are important to use on a regular basis after the procedure. Depending on the level of discomfort, your provider may prescribe a narcotic medication that can be used as needed for severe postoperative pain.
Using an ice-pack the first ~3 days will help to reduce the effect of swelling which can contribute to discomfort. You may be placed on an antibiotic for an underlying infection, which, when treated, will improve symptoms of pain. Anti-inflammatories (i.e. Ibuprofen) and Tylenol, if you don't have any allergies or contraindications to those medications, are important to use on a regular basis after the procedure. Depending on the level of discomfort, your provider may prescribe a narcotic medication that can be used as needed for severe postoperative pain.
How long does overbite surgery take?
Corrective jaw surgery may involve a combination of upper jaw (maxilla) and/or lower jaw (mandible) surgery. Furthermore, depending on the nature of your existing and desired esthetics, READ MORE
Corrective jaw surgery may involve a combination of upper jaw (maxilla) and/or lower jaw (mandible) surgery. Furthermore, depending on the nature of your existing and desired esthetics, chin reduction or "augmentation" procedures may be performed at the same time. That being said, the surgery can be as short as <1 hour but may take up to 3-5 hours depending on the complexity of your case.
Is it normal for an implant to hurt?
Discomfort is common after dental implant surgery and should be expected in the immediate postoperative period. Discomfort should get better day by day and it is not uncommon to READ MORE
Discomfort is common after dental implant surgery and should be expected in the immediate postoperative period. Discomfort should get better day by day and it is not uncommon to have some discomfort that continues to resolve 1 week after the procedure. Your recovery will also depend on whether or not any other procedures were performed at the same time - i.e. tooth extraction, bone grafting, bone graft harvest, sinus augmentation.
If you are having pain that is not relieved with pain medicine, I would contact the surgeon who placed your implant or present to an urgent dental care clinic in the event they are unavailable. Furthermore, if you have discharge or signs of infection, you will want to be evaluated on an urgent basis.
In the meantime, optimize over the counter medicines (taking into account other medicines you may take, your medical history, and allergies) and any other pain medicines that were prescribed.
If you are having pain that is not relieved with pain medicine, I would contact the surgeon who placed your implant or present to an urgent dental care clinic in the event they are unavailable. Furthermore, if you have discharge or signs of infection, you will want to be evaluated on an urgent basis.
In the meantime, optimize over the counter medicines (taking into account other medicines you may take, your medical history, and allergies) and any other pain medicines that were prescribed.
How long does a jaw alignment take?
Orthognathic surgery can include a combination of upper jaw surgery (maxilla), lower jaw surgery (mandible), and chin surgery. Depending on the combination needed to correct your READ MORE
Orthognathic surgery can include a combination of upper jaw surgery (maxilla), lower jaw surgery (mandible), and chin surgery. Depending on the combination needed to correct your dental and skeletal relationship, the surgery may take <1 hour or up to 4+ hours.
Is dental implant removal painful?
Dental implant removal is performed under local anesthesia +/- nitrous, oral sedation, or intravenous sedation. You should not feel sharp pain during the procedure itself if you READ MORE
Dental implant removal is performed under local anesthesia +/- nitrous, oral sedation, or intravenous sedation. You should not feel sharp pain during the procedure itself if you have been given adequate local anesthesia. The recovery will be similar to when the implant was placed and you should expect some swelling, discomfort and bleeding in the recovery period.
Is a CT scan required before dental implants?
A CT scan (CBCT [cone beam CT]) most commonly) is recommend prior to dental implant surgery because it gives the most information about the amount and quality of bone available READ MORE
A CT scan (CBCT [cone beam CT]) most commonly) is recommend prior to dental implant surgery because it gives the most information about the amount and quality of bone available and the relationship of the planned implant site with neighboring teeth, the maxillary sinus, inferior alveolar nerve, nasal cavity, and the incisive canal.
Are you put to sleep for a bone graft?
Oral surgeons offer a range of anesthetic options including local anesthesia +/- nitrous oxide, oral sedation, or intravenous sedation. The anesthetic choice will depend on the READ MORE
Oral surgeons offer a range of anesthetic options including local anesthesia +/- nitrous oxide, oral sedation, or intravenous sedation. The anesthetic choice will depend on the nature of the bone grafting procedure, your medical history, and your preference, as well as the surgeon's preference.
Can I get 4 dental implants at once?
Certainly! Multiple dental implants can be placed safely during a single visit.
Can molars be replaced with implants?
Yes, although there are special considerations for molar teeth in the upper jaw (alveolar/maxillary bone loss, proximity of the maxillary sinus) and lower jaw (alveolar/mandibular READ MORE
Yes, although there are special considerations for molar teeth in the upper jaw (alveolar/maxillary bone loss, proximity of the maxillary sinus) and lower jaw (alveolar/mandibular bone loss, proximity of the inferior alveolar nerve) so an evaluation with someone trained in dental implants is essential to ensure you are a candidate for implants.
Can a dentist stabilize a loose tooth?
Depending on the cause of tooth mobility (e.g. trauma, periodontal bone loss, root/crown fracture) your dentist, or an oral surgeon, can provide you tooth stabilization options. READ MORE
Depending on the cause of tooth mobility (e.g. trauma, periodontal bone loss, root/crown fracture) your dentist, or an oral surgeon, can provide you tooth stabilization options.
Can you eat after wisdom teeth surgery?
It is essential to have adequate nutrition after wisdom tooth removal to optimize healing. Your oral surgeon may recommend a specific diet (liquids, soft foods) based on their READ MORE
It is essential to have adequate nutrition after wisdom tooth removal to optimize healing. Your oral surgeon may recommend a specific diet (liquids, soft foods) based on their preference and the nature of the procedure. Ask your provider what foods they prefer during the healing process.
How long do you stay in hospital after jaw surgery?
Depending on the type of jaw surgery you are having (upper jaw, lower jaw, or both jaws) you may be admitted and observed in the hospital postoperatively. Most patients stay overnight READ MORE
Depending on the type of jaw surgery you are having (upper jaw, lower jaw, or both jaws) you may be admitted and observed in the hospital postoperatively. Most patients stay overnight and are safe for discharge on the first postoperative day.
How long does your nose bleed after jaw surgery?
Nose bleeds are common after jaw surgery, either related to upper jaw surgery or from the nasal endotracheal tube used during your surgery. That being said, you should contact READ MORE
Nose bleeds are common after jaw surgery, either related to upper jaw surgery or from the nasal endotracheal tube used during your surgery. That being said, you should contact your surgeon if this continues or you cannot stop the nose bleed especially if you are on any blood thinning medications or have a history of bleeding problems.
Is jaw surgery necessary for open bite?
Depending on the overall relationship of your upper and lower jaw and your teeth, and the degree of open bite, you may benefit from orthognathic surgery. Your dentist, orthodontist READ MORE
Depending on the overall relationship of your upper and lower jaw and your teeth, and the degree of open bite, you may benefit from orthognathic surgery. Your dentist, orthodontist and oral surgeon can work with you to offer treatment options based on your goals and the nature of your “bite”.
