Wisdom teeth are the third set of molars and the last adult teeth to erupt into the mouth. Most people have four wisdom teeth, two on the bottom and two on top. Many people do not have enough room for these molars to emerge completely, causing them to become impacted in the gum. Impacted wisdom teeth are difficult to clean, making them more susceptible to decay and disease. Other dental problems caused by impacted wisdom teeth include pain, damage to surrounding teeth, and bite alignment issues. For these reasons, your dentist may recommend having the impacted teeth removed to prevent future problems.
Surgery to extract an impacted wisdom tooth or set of wisdom teeth is usually an outpatient procedure done in your dentist or oral surgeon’s office. If the tooth or surrounding area are deemed to have an infection prior to the procedure, surgery will be delayed, and your dental professional will likely prescribe antibiotics to help heal the area.
On the day of surgery, local anesthesia will be administered to numb the area where the extracted tooth will be removed. Depending on the severity of your case, your dentist or oral surgeon may also utilize a general anesthetic.
Once the anesthesia has taken effect, an incision will be made to open up the gum and any bone blocking the tooth will be removed. Your dentist or surgeon will then separate the tissue connecting the bone to the tooth and extract the tooth. Some teeth are too large to remove in one piece, in which case your surgeon will cut the tooth into smaller pieces to make it easier to remove. Finally, the incision is closed with stitches and packed with gauze to help alleviate bleeding.
Long-term complications from impacted wisdom tooth surgery are rare. To ensure a successful recovery from this or any oral surgery, be sure to follow all aftercare instructions provided by your dentist or oral surgeon.
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Wisdom teeth are the third set of molars, and usually emerge in the late teens or early twenties. Standard dental practice is to remove wisdom teeth prior to them being fully formed when the roots have not yet had a chance to develop and fully root into the jaw. Younger patients usually have an easier recovery from surgery and many dentists believe early removal prevents future dental problems associated with wisdom teeth.
If your wisdom teeth were not removed as they emerged, there are some signs and symptoms that would indicate the need for extraction including:
- Wisdom teeth that are impacted, which means they have become trapped in the jawbone or gums.
- Wisdom teeth that are emerging at an awkward angle, causing pressure on adjacent teeth.
- Wisdom teeth that do not fit in your mouth, causing crowding of the surrounding teeth as well.
- Wisdom teeth that are suffering from decay or disease caused by the inability to keep them cleaned properly.
- Wisdom teeth that have developed fluid-filled cysts near the gumline.
- Wisdom teeth that are causing pain due to any of the above reasons.
The decision about whether or not to remove your wisdom teeth should be made in consultation with your dental professional. Your dentist or oral surgeon can assess the position and health of your wisdom teeth and make a recommendation for treatment.
If extraction is recommended, they may choose to extract one tooth or all four molars at once. Recovery from the outpatient procedure takes just a few days, and you will quickly be back to normal. Contact our dental office if you are experiencing any of these symptoms listed to determine if you should consider wisdom tooth removal to ensure your future good oral health.
Oral surgery to correct problems with the jaw is known as orthognathic surgery. Jaw issues can result from birth defects, changes due to growth, or injury or trauma to the face. While orthodontics can correct bite problems when only the teeth are involved, oral surgery may be required when repositioning of the jaw is necessary to correct the issue. If you suffer from any of the following concerns, orthognathic surgery may be a consideration:
- Difficulty chewing, biting or swallowing
- Problems with opening and closing your mouth, or with speaking
- Persistent jaw or temporomandibular joint pain
- Clenching or grinding of teeth causing excessive wear to the teeth
- Inability to make the lips meet without straining
- Un-proportional facial appearance or protruding jaw
- Malocclusion, open, or incorrect bite
- Recessive lower jaw and chin
- Sleep apnea and breathing problems
Most jaw surgeries are performed completely in the mouth, so no facial scars are visible. The oral surgeon makes cuts in the jawbone and then moves them to the correct position. Once the jaw is correctly aligned, screws and bone plates are placed to secure the jaw into the new position. Sometimes it may be necessary to add extra bone to the jaw from your hip, leg, or rib.
Orthognathic surgery is performed by an oral and maxillofacial surgeon usually in a hospital setting. Recovery time from jaw surgery takes three to six weeks. Your general or family dentist should be able to refer you to a skilled oral surgeon for a consultation and examination to determine a treatment plan. Jaw surgery can improve not only your facial appearance, but also chewing, speaking and breathing functions.
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Your family, general, or pediatric dentist or orthodontist may refer you to an oral and maxillofacial surgeon for some dental treatments that require oral surgery. An oral surgeon is a specialist who has graduated from an accredited dental school and also completed additional education and residency related to surgical procedures needed to treat various oral diseases and conditions. An oral surgeon is trained in treating the following conditions:
- Removal of diseased or impacted teeth
- Placement of dental implants
- Treatment of facial trauma involving gums, jaws, nasal cavities, cheekbones, eye sockets, and forehead
- Evaluation of pathologic conditions such as cysts and tumors of the mouth and face or acute infections of the oral cavity, salivary glands, neck, and jaws
- Treatment of facial pain including those caused by temporomandibular (TMJ) problems
- Cosmetic or reconstructive surgery to correct jaw, facial bone, and facial soft tissue problems
- Corrective jaw surgery
- Cleft lip and cleft palate repair
- Surgical treatment for sleep apnea
There are many different techniques that oral surgeons use to accomplish your treatment goals. The choice of techniques may vary between surgeons and should be discussed between you and your surgeon prior to the procedure.
Many oral surgery procedures can be completed in an outpatient setting. Often you are only in the office for a few hours and can return to your regular routine in a matter of days. A good oral surgeon will be able to perform these procedures with little chance of complications, and will be able to provide you with the information you need to understand the recovery process. Your oral surgeon will often collaborate with other specialists, such as an orthodontist or cosmetic dentist, to achieve your ultimate treatment goals.
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Obstructive sleep apnea is a condition created when a portion of the upper airway is blocked, causing breathing interruptions during sleep and low blood oxygen levels. As many as 20% of adults are affected by mild obstructive sleep apnea, while one in fifteen suffers from more severe apnea.
Symptoms of obstructive sleep apnea include snoring, extreme daytime drowsiness, restless sleep, high blood pressure, depression, problems with mental function, as well as a host of other mental and physical concerns. Left untreated, obstructive sleep apnea can lead to a long list of serious medical conditions, including hypertension, heart attack and stroke.
If you have been diagnosed with obstructive sleep apnea, your doctor may initially treat the condition with a CPAP device that you wear while sleeping. While a CPAP machine will reduce the obstruction to the airway, it is not a cure and will only be effective during use. Other non-surgical treatment recommendations may include the wearing of mouthguards to reposition the jaw, sleep position changes, or weight loss.
Tongue muscle advancement involves moving the bony attachment of the tongue muscles, and can be combined with palatal surgery to reduce excess tissues. This therapy may also include removing enlarged tonsils and nasal surgery. These treatments are most often used for milder cases of obstructive sleep apnea.
However, if these treatments do not work or for more severe cases of obstructive sleep apnea, oral surgery offers solutions to correct apnea. Maxillomandibular Advancement is a procedure that repositions the upper and lower jaw and chin to open the airway. This treatment is highly successful and offers the greatest chance of permanent correction in moderate to severe cases of obstructive sleep apnea.
For more information about how surgical therapies and treatments can be utilized to address your obstructive sleep apnea, consult with a qualified oral and maxillofacial surgeon.
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If you or a loved one is scheduled to have or has recently had oral surgery, you probably have a lot of questions. Here are some of the most common questions:
- One of my stitches came out after my surgery, should I be worried? Losing a stitch isn’t a problem. In the majority of cases, stitches are put in place during surgery to assist in clot formation and bleeding control. If you have undergone a bone-graft procedure, however, contact your surgeon because you may need to be seen immediately.
- What can I eat after surgery? Immediately following surgery, eat only soft foods of tepid temperature. Avoid very hot or very cold foods. Eat nothing that is crunchy or chewy so you won’t damage the surgical site.
- I am having a lot of pain following my procedure, what should I do? If you have been prescribed pain medication, take it as recommended. If no prescription was given, use over-the-counter medicines containing natural anti-inflammatory properties such as ibuprofen. Stay hydrated by drinking room temperature water and get plenty of rest.
- I had a tooth extracted, how can I tell if I have a dry socket? Dry socket is the result of the loss of the blood clot present in the extraction site. Smoking, using a straw, poor oral hygiene or failure to rest properly following the extraction procedure can lead to this condition. Typically dry socket will present within one week of extraction and is treated with sterile wash and pain-relieving, medicated gauze.
- I had a procedure this morning and am still bleeding. Is that normal? Bleeding following extractions or other surgical procedures is common. If you are bleeding more than normal, bite down on some sterile gauze or a damp teabag for twenty or thirty minutes. Don’t keep removing the gauze to look for blood; that can make the bleeding worse. Call your surgeon if you feel your bleeding is excessive.
Your oral surgeon can answer these questions and more. Don’t hesitate to call the surgeon’s office to get the peace of mind you require to heal comfortably following your procedure.
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