Wisdom teeth are the last adult teeth to erupt into the mouth, generally emerging between the ages of seventeen and twenty-one. They are the third set of molars and are in pairs: two each on the top and bottom arch of teeth. While some patients don’t have wisdom teeth, most do. Many of those who do have them don’t have enough room for those teeth to erupt fully, causing them to be wedged under the back of another tooth, impacted in the gum.
Impacted wisdom teeth are very difficult to clean, and can negatively affect the surrounding teeth. They are highly vulnerable to disease and decay and may lead to tooth pain and damage to adjacent teeth. For these and other reasons, a dentist may recommend that the teeth be extracted through oral surgery as soon as necessary to prevent any problems.
Extraction of wisdom teeth is typically an outpatient procedure done in an oral surgeon’s office. A healthy patient can proceed with a typical surgery, but if any infection is detected, the surgery can’t move forward until the infection is cleared up through the use of a full course of antibiotics. Once the surgery is moving forward, the surgeon’s team will administer some form of anesthesia to numb the area surrounding the tooth or to possibly sedate the patient through IV sedation dentistry.
After the anesthesia has fully taken effect, the surgeon makes an incision to open the gum and to remove any bone that is blocking the tooth from extraction. The tissue connecting the bone to the tooth will be separated and the tooth will be removed. In some cases, the surgeon will have to break the tooth into smaller pieces to make it easier to remove. After thoroughly cleaning the area and removing any remaining debris, the incision will be closed, stitched and packed with sterile cotton gauze to staunch any bleeding.
The surgeon will provide aftercare instructions. Patients should follow these instructions to the letter in order to ensure the best and fastest healing of the surgical site.
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There are a number of reasons that dentists or oral surgeons recommend surgery, but facial injuries are probably the most unexpected and alarming cause. Maxillofacial injury, or facial trauma, refers to any injury to the mouth, jaw, and face. Most of these injuries result from sports, car accidents, job accidents, violence, or an accident at home. Let’s learn about oral surgery resulting from facial trauma.
Broken bones are a common type of serious facial injury. Fractures can occur in the upper or lower jaw, cheekbones, palate, and eye sockets. Injuries in these locations may affect vision and the ability to eat, talk, and breathe. Hospitalization is often required for treatment, which is similar to that for fractures in other parts of the body. The bones must be lined up and held in place to allow time to heal them in the correct position. Because casts are not possible in facial injuries, the surgeon may use wires, screws, or plates to treat fractures. Sometimes healing takes as long as six weeks or more.
Even though some facial injuries are worse than others, all of them should be taken seriously. They affect an important area of the body, so it is recommended to seek treatment from an oral surgeon to make sure you receive optimum care. Even if stitches are all that’s required, it’s best to have them performed by an oral surgeon who can place them exactly as needed to produce the best results.
It’s no surprise that the best solution for facial injuries is to prevent them in the first place. Oral surgeons suggest consistent use of mouth guards, seat belts, and masks and helmets as required. Improvements have been made to safety gear to make these items more comfortable and efficient, so there should be no excuses for not using them to protect yourself and avoid injuries that can lead to oral surgery.
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Many oral surgeries go beyond simply removing a tooth, and the cause is not always related to poor dental hygiene. Some reasons for oral surgery just can’t be predicted or avoided, such as injuries, birth defects, or cancer. Great strides have been made in oral surgery, especially for restoration and reconstruction techniques. These are some common reasons that oral surgery is advised.
Tooth loss
Replacing missing teeth with dental implants requires oral surgery so that the titanium implant can be inserted into the jaw. Providing an alternative to dentures and bridges, implants offer a secure and permanent solution that looks very natural. Candidates with adequate bone density, good overall health, and who practice proper oral hygiene are considered for implant surgery. After the implant heals, a crown will be placed on top to complete the restoration.
Impacted teeth
One of the most common oral surgeries is to remove impacted wisdom teeth. Often occurring during the late teen to early adult years, wisdom teeth are unable to erupt properly and must be extracted to prevent future problems.
TMJ
Temporomandibular joint disorders involve the joint where the skull and lower jaw come together in front of the ear. Facial pain, headaches, popping, and jaw problems can result, and dentists try to treat the disorder with solutions like splints, physical therapy, and medications. Severe cases can require surgery to fully correct the TMJ problems.
Injuries
Car accidents, sports injuries, and other trauma can cause broken facial bones or jaws. Surgery may be necessary to realign the jaws, wire bones together, and otherwise repair the injury so that normal function and comfort can be restored.
Cleft repairs
Birth defects like a cleft lip or palate are corrected through oral surgery. Usually a series of surgeries over a span of years is needed to improve the appearance and proper function of the areas affected by the birth defect.
Biopsy
Surgery is performed to remove cancerous tumors or lesions in the jaws or facial bones. This is especially true when the joints or connecting muscles and tendons are involved.
Wisdom teeth, your third set of molars, are named that because they are the final teeth to erupt. They usually come in between ages 17 to 25, and are located in the very back of your mouth on the top and bottom. Your dentist will examine you to find out if your wisdom teeth are properly positioned and healthy. If they aren’t, your dentist will recommend removal.
How do you know wisdom teeth should be removed?
Some of the signs there is a problem with your wisdom teeth include pain, infection, cysts, gum disease, damage to nearby teeth, and tooth decay. If you experience any of these symptoms, see your dentist for an examination.
What are impacted wisdom teeth?
Sometimes your teeth just don’t have room to grow in properly. They can erupt at angles within your jaw, sometimes even horizontally. If wisdom teeth aren’t able to erupt normally they can become trapped, or impacted, inside your jaw. Symptoms of impacted wisdom teeth are pain, infection, and swelling. When teeth are impacted, they can lead to serious problems. Many dentists want to avoid impacted teeth and therefore remove your wisdom teeth before they erupt or grow too big.
Are there less obvious reasons to remove wisdom teeth?
It’s not always clear when these teeth way in the back of your mouth are causing problems, or might in the future. Many dentists remove them in teens or young adults so they don’t cause problems later, or become too firmly planted in the jaw. Also, sometimes wisdom teeth are removed as part of orthodontic, periodontal, or restorative treatment plans.
What happens if I don’t have them removed?
Some dentists prefer to wait and see what happens with time to your wisdom teeth. Make sure you continue to have these teeth monitored, because the risk of problems doesn’t go away with age. Removing wisdom teeth isn’t always necessary, because if there’s room in your mouth and they come in properly, they work just like any other teeth. The key is to watch them to make sure problems don’t arise in the future.
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If oral surgery is in your future, you might be worried about what’s to come. The way to relieve that worry is to talk to your oral surgeon. Your oral surgeon has the experience and knowledge necessary to guide you through whatever concerns or questions you may have. Here is a guide to some of those questions and answers:
How will I handle pain following surgery?
- In many cases, you will have been prescribed narcotic pain relievers. If you are taking narcotics, take them only as recommended and do not mix them with over-the-counter pain relievers or alcohol. Driving while on narcotics is dangerous and can have serious consequences for you personally and for others. If you weren’t prescribed any medication, use anti-inflammatory analgesics such as ibuprofen or naproxen sodium.
What will happen to my stitches in the days following surgery?
- Some stitches will be designed to dissolve over time and will not need to be removed. Others will not come out on their own and will need to be removed at a subsequent appointment. In many cases, losing a single stitch or two in the days following surgery isn’t serious; however, for bone-graft treatments, it is problematic and you should contact your surgeon immediately.
Can I eat normally after surgery?
- Immediately after surgery when you’re still experiencing any mouth or tongue numbness, don’t eat anything. You could mistake the soft tissues of your mouth for food and do serious damage to your mouth without realizing it. After your numbness subsides, consume soft foods of tepid temperatures for several days to allow for healing. Talk to your surgeon to learn when you can resume normal eating patterns as dictated by your particular surgery.
What other tips do you have?
- Stay hydrated and rest as much as possible to facilitate complete and quick healing. Call your surgeon if you have excessive bleeding or pain that doesn’t lessen with time. Be aware of signs of infection (swelling, redness, odorous or sour discharge) at the surgical site and seek professional care when needed.
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Gum disease is a serious problem. You should treat it as soon as possible following the recommendations of your dentist. Also known as periodontal disease, it has several treatments, depending on the severity of the issue.
Your first course of action is to completely revamp your oral hygiene habits. Daily flossing and brushing following meals are essential habits to develop. You must have a clean mouth before you go to bed. If you smoke, you should stop. Your mouth’s health depends on it.
If you haven’t been keeping up with your professional checkups and cleanings, you need to start again. Long-term gum health is greatly impacted by the plaque, tartar, food debris and bacteria left on teeth. Hardened calculus, or calcified plaque, can be removed using a process called scaling. This process may require local anesthesia.
Your progress will be evaluated by your dentist to see if your gum tissue is recovering. With enough progress and response to treatment, your gum disease treatment may not progress beyond these initial steps; however, for more severe cases of gum disease, you may require oral surgery.
Surgical procedures are available that can regenerate and repair the soft gum tissue in the mouth, as well as hard tissues such as bone or teeth. Your oral surgeon will want to reduce or completely eliminate gum pockets, or open areas beneath the gum line, improving and renewing gum to tooth attachment. Normal oral functions and aesthetic appearances are aimed to be restored.
There are many sedation dentistry options available to patients treating their gum disease with oral surgery. These include local anesthesia and IV or conscious oral sedation. Talk to your oral surgeon to see what’s appropriate for your specific needs.
Don’t wait to treat your gum disease. Do what you need to do to ensure a lifetime of better oral hygiene and gum health.
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