Oral Surgery
Wisdom Teeth
Wisdom teeth are the third and final set of molars that emerge, usually during your late teens to early twenties. For some people the wisdom teeth emerge through the gums and have enough room to grow in naturally. For others, wisdom teeth often cause problems as they are trying to protrude through the gums. When a wisdom tooth is impacted the tooth is coming in at an angle and not straight through the gum line. This can cause pain, the tooth can come in unevenly, or the tooth may only emerge partially.
Impacted wisdom teeth can cause structural damage to the jaw and other teeth. They can also provide a place for bacteria to gather since they are hard to reach and clean. These potential problems make it necessary to remove impacted wisdom teeth so that larger problems do not arise. Routine x-rays during a dental exam can reveal if you will need to have your wisdom teeth removed.
Extractions
Wisdom teeth extractions are a fairly common procedure. Wisdom teeth often cause problems as they are trying to protrude through the gums. When a wisdom tooth is impacted, it means the tooth is coming in at an angle and not straight through the gum line. This can cause pain, the tooth can come in unevenly, or the tooth may only emerge partially.
When a wisdom tooth only emerges partially a flap of skin, called an operculum, may form over the tooth. This can make the tooth hard to clean, and pieces of food may be caught under the skin. This makes it easy for an infection, called pericoronitis, to develop. It will usually go away on its own, but it causes swelling and pain in the area.
Impacted teeth and wisdom teeth that can potentially cause problems, like infections, need to be removed. Extractions can range from a single tooth, to removing all four wisdom teeth at once. Based on the preference of the doctor and/or the patient, a local anesthetic could be used to numb the areas where the teeth will be extracted. Others will prefer to go under a general anesthetic so that they will be sedated during the procedure.
The gum tissue around the wisdom tooth is cut open to reveal the tooth. The tooth is loosened by gripping it tightly and wiggling it back and forth until it can be lifted out of the gums. Sometimes a tooth may be impacted so tightly that it cannot be simply lifted out of the gums. In cases like this the tooth will be broken up into pieces first before being removed. Depending on the incision and extraction site, sutures may be needed to close the area. Soluble sutures are the best option, which will dissolve on their own.
After the surgery you will need to rest. You need to be driven home by a friend or family member because of the anesthesia. You can expect for the extraction site to bleed for a little while after the surgery. Gauze will be applied at the completion of the surgery, and you will need to change it when it becomes soaked. If bleeding continues for longer than 24 hours you should call your dentist. Rest when you return home, but do not lie flat. This could prolong the bleeding. Prop your head up on a pillow when lying down. Your dentist will prescribe you pain medication, so if you become sore take as directed. You can also use an ice pack for the pain. Your dentist might also provide you with a cleaning solution to clean the extraction site.
You will be limited to soft foods for a few days after your surgery. Some recommended foods are:
- Gelatin
- Pudding
- Yogurt
- Mashed Potatoes
- Ice Cream
- Thin Soups
- ...and other food you can eat without chewing.
When drinking, make sure you do not use a straw. The sucking motion can loosen your sutures and slow the clotting process. The same goes for smoking. If you have prolonged pain, bleeding, irritation, or don't feel that the extraction site is healing properly call your dentist for a follow up.
Bone Grafting
Bone grafting is where the jawbone is built up to accommodate a dental implant or other restorative device. Bone grafting is a common procedure that is used frequently for dental implants and other periodontal procedures. The bone used to graft is taken from a sample from the patient. Many times, the bone is taken from another area of the mouth when drilling takes place. The bone fragments are suctioned from the mouth and used for the graft. Cadaver bone fragments are also used. They are harvested by bone banks and are a very safe source for bone donation.
Sleep Apnea
Using oral surgery to help sleep apnea seeks to remove the excess tissue in the throat that is vibrating and blocking the upper air passages. One surgical procedure is an Uvulopalatopharyngoplasty (UPPP). This procedure involves removing the excess tissue from the upper mouth and throat. This procedure in performed in a hospital under general anesthesia.
Maxillomandibular advancement is another type of procedure used to assist with sleep apnea. This procedure involves the upper and lower part of the jaw. In this procedure, the jaw is moved forward from the rest of the facial bones. This allows more room behind the soft palate, thereby reducing the obstruction. Finally a Tracheostomy is a last ditch effort when other treatments have failed. This involves the surgeon inserting a tube in your throat so you can breathe. It is covered during the day, but opens at night while you sleep. All of the aforementioned surgeries are routine and very safe.
TMJ
TMJ is the initialism for temporomandibular joint, which connects your lower jaw (the mandible) to your skull at the temporal bone. This joint controls many jaw functions, like chewing. If the chewing muscles or the joint itself are causing you pain you may have temporamandibular disorder, or TMD. TMD can be caused by stress, continual clenching of the jaw muscles, or teeth grinding.
Some of the symptoms of TMD are:
- Pain when opening or closing mouth
- Trouble chewing
- Jaw becoming stuck open or shut
- Headaches or ear pain
- Clicking or popping sounds when opening your mouth
- Teeth Grinding
Many of these symptoms can often be associated with other health problems, so only a medical professional can tell you if it is due to TMD. Teeth grinding is an especially problematic symptom because it can lead to further problems. Prolonged teeth grinding, or bruxism, can cause enamel to wear off teeth and expose dentin. This material is softer than enamel and more susceptible to decay. Sensitivity to hot and cold food or drink may also develop from excessive teeth grinding.
If you suspect you may have TMD come in for a consultation. We can help diagnose you and provide relief for your symptoms. Pain relievers and hot/cold compresses are short term methods to provide relief for pain symptoms. A night guard can be used to help prevent or lessen the effects of teeth grinding at night. This can lead to a more permanent solution. In very severe cases of TMD surgery may be required, but behavioral treatments to change the way you use your jaw muscles are usually enough to provide relief.