Oral Surgery

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 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. 

Extractions

Root Canal (Endodontics)

 

Endodontics is the dental specialty that entails the nerves of the teeth. Root canals are probably the most notorious procedure in dentistry and the most common procedure relating to Endodontics. When a tooth becomes infected it is usually related to the nerves in the root of the tooth. The infected nerves need to be removed. If left untreated an infection can turn into an abscess, which is a much more serious problem that includes bone loss in the jaw. 

The area around the tooth is numbed with a local anesthetic to start the procedure. The dentist will then drill down into the tooth to create an opening into the canal. They will then be able to remove infected tissue and clean the canal. After the infection has been removed, the space is filled with a sealant called gutta percha. It is highly recommended that a tooth that has undergone a root canal is fitted with a crown. This will improve the appearance of the tooth, and will also make it much more likely that the root canal is successful. 

 

"Root canal" has become a scary term for dental patients to hear, but the benefits of the procedure and advances in dental technology have made it much less "scary". Local anesthetics and proper pain medication allow the procedure to be performed with little to no pain in most cases. There may be some soreness following the procedure, but that is normal for most dental procedures. Over the counter painkillers are usually enough to relieve any pain afterwards, but your dentist may prescribe medication. The procedure will also relieve you from pain caused by the infection allowing you to enjoy all the foods you love without any pain from heat, cold, or biting too hard. If you are experiencing pain consult your dentist today.

Root Canals

 

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.

Bone Grafting

Loss of posterior teeth may result in excessive forces being placed on your remaining teeth. Fortunately, the use of dental implants and crowns allow you to replace these missing teeth. However, the position of the sinus in the upper posterior areas may be too low for proper placement of dental implants.

 

A simple procedure allows the sinus floor to be repositioned, creating enough space to properly place an implant. Various grafting materials are used to encourage your bone to grow more quickly into the area, helping to stabilize the dental implant.

Under certain conditions, an even simpler procedure can be executed. When possible, the bone remaining under the sinus floor is gently “pushed up”, thus lifting the floor of the “dropped” sinus. Bone replacement materials are then placed beneath this lifted bone. Once again the bone materials are replaced as your body grows new bone into this area.

 

Sinus augmentation procedures are highly predictable, with studies reporting over 95% success. Following sufficient healing of a sinus augmentation (6-10 months), implants are placed in a predictable and successful manner. It is important to realize that if the sinus augmentation procedure does not result in enough bone for implant placement, additional bone may be regenerated through a second sinus augmentation procedure at the time of implant placement.

Sinus Augmentation

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