Oral and maxillofacial surgery requires an additional four years of hospital-based surgical training in order to manage a wide variety of problems related to the mouth, teeth and facial regions. As with the other specialty disciplines, DentalPros utilizes doctors with the best credentials to achieve beautiful, comfortable smiles.
Oral Surgery Services
While the most widely known service of oral surgery is wisdom teeth/3rd molar extractions, we provide care on all of the following:
- Wisdom Teeth Removal
- Exposure & Bracketing
- Dental Implants
- Tooth Extraction
- Oral Pathology
- Cleft lip and palate repair
- Facial Injury Repair
- Sleep Apnea
Wisdom Teeth Removal
What Are Wisdom Teeth?
Wisdom teeth are a 3rd set of molars in the back of your mouth. By the time someone reaches adulthood, they should have 32 teeth total – 16 on the top and 16 on the bottom. The Third Molars, also known as the “wisdom teeth,” are the last teeth to erupt within the mouth. However, the average mouth is only made to hold 28 teeth, which means that when those four additional wisdom teeth do erupt, they can cause overcrowding, pain, and other oral issues for many individuals.
When Should Wisdom Teeth Be Removed, And Why?
If your wisdom teeth align properly in your mouth without affecting your other teeth and the gum tissue surrounding them remains healthy, congrats – you are one of the rare, lucky individuals who don’t need to have your wisdom teeth removed!
Unfortunately, this is not typically the case for most people. Oftentimes, lack of adequate space in the mouth for eruption causes wisdom teeth to grow in sideways, only partly emerge from the gum, or remain completely submerged beneath the gum and the bone.
In these cases, many issues can potentially occur, including infection that results in swelling, stiffness, pain, and illness. It is also common for wisdom teeth that don’t erupt properly to move your other teeth and push them out of alignment, negatively impacting your smile and jawline. The most serious issue that can occur is the possibility of tumors or cysts forming around impacted wisdom teeth, which can destroy your healthy teeth and jawbone.
For these reasons, early removal of wisdom teeth that are not growing in correctly is highly recommended to avoid these issues and eliminate any health problems they may cause.
What Is The Process For Removing Wisdom Teeth?
First, your dentist will perform an oral examination of your mouth and take x-rays to determine the position of your wisdom teeth and gauge any present or potential issues to determine if removal is necessary.
If it is, the procedure will be done either under anesthesia or laughing gas, depending upon your needs and/or preferences. Following the removal, your gums will be sutured and you will recover for a brief period in-office until it is safe for you to drive home.
At that point, you will be given post-operative care instructions and a prescription for antibiotics and pain medication to take home with you, and we will schedule an appointment for the following week to remove the sutures.
Do I or my child need wisdom teeth removed?
While wisdom teeth can come in any time, Dr. Caroline Kacer, DenalPros’ Oral Surgeon, recommends you have an oral surgery consultation by age 16 to determine whether you or your child will need wisdom teeth removed. When surgery can be performed between the ages of 16-18, patients tend to heal faster and have a more seamless experience. At this time, it is easier to predict whether the wisdom teeth are malpositioned or too large for the available space in the mouth. Wisdom teeth removal is common for a variety of reasons. Come see our oral surgeon Dr. Caroline Kacer at DentalPros for an evaluation and assessment of your wisdom teeth position.
Some reasons for wisdom teeth removal are:
- They’re impacted. Wisdom teeth could become trapped in your jawbone or gum and can cause severe pain.
- Size of jaw. Some of us don’t have jaws big enough to accommodate wisdom teeth.
- Growth of teeth. If wisdom teeth come in at a different angle, they could impact the rest of the teeth and cause movement among your other teeth
Preparing for Anesthesia
Every surgery is different so your doctor will discuss the specific preparations and plan for surgery. Since most surgeries require the use of anesthesia, you will need to arrange transportation from your surgery. The length of your surgery can vary based on your procedure. Our team will walk through that information with you at your appointment prior to your surgery appointment.
Your doctor will provide you with detailed instructions on follow up home care, along with a date for a post-surgery appointment. Should an emergency arise, please contact our office for instruction 520-290-8787.
For an in-depth FAQ on what to expect, read this.
Exposure & Bracketing
What Is An Impacted Tooth?
When someone has an impacted tooth, it means that tooth is stuck and unable to erupt from the gum line and function successfully. The most common impacted teeth are the wisdom teeth followed by canines and second molars. Impacted third molars are usually removed because there is limited space in the mouth and they are often malpositioned. Wisdom teeth don’t serve a functional need, so they are typically extracted if they cause problems. However, the cuspid teeth are very strong biting teeth that play a critical role in dental arch and bite alignment, so every effort must be made to get them to erupt in their proper position within the patient’s dental arch. Canines are the “eye teeth” and are important to try and save, as they serve an esthetic role as well as a functional role when chewing.
How Do I Prevent Getting An Impacted Tooth?
The older the patient, the less likely it is that an impacted tooth will erupt on its own, which is why the American Association of Orthodontists and our team at DentalPros recommends that anyone over the age of seven years old should undergo a preventative panorex screening x-ray and dental examination to count adult teeth and ensure that there are no eruption issues occurring. If any eruption problems are identified, a treatment plan will be put in place that may involve our orthodontist, Dr. Kurt Kacer, placing braces to open up spaces that will allow for eruption or working with our oral surgeon to remove baby teeth that might be blocking the eruption of adult teeth. Catching potential eruption issues before the age of 12 is one’s best bet for avoiding major tooth impaction issues down the road.
What is the Recommended Course of Treatment if I Have an Impacted Tooth?
If an adult tooth doesn’t erupt naturally even after the necessary space is created inside the mouth for it to do so, then DentalPros’ orthodontist and oral surgeon will work together to force the eruption through the process of exposure and bracketing. This typically calls for Dr. Kurt Kacer, DentalPros’ Orthodontist, to place braces where necessary on the teeth, which will create space for the impacted tooth to be moved into its proper position in the dental arch. Once that space is created, Dr. Caroline Kacer, DentalPros’ Oral Surgeon, will then expose and bracket the impacted tooth.
What Does Exposure and Bracketing Entail?
A patient has to be in orthodontic treatment prior to having an exposure and bracketing procedure. This simple procedure is either performed under local anesthesia or depending on the severity of the impacted tooth, a patient may undergo sedation. The gum on top of your impacted tooth is lifted to expose the hidden tooth beneath it. If there is a baby tooth present, it is removed. Then, Dr. Caroline Kacer bonds an orthodontic bracket to the exposed tooth before returning the gum to its original location. Several days after surgery, you will come back to have a rubber band attached to the bracket that gently pulls the impacted tooth towards its proper place within your dental arch. This is a slow, measured process that can take up to a year to complete. Once the tooth has successfully erupted and is in its proper position, the tooth and gum are evaluated to make sure they are strong, healthy, and ready to successfully sustain a lifetime of chewing!
What Can I Expect Post-Surgery?
You can anticipate that there will be a minor amount of bleeding and discomfort that occurs around the surgical site for a brief time following surgery. However, most patients find over-the-counter pain relievers like Tylenol and Advil to be perfectly sufficient for pain management. There may also be minor lip swelling where it was held up during surgery, which can be minimized by applying ice or a cold compress to the affected area. A soft, bland diet is recommended immediately following surgery until you feel more comfortable chewing. It is also recommended to avoid sharp, crunchy food items during the healing process to keep from irritating the wound.
Why Is It So Important To Replace A Missing Tooth?
Missing teeth can create a host of oral issues that affect your bite, speech, and ability to eat certain food items, as well as other physical symptoms like headaches and jaw pain. Missing a tooth or multiple teeth also puts additional stress on your remaining teeth, creating unnecessary wear and tear that makes them more likely to become damaged or lost, as well. Over time, missing teeth chip away at your jaw bone, leading to a loss of 25% of your supporting jaw structure within the first year of tooth loss. If left untreated, tooth loss will cause a progressive deterioration in both your appearance and oral health.
What Is The Best Course of Treatment For Tooth Loss?
When a tooth is lost, the most effective and permanent way to treat it is to replace it with a dental implant. An implant acts just like your natural tooth, functioning in the same exact way and successfully maintaining your bone structure, oral health and appearance. Implants are a safer, more cost-effective option than a bridge or dentures because they do not damage or displace healthy teeth, and they are durable enough to last a lifetime.
What Does A Tooth Implant Procedure Entail?
At your consultation, our team at DentalPros will take an x-ray to ensure that your jaw can successfully accommodate an implant. Once you are found to be a viable candidate, Dr. Caroline Kacer will replace the root of your tooth with a small dental implant. Then, a waiting process is put into place to allow time for the bone to heal and grow around your implant, fusing it to your jawbone.
Once that solid foundation is created, our team will use a high-tech digital scanner to take an image of the implant and create a 3D model. Our lab will use that model to create a crown.
After the support post and replacement tooth have been created, they are then attached to the implant. This process is done in partnership with both your oral surgeon, who performs the implant surgery, and your dentist, who fits and creates the permanent replacement tooth. The amount of time between implantation and your replacement tooth being placed is different for everyone based on their unique situation and needs, and can take anywhere from 1-12 months.
What If I Need Temporary Teeth While My Implant Heals?
There are many temporary teeth options available that can be customized to meet your specific needs. If you need a replacement tooth while your implants are healing, we can outfit you with temporary removable teeth or a temporary bridge. If all of your teeth are missing, we can modify your current dentures or make you a new temporary denture. If you would like a non-removable option, it is usually possible for us to place temporary transitional implants along with the permanent implants, which can be made and inserted on the same day.
What Can I Expect Post-Procedure?
Significant pain is not typically experienced following implant surgery, but you will be prescribed pain medication and antibiotics to make your recovery as easy and comfortable as possible. While uncommon, there is the small possibility that infection, tooth injury, or nerve irritation can occur, despite the great care we take to ensure that they don’t. In the unlikely event that you experience one of these side effects, notify DentalPros of any pain or numbness you might be feeling, and we will manage and treat it immediately.
When do I need them?
In most cases when extractions are necessary, it is due to disease, trauma or crowding. There are two types of tooth extractions—simple and surgical.
What’s the difference between a simple and surgical extraction?
A simple extraction can be done when a tooth is visible above the gum line and can be easily removed. A surgical extraction is necessary if gum tissue or bone needs to be removed in order to extract the tooth. In this type of surgical extraction, our oral surgeon, Dr. Caroline Kacer, will need to place stitches within the mouth so that the mouth can heal.
As with all types of extractions, we strongly recommend following your oral surgeon and dentist’s instructions after the extraction has taken place.
Some tips to make recovery from a tooth extraction easier include:
- Rest after surgery.
- Keep gauze piece in place for 1-2 hours following the procedure.
- Don’t smoke or rinse your mouth vigorously.
- Avoid drinking through a straw for 24 hours.
- Follow the diet your oral surgeon and dentist suggest.
- Avoid anything that might prevent normal healing.
- If you must rinse your mouth during the first few days, do so gently.
- If you experience swelling, apply a cold cloth or ice bag and call your oral surgeon or dentist.
- Don’t brush the area where the tooth was extracted or the teeth next to where the tooth was removed. You can brush and floss all other teeth gently.
Complications to Tooth Extractions
As with any surgery or medical procedure, there are a few complications that can arise when having a tooth extracted. Complications can include infection, bleeding and dry sockets.
Infection happens in about 5% of patients that have tooth extractions, according to the American Association of Oral and Maxillofacial Surgery. After your extraction, Dr. Caroline Kacer may recommend an antibiotic prescription. For simple tooth extractions, an antibiotic may not be necessary. For surgical tooth extractions, an antibiotic is commonly recommended. The human mouth is full of bacteria, and it’s sometimes necessary to prevent bacteria from getting into the stitched-up area where your tooth was extracted to avoid infection. If you experience pain or swelling following an extraction, call DentalPros immediately.
Bleeding is another complication that some patients experience after having a tooth extracted. It’s important that a patient follows the oral surgeon’s instructions to rest and keep the gauze in place for 1-2 hours immediately following the extraction to stop the bleeding. If you have a history of a bleeding disorder, it is important that you provide this information in your medical history to your oral surgeon before the extraction takes place. Patients who are also taking aspirin or non-steroidal analgesics may also experience increased bleeding.
Dry Sockets can occur several days after the tooth extraction, and can be a very uncomfortable complication. A socket the hole in the bone where the tooth was extracted. Dry sockets can happen when the blood clot that forms to protect the bone after extractions becomes dislodged. When bacteria, saliva or food clogs the socket, it can cause discomfort. While you may feel fine for a day or two following the tooth extraction, pain can begin to radiate from the socket itself to the ear, usually after two days following your extraction procedure. Pain is often described as throbbing, and there is usually a bad taste and odor in the mouth. If this happens, you are likely experiencing a dry socket. It’s a relatively rare complication, but it tends to happen more in the lower teeth than in the upper teeth and in teeth that are already erupted. Women and smokers also experience a greater risk for dry sockets.
Dry sockets can be caused by loosening of the blood clot from using a straw or smoking. The suction action physically removes the blood clot. Other causes include over-rinsing and spitting, vomiting and food particles getting stuck in the socket.
There are steps that can be taken to avoid a dry socket. Dr. Caroline Kacer recommends practicing good oral hygiene. Avoid rinsing for the first 24-48 hours. When eating, it is best to adhere to a full liquid diet for the first 24 hours. Liquid foods like soup broths and milkshakes are best. After the first 24 hours, you can upgrade to soft foods like mashed potatoes, pudding, or any type of soft food that does not leave residual particles in the mouth. Avoid carbonated sodas and beverages for the first 48 hours. When changing the gauze in your mouth, dampen it a little bit and only use it for active bleeding. If you are a smoker, it is recommended to stop smoking for a minimum of 24 hours after your tooth is extracted.
To treat a dry socket, use anti-inflammatories to ease any discomfort. Call DentalPros and schedule an appointment to clean and remove any food debris caught in the socket. Dr. Caroline Kacer will also place a medicated packing in the socket. Several appointments may be necessary until the dry socket is not causing any pain.
If you think you are experiencing a dry socket, call DentalPros immediately.
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