Oral and Maxillofacial Surgery is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of disease, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Removal of Diseased and Impacted Teeth, and Anesthesia
Oral and maxillofacial surgeons remove impacted, damaged and non-restorable teeth. They also provide sophisticated, safe, and effective anesthesia services in their office including intravenous (IV) sedation and general anesthesia.
Dental Implants
Oral and maxillofacial surgeons, in close collaboration with restorative dentists, help plan and then place implants used to replace missing teeth.
They can also reconstruct bone in places needing bone for implant placement and modify gingival (gum) tissue surrounding implants when necessary to make teeth placed on implants look even more natural.
Facial Trauma
Oral and maxillofacial surgeons care for facial injuries by repairing routine and complex facial skin lacerations (cuts), setting fractured jaw and facial bones, reconnection severed nerves and ducts, and treating other injuries. These procedures include care of oral tissues, the jaws, cheek and nasal bones, the forehead and eye sockets.
Pathological Conditions
Oral and maxillofacial surgeons manage patients with benign and malignant cysts and tumors of the oral and facial regions. Severe infections of the oral cavity, salivary glands, jaw, and neck are also treated.
Reconstructive and Cosmetic Surgery
Oral and maxillofacial surgeons correct jaw, facial bone and facial soft tissue problems left as a result of previous trauma or removal pathology. This surgery to restore form and function often includes moving skin, bone, nerves, and other tissues from other parts of the body to reconstruct the jaws and face. These same skills are also used when oral and maxillofacial surgeons perform cosmetic procedures for improvement of problems due to unwanted facial features or aging.
Facial Pain
Oral and maxillofacial surgeons possess skills in the diagnosis and treatment of facial pain disorders including those due to temporomandibular (TMJ) problems.
Correction of Dentofacial (Bite) Deformities and Birth Defects
Oral and maxillofacial surgeons, usually in conjunction with an orthodontist, surgically reconstruct and realign the upper and lower jaws into proper dental and facial relationships to provide improved biting function and facial appearance. They also surgically correct birth defects of the face including cleft lip and palate.
Wisdom teeth – or third molars – are the last teeth to come in, and the ones least needed for good health. They may not erupt, or emerge from you gums, until your late teens or early twenties – if they erupt at all. Most often, they remain impacted, or trapped in the jaw bone and gums, usually because there is not enough room for them in your mouth. Our jaws are smaller than those of early humans, who needed large jaws and more teeth for their tougher diets. We don’t need that extra chewing power anymore. In fact, wisdom teeth often do more harm than good; because of this, your dentist may recommend removing them and refer you to a specialist for care.
Wisdom tooth or third molar removal is the most common procedure performed by oral and maxillofacial surgeons. Usually, all four wisdom teeth are removed at once using both local anesthetic for pain and sedation to keep the patient calm. Moderate swelling and pain usually persist for a few days but can generally be controlled with medication.
Dental Implants are becoming an increasingly popular alternative to traditional dentures and bridges for people who have lost one or more teeth. Implants are more comfortable, stronger, longer lasting and less likely to cause damage to surrounding teeth and bone than dentures or bridges. Also, you don't have to soak them in a glass at night.
TMJ disorder refers to a variety of injuries or dysfunctions of the temporomandibular joint (TMJ), which is the joint located in front of the ear where the skull and lower jaw meet. TMJ symptoms may include earaches, headaches, a clicking or grinding noise from the jaw joint, limited jaw movement or pain when the jaw is opened or closed. Arthritis and injury are two major causes of TMJ. Symptoms may also result from a slipped disc in the joint or jaw spasms. TMJ treatment varies with the cause and severity of the symptoms and may include physical therapy, joint splints or surgery.
We often have questions about pre-operative instructions. Our office has prepared the following list of instructions for our patients.
Our office has prepared the following list of post-operative instructions for our patients.
Bleeding
Fold two 2x2 gauze pads and place over the extraction site (sites). Gently bite to apply pressure for 20 to 30 minutes. The pad should be thick enough that the front teeth do not touch. This is the best way to stop bleeding and should be repeated as often as needed. Rest with head elevated until bleeding stops. Do not expectorate (spit). Expectoration increases bleeding.
Infection
To prevent post-operative infection one should maintain good oral hygiene. Starting 24 hours after surgery rinse mouth with warm salt water (1/2 teaspoon salt in 8 oz. of warm water) 4 to 6 times a day and brush teeth after meals and at bedtime. Avoid vigorous rinsing and sucking on the wound. These actions increase bleeding.
Swelling
Swelling will become progressively worse after 3 days, and may not subside completely for 10 days. The application of ice packs during the first 24 hours may help reduce swelling. Apply for 20 to 30 minutes then switch sides. Do not go to sleep with ice pack in place and be sure to wrap accordingly. A towel placed over a pillow is helpful to prevent staining.
Eating
Good nutrition is necessary for proper healing. Following oral and maxillofacial surgery it is often necessary to take a liquid or semi-liquid diet of soups, jello, puddings, custards, and blenderized foods. Smaller multiple meals help one to consume adequate nutrition.
Smoking
Smoking is detrimental to your health and healing after oral and maxillofacial surgery. Do not smoke.
Pain
Post-operative pain should be expected and may be most severe the first day. It will diminish each day thereafter.
Medications
Take any medications prescribed by our doctor as indicated on the label. Do not drive or do anything dangerous if you are taking pain medication. Nausea is a common side effect of pain medications.
Temperature
A low grade fever is common after oral and maxillofacial surgery. Contact the office for temperature of 100 degrees or above.
Commercial mouthrinses
Commercial mouthwashes should be diluted 1/2 by water.
Activities
Avoid exercise until clearance is given our doctor. If you received a general anesthetic or sedation do not drive, return to work, or return to school the day of your surgery.
Concerns
Any difficulty which you consider abnormal contact our office immediately.
If your jaws don’t meet correctly or your teeth just don’t seem to “fit” your jaws, you may have a bite problem that makes eating difficult. Your face may appear “out of balance” and you may not be happy with the way you look. The bones of your face and jaw may have grown that way from when you were a child or you may have experienced a traumatic injury that altered your appearance. Whatever the reason, these issues can be corrected and our Oral & Maxillofacial Surgery specialists are uniquely trained to create a more balanced appearance with teeth and jaws that function well together.
When you lose a tooth in the front of your mouth, where the bone is very thin, the bone will usually melt away rather quickly, giving the appearance that the bone and/or gums are caving in, or collapsing. Very often this defect is visible when smiling. If you replace a front tooth with a traditional bridge, the replacement tooth looks like a false tooth as the gums and bone above it begin to collapse, leaving an obvious black space above the tooth.
When all of your posterior teeth are missing, the back of your mouth actually collapses as the bone deteriorates. The teeth in the front of your mouth begin to flare out as the entire bite collapses and the corners of your mouth droop. You appearance begins to change as the height of the jawbone decreases. If your posterior teeth are placed with a partial denture, the bone deterioration actually accelerates as the partial denture presses down on the gums and underlying bone when you eat.
When all of your teeth are missing, the jaw bone deteriorates rapidly. In addition, as the bone melts away your muscles migrate - or pull back - from their natural position. Your lips cave in as they lose bone support and wrinkles increase dramatically as your bony facial structures melt away.
Fortunately, there are techniques available that can replace bone that you may have already lost.