Dental care beyond regular cleaning is sometimes necessary to maintain a healthy smile. Oral surgery is an important specialty within dentistry, with its primary concern being the diagnosis and treatment of complex conditions of the teeth, jaws, and facial tissues. It may be the removal of a problematic wisdom tooth. Dental implants offer a solution because they can significantly improve oral function and aesthetics, or address the need to fix your misaligned jaw. This is why all of these procedures are performed to relieve pain and restore functionality in the long run.
At The Encino Dentist, we know that the word “surgery” can be rather intimidating. That is why our approach combines clinical accuracy and a relaxing patient-centered atmosphere. Our highly developed diagnostics and new technologies will help provide you with faster recovery and more predictable outcomes. To understand oral surgery, it helps to look at the most common procedures. Below is a breakdown of what these treatments involve.
Teeth Extraction
Although you usually go to a dentist and save your natural teeth, some clinical reasons force you to extract a tooth to protect your overall oral health. The procedure, also called a dental extraction, is an irreversible procedure in which a tooth is removed when irreparable structural damage to the tooth is present. Your teeth could be extracted because of the following:
- Long-term infection
- Obstruction
- Crowding
Clearing space allows your mouth to heal and prevents bacteria from spreading to surrounding healthy teeth and the underlying jaw.
The need for extraction is often due to acute dental problems that make restorative therapy, like crowns or root canals, ineffective in your situation. You could also have a severe case of dental caries, which eats up so much of your enamel and dentin that there is no stable surface to hold a filling or cap. Similarly, vertical root fractures, cracks that run deep below the gum line, leave a permanent pathway for infection that cannot be sealed. Advanced periodontitis only worsens your condition by destroying the bone and ligaments, which anchor your tooth. This leaves your tooth eventually mobile and non-functional in your socket.
When your dentist decides that extraction is needed, the exact method they use depends on the accessibility of your tooth and its structural integrity. A simple extraction is performed on all teeth that are completely erupted and visible above your gumline. In this scenario, a dentist simply uses a dental elevator to loosen the tooth back and forth, gradually enlarging the bony socket and cutting periodontal fibers. When the tooth becomes mobile enough, the dentist uses their forceps to remove it from the socket. The procedure is a mechanical mode of rocking that provides a clean dissociation without harming your surrounding soft tissue.
Alternatively, a surgical extraction might be necessary for more complex presentations, for example, when teeth are fractured at the gumline or remain subgingival. This is a more advanced form of oral surgery, which demands a little opening in your gingival tissue to allow the clinician a direct view of the submerged root in the impacted crown. If your tooth is still held by dense bone, the surgeon can chip away part of it or section the tooth into smaller pieces. Breaking the tooth into parts makes it possible to perform a safer removal, especially when dealing with multi-rooted molars or malpositioned wisdom teeth that pose a threat to neighboring teeth.
After the physical extraction of your tooth, your body begins a complex healing process that centers on the formation of a stable blood clot. This clot serves as a protective network, covering exposed bone and nerve endings and providing a guide for new tissue formation. Protect this site for the first 24 hours by following these steps:
- Consuming soft foods
- Avoiding any activity that could cause increased pressure in your mouth
- Avoiding smoking
- Avoid using a straw because it can create suction and loosen your clot. Your bone can then be exposed to the oral environment, causing a painful condition known as dry socket. When you keep your original clot intact, you allow the extraction site to become a wound that can serve as a healing base for your future restorative solutions.
Wisdom Teeth Removal
Just before your late teenage years or early twenties, you tend to encounter a certain evolutionary challenge referred to as the third molars or wisdom teeth. Although in the past people used to grind with these large flat teeth on a diet of coarse, fibrous vegetation and crude meat, the evolution of the modern human jaw has changed significantly. Today, diets are lighter, and facial features are smaller. Consequently, you are not likely to have the room in the dental arch that these later-erupting teeth demand. This mismatch between your jaw size and the arrival of these molars creates a dilemma in which the teeth do not reach their functional positions. This results in a range of clinical problems.
As your wisdom teeth attempt to emerge but lack enough room, they often become stuck and remain under your gums or bone. The tooth’s orientation and depth affect the level of impaction. A soft tissue impaction occurs when the crown has already pierced the bone and is still covered by your gums. On the other hand, a partial bony impaction occurs when a tooth has been partially covered by bone. In more complicated cases, you can deal with a complete bony impaction, in which the tooth is completely embedded in the jawbone, and is usually lying horizontally or at an angle that would threaten the roots of your healthy second molars.
Postponing the extraction of these already affected teeth exposes you to significant risks to your long-term oral health, including a painful infection known as pericoronitis. The condition occurs when a piece of gum tissue covers a partially erupted tooth, creating an environment where bacteria and food particles cannot be removed with a toothbrush. Other than being infected, the wisdom teeth, when pressed against your neighboring molars, may result in root resorption, cavities, or decay in the healthy teeth. In others, the sac around an unerupted wisdom tooth can become filled with fluid, forming a cyst that can hollow out parts of your jawbone. This can cause permanent damage to the surrounding nerves.
To prevent these issues, wisdom teeth are usually removed in your late teens or early twenties, when your roots are not fully calcified, and your bone is stronger. In the process, the surgeon makes you comfortable with the use of local anesthesia or sedation before reaching the trapped tooth. Since a molar affected is often lodged in the bone, the surgeon may section the tooth, cutting it into a few smaller pieces. By removing the tooth bit by bit instead of in one piece, the surgeon can also prevent excessive bone removal, thereby preserving the bone structure of your jaw.
After extraction, there is a critical recovery phase in which the main objective is to safeguard the surgical site to allow proper tissue regeneration. It might take a few days, but you may experience some swelling and stiffness, which will gradually improve. If your jaw is stiff, stick to a soft diet and keep your mouth hygienic to help you heal.
When you opt to have your wisdom teeth extracted before the onset of active pain or damage, you take preventive measures to reduce the risk of crowding and infection. This helps you maintain your smile at a healthy level and balanced position in the future.
How Dental Implants Replace Missing Teeth
Losing a permanent tooth is more than an aesthetic gap in your smile. You will also be deprived of the stimulation your jawbone needs to stay healthy and strong. This loss is addressed through dental implant surgery, which offers a permanent, clinically proven solution that replicates the structure of a natural tooth. Unlike traditional surface-level treatments, this procedure is a surgical process in which a small titanium screw is surgically put directly into your jawbone. This post serves as an artificial root, forming a sound, stable anchor that prevents your other teeth in the area from moving out of place.
Osseointegration is an extraordinary biological process that determines the success of your dental implant. When you have placed the titanium post in your mouth, the living bone cells start growing and attaching themselves to the microscopic surface of the metal. Titanium is biocompatible and integrates with bone tissue. Your body will view the implant as a natural component of your structure rather than a foreign object. This forms a stable foundation so that your replacement tooth will be able to withstand the same bite force as is the case with your original natural teeth.
Dental implants require patience because the process of your bone fusing to the metal post takes time and cannot be rushed. Following the initial surgery, a normal healing period is 3 to 6 months. You may need to wear a temporary restoration during this period as the jawbone gradually fuses to the implant. Rushing this process can compromise the root’s stability. Giving your bone the full time it needs to fuse with the implant ensures your new tooth sits on a foundation that can last for decades.
The outcomes of this patient system are much better than the conventional bridges or removable dentures. Since a dental implant uses the root, it still helps maintain jawbone density during chewing, thus preventing bone resorption and facial sagging that are common after tooth loss. Furthermore, implants do not require any adjustment to your existing healthy teeth, so your natural tooth structure is not affected at all. The result is an implant you can brush and floss just like a natural tooth.
Bone Grafting and Sinus Lift Surgery
The success of dental restoration largely determines the quality and quantity of the skeletal structure that holds your teeth. When a permanent tooth is lost, your jawbone undergoes a biological process known as resorption, during which the bone gradually resorbs, loses volume, and becomes narrower due to the lack of stimulation from a tooth root. This quick bone loss may leave your jaw too thin or shallow to support a dental implant. To overcome this degradation, you might need pre-prosthetic surgery to reconstruct the required size of your jawbone and then continue with additional treatments.
The solution to this predicament is dental bone grafting, which involves the introduction of additional material into the areas where your bone has lost thickness. This material can be human, animal, or synthetic. Your body treats this grafting material like a scaffold, which is eventually replaced by your natural, living bone, and the healing process takes several months. In most instances, your dentist would perform a procedure known as socket preservation on the same day they extract your tooth. This helps preserve bone structure during healing by filling the empty socket with the grafting material.
A normal graft addresses jaw width, but the maxillary sinuses’ proximity can also be an issue in the upper back of your mouth. These are air-filled spaces slightly above the upper molars. When the teeth are gone, the sinus floor tends to pneumatize (expand downward). This gives you very little bone depth to place an implant post. This is corrected through a sinus lift surgery that elevates the thin sinus membrane and creates a tiny space. Your surgeon then fills this new space with bone-grafting material, which in effect adds vertical height to your upper jawbone.
The time spent on these first surgeries will ensure your dental implants have a solid, firm foundation to develop. An implant will most likely fail or even enter the sinus cavity, causing discomfort or even infection, without proper bone volume. Maintaining your jaw by taking the initiative to rebuild it through grafting and sinus lifts will help you give your face the structural support it needs to maintain its natural structures. The preparation gives a weakened jaw a strong base to support so that you can have a permanent, fully functional smile throughout your life.
What is Corrective Jaw Surgery (Orthognathic Surgery)?
Although orthodontics can shift your teeth into proper alignment, not all skeletal discrepancies can be corrected using braces. Orthognathic surgery can be performed to correct these significant structural concerns, with corrective jaw surgery, which is commonly called “orthognathic surgery.” The procedure repositions your facial bones to enhance both function and appearance. When your teeth fail to fit your jaws, or you have chronic problems with chewing, speaking, and even breathing, there is a failure to match your upper and lower jaws. Through the surgical realignment of these structures, you resolve the symptoms and cure the disease itself.
This special treatment is required when you have extreme bone disorders that affect your quality of life. You may be interested in orthognathic surgery to fix the following:
- A severe underbite
- An open bite (with your front teeth not touching)
- Facial asymmetry that hinders the efficiency of your bite
Other than dental alignment, this surgery offers a life-changing procedure to people with chronic temporomandibular joint (TMJ) disorders and severe obstructive sleep apnea. The surgeon rotates your jaw forward or moves it to help you breathe more freely while you sleep, ensuring your jaw joints are not overworked.
Highly specialized personnel perform this treatment during your hospital stay, as it involves numerous structural transformations. Your oral and maxillofacial surgeon has a close alliance with your orthodontist in coming up with a course of treatment that will often begin with a stage of braces to make your teeth fit their new positions. The specialist does the procedure as your surgery proceeds, where the specialist will realign your jawbones and fix them using small plates and screws that will ultimately become a part of your skeleton. Once your bones heal, this practice will guarantee the perfect synchronization of your teeth and jaws.
The decision of having corrective jaw surgery involves the commitment to a lengthy recovery process, but the result is well worth the long process of healing. Your biting and chewing will improve significantly, and your facial profile will be more balanced. You will also have more attractive natural features. Above all, you also gain the long-lasting structural base that helps to avoid the untimely erosion of your teeth and safeguard your joints in a way that will not be damaged in the future. With a realignment of your jaw, you will have a functional, healthy, and confident smile that orthodontics itself could never achieve.
How Sedation Dentistry Reduces Pain and Anxiety During Dental Procedures
Modern oral surgery prioritizes your physical comfort and emotional state by providing a range of anesthesia and sedation options that depend on the complexity of your surgery. You may feel a little anxious, or you may be very anxious, about dental work. Whatever the case, these pharmacological tools can help you feel relaxed and comfortable, supporting you through the treatment.
The choice of the right amount of sedation will ensure that your surgical experience is pain-free and your clinical staff concentrates on executing your surgery to the utmost level of accuracy.
Local Anesthesia for Minor Dental Procedures
In cases of minor surgery, like simple extractions or small fillings, you are normally given local anesthesia to numb the operative site. A numbing agent is a concentrated injection injected directly into the gum tissue. It temporarily blocks nerve signals that carry pain signals to your brain.
When you remain awake and are aware of what is going on around you, you feel only a dull pressure, not sharp discomfort. This local procedure will enable you to get home as soon as you finish your appointment, as it will not affect your cognitive or motor abilities.
Local Anesthesia for Minor Dental Procedures
If you need more relaxation when undertaking moderate procedures, a dentist could recommend nitrous oxide, which is popularly referred to as laughing gas. You breathe in this colorless, odorless gas with a little mask over your nose, and within a few minutes, you feel a sense of euphoria and calm. The effects fade nearly immediately due to the speed at which your body gets rid of the nitrous oxide as soon as the mask is taken off. This means the effects will leave you with a safe, convenient choice without any grogginess.
Oral Conscious Sedation for Deeper Calm
Oral conscious sedation, which entails the use of a specific Valium or Halcion pill to induce a deeper feeling of drowsiness, is recommended for the individual who wants a more intense feeling before you even have to step into the dentist’s chair.
IV Sedation for Complex Oral Surgery
IV sedation or deep sedation is the best option for patient comfort in the most complex cases of oral surgery, such as impacted wisdom tooth removal or complete-arch dental implantation. The surgeon or a qualified anesthesiologist injects sedative substances into your blood. You can be placed into a controlled state of deep relaxation, and the degree of your consciousness is immediately measured and monitored.
When in IV sedation, you are under a sort of twilight state wherein you are still able to reply to basic instructions but generally recall nothing of the actual procedure once you come to yourself. This amnesic property nullifies the possibility of dental trauma so that even the most engaged surgical procedures would leave you with a positive and anxiety-free attitude towards your oral health.
Find a Dentist Near Me
Choosing oral surgery is a smart move to protect your long-term health and get your smile working perfectly again. Whether you need to treat damaged teeth, prepare for implant installation, or just relieve nagging pain, these procedures provide the foundation for a lifetime of wellness. Modern methods prioritize your comfort and aim to make the process as efficient as possible. When you address the underlying issues, you avoid more complicated problems in the future. For any dental concerns or if you need any clarification about any oral surgery, call The Encino Dentist at 818-650-0429 and schedule your consultation and discuss your personalized treatment plan.