Oral Surgery is recommended for any complicated dental treatment such as:
wisdom teeth extractions
impacted tooth exposure
jaw movement surgery
require expertise of an oral surgeon. An oral surgeon is a dentist that has studied 4 to 6 more years after finish dental school.
Wisdom teeth extractions
Wisdom teeth extractions: Wisdom teeth are the last teeth on the upper and lower jaw which appear from age 17 to 25. In some people they appear normal, however, in some other people they appear impacted, and in some cases they are missing.
Some people can sense the growth of their wisdom teeth due to pain and pressure in the area. If there is no room for growth of these teeth, are if they have cavity, it is recommended to be extracted as early as age of 17.
If there is not enough room inside of the mouth for adult teeth to erupt, or when a baby tooth has been lost at early age, the adult tooth may get stuck inside of the jaw. In this situation after orthodontic consultation, the orthodontist will refer the patient to an oral surgeon for placing a hook on the impacted tooth to bring the tooth inside of the mouth.
The surgeon will lift the gums and sometimes remove the bone to find the tooth that is stuck inside of the bone. Then the tooth will be isolated and dental bonding material will be placed on it.
A gold chain will be attached to the tooth and the gums will be sutured. The end of the gold chain will be used by the orthodontist to gently pull the tooth down into the occlusion.
The pulling down usually last 6-9 months and the tooth will come out of the bone and then a bracket will be placed on it.
Removal of excess tissue that connect the lips to mouth or tongue to jaw bone is called Frenectomy. The oral surgeon or dentist will remove the tissue using laser or surgical blade. The excess tissue may cause spacing of the teeth or not allowing the tongue to move freely.
Implants are made out of 3 parts:
the implant which is a titanium that gets inserted inside of the jaw bone
the abutment which is attached to the implant and the crown of implant
the crown of implant which will replaces the actual tooth
How do you I know if I am a good candidate for implant?
The dentist, oral surgeon or periodontist will evaluate the health of your teeth and gums based on visual exam, x-ray or 3 dimensional X-ray (CBCT). If you are missing a tooth or multiple teeth, it is very important to replace the missing teeth either with an implant or bridge. If missing teeth are not restored then the side teeth will shift to their space, this unwanted movement will cause periodontal defects, eating difficulties and possible more cavities.
The dentist will evaluate the adequacy of the amount of the bone for implant placement. If there is not enough bone available for implant placement, the dentist might recommend other restoration option or placing bones in the missing teeth area.
After the dentist decides that there is enough bone available then he will place the implant on the missing tooth area. This procedure is performed under local anesthesia, however, in some situations IV sedation is recommended. The appointment should last about 30 minutes to 1 hour. After the implant is placed, the dentist will follow up with the patient for the next 3 to 6 months to make sure that the implant has been attached to the bone. The dentist and the patient will decide on the shape and color of the crown and the dentist take an impression for the crown of the implant. And the crown will be manufactured by the laboratory about two to three weeks. The dentist will place the crown and will check the bite and contact to make the necessary adjustments.
Should I get my braces first or implant first?
Before placing an implant, it is best to consult with an orthodontist. The orthodontist is specialized in treating occlusion problems. It’s usually recommended to get braces first to correct any rotational and space problems. After all teeth are in ideal position then the orthodontist will refer to the dentist, oral surgeon, or periodontist to evaluate space adequacy for implant placement.