Fairfield Oral and Maxillofacial Surgery

• General Anesthesia

• Wisdom Teeth

• Implants

• Biopsies

• Jaw Surgery (Orthognathic)

• Repair and Reconstruction of
  Facial Injuries

General Anesthesia

Modern anesthesia technology now makes it possible to safely perform even complex surgery in the dental office. Current medications have significantly improved the anesthesia recovery time, allowing patients to resume normal activity sooner.

Wisdom Teeth 

Wisdom teeth are the last teeth to erupt within the mouth. When they align properly, and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen. The extraction of wisdom teeth is necessary when they are prevented from properly erupting within the mouth. They may grow sideways, partially emerge from the gum, and even remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to erupt successfully.

 

These poorly positioned impacted teeth can cause many problems. When they are partially erupted, the opening around the tooth allows bacteria to grow and may eventually cause an infection. The result – swelling, stiffness, pain, and illness. The pressure from the erupting wisdom tooth may move other teeth and disrupt the orthodontic or natural alignment of teeth. The most serious problem occurs when tumors or cysts form around the impacted wisdom tooth, resulting in the destruction of the jawbone and healthy teeth. Removal of the offending impacted tooth or teeth usually resolves these problems. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure.

Benefits of Early Removal

Having your wisdom teeth removed while still in your teen age years, often before symptoms are present, provides many advantages to waiting until you are older. Among the more common advantages are:

• avoiding the discomfort and risk of infection associated with partially erupted wisdom teeth
• more complete and faster healing
• decreased chance of post-operative problems such as infection, numbness from nerve injury, or injury to nearby teeth during surgery.
• decreased chance of wisdom teeth causing crowding of your other teeth or cavities in the adjacent molars.
• less disruption of school and work related

	22 year old patient… Fully developed wisdom tooth roots placing the nerve at high risk for injury. A cavity is present on the second molar.
	20 year old patient with hooked roots on a fully developed lower wisdom tooth. This increases the difficulty of surgery and the chance of surgical complications. The upper wisdom tooth has distorted the roots of the upper second molar, placing it at risk for injury during removal of the wisdom tooth.
	25 year old patient… Horizontal impaction placing the second molar at risk for poor healing due to loss of bone height.
	Area of the lip and chin affected by the nerve. To decrease the incidence of post-operative numbness the wisdom teeth should often be removed before full root formation.

What to expect during healing after Wisdom Tooth Surgery

Surgery to remove wisdom teeth is, many times, the first medical procedure for a young adult. The following information is provided to help you better understand what to expect after surgery. There are four basic consequences of any surgery, whether it be removing a wisdom tooth, or having your tonsils or appendix removed. These four consequences are discomfort, bleeding, swelling and a risk of infection. Because each patient is unique, a spectrum of different responses is expected, but the majority of patients will experience the following:

Discomfort
Every patient will experience some level of discomfort. You will usually be provided two different pain medicine prescriptions. Many patients report after the first few days that Ibuprofen manages their discomfort very well. Some patients have reported not needing any pain medicine after the first few days.

Bleeding
Expect mild oozing from the surgical area for about 24 hours. As you progress through the first week of healing, expect occasional, mild bleeding after eating soft foods. Many patients will experience an odd taste in their mouth during this week. This is normal.

Swelling
Swelling is the number one cause of discomfort after any surgery. Every patient can expect some degree of swelling, which may last up to a week or more. The swelling after wisdom tooth surgery may make your cheeks appear puffy and result in bruising of the cheeks. The swelling which occurs in the jaw muscles will cause them to feel stiff and sore resulting in difficulty opening your mouth wide. Ice for the first 24 hours will help decrease the amount of swelling, as will keeping your head elevated when lying down. After the first few days, moist heat packs may help alleviate the jaw stiffness.

Infection
 As with any surgical procedure, the risk of developing an infection is possible. This is usually due to the trapping of food in the surgical area. By following the post-operative instructions, very few patients develop this problem. The most common time for an infection to develop is one to three weeks after the surgery. Treatment may require only an antibiotic. Some infections will require cleansing of the site by the doctor.

How Long will the Healing Take?

This depends on your age and how deep the wisdom teeth are impacted. The majority of patients under 25 years of age will experience the above consequences for about a week to ten days. At the post-operative check-up, patients under 25 are still a little sore and have some swelling still present, but feel like they are getting better.

Patients older than 25 are more likely to experience a longer healing time and thus have a greater opportunity to develop problems during their healing. Sometimes they do not feel completely back to normal for up to 4 weeks. Rarely however, does this affect their work schedule for more than a few days.

Implants - See LikeNaturalTeeth.com

Dental implants are changing the way people live! They are designed to provide a foundation for replacement teeth which look, feel, and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that teeth appear natural and that facial contours will be preserved.

The implants themselves are tiny titanium posts that are inserted into the jawbone where teeth are missing. These metal anchors act as tooth root substitutes. They are surgically placed into the jaw bone. The bone bonds with the titanium, creating a strong foundation for artificial teeth. Small posts are then attached to the implant that protrude through the gums. These posts provide stable anchors for artificial replacement teeth.

Implants also help preserve facial structure, preventing the bone deterioration which occurs when teeth are missing.

The Surgical Procedure

For most patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone. For the first three to six months following surgery, the implants integrate with the jawbone. You should be able to wear temporary dentures and eat a soft diet during this time.

After the implant has bonded to the jawbone, the second phase begins. We will uncover the implants and attach small posts which will act as anchors for the artificial teeth. These posts protrude through the gums. When the artificial teeth are placed these posts will not be seen. The entire procedure usually takes four to eight months. Most patients experience minimal disruption in their daily life.
To learn more: visit LikeNaturalTeeth.com

Biopsies

A biopsy may be necessary when changes of the skin, lips, or tissues of the mouth are noticed. These changes may include any of the following: changes in color, ulceration, swelling, pain, infection, increase in size, scabbing or crusting. Often, the earliest signs of disease, especially oral cancer, are changes in the color of the tissue. Not all soft tissue lesions will have symptoms.

Many of the lesions which occur in the jaw bones do not have symptoms until they become very large and destructive. Early detection is only possible through x-rays. A thorough yearly examination by your general dentist is an important part of maintaining your general health.

Orthognathic Surgery

Orthognathic surgery is considered when jaws do not meet correctly and/or teeth do not seem to fit with the jaws. Teeth are straightened with orthodontics, and corrective jaw surgery repositions misaligned jaws. This not only improves facial appearance, but also ensures that teeth meet correctly and function properly.

Who Needs Orthognathic Surgery?

People who can benefit from orthognathic surgery include those with an improper bite or jaws that are positioned incorrectly. Jaw growth is a gradual process and, in some instances, the upper and lower jaws may grow at different rates. The result can be a host of problems that can affect chewing function, speech, long-term oral health, and appearance. Injury to the jaw and birth defects can also affect jaw alignment. While orthodontics alone can correct bite problems if only the teeth are involved, orthognathic surgery may be required if the jaws also need repositioning.

Difficulty in the Following Areas Should be Evaluated:

• difficulty in chewing, biting or swallowing

• speech problems

• chronic jaw or TMJ pain

• open bite

• protruding jaw

• breathing problems

• recessive (small) jaw

Any of these can exist at birth or may be acquired after birth as a result of hereditary or environmental influences or trauma to the face. Before any treatment begins, a consultation will be held to perform a complete examination with x-rays. During the pre-treatment consultation process, feel free to ask any questions that you have regarding your treatment. When you are fully informed about the aspects of your care, you and your dental team will make the decision to proceed with treatment together.

Technology and Orthognathic Surgery

Dr. Cutright uses modern techniques and three dimensional models to show you exactly how your surgery will be approached and how your bite will be improved. This helps you understand the surgical process and the extent of the treatment prescribed and to see the benefits of orthognathic surgery.

Repair and Reconstruction of Facial Injuries

Because of their expanded dental/medical background and hospital-based training, oral and maxillofacial surgeons are uniquely qualified to deal with injuries to the face, jaws, mouth, and teeth. Dental occlusion is the most important piece of the puzzle in dealing with complex facial fractures. Oral and maxillofacial surgeons have extensive training in repairing traumatic injuries, including fractures of the lower jaw, upper jaw, eye sockets, cheekbones and forehead, as well as repair of facial lacerations. Childhood injuries resulting from skateboarding, sports or bicycle accidents often involve dental or maxillofacial trauma. Younger children often sustain damage to teeth or supporting structures from falls. Such traumatic injuries can usually be effectively treated in the oral and maxillofacial surgery office.