Oral Surgery (Extractions and more)
Depending on which teeth were determined to need extracting largely determines when they will be done. If the teeth needing to be removed are 3rd molars (wisdom teeth), they will likely be done last. Doing so allows your time and money to be spent treating teeth you really want to keep; wisdom teeth generally aren’t needed and many people don’t have sufficient room to keep them anyway. For those other teeth that can’t be restored, if they are hurting, they are going to be extracted early in your treatment – after all, no one wants to live with a toothache. If they aren’t hurting, but cannot be restored, oftentimes the extraction can be done in conjunction with another appointment where you are already numb. Face it; no one likes shots or the numb feeling. If you are already numb in an area, if possible, do as much treatment as possible. Sometimes however, it may be better to get the tooth removed first allowing for better access for restoring an adjacent tooth. The treatment plan hopefully includes replacing the tooth. Whether placing a partial, bridge or implant, the gum and bone needs to be healed before replacing to optimize the fit. That means getting extractions done early in the treatment or having to wait for healing at the end. While some treatment can be done without anesthetic, this is one you won’t want to. Once numb it is a simple matter of leveraging the tooth out of its boney socket. Root shape and length will affect just how hard it is to remove. Sometimes due to curvatures it is easier to section the tooth and remove it in pieces. Bleeding after an extraction is normal and needed in order to heal. If you don’t form a blood clot or you lose it, you’ll end up with what is commonly referred to as a dry socket. Basically just some bone that isn’t covered and since bone is living tissue with nerves in it, if it is uncovered it will ache. Instructions after an extraction should include don’t drink through a straw, don’t smoke and don’t rinse vigorously; all may lead to losing the blood clot.
A little more about wisdom teeth now; as a general rule it will probably be recommended that they be removed. Keeping them often causes problems in the future and can come in many forms. They can cause crowding issues, particularly with the mandibular (lower) front teeth. They can cause resorption in the adjacent tooth. Being more difficult to clean, you may get a cavity in it or the adjacent tooth. You may develop a cyst around it or you may develop pericoronitis, an infection in the gum around it. Since you generally heal better when you are young, and teeth won’t “uncrowd” after extracting, have them removed before there is a problem, especially if you have had orthodontics. If they haven’t yet erupted, you will likely be referred to an oral surgeon for this procedure.
Oral surgery also includes treatment for lacerations(cuts), trauma and jaw repositioning.
Any kind of cut to your face and the delicate soft tissues inside your mouth should be addressed immediately in order to prevent further tissue damage and infection.
If a traumatic injury involves a broken facial bone such as the jaw, nose, chin or cheek, maxillofacial surgery may be required.
With jaw surgery, rubber bands, tiny wires, metal braces, screws or plates are often used to keep a fractured jaw in place following surgery. This allows the bone to heal and stay in proper alignment. Dental splints or dentures may also be required to supplement the healing process following jaw surgery.
In some people, maxillary (upper) and mandibular (lower) jaws do not grow at the same rate; one may come in larger than the other, or simply not be aligned properly with other bony structures in the skull. The person who appears to have no chin, or one that sticks out well beyond the upper are indications of this. This can cause problems other than appearance issues; an improperly aligned jaw can cause problems with the tongue and lips, and speech and chewing problems as well. Jaw surgery can move jaws into their proper place.