Oral and maxillofacial surgery is surgery to correct a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. It is a recognized international surgical specialty.

Treatments may be performed on the craniomaxillofacial complex: mouth, jaws, neck, face, skull, and include:

• Dentoalveolar surgery (surgery to remove impacted teeth, difficult tooth extractions, extractions on medically compromised patients, bone grafting or preprosthetic surgery to provide better anatomy for the placement of implants, dentures, or other dental prostheses)
• Diagnosis and treatment of benign pathology (cysts, tumors etc.)
• Diagnosis and treatment (ablative and reconstructive surgery, microsurgery) of malignant pathology (oral & head and neck cancer).
• Diagnosis and treatment of cutaneous malignancy (skin cancer), lip reconstruction
• Diagnosis and treatment of congenital craniofacial malformations such as cleft lip and palate and cranial vault malformations such as craniosynostosis, (craniofacial surgery)
• Diagnosis and treatment of chronic facial pain disorders
• Diagnosis and treatment of temporomandibular joint (TMJ) disorders
• Diagnosis and treatment of dysgnathia (incorrect bite), and orthognathic (literally "straight bite") reconstructive surgery, orthognathic surgery, maxillomandibular advancement, surgical correction of facial asymmetry.
• Diagnosis and treatment of soft and hard tissue trauma of the oral and maxillofacial region (jaw fractures, cheek bone fractures, nasal fractures, LeFort fracture, skull fractures and eye socket fractures.
• Splint and surgical treatment of sleep apnea, maxillomandibular advancement, genioplasty (in conjunction with sleep labs or physicians)
• Surgery to insert osseointegrated (bone fused) dental implants and Maxillofacial implants for attaching craniofacial prostheses and bone anchored hearing aids.
• Cosmetic surgery limited to the head and neck: (rhytidectomy/facelift, browlift, blepharoplasty/Asian blepharoplasty, otoplasty, rhinoplasty, septoplasty, cheek augmentation, chin augmentation, genioplasty, oculoplastics, neck liposuction, lip enhancement, injectable cosmetic treatments, botox, chemical peel etc.)

Wisdom Teeth

Why are they called Wisdom Teeth?

The last teeth to develop and erupt into the jaws are called the third molars. Third molars usually erupt in the late teen years, which coincides with passage into adulthood and is referred to by some as the age of wisdom; hence "wisdom teeth". Unfortunately, the wisdom teeth are now usually trying to erupt into a jaw that is too small.

Wisdom teeth used to serve a useful purpose, but are now considered vestigial organs. A vestige is a degenerative or imperfectly formed organ or structure having little or no utility, but in the earlier stage of development of a species performed a useful function. The reasons that wisdom teeth are now "outdated" are many. Until quite recently, our diet included mostly very coarse food, as well as impurities such as dirt and sand. This coarseness would abrade teeth so significantly that they would take up less space in the jaw. Permanent teeth were also frequently lost at an early age, which would create more space in the jaw. Because the diet was so coarse and hard to chew, the jaw itself would develop into a larger bone because of this constant workout. All of these factors would create more space for the wisdom teeth when they came in.

The heavily processed diet of today does not produce the tooth abrasion or jaw development that we used to see. Modern dentistry has pretty much eliminated significant loss of permanent teeth at an early age. This leaves us with too many teeth and not enough jaw. The wisdom teeth still develop as they always have, but they have no where to go. When this happens, the teeth are considered "impacted," meaning that they are not in normal position and function.

Impacted wisdom teeth

Besides serving no useful function, the impacted teeth will often cause damage because they cannot be cleaned properly and can collect food debris, bacteria and plaque around them. This can result in tooth decay, gum disease, infection and abscess of not only the wisdom teeth, but of the molars next door and of the surrounding gum tissue. The molars in front of the wisdom teeth are sometimes lost because of cavities and gum disease caused by the inability to clean the wisdom teeth properly. Cyst formation and other destructive pathology are also seen around impacted wisdom teeth.

Cavities caused by poor cleaning around wisdom teeth

Cyst forming around wisdom tooth

If removal of the wisdom teeth is indicated, the procedure is recommended in the late teenage years, before the roots are completely formed. Surgical procedures in general are better tolerated when one is young and healthy, and the gum tissues tend to heal better and more predictably when young. Most people experience minimal disruption of their normal routines, and time off from work or school is usually minimal.

When indicated, the removal of wisdom teeth can be of great benefit to your ultimate oral and general health.

How do you keep my mouth open during surgery when I’m asleep?

A small rubber cushion is placed between your teeth before you go to sleep, and this holds your mouth open.

What is a " dry socket "?

Dry socket is a term that refers to a healing complication that used to be seen somewhat frequently, but is rarely a problem today. With current techniques we have all but eliminated "dry sockets", although we encourage you to call us if you experience anything postoperatively that is not improving day by day or just doesn’t feel right.

When can I go back to work or school?

Every individual has a different healing response to surgery, but on average there is not much disruption of one’s activities, and generally not for more than a few days. We frequently see people back at work or school on the day following surgery, even when all four wisdom teeth have been removed.

When can I brush my teeth after surgery?

Teeth can be brushed immediately, being careful to avoid the surgical areas for the first day or so.

When will my stitches dissolve?

Unless you are told otherwise, your stitches will dissolve after about a week.

When can I take the gauze out that I was biting on when I left your office?

The gauze may be removed when you get home; to be replaced with new gauze if significant bleeding continues, or if it feels better to have gauze in place. If the bleeding is not tapering off within a few hours of surgery, you should call our office. A small amount of blood on your pillow on the night following surgery is nothing to be alarmed about of there is no active bleeding.

When should I start the prescription mouth rinse?

The prescription mouth rinse should be used for the first time before you go to bed on the night following surgery. Rinse very gently, because your blood clots are still somewhat fragile.

If I’m a smoker, how long should I wait to smoke after surgery?

Smoking is harmful to the healing process and makes numerous complications more likely. Smoking in the first two weeks is especially harmful.

Sinus Lift Surgery