Oral and Maxillofacial (OMS and OMFS) Surgery
With improving technology and the advance in surgical techniques, Oral and Maxillofacial surgery is internationally recognized as a specialty surgery and can be broken down into the areas of the face and jaw. Although there is sometimes overlap between the various specialties, there are a few specific issues which come under the guise of Oral Surgery. The spectrum runs from simple tooth extraction to Head and Neck cancer (microvascular reconstruction) and everything in between. Some of the procedures include:
- Dental Implants
- Impacted Wisdom Teeth
- Root Canal
- Sleep Apnea
- Reconstructive Surgery
These are a few of the more common types of procedures, although there are many areas which are also included such as Maxillofacial Traumatology, Head and Facial Deformities, Cleft Palate, Biopsies, Mandibular Surgery, Saliva Gland Surgery, Facial Trauma Surgery and many others. This specialty has grown in significant leaps and bounds in the past 30 years and it takes a highly skilled and highly educated individual to master all of these procedures and to do them well.
The most common form of any dental or oral surgery is the removal of one or many of your teeth. This can occur for a number of reasons and does not necessarily mean that there is a health issue. For many adolesents who are to receive braces, there is sometimes a need to remove a tooth or two as to provide space for the teeth to align and to overcome any issues which the braces are intented to correct. Another and more serious reason for tooth extraction is if there is an infection around the tooth which has caused an abscess. In this case the tooth will have to be removed if there are no other alternatives. If the tooth is not removed, then the infection could spread to other areas of the mouth and eventually create issues with the rest of your body.
Root Canal treatment is a procedure where the goal is to preserve the tooth which has become decayed or badly infected. To preserve the tooth, both the pulp and the nerve are drilled out and the canal of the tooth is cleaned properly and the tooth is sealed. It is critical that all of the infected area is cleaned, as not properly doing so can cause further complications. Because the tooth is weak and susceptible to cracking, a crown is put over the tooth to bring it back to its original strength and shape.
What are Wisdom Teeth?
Another common reason for the removal of teeth is the problematic small incisors/third molar or as most of us know them, the infamous Wisdom Teeth. We’ve all heard horror stories about these, but in reality they are common procedure for any Oral Surgeon. Wisdom Teeth are a vestige of ancient humans when we were chewing foliage and our jaws were much larger. Since our jaws have become a bit smaller, because of agriculture and other foods, there is sometimes no room for the wisdom teeth to grow, thereby impacting all of the other teeth
What problems are associated with Wisdom Teeth?
The most common issue with Wisdom teeth is the pain they cause when they are growing into the back of the mouth. Since the Wisdom Teeth erupt between the ages of 18-25 they usually cause issues with some or all of your existing permanent teeth. To find room to grow they will push the other teeth into awkward positions which will eventually effect your bite. Also associated with Wisdom Teeth are cavities and periodontal issues, especially infections that can result in tooth loss and gum disease.
The Wisdom Teeth growth can cause a pouch in the gums where food and bacteria will collect, which increases the issue of gum related diseases. A cyst in the jaw caused by the Wisdom Teeth is another issue which if not treated in a timely manner can cause numerous complications for the patient. Another more common reason for the removal of the Wisdom Teeth is Orthodontal Treatment or the addition of Dental Braces to your mouth. The job of your “braces” is to align the teeth in a fashion that keeps your teeth straight and corrects any overbite, underbite, open bites, deep bites, malocclusions, and other issues with the teeth and jaw.
What is the procedure for Wisdom Teeth extraction?
As mentioned above, the removal of Wisdom teeth, whether it be all four or just one, is a common procedure and is usually done tin the office of the Dentist. In a few circumstances when the teeth are impacted, the procedure might be done in a hospital, but as an out-patient procedure.
Normally local anesthesia is used although in some cases Sedation anesthesia or General anesthesia will be used on the patient. Much of this depends on the complexity of the extraction and/or the comfort level of the patient.
After the anesthesia is administered the dentist will make an incision into the gum, remove some bone for easier access, sometimes divide the tooth for easier extraction, remove the tooth and any debris left behind, clean out the area of the extracted too, suture the exposed and incised area and finally add gauze for the bleeding, as well as to assist in the clotting of the blood. The Dentist will sometimes provide antibiotics before and after the procedure to ward off any infection. This has proven very effective in the past and is being adopted by more and more dentists
What are the side effects of extraction?
Side effects can be limited if you follow your Dentist’s instructions. The most likely effects are bleeding, swelling, bruising and some pain. If there was bone removed and the tooth was impacted, then the Doctor will prescribe pain medication. In most cases over the counter medication will suffice for pain management, and to avoid or stop a fever, take antifebrile medication.
What is the best way to recover from surgery?
To heal properly from the surgery, it is advised that you rest and avoid any activity. Although you might feel the need to brush, this should only be done after the initial 24 hours and be done very carefully. Rinse if advised but be advised not to gargle as this can loosen the clots and run the risk of bleeding. As with any surgery, drink plenty of water to fend off dehydration and eat only soft foods.