Oral and Dental Surgery

Oral and Dental surgery can be a little intimidating but it does not have to be. Good anesthesia and relaxation techniques will help you through the process.

Very badly decayed teeth, impacted teeth, broken teeth, teeth with pathologies like cysts or tumors need to be extracted. Decay can be prevented by good oral hygiene and regular check ups and a proper diet. Fractures may be due to grinding and clenching and may be prevented by wearing a night guard. Fractures due to sports trauma can be avoided by wearing a sports guard. Other trauma may not be avoidable but it is best to get professional consult right away if the tooth can be saved.

Extractions

If the tooth has to be extracted, it can be done using several relaxation techniques and anesthesia:

  • Local anesthetic
  • Laughing gas
  • Oral Sedation
  • IV Sedation

Appropriate technique is based in on each individual situation and you will be given all the choices; and Dr. Bogg will discuss them with you so you can make an educated decision.

Impacted Teeth

A tooth that has not fully broken through (erupted) the gum is referred to “impacted.” Here are a few of the reasons these teeth cannot erupt or erupt only partially:

  • Lack of space (crowding)
  • Misalignment (tooth is rotated out of position)
  • Conflicting position (another tooth has erupted over that position)

teeth-xray-gentle-dental

In some cases, if the impacted tooth does not get the professional attention it needs, it can fuse (permanently connect) to the surrounding bone. This tooth then stays ‘frozen’ in whatever stage it was in. This condition is known as ankylosis. The most common teeth to become impacted are “wisdom teeth”, also known as the third molars. Because they are the last to erupt, there is usually little or no room for them to come in correctly. If the tooth is below the gum line, it can affect the teeth that lay beside it and their roots. If it is above the gum line it can make a “food trap” that is difficult to brush or floss, [that can] eventually leading to decay.

A comprehensive exam and X-Rays will be taken to help us in diagnosing the position and the direction of the wisdom teeth.

If the wisdom teeth are impacted and there is no space for them to come in, causing pain and harm to adjacent teeth, they need to come out. Removal of wisdom teeth can be done under sedation so you don’t feel a thing.

If the teeth are deeply impacted but are not harming the other teeth or the joint in any way, they might just need to be kept under regular observation when you come in for your routine cleanings.

If the wisdom teeth are erupting and your jaw has enough space to accommodate them, they may cause some discomfort (teething pains) but they can erupt and function as regular teeth.
Not all wisdom teeth need to be extracted

Other Minor Surgical Procedures

Incision and Drainage: It is a minor surgical procedure to release the pressure built up by infection. If there is an infection in the gums or in the tooth or at the tip of the root and is not taken care of, the bacteria continue to grow and form an encapsulated mass which contains bacteria and pus. If it reaches a certain size, it causes pressure and pain. If the abscess is diagnosed early enough, it can be treated with antibiotics and the cause (infected gum or tooth) can be treated. If late, the pressure needs to be drained before definitive treatment. The abscess is lanced and a drain is put in for a couple of days to get the pus out. Then the cause can be treated.

Frenectomy: Frenum is a small band of tissue which connects the check to the alveolar bone or the lip to the gums or the tongue to the floor of the mouth. The frenum that connects the lip to the gum in the front of the mouth , especially on the upper jaw, sometimes connects a little lower than normal and does not allow the two front teeth to come together. This frenum needs to be incised and reset – treatment is based on clinical exam.

frenum
frenum2

Gingivoplasty and Gingivectomy: Sometimes Gums around your teeth over grow covering part of your teeth. There are various causes:

  • Inflammation
  • Medication Induced
  • Systemic factors
  • Hereditary factors

Gingivoplasty is for minor enlargement and reshapes the gums. Gingivectomy is for slightly larger enlargements and trims and shapes the gums. Treatment is based on cause and clinical exam and other diagnostic procedures.