Oral Surgery Basics

 

By: Consumer Guide to Dentistry

 

😀 An oral surgeon is skilled to treat different mouth conditions. They provide services suitable for your needs. Read more! The Oral Surgery DC Team

The American Dental Association recognizes oral and maxillofacial surgery – commonly referred to as oral surgery – as one of dentistry’s nine specialty areas. This dental specialty focuses on the diagnosis and surgical and adjunctive treatment of diseases, injuries, and defects related to the functional and esthetic aspects of the face, mouth, teeth, and jaws (maxillofacial area).

Conditions Treated With Oral Surgery

An oral surgeon is an important link in your referral network of primary care providers. When functional dental concerns – such as keeping teeth, overcoming congenital growth issues, controlling serious oral disease and treating trauma-related damage – supersede esthetics, oral surgeons are the appropriate dental specialists with whom to seek a referral.

General dentists, orthodontists, pediatric dentists and medical physicians usually serve as the referrers. Prosthodontists often work hand-in-hand with oral surgeons to develop orthotics and prosthetic appliances to treat a number of functional issues. However, it’s important to note that whenever surgery involves the face, a cosmetic dentist should also be consulted as part of the dental team. Some patients also may wish to consult with a plastic surgeon.

An oral surgeon is skilled in the following:

Removing diseased and impacted teeth and administering anesthesia. An oral surgeon can remove impacted and damaged teeth and provide in-office anesthesia services, including intravenous (IV) sedation and general anesthesia.

Placing dental implants. In collaboration with a cosmetic or restorative dentist who designs your new smile or restorations, your oral surgeon can help with the planning and subsequent placement of your tooth implants. Oral surgeons can reconstruct bone in areas requiring it for implant placement and, when necessary or desired, modify gum tissue around the implants to produce a more natural and attractive appearance.

Treating facial trauma. Oral surgeons can repair minor-to-complex facial skin lacerations, set fractured jaw and facial bones, reconnect severed nerves and treat other facial injuries involving the oral tissues, jaws, cheek and nasal bones, eye sockets, and the forehead.

Evaluating pathologic conditions. Oral surgeons treat patients with benign cysts and tumors of the mouth and face, as well as people with malignant oral, head and neck cancer, and severe infections of the oral cavity, salivary glands, jaws, and neck.

Alleviating facial pain. An oral surgeon can diagnose and treat facial pain disorders, including those caused by temporomandibular joint (TMJ) problems. Your oral surgeon can order imaging studies of the joints and make appropriate referrals to other dental and medical specialists, or a physical therapist. When non-surgical treatment is insufficient or there is definite joint damage, your oral surgeon may suggest surgery.

Performing reconstructive and cosmetic surgery. Oral surgeons can correct jaw, facial bone and facial soft tissue problems that result from trauma or the removal of cysts and tumors. Such corrective surgeries restore form and function to the maxillofacial area and often involve using skin, bone, nerves and different tissues from other parts of the body to reconstruct the jaws and face.

Performing corrective jaw (orthognathic) surgery. Oral surgeons correct minor and major skeletal and dental jaw irregularities to improve chewing, speaking and breathing. Usually, in collaboration with an orthodontist (a dental specialist who treats improper bites or malocclusions), an oral surgeon surgically reconstructs and realigns the upper and lower jaws into proper dental and facial relationships in order to improve biting function and facial appearance. Oral surgeons also surgically correct birth (congenital) defects of the face and skull, such as cleft lip and cleft palate.

Your dentist, orthodontist and oral surgeon all must collaborate to determine whether orthognathic surgery is right for you or your child. However, it is the oral surgeon who decides which procedure is appropriate. As part of the dental team, the oral surgeon often provides surgical consultation and educational and emotional support for the family over the course of long-term treatment.

Providing surgical treatment for obstructive sleep apnea (OSA). If your dentist suspects that you have a sleep disorder, you will likely be referred to a sleep clinic for a polysomnography, an overnight clinic test that monitors your sleep patterns. Your dentist then will help select the best treatment for you based on whether your OSA is mild, moderate or severe. If non-surgical treatments such as behavior modification or oral appliances do not work, your dentist may refer you to an oral surgeon for a surgical procedure. Surgical procedures to correct sleep apnea include:

  • Uvulopalatopharyngoplasty, which shortens and stiffens the soft palate by partially removing the uvula and the edge of the soft palate to correct airway collapses
  • Genioglossus advancement, which opens the upper breathing passage by tightening the front tongue tendon, reducing tongue displacement into the throat
  • Maxillomandibular advancement, which surgically moves both jaws forward to open the upper airway

Education and Training for Oral Surgeons

To be certified as a diplomate of the American Board of Oral and Maxillofacial Surgery, an oral and maxillofacial surgeon (commonly called an OMFS or oral surgeon) must graduate from an accredited dental school and be licensed in the state in which he/she is practicing. The oral surgeon also must have completed four or more additional years of training in an accredited, hospital-based oral and maxillofacial surgery residency program.

Oral surgeon residents train alongside medical residents in general surgery, advanced anesthesia, plastic surgery (reconstructive or bone grafting/tissue grafting), medicine and pathology. An OMFS may treat patients in hospitals, outpatient facilities, and surgery centers, as well as in a dental practice setting.

Choosing an Oral Surgeon

When selecting an oral surgeon, key questions to consider include:

How long has the oral surgeon been in practice? Ideally, you want to select and be referred to an oral surgeon who has built a successful practice through years of experience. The more procedures an oral surgeon has performed, the more experience and expertise he or she can offer you.

What are the oral surgeon’s training and clinical experience in performing the specific procedure(s) you require? Ask about his or her experiences, knowledge and background with your particular problem.

What do professional dental societies the oral surgeon belong to? Has the oral surgeon received any credentials or credible accolades from these groups? Select an oral surgeon that is certified as a diplomate of the American Board of Oral and Maxillofacial Surgery.

What continuing education courses the oral surgeon has taken? How recently have they been completed? Each state and the American Dental Association require that dentists take continuing education classes to keep them up-to-date on the latest procedures and technological advances in the field.

What are the oral surgeon’s diagnosis and proposed treatment plan? Be sure to ask about all the options to treat or correct your condition, as well as the pros and cons of each. Make sure that all aspects are thoroughly explained to you.

What are the estimated costs of the proposed treatment options? In cases where dental insurance does not cover treatment costs, does the oral surgeon offer third party and/or in-house financing?

What are the oral surgeon’s referral process and dental/medical/laboratory/hospital network? When your oral surgeon works in collaboration with other dental and medical professionals on your case, it is important that you have the same level of trust and confidence in their professional skills and care as you do in those of your oral surgeon. You also need to determine whether these dental/medical professionals – as well as the hospital and/or other surgical centers where they and/or your oral surgeon may practice – accept your insurance, and whether the specific treatments/procedures they will perform, are covered under your insurance plan. If laboratory-fabricated restorations are involved, is the laboratory technician certified or accredited? How long has your oral surgeon worked with this laboratory/technician? Is your oral surgeon satisfied with the quality of the laboratory and/or technician?

Emergencies are unlikely but do find out what provisions the practice offers. What type of emergency care does the oral surgeon offer? For instance, can the oral surgeon be reached and readily available after office hours, on weekends and holidays? 

 

Sources: https://www.yourdentistryguide.com/oral-surgery/?

Effects Of Smoking On Teeth And How To Kick The Habit

 

By: Donna M. Rounsaville, Colgate

 

  It’s No Smoking Day, a holiday we definitely endorse! Smoking takes a toll of smoker, and their teeth. The Oral Surgery DC Team

Although they aren’t addressed as often as the rest of the body, the effects of smoking on teeth and the oral cavity are important pieces of information in the process of smoking cessation. Everyone knows smoking is bad for your health, but did you know it is a major contributor to dental problems as well? Although true strides have been made, the tobacco epidemic continues. Nonetheless, according to the U.S. Department of Health & Human Services, opportunities abound for kicking the habit.

Why be concerned with the oral effects of smoking? A healthy smile is paramount for most adults. It is often the first thing people notice when they’re introduced to someone for the first time. And nobody wants a smile that is dull or discolored, let alone emits bad breath. The problem is that routine brushing is only half the solution; it doesn’t remove the stains or reduce halitosis by itself. In addition, seek more frequent dental cleanings. These visits can foster a dialogue that opens a path to quitting.

Effects on Teeth and Oral Cavity

According to the American Dental Association (ADA) Mouth Healthy site, smoking and tobacco use cause stained teeth, bad breath and a diminished sense of taste. Over time, smoking can hinder your immune system, producing more concerning side-effects that include a reduced ability to recover after surgery. Because of this, smoking is also one of the most significant risk factors associated with gum or periodontal disease, which causes inflammation around the tooth. This irritation can affect the bone and other supporting structures, and its advanced stages can result in tooth loss.

The use of tobacco – especially smokeless tobacco – increases your risk of oral cancer as well, which can be aggressive due to the abundance of blood vessels and lymph nodes in your head and neck.

Ultimately, the effects of smoking on teeth can lead to tooth decay, and pose a challenge with restorative dentistry. Because tobacco causes tooth discoloration, the aesthetic results of this treatment are not always ideal – both extrinsic and intrinsic. In addition, gum recession can cause uneven margins on crowns and other restorations.

Smoking Cessation and Your Dentist

Dental health professionals play an important role in smoking cessation, and can increase your rate of successfully quitting. According to the University of Wisconsin Center for Tobacco Research and Intervention, the qualities and attributes of the dental team are uniquely poised to combat this stubborn habit. These benefits include:

  • Skills for interviewing and questioning patients about tobacco use
  • Reviewing of medical histories at every visit
  • Educational and motivational skills
  • Trusting relationship and rapport with patients
  • Regular visits that allow for follow-up and support

Dental patients are seen more frequently for oral health appointments than by their primary care providers. Taking advantage of these regular visits can be an important step to beginning and monitoring a smoking cessation program.

Steps to Take

Using the Centers for Disease Control and Prevention (CDC)‘s five keys for quitting is a terrific way to start a course for successful tobacco cessation. All health care providers, especially your dental hygienist and dentist, can provide support and resources. These five steps are:

  1. Get ready by setting a date to quit.
  2. Seek support from your friends and family, as well as your doctor, dentist, counselor, etc.
  3. Practice behavioral distractions (such as the use of Colgate® Wisp® for on-the-go brushing) when the urge to smoke comes up.
  4. Make use of medications – both prescription and over the counter – and use as directed.
  5. Prepare for setbacks and seek help for overcoming obstacles or relapses.

The effects of smoking on teeth, breath, clothes and your health in general can all influence a patient’s desire to quit, but a visit to the dentist is an important first step. Dentists and dental hygienists will have a crucial plan that starts the process. Everyone wants white teeth, fresh breath, a healthy mouth and firm gums, and with help from your dental office, you can achieve all of these. It’s never to late to quit being unhealthy.

 

Sources: https://www.colgate.com/en-us/oral-health/basics/threats-to-dental-health/effects-of-smoking-on-teeth-and-how-to-kick-the-habit-0115?

 

Is Dental Sedation Safe For Kids?

By: Jenny Green, Colgate

 

👩‍👧  Parents play an important role during the dental sedation procedure. Prepare your child and follow the guidelines to gain positive results. The Oral Surgery DC Team

 

Safety is parents’ top consideration when it comes to their child receiving dental sedation. Dentists may recommend sedation for long, complex procedures and for patients who are especially young or nervous. Sedating a patient is normally a very safe procedure, and parents can help reduce the risks and stress level for their child before, during and after the treatment.

Types of Sedation

Oral sedation, nitrous oxide and intravenous sedation are the major types of sedation dentists provide. According to the Children’s Hospital of Pittsburgh of UPMC, oral sedation is taken by mouth or through the nose as soon as the patient arrives at the appointment, as the medicine usually takes up to 20 minutes to work. Oral sedation doesn’t put patients to sleep, but it helps them stay calm and relaxed.

Nitrous oxide, or laughing gas, also helps children remain calm. A mask delivers a mixture of nitrous oxide and oxygen, and within five minutes, the patient relaxes and experiences euphoric feelings. At the end of the procedure, pure oxygen is given to the patient to clear out any remaining nitrous oxide.

Intravenous sedation is delivered through a needle inserted into the patient’s vein. The American Society of Dentist Anesthesiologists explains that nitrous oxide is used to send the child to sleep before a needle is inserted, usually into a vein on the back of the child’s hand. A tube is also inserted into the patient’s throat to aid breathing.

Before Sedation

The American Academy of Pediatric Dentistry advises parents that children tolerate sedation and other dental procedures best if the parents understand what is happening and help prepare the child. Parents must restrict food and drink before sedation, and it’s especially important that parents follow these guidelines closely for key safety reasons, as sedation poses the risk of stomach contents being vomited and inhaled into the lungs. Dressing the child in loose-fitting clothing also helps because it allows dental assistants to attach monitors quickly and without fuss. Parents must provide a full medical history and tell the dentist if the child is receiving any prescriptions, over-the-counter medication or herbal supplements.

At the Dentist’s Office

Parents can help their children stay relaxed by being calm and encouraging, according to the Children’s Hospital of Pittsburgh. Try bringing along a comfort item for the kid to hold, such as a favorite toy or stuffed animal. Holding the child’s hand and talking or singing gently are other good comfort tactics. Parents should also avoid bringing other children to the appointment so that they can focus their full attention on the child receiving care.

Safety Checks

For dentists, ensuring the patient’s safety is paramount during dental sedation. While sedated, the patient’s blood oxygen level, blood pressure, temperature, and heart rate are closely monitored. A patient who requires general anesthesia may be referred to the dental hospital, such as that at the University of Maryland School of Dentistry.

After Sedation

At the Children’s Hospital of Pittsburgh, parents are usually asked to be present while their child wakes up after sedation. The child may be confused or fussy and may feel nauseous. Two adults should accompany the child or teen on the way home — one to drive and one to check the child’s breathing. Longer-lasting aftereffects of sedation include loss of physical coordination, dizziness, sleepiness, and nausea, so going back to school or daycare is definitely not an option on the day of the procedure.

For the first few hours after the procedure, parents should give the child only soft foods. If the child experiences vomiting, severe pain, severe bleeding or fever, parents should contact the dentist immediately. When the mouth has healed, the child may continue caring for his teeth as normal, brushing twice a day with a fluoride toothpaste, such as Colgate® Kids 2in1.

Dental sedation is a safe and fuss-free procedure with the right preparation and proper care after it’s over. By communicating clearly with your child’s dentist, you’ll provide the best possible experience for your child.

 

Resource: https://www.colgate.com/en-us/oral-health/procedures/anesthesia/is-dental-sedation-safe-for-kids-0415