ORAL & MAXILLOFACIAL SURGERY

Oral & Maxillofacial Surgeons are specialists with expertise in the diagnosis and treatment of head and neck injuries and conditions. Your Dental Surgeon will have expertise in the following areas:

TOOTH EXTRACTION WISDOM TEETH IMPLANTS BONE GRAFTING SINUS AUGMENTATION APICOECTOMY CYSTECTOMY TMJ (TEMPRO-MANDIBULAR JOINT DISFUNCTION)

WISDOM TEETH EXTRACTIONS What are Wisdom Teeth? Wisdom teeth are third molars, usually the last four of 32 teeth to surface in the mouth when you are between the ages of 17 to 25. They are called ‘Wisdom Teeth’ because it was thought that they appeared at the same time as the person reached maturity or ‘wisdom’. Wisdom teeth become problematic when there is not sufficient space in the mouth for the teeth to erupt and function normally. The tooth may then become impacted in a damaging position. If untreated, this can lead to infection, damage to other teeth and even cysts and tumours.

Why remove Wisdom Teeth? Your dentist may recommend extraction if you are suffering from pain, swelling, decay, infection or if as a preventative measure to avoid serious problems in the future which can include: Damage to nearby teeth: - tooth decay, gum disease and possible bone loss. Disease:- Not usual however cysts and tumours can occur in areas surrounding impacted wisdom teeth. Infection:- Bacteria can become trapped under the gum tissue, resulting in infection causing serious pain. Tooth crowding:- Impacted wisdom teeth can put pressure on other teeth and cause them to become overcrowded or twisted

What happens when you have a Wisdom Tooth / Teeth Removed

Before removing a wisdom tooth, your dentist will give you a local anesthetic to numb the area where the tooth will be removed. A general anesthetic may be used, especially if several or all of your wisdom teeth will be removed at the same time. A general anesthetic prevents pain in the whole body and will cause you to sleep through the procedure. Your dentist will probably recommend that you don't eat or drink after midnight on the night before surgery so that you are prepared for the anesthetic. To remove the wisdom tooth, your dentist will open up the gum tissue over the tooth and take out any bone that is covering the tooth. He or she will separate the tissue connecting the tooth to the bone and then remove the tooth. Sometimes the dentist will cut the tooth into smaller pieces to make it easier to remove. After the tooth is removed, you may need stitches. Some stitches dissolve over time and some have to be removed after a few days. Your dentist will tell you whether your stitches

need to be removed. A folded cotton gauze pad placed over the wound will help stop the bleeding.

What To Expect After Surgery In most cases, the recovery period lasts only a few days. Take painkillers as prescribed by your dentist or oral surgeon. The following tips will help speed your recovery. •

Bite gently on the gauze pad periodically, and change pads as they become soaked with blood. Call your dentist or oral surgeon if you still have bleeding 24 hours after your surgery.

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While your mouth is numb, be careful not to bite the inside of your cheek or lip, or your tongue.

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Do not lie flat. This may prolong bleeding. Prop up your head with pillows.

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Try using an ice pack on the outside of your cheek for the first 24 hours. You can use moist heat-such as a washcloth soaked in warm water and wrung out-for the following 2 or 3 days.

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Relax after surgery. Physical activity may increase bleeding.

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Eat soft foods, such as gelatin, pudding, or a thin soup. Gradually add solid foods to your diet as healing progresses.

• Do not use a straw for the first few days. Sucking on a straw can loosen the blood clot and delay healing. • After the first day, gently rinse your mouth with warm salt water several times a day to reduce swelling and relieve pain. You can make your own salt water by mixing 1 tsp (5 g) of salt in a medium-sized glass [8 fl oz (240 mL)] of warm water. •

Do not smoke for at least 24 hours after your surgery. The sucking motion can loosen the clot and delay healing. Also, smoking decreases the blood supply and can bring germs and contaminants to the surgery area.

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Avoid rubbing the area with your tongue or touching it with your fingers.

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Continue to brush your teeth and tongue carefully.

Your dentist will remove the stitches after a few days, if needed.

IMPLANTS What are Implants? The best solution to replace missing teeth or stabilise loose dentures. They are artificial roots and teeth (titanium) that are surgically placed into the upper or lower jaw bone. Patients are delighted to see that these teeth attached to implants look natural and give them a wonderful smile. Dental implants normally last for many years but occasionally need retightening or replaced due to wear and tear. Why might you need dental implants? If you want to replace missing teeth without affecting the adjacent teeth As a solution for joint pain or bite problems due to teeth moving into missing tooth space If you need to support a bridge or denture To aid chewing or speech For restoring or enhancing facial tissues

How do you get dental implants? You will need appointments at your clinic over several months. After taking impressions, the implant will be surgically positioned into the bone and permitted to heal and integrate itself onto to the bone for up to six months. You may need additional surgery depending on the type of implant so that the ‘post’ will hold the artificial tooth in place. The artificial teeth are made and fitted to the anchor after they have several weeks to heal. This stage may take some months. At this stage, your teeth should feel comfortable and stable. Your doctor will advise you on how to care for your teeth - nothing complicated just regularly visiting the clinic and good oral hygiene at home.

BONE GRAFTING Bone grafting is often closely associated with dental restorations such as bridge work and dental implants. In most cases, the success of a restoration procedure can depend on the height, depth and width of the jawbone at the implant site. When the jawbone has receded or been damaged, the implant is not able to be supported on the unstable foundations and therefore bone grafting is recommended to allow the procedure to continue.

SINUS AUGMENTATION Why you may need a Sinus Augmentation? You are likely to need a Sinus Augmentation if you are having implant work done. The implant is an artificial tooth root attached to the jaw bone. For the implant procedure to be successful, the quality and quantity of jaw bone is important. If the bone has been lost due to injury or periodontal disease, a sinus augmentation can raise the sinus floor to allow for new bone formation.

What happens when you have a Sinus Augmentation? Your dentist will carefully make a tiny incision near the upper premolar or molar region to expose the jawbone. A small opening is cut into the bone and the membrane lining the sinus on the other side of the opening is gently pushed upwards. The underlying space is filled with bone graft material and the incision is closed. Your dentist will give you the option of using bone graft from your own bones, from a cadaver or synthetic materials. The implants are placed after healing has occured and will have a higher success rate following a sinus augmentation procedure.

APICOECTOMY Why you may need a Apicoectomy? When inflammation or infection persists after root canal treatment, an apicoectomy may be necessary.

What is an Apicoectomy?

This is the removal of the apex or root tip followed by a filling procedure to seal the root from further infection. If left untreated, infected roots will damage other teeth, spread infection and cause regression of the jawbone.

CYSTECTOMY A cystectomy is the complete surgical removal of a small cyst with subsequent wound closure. The cyst is completely removed after a mucosa incision. This operation can also be combined with a root tip resection. The mucosa above the bone defect is then tightly sealed. New cysts may arise from any cyst residues.

TMJ (TEMPRO-MANDIBULAR JOINT DISFUNCTION) What are the symptoms of TMJ? TMJ (Tempro-Mandibular Joint Dysfunction) is a common condition affecting a wide variety of people. You may be suffering with severe headaches, jaw pain, grinding teeth and occasional ringing in the ears. The majority of sufferers are unaware that their dentist is able to treat these problems. The symptoms usually worsen during stressful periods and can also result in neck pain and dizziness. The most common cause of TMJ is the misalignment of teeth - also known as ‘bad bite’. It is possible for the dentist to realign or adjust the teeth without the need for painful or expensive surgeries. This realignment will stop the headaches, jaw pain and dizziness. It is very important that you make an appointment with your dentist if you are experiencing the above symptoms.