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Question: What does an Oral and Maxillofacial surgeon do?

Answer: An Oral and Maxillofacial surgeon (Oral Surgeon) is someone who is well trained to correct a wide variety of diseases, defects and injuries in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. Oral surgeons have attended four years of dental school and at least four years of a hospital surgical residency program. They are specially trained to place dental implants, address TMJ (temporomandibular joint) disorders, handle various types of facial pain, and perform restorative surgical procedures such as bone grafting, sinus lifts, apicoectomies and wisdom teeth removal (both erupted and impacted). Oral surgeons specialize in addressing facial injuries, such as broken jaws, and are trained to treat oral cancers. An oral surgeon also has advanced training in anesthesia, so they can make your experience as painless and comfortable as possible. An oral surgeon attends four years of dental school and at least four years of hospital surgical residency.

Question: What does it mean to have an impacted wisdom tooth (third molar)?

Answer: Wisdom teeth usually erupt into the mouth between the ages of 17-21. Even when the wisdom teeth are fully formed, not everyone’s wisdom teeth grow in (impacted), and some only grow in partially (partially impacted). Sometimes a person’s jaw doesn’t grow large enough to accommodate the growth of the wisdom tooth (third molar from the midline of the face), and other times the tooth develops on its side and will not erupt.

Question: When is it recommended to remove the wisdom teeth?

Answer: It is generally recommended to remove the wisdom teeth when:
+ they are partially erupted, as this can leave an open communication for bacteria to enter and cause an infection
+ they are growing in such a way that they can damage adjacent teeth
+ If a cyst (fluid-filled sac) forms, destroying surrounding structures such as bone or tooth roots

Question: What is a sinus lift procedure, and when is it necessary?

Answer: In order for an implant to be successful and predictable, it needs to be placed in an area with adequate bone surrounding it. Surgeons prefer the minimum height of bone to be 7mm and the width to be at least 5mm, in order to have successful integration of bone and adequate support and strength. When the patient doesn’t have enough bone; certain procedures can be performed in order to make that patient a better candidate, such as bone grafting and sinus lifts (sinus augmentation). For patients who need to have teeth replaced in the back part of the upper jaw, many times the floor of the sinus is in the way, preventing the placement of an implant in that area. The oral surgeon can augment the sinus by lifting the sinus membrane and filling in the base of the sinus with bone grafting material to give more vertical height. For example, if an 8 mm implant needed to be placed, but there was only 4mm of bone beneath the floor of the sinus, after the sinus is lifted and bone is placed, we can now get at least 4mm of extra bone for its successful placement. This procedure takes place at the oral surgeon’s office and begins with a local anesthesia to the area being worked on.

Question: What is bone grafting, and where does the bone come from?

Answer: Bone grafting is the placement of bone within and around certain areas that are deficient in bone or have some defects that could compromise the placement of implants and affect function and esthetics in the mouth. The best source of bone for your graft is your own bone tissue from elsewhere in your body, because it is the most biocompatible and offers faster healing times when compared to other methods. However, it is not always the most practical or desired, since this bone would usually involve a procedure that takes some bone from your chin, the back of your lower jaw, the hip or your tibia. In many cases, a combination of artificial bone substitutes and freeze dried, demineralized, sterilized cadaver bone is used. The grafted bone provides an anchor and allows the existing bone to integrate with it, providing an environment suitable for the placement of implants.

Question: What would happen if I just left the space after the Oral Surgeon extracts my back tooth?

Answer: The loss of a back tooth can affect your dental health, your physical appearance and the way you chew, speak, sing and smile. When a tooth is lost, the adjacent teeth may tilt towards that empty space, or the teeth in the opposing jaw may drift up or down towards that space. Tipped teeth are more difficult to maintain, and are therefore more prone to decay. In addition, the surrounding bone and gum tissues may break down, resulting in an increased risk for gum disease. You may find yourself favoring the opposite side of your mouth when you chew, causing additional stress to your teeth and gum tissues. The loss of a tooth may also result in the failure to maintain the natural shape of your face, due to the lack of lip and cheek support in that area. The outcome may be an older appearance due to a sinking of your mouth in the region where the tooth was lost. Missing teeth can and should be replaced. Speak to your dentist to explore the many options you have, including implants and fixed bridges, which come very close to duplicating the function and appearance of your natural teeth.

Question: How soon can one exercise after minor dental surgery like a tooth extraction, gum surgery, apicoectomy, root canal, etc.?

Answer: There is no definite answer for everyone. As a general rule do not perform heavy exercise for at least one or two days from after your swelling has subsided. This may wind up being a week or until your stitches come out, but use common sense or ask your dentist if you have any questions. Exercising too early after surgery will make bleeding more likely. Rest, sleep, proper care and attention at home are important for the wound to heal properly. You have to listen to your body before you re-start your exercise regimen. You may resume your normal activities the next day, but just do not engage in vigorous exercise such as heavy lifting, competitive sports, running, biking, etc.

Question: Can wisdom teeth cause your teeth to crowd as they grow in?

Answer: People who notice that their teeth are crowding as their wisdom teeth are growing in, may be blaming the wrong culprit. This crowding tends to happen at this age (late teens to early 20’s) whether or not the patient has wisdom teeth. This crowding may also occur whether or not that individual had braces too. Often times teeth tend to crowd because of a late growth of the lower jaw coupled with a flattening of the profile of the face. Of course, the lack of compliance with wearing their retainer after orthodontic treatment may also be the source of this crowding, resulting in a relapse of the original crowding.

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