Oral and maxillofacial surgery is a dental specialty in the diagnosis and treatment of diseases, defects and injuries to the hard and soft tissues of the jaws, mouth, neck and face. Oral & Maxillofacial surgeons complete four to six years of training in addition to dental school.
Oral & maxillofacial surgeons perform a variety of surgeries, including:
- dental implants
- tooth extraction
- wisdom teeth extraction
- facial reconstruction
- cleft palate surgeries
- jaw misalignment treatment
- apicoectomy (root end surgery)
- biopsy and treatment of oral cancers, tumors and cysts
- sleep apnea treatment
- facial cosmetic surgery
Wisdom Teeth Extractions
Third molars, also called wisdom teeth, are the last teeth to surface, usually between ages 17-25. Most people have four wisdom teeth, some don’t have any, and in rare cases people have more than four. Your dentist observes your wisdom teeth with x-rays as part of regular examinations.
The American Association of Oral & Maxillofacial Surgeons estimates that 85% of wisdom teeth will eventually require removal. Wisdom teeth are often impacted – not properly emerged through the gums, instead growing crooked or even completely sideways. Left untreated the impacted teeth can cause a host of problems including crowding or misalignment of the other teeth and jaw, headaches and infections. Even if not impacted, wisdom teeth can be difficult to clean and may require removal to reduce the risk of decay and infection.
The best time to remove wisdom teeth is when the patient is in their late teens-early 20’s, according to the Canadian Association of Oral & Maxillofacial Surgeons. Surgeries performed later in life can still be very effective, but healing may be slower, and the risk of complications slightly higher.
Wisdom teeth extraction is performed under local or general anesthetic and does not require an overnight stay.
Dental bone grafting is performed to build up the jawbone. In cases where the jaw bone is damaged or receded, bone grafting is performed as a preparation step prior to a dental implant or restoration. These restorations require sufficient jaw bone volume for optimal chances of success.
Jaw bone volume can be insufficient for a number of reasons:
Periodontal (gum) disease and infections – progressively attacks gum tissue and will eventually damage the jaw bone if left untreated. Other infections can also diminish bone.
Tooth extraction – it is estimated that following a tooth extraction, the patient loses 40-60% of the bone surrounding the tooth site within three years.
Injury – blows to the jaw or other dental injuries can cause the jaw to recede.
Bone grafting treatment can take several months to complete. It is performed as an outpatient surgery (no overnight stay.) Typically, bone is harvested from another part of the patients’ body. The extraction and grafting sites are numbed with local anesthetic, then small incisions are made to access the bone. The bone is harvested, then anchored to the grafting site. Both sites are closed with sutures. The new bone will eventually fuse with existing bone and encourage new bone growth.