Oral surgery encompasses complex procedures including wisdom-tooth extraction, dental-implant placement, corrective jaw surgery, and managing complicated oral conditions. Patients are freed from constant pain and regain confidence after a fully restored smile. These are the everyday successes of oral surgery.
Are you in need of professional oral solutions for your oral health? Contact Agoura Hills Advanced Dentistry to experience unmatched skill and compassionate oral surgery care. But first, let us look at what oral surgery entails.
Typical Signs and Conditions that Show You May Need Oral Surgery
Oral surgery becomes necessary when a problem is beyond the scope of general dentistry, and it affects overall well-being, not just oral health. It deals with various complicated diseases and disorders of the teeth, gums, jaw, and face. Because symptoms may range from pain to functional limitations, it is important to know when to consult a specialist, like an oral surgeon, to treat and relieve the condition effectively in the long term.
Impacted teeth, especially wisdom teeth, are among the most common reasons for oral surgery referral. These third molars often lack sufficient space to erupt, and as a result, they become impacted in the jawbone or erupt at an unnatural angle. This impaction can cause jaw pain, pain on touching the gums, swelling, difficulty chewing, persistent bad breath, or an unpleasant taste caused by trapped food and bacteria.
Without treatment, impacted teeth may destroy surrounding healthy teeth, cause gum disease, develop cysts or tumors, and cause repeated infections. So, surgical removal is an essential step toward avoiding additional problems.
Other major dental issues require oral surgery besides the impacted wisdom teeth. Tooth loss through decay, trauma, or gum disease may also require oral surgery, including dental implant placement or the surgical insertion of titanium posts into the jawbone to act as anchors to support replacement teeth.
Problems with the jaw, including temporomandibular joint (TMJ) disorders, malocclusion (misaligned bite), or congenital jaw deformities, can be excruciating and could make it difficult to eat or talk, and may need corrective jaw surgery (orthognathic surgery) to fix the problem. Also, removal of oral lesions or pathology, repair of facial trauma, including broken jaws, and, in some instances of sleep apnea, when anatomical blocks are causing the problem, are all within the scope of an oral surgeon.
Although a general dentist can handle most basic dental treatment, referring a patient to an oral surgeon when a disease needs special surgical skills, specialized anesthesia, or complex understanding of the maxillofacial area to provide optimal results is important.
The Common Oral Surgery Procedures
Oral surgery is a diverse set of procedures to treat complicated dental, jaw, and facial disorders beyond the usual dental treatment. These special interventions are used to relieve pain, regain functions, enhance beauty, and clear underlying oral health problems that would have resulted in more serious conditions. The common procedures include:
Wisdom Tooth Extraction
Wisdom tooth removal is one of the most common oral surgery operations. The third molars are also called wisdom teeth, as they are the last to appear at the age of 17 to 25. In many cases, the jaw does not have sufficient space to allow the normal eruption of these teeth. Thus, they become impacted. The wisdom tooth may also grow at different angles, like horizontally, vertically, at an angle towards the adjacent molar, or back towards the jawbone and gum tissue, or it may be completely or partially embedded into the jawbone and gum tissue. This impaction may produce much pain, swelling, infection (pericoronitis), destruction of neighboring teeth, cysts, or tumors.
Surgical extraction is a delicate procedure that includes making an incision in the gum tissue and even taking out a tiny bit of bone to reach and get the tooth out, usually in pieces. Afterward, the area is stitched back together to heal well.
Dental Implants
Dental implants provide a predictable, long-term solution for patients with missing teeth. This surgical process entails inserting a tiny screw-like post in the jawbone where the tooth is lost. This implant serves as an artificial root of a tooth. After several months, the implant integrates with the bone in a process known as osseointegration, forming a secure anchor. When integrated, an abutment (a connection) is fitted to the implant, and a custom-made crown is placed on the top, which is carefully color-matched, shaped, and sized to fit perfectly with adjacent teeth.
Dental implants permanently solve lost teeth, offering chewing ability and aesthetic value.
Bone Grafting
Before an implant can be positioned or when there has been considerable bone loss as a result of periodontal disease, trauma, or long-term loss of a tooth, bone-grafting procedures are often required. This is done by grafting bone material to the jaw where there is insufficient volume of bone to support an implant or stabilize the teeth.
The grafting material may be derived in several forms:
- Patient bone (autograft)
- Donor bone (allograft)
- Animal bone (xenograft)
- Synthetic (alloplast)
The grafted bone induces the body to naturally regenerate bone, forming a strong base that can then be used to hold dental implants or enhance the overall structural strength of the jaw.
Orthognathic Surgery
In addition to personal tooth-related concerns, oral surgery also treats broader structural concerns, with corrective jaw (orthognathic) surgery realigning the jaws and facial bones to treat deformities such as:
- Facial asymmetry, including misaligned jaws (malocclusion)
- Problems chewing, talking, or breathing
This procedure involves the delicate realignment of the portions of the upper jaw (maxilla), lower jaw (mandible), or chin to obtain proper fit and functioning. Oftentimes used in combination with orthodontics, the orthognathic surgery significantly alleviates the bite mechanics, reduces temporomandibular-joint (TMJ) strain, and enhances facial harmony.
Biopsies and Lesion Removal
Oral surgeons also play a key role in diagnosing and removing oral lesions through biopsy and excision. Any soft tissue abnormality, cyst, or suspicious tumor in the mouth or jaw should be investigated thoroughly.
Oral surgeons will conduct biopsies where they will take a small sample of the tissue and examine it under a microscope to determine whether the lesion is benign or malignant. If a lesion is found to be problematic, the surgeon will remove it surgically, with clear margins to eliminate recurrence. This is critical in the early diagnosis and successful management of oral pathology, like oral cancer. These routine procedures emphasize the importance of oral surgery in preserving and restoring the health, functionality, and appearance of the oral and maxillofacial area.
Oral Surgery Appointment Preparation
Proper preparation is essential for a smooth procedure and comfortable recovery.
Although your oral surgeon’s office will give you specific instructions based on your case, knowing the general preoperative recommendations is helpful. Hence, you are prepared and less nervous about your upcoming visit. Preparation in advance means concentrating on recovery without any last-minute worries.
The preparation process generally starts with an in-depth consultation with your oral surgeon. In this visit, it is important to give a detailed and correct medical history, any pre-existing conditions, what medicines you are taking (prescription, over-the-counter, supplements, and herbal remedies), and what allergies you are aware of. Your surgeon will take up your case and inform you about the intended procedure, the possible risks and advantages, and the type of anesthesia that will be administered. This is your moment to seek clarification of any questions and ensure you are well informed and comfortable with the treatment plan. Do not be afraid to ask questions concerning post-operative pain management, the approximate time of recovery, and limitations you will have.
As the day of surgery draws near, concentrate on logistical arrangements. Arrange for a responsible adult to drive you to and from your appointment because you cannot drive after the anesthesia. If your surgery is in the morning, ensure you have organized your work or school responsibilities on the surgery day and possibly some days after, depending on how complicated the procedure is. Follow any fasting (NPO (nil per os), nothing by mouth) requirements given to you by the surgical team to the letter. This is usually nothing to eat or drink, even water, for a set amount of time, usually 6 to 8 hours before surgery, particularly when you are to be sedated with IV medication or under general anesthesia, to avoid complications like aspiration.
Furthermore, prepare your home a bit to facilitate your recovery. Prepare your pantry with soft, easily consumable food such as soups, yogurt, mashed potatoes, and smoothies because chewing can initially become cumbersome.
Pre-fill any medications that may have been prescribed, including pain-relief medication or antibiotics, so that they are ready when you go home. Make a comfortable healing area with pillows, blankets, and entertainment. Taking care of these practical matters before surgery establishes the best conditions to rest and heal.
You could ask your surgeon the following questions as part of the preparation:
- Which type of anesthesia will be used, and what should I expect?
- What are some of the risks of my procedure?
- What is the duration of the surgery?
- How long will it take to recover, and what will be my limitations?
- What are the pain management options, and when should I begin taking medication?
- How soon can I return to normal, like eating solid foods or exercising?
- What symptoms do I need to worry about after the surgery, and when should I call the office?
What to Expect on the Day of Surgery: Anesthesia and the Procedure
Your oral surgery appointment day may be intimidating, but knowing the general procedure, particularly about anesthesia and the surgery itself, may relieve a lot of your anxiety. As soon as you enter the facility, the whole surgical team will be preoccupied with your safety, comfort, and the effective resolution of the treatment.
When you arrive at the office of the oral surgeon or surgical center, you will be welcomed by the administrative staff. You will then complete any final paperwork, and a clinical assistant will escort you to the pre-operative area. In this case, they will examine your vital signs (blood pressure, heart rate, oxygen saturation), and the surgical staff will also check your medical history and ask you once again to make sure you know what you are signing up for. You will also get a chance to ask any last-minute questions here.
The highly skilled team, which includes the oral surgeon, an anesthesiologist (in case of general anesthesia), and surgical assistants, collaborates, and each of them is an important part of your treatment. Their combined experience will guarantee the strictest safety and efficiency standards during your procedure.
The essence of the surgical experience is demystifying anesthesia, which is customized to your needs and the complexity of the procedure. Local anesthesia is used by injecting it into the surgical area to make you remain awake and alert at the same time, and pain-free. If you have anxiety, you can be given nitrous oxide (“laughing gas”) to calm you down a bit, but still be awake. Deeper options include intravenous (IV) sedation, in which drugs are injected into a vein to achieve a very relaxed and semi-conscious state, usually with little or no memory of the procedure.
Furthermore, general anesthesia makes you unconscious and is controlled by a certified anesthesiologist or nurse anesthetist. The type of anesthesia applied is based on the invasiveness of the process, the extent of your anxiety, and your past medical history, which are all addressed during your first visit.
After administering the anesthesia, the oral surgeon will carefully execute the intended procedure. The surgical team will monitor your vital signs continually throughout the whole process. After the procedure, you will be escorted to the recovery area. In this case, you will be closely observed as the anesthesia wears off.
Although waking up may range from a pleasant awakening to a short experience of grogginess, the team will ensure that you are comfortable and stable enough to give detailed post-operative instructions and send you into the hands of your responsible adult escort.
Oral Surgery Recovery Process Week-by-week
Having oral surgery starts a critical period of recovery, and appropriate postoperative care is essential to guarantee the best healing process and avoid complications. Although the healing process can be different, depending on the nature of the treatment and your health condition, knowing the overall scope of the recovery process and what to expect each week can significantly increase your comfort and the overall outcome. The key to a successful recovery is to follow your surgeon to the letter.
Immediate Post-Op (First 24 Hours)
The first 24 hours are the most serious for immediate management. When you leave the surgical facility, gauze is usually taped on top of the surgical area to assist in combating the bleeding. This should be changed as instructed, usually every 30 to 45 minutes until the bleeding lightens to an ooze. The following are non-negotiable:
- No strenuous activity
- No bending
- No lifting
Swelling is a normal reaction. An ice pack on the outside of your cheek for 20 minutes on and 20 minutes off can help a lot in the first 24 hours. Begin prescribed pain medication as soon as the local anesthetic starts to wear off. Therefore, take prescribed pain medication as prescribed before the pain becomes unbearable. Stick to cool, soft liquids like water, broth, and juice, and do not use straws because the suction may remove a blood clot.
The First Week of Recovery
Pain and swelling are a priority as you move into the first week of recovery. Take pain medication as prescribed, and take over-the-counter anti-inflammatories such as ibuprofen as your surgeon recommends. The swelling usually reaches its maximum at 48 to 72 hours and slowly decreases. It can be treated with moist heat applied after the first 48 hours. You should still eat soft, nutritious foods without much chewing, such as mashed potatoes, scrambled eggs, yogurt, and soft pasta.
Avoid crunchy, chewy, or hot food that might irritate the surgical area. Gentle oral care is essential: start rinsing your mouth with warm salt water (1/2 teaspoon of salt in 8 ounces of warm water) 5 to 6 times a day, especially after meals, to clean the area. Do not brush aggressively in the area of surgery, and do not spit or rinse hard, as this can wash away the significant blood clot that forms in the socket.
Most people recover without incident, but call your surgeon immediately for any red-flag complications, such as:
- Persistent and severe pain that fails to respond to medication
- A fever above 100°F or 37.8 °C
- Unusual swelling beyond 72 hours
- Pus or foul discharge
- Excessive bleeding at the surgical site
The most painful complication is a dry socket, especially after a tooth extraction, when the blood clot prematurely dislodges, exposing the bone. When you notice any of these indicators, consult a professional immediately.
Long-Term Healing
Moving into long-term healing, your surgeon will probably make a follow-up appointment with you, usually within one to two weeks, to check on your progress in healing and remove any sutures you still have. Over the next few weeks, you can slowly incorporate more solid foods back into your diet as comfort permits, listening to your body. You can resume regular activity gradually, but avoid strenuous exercise for at least two weeks to prevent bleeding or swelling. A complete bone recovery, particularly involving an implant insertion, may require months. It is important to practice excellent oral hygiene and visit the dentist frequently to check your oral hygiene and to guarantee the success of your oral surgery in the long run and your overall mouth health.
Find an Oral Surgeon Near You
Oral surgery is a specialized practice that provides essential answers to a broad range of complex dental and facial pathologies, including treating impacted wisdom teeth and replacing missing teeth using dental implants. It is a testimony to the fact that modern dentistry can relieve pain and considerably improve the quality of life and overall well-being. Understanding the process in advance greatly improves outcomes.
Whether you have chronic mouth pain, have a complex dental concern, or simply want to ensure you keep a healthy smile, contact the dental team at Agoura Hills Advanced Dentistry at 818-878-7300 for further guidance.