What is an impacted tooth?

A tooth is termed impacted when there is a lack of space in the dental arch and its growth and eruption are prevented by overlying gum, bone or another tooth.  A tooth may be partially impacted, which means a portion of it has broken through the gum, or totally impacted and unable to break through the gum at all.

How serious is an impacted tooth?

Impacted and partially impacted teeth can be painful and lead to infection, gum disease, and bone loss.  They may also crowd or damage adjacent teeth or roots.  More serious problems may occur if the sac surrounding the impacted tooth becomes filled with fluid and enlarges to form a cyst.  As the cyst grows, it may hollow out the jaw and permanently damage adjacent teeth, the surrounding bone and nerves.  Rarely, if a cyst is not treated, a tumor may develop from its walls and a more extensive surgical procedure may be required to remove it.

When should I have my wisdom teeth removed?

It isn’t wise to wait until your wisdom teeth start to bother you.  In general, earlier removal of wisdom teeth results in a less complicated healing process.  The AAOMS/OMSF study strongly recommends that wisdom teeth be removed by the time the patient is a young adult in order to prevent future problems and to ensure optimal healing.  The researchers found that older patients may be a greater risk for disease, including periodontitis, in the tissues surrounding the third molars and adjacent teeth.  Periodontal infections, such as those observed in this study, may affect your general health.

Must the tooth come out if it hasn't caused any problems yet?

Not all wisdom teeth require removal.  Your Oral and Maxillofacial Surgeon will help you determine what is best for you.  Not all problems related to third molars are painful or visible.  Damage can occur without your being aware if it.  As wisdom teeth grow, their roots become longer, the teeth become more difficult to remove, and complications become more likely.  In addition, partially or totally impacted wisdom teeth may cause problems as patients age.

What happens during surgery?

Before surgery, your Oral and Maxillofacial Surgeon will discuss with you what to expect.  This is a good time to ask questions or express your concerns.  It is especially important to let the doctor know about any illnesses you have and medications you are taking.  Most wisdom tooth extractions are performed in the Oral and Maxillofacial surgery office under local anesthesia, intravenous sedation, or general anesthesia.  Your Oral and Maxillofacial Surgeon will discuss the anesthetic option that is right for you.

What happens after surgery?

Following surgery, you may experience some swelling and mild discomfort, which are part of the normal healing process.  Cold compresses may help decrease the swelling, and medication prescribed by your Oral and Maxillofacial Surgeon can help manage the discomfort.

Please follow your post-operative instructions closely, as they will help you to be most comfortable during the first few days after surgery.  The majority of patients begin to feel improvement in 3-5 days.  If deemed necessary by your doctor, a post-operative visit will be scheduled.

What are dental implants?

The actual dental implant is a tiny titanium post surgically inserted into the jawbone where a tooth is missing.  This serves as a substitute for the tooth root.  Over several months, the titanium fuses with the jawbone, creating a strong foundation for the artificial tooth.

How are dental implants placed?

Generally, the placement of dental implants involves two separate surgical procedures.  First, the titanium implant is placed into the jawbone.  The implant itself is not visible and may need months for the bone and implant to heal together, a process called osseointegration.  After osseointegration, your surgeon will perform a simple procedure to uncover the implant and attach a small post.  This will serve as an anchor upon which your general dentist will place the artificial tooth.  In some cases treatment may require only one surgical procedure and patients can have teeth placed almost immediately.

Dental implants are a team effort.

Dental implants combine the best of modern science and technology including a team approach spanning several disciplines.  A successful implant requires that all parties involved such as the patient, the restorative dentist who makes the crown for the implant, and the Oral and Maxillofacial Surgeon who surgically places the implant, follow a careful plan of treatment.  All members of the implant team stay in close contact with each other to make sure everyone clearly understands what needs to be done to meet the patient’s expectations.

Are you a candidate for dental implants?

Whether you are a young, middle-aged or older adult, whether you need to replace one tooth, several teeth, or all your teeth, there is a dental implant solution for you.  With the exception of growing children, dental implants are the solution of choice for people of all ages, even those with the following health concerns:

Existing Medical Conditions.  If you can have routine dental treatment, you can generally have an implant placed.  While precautions are advisable for certain conditions, patients with such chronic diseases as high blood pressure and diabetes are usually successful candidates for dental implant treatment.

What is Intravenous Sedation?

Many of the more complicated oral surgery procedures can now be performed in the office with the aid of intravenous sedation. Commonly referred to as “twilight sleep” sedation differs from general anesthesia in that you will always be responsive to your environment even though the chances are you won’t remember much about the procedure.

We require that you eat or drink nothing for six hours before the procedure. If your surgery is to be in the morning, eat or drink nothing upon arising. An empty stomach at surgery time means you are less likely to have nausea later or a very serious problem during the surgery. If your surgery is planned for the afternoon, you may have clear liquids for breakfast (soup broth, black coffee, water, apple juice, etc.) then nothing.

If you have had drug reactions or sensitivities, you must tell your doctor about these, for they may influence his choice of medications. If you are a diabetic or take medications regularly and are concerned about missing a dose, please call for special instructions.

Because you will have received sedation medications, your reflexes and level of consciousness will be depressed for several hours after the procedure. You are not to drive, operate machinery, or be walking about by yourself for the remainder of the day. A responsible adult must be with you in the office AT THE TIME OF SURGERY AND AFTERWARD for four to six hours or longer if necessary until the medication has worn off, and you are completely awake and alert and able to take care of yourself.

Our doctor and staff will discuss your medical history with you. Your blood pressure will be evaluated. In order to watch your pulse throughout the entire procedure, a heart monitor and oxygen level sensor is used. Medications for relaxation and discomfort will be given intravenously in your vein. A local anesthetic is also administered to further increase the comfort and safety of your procedure.

You can relax confidently, knowing that a staff person will remain with you at all times until the procedure is finished, and you are transferred to the recovery area where you will be with your escort until you are ready to go home. Before you leave, the doctor or nurse will check you and answer any questions you may have.

As with any procedure or anesthetic, there is always a slim possibility of complications occurring before, during or after surgery or sedation. We always attempt to identify those patients beforehand who will be an increased risk and give them special care to avoid problems. You will also have this special evaluation, treatment and care by extraordinarily trained personnel to minimize as many problems as possible, so you can confidently approach your oral surgery knowing it will be as safe as humanly possible.

Gum Disease or Problem Teeth.  Almost all implants placed in patients who have lost their teeth to periodontal disease or decay have been successful.

Currently Wearing Partials or Dentures.  Implants can replace removable bridges or dentures, or they can be used to stabilize and secure the denture, making it much more comfortable. Although smoking lowers the success rate of implants, it doesn’t eliminate the possibility of getting them.

Bone Loss.  Bone Loss is not uncommon for people who have lost teeth or had periodontal disease.  Oral and Maxillofacial Surgeons are trained and experienced in grafting bone to safely and permanently secure the implant.

Implant tooth replacement in children is usually deferred until their jaw growth is complete.  There are, however, some instances when a dental implant may be appropriate such as when it is part of the child’s orthodontic treatment plan.  Your family dentist or orthodontist can guide you in this instance.