Oral & Maxillofacial Surgery
- Orthognathic Surgery
Wisdom Teeth / third molar.
Orthognathic surgery is surgery performed on the bones of the jaws to change their positions. Orthognathic surgery is corrective facial surgery where deformities of the jaw exist. It may be indicated for functional, cosmetic, or health reasons. It is surgery commonly done on the jaws in conjunction with orthodontic treatment, which straightens the teeth.
Removal of wisdom tooth/third molar:
The Wisdom tooth, ( also called Third Molar ) usually do not push through the gums until the late teens or twenties. Wisdom teeth are usually the last teeth to come through the gums.
In the majority of cases, there will not be enough room in the jaw for a wisdom tooth or all wisdom teeth to fully emerge. This can lead to several complications. If the exit of the wisdom teeth is stalled at the halfway point (soft impaction), this can make brushing and flossing the wisdom teeth extremely difficult. Food and bacteria builds up between the wisdom teeth and its neighbouring molars, and decay and gum infection are very likely to occur. Crowded wisdom teeth in the upper jaw have a tendency to lean sideways and grate against the cheek. These wisdom teeth usually cause ulceration and chewing problems. A further problem is wisdom teeth crowding- the pressure from wisdom teeth may also force the other teeth closer together, and interfere with the bite. Gum disease and cyst formations are also complications of impacted wisdom teeth. Very rarely, tumours may also form from the wisdom teeth. Pressure from the wisdom teeth can also cause toothache on the tooth next to it. Ulceration can also be caused by wisdom teeth. Upper wisdom teeth may push sideways out of the gum and cause ulcers inside of the cheek.
Antibiotics are a short term solution for impacted wisdom teeth
Mouth infections such as pericoronitis caused by wisdom teeth can be treated with antibiotics, but the infection will reoccur unless the wisdom teeth removal is performed.
Wisdom teeth removal surgery is best done early
Toothache prompts patients to come to the dentist. However, wisdom teeth do not usually cause pain until damage has already been done! Wisdom teeth removal surgery is best performed sooner rather than later.. X-rays taken earlier can indicate whether or not wisdom teeth will cause problems. The dental surgeon or oral surgeon will tell you when is the best time for the wisdom teeth removal.
Procedure, pre surgical consultation and review of wisdom teeth removal
During a consultation involving x-rays and examination, the dental surgeon or the oral surgeon can determine which wisdom teeth are, functional, and which ones need to be removed. In many cases all four wisdom teeth will need to be removed. The wisdom teeth removal commonly involves an incision to open the gum, and sometimes a small portion of the bone may need to be removed to provide access for the wisdom teeth removal. The wisdom teeth may also need to be divided into segments so it can be removed safely and easily. Perfect wisdom teeth technique and a lot of experience is a must for these surgical procedures. The incision in the gum may then need to be closed with stitches.
Orthodontics and wisdom teeth
Many orthodontists believe that developing wisdom teeth can cause the front teeth to become over crowded, and often recommend wisdom teeth removal before or immediately after orthodontic treatment
Wisdom teeth removal for prosthetic reasons
Wisdom teeth removal surgery or impacted tooth extraction may need to be considered before construction of dentures. Sometimes the wisdom teeth erupt beneath the denture and that can cause severe irritation and infection
Wisdom teeth removal surgery when acute infection is present
Generally speaking, wisdom teeth removal should be delayed in the presence of infection. Most of the time is preferable to control the infection with antibiotics and oral hygiene first. The tooth extraction of the opposing wisdom tooth is also sometimes advised but that needs to be decided during the consultation with the dental surgeon.
Asymptomatic impacted wisdom teeth
There is always a risk that impacted wisdom teeth may cause problems. it may occur at inconvenient and unpredictable times. If the wisdom teeth appear to have a high chance of causing problems in the future, the dental surgeon may advice removal of wisdom teeth.
Removal of wisdom teeth:
- by extraction, if the wisdom teeth have already erupted into the oral cavity
- surgically, if the wisdom teeth are partially or completely impacted in the bone
Removal becomes more difficult with increasing age through progressive root growth and increasing density of the jaw bone. For this reason the operative removal should take place in adolescence if possible −as soon as it can be seen that the wisdom teeth are unable to come through correctly. Through a good healing tendency, the bone and mucous membranes heal quickly and practically without defect.
Wisdom teeth removal surgery is not something people look forward to, but modern surgical and anesthetic techniques as used recently have now combined to make wisdom teeth removal surgery a much more acceptable procedure than in the past.