Oral surgery, generally called oral and maxillofacial surgery, is a specialized dentistry field that extends beyond routine dental care. It focuses on diagnosing and surgically treating diseases, injuries, and related facial structures. Dental surgery can often cause anxiety. However, understanding the procedure will help you stay informed and ease the uncertainty.
Are you considering oral surgery for your dental needs? Contact The Hawthorne Dentist today for a consultation and to learn more about how our oral surgeons can help you achieve a healthy and confident smile. Our team offers complete and considerate oral and maxillofacial treatment.
Dental Problems that Could Require Oral Surgery
Oral and maxillofacial surgeons, or OMFS, conduct various surgical procedures. OMFS surgeons help restore function, alleviate pain, and improve oral health. You may be sent to an oral surgeon for a number of the following procedures:
Wisdom Teeth Extraction
It is common to visit an oral surgeon for wisdom teeth removal. The third molars are not always able to erupt correctly, as expected. As a result, they do not have enough room and can become impacted. Impacted teeth can cause pain, pressure, crowding, infection, and cysts. Even if they have come fully out, wisdom teeth can be difficult to clean, leading to decay and gum disease.
The tooth extraction procedure involves the use of anesthesia. Sometimes, your tooth could be divided, and a small incision can be made in the gum. After the surgery, you will be swollen and in pain for days to a week. As part of managing this, you should also expect dietary changes. You should follow post-operative instructions to prevent dry sockets.
Dental Implant Placement
Dental implants offer a top-grade solution for replacing missing teeth. These are surgically implanted in the jawbone. They are titanium artificial roots that anchor the crown, bridge, or denture. Some of the benefits they offer include:
- Bone maintenance
- Improved aesthetics and function
- No dependence on adjacent teeth
The implant is done in stages, which include osseointegration (bone fusion), abutment attachment, and the final crown. If you have insufficient bone, you may need a bone graft, a sinus lift, or surgery to add bone under the sinus.
Recovery time and cost vary, depending on bone grafting and final restoration.
Corrective Jaw (Orthognathic) Surgery
Orthognathic, or corrective jaw surgery, addresses problems with jaw and teeth alignment. It solves problems with biting, chewing, speaking, jaw joint pain, and sometimes sleep apnea. This procedure is often done with orthodontics, and the positioning of the upper or lower jaw is corrected so that the jaws and teeth can achieve proper alignment and facial balance. It will improve facial aesthetics and functionality and can be used to correct underbites, overbites, and misaligned jaws.
Recovery takes longer, has swelling, and starts with a liquid diet. With this procedure, bite issues are improved. Facial, speech, and pain issues are reduced.
Surgical Treatment for Obstructive Sleep Apnea (OSA)
When CPAP (continuous positive airway pressure) fails, oral surgery provides solutions for OSA. OMFS performs techniques like maxillomandibular advancement (MMA), forwarding both jaws to enlarge the airway with a high success rate. Other options include moving the tongue and the hyoid suspension. Recovery is similar to corrective jaw surgery.
Oral Pathology
Oral surgeons treat cysts and tumors (benign and malignant), infections, and other oral lesions. An oral biopsy, incisional or excisional, is often needed to diagnose. Early detection of oral cancer is crucial. The oral surgeons can remove jaw cysts and fully remove all lesions with possible reconstruction.
Apicoectomy (Root-End Surgery)
An apicoectomy is performed on a tooth reinfected even after successful root canal therapy. It surgically removes the infected tooth root tip and seals the end. This is a last resort procedure performed by an OMFS to avoid extraction when a root canal has failed, often due to complex root anatomy or a new infection.
Gum Procedures
Oral and maxillofacial surgeons perform gum-related surgeries in consultation with gum surgeons or periodontists. Although periodontists primarily deal with the gums and the structures supporting the teeth, OMFS typically handles more complex cases. Gum grafting surgery is often done by OMFS specialists when placing a dental implant to ensure enough healthy tissue for a stable and aesthetically satisfactory implant. They also do soft tissue grafts due to the excision of oral pathology (tumor or cyst).
OMFS specialists are often routinely involved in the surgical preparation of the mouth for prosthetics and denture pre-prosthetic surgery procedures. This treatment includes surgical procedures like smoothing and recontouring the jawbone, alveoloplasty and removing bony growths called tori that affect denture fit.
If a tooth cannot erupt properly, it may become impacted. When orthodontic treatment of an impacted tooth is necessary, oral surgeons typically need to conduct orthodontic surgery to expose the impacted teeth. The orthodontist will then be able to guide the tooth into its proper place.
OMFS performs frenectomies in complicated cases, like in older patients or other anatomical variations requiring surgical expertise. Both periodontists and oral surgeons perform gum surgery, but there is a detailed difference in the procedure and the overall treatment plan. OMFS usually involves cases involving bone, implants, or other surgery.
Other Procedures
Apart from the more common types of procedures, OMFS plays an indispensable role in the following:
- Facial trauma surgery — This includes the surgical repair of fractures of the jaw (broken jaw), cheekbone (cheekbone fracture), eye socket, and other bones of the face that were injured from an accident.
- Severe TMJ disorders when other treatments do not work — In certain situations, surgical procedures like the TMJ arthroscopy procedure might be required.
- Undertaking complex surgical tooth extraction — This extraction procedure includes those involving severely impacted teeth, teeth that cannot be extracted due to a unique or complicated root structure, teeth that fracture below the gum line, and teeth that are closely associated with important nerves, as in a coronectomy procedure or removal of a severely decayed tooth removal surgery. In these cases, an OMFS’s higher surgical expertise is needed.
What to Expect During Your Oral Surgery Journey
Oral surgery can feel overwhelming, but understanding what is involved and what to expect can help alleviate your fears. So, let us explore every step when you are scheduled for one.
The Consultation
Your oral surgery consultation is a vital first step in treatment. The oral and maxillofacial surgeon will gather important information to formulate a customized strategy. The oral surgeon reviews your medical history for dental surgery. He/she will discuss your conditions, allergies, and medications. The surgeon will then thoroughly review your mouth and face, which could involve looking at your dental X-rays and whether oral surgery will be the best solution for your issue.
After this, your surgeon will discuss your diagnosis and all the treatment options. The surgeon will explain how the recommended procedure works, how long it takes, and what anesthesia options are available. The oral surgeon will also discuss your procedure’s risks, benefits, and costs.
The oral surgery consultation is an opportunity to ask the oral surgeon any questions you may have, so it can be helpful to prepare a list. Inquire about the risks, anesthetic options, recovery period, aftercare, and full costs.
Preparing for Your Surgery
After choosing your treatment pathway, you will be given essential instructions before the operation. Following these instructions carefully during the preparation period helps ensure your body is ready for the treatment and supports effective recovery.
If you are going to have sedation or general anesthesia, you will receive clear instructions on fasting. Knowing when to stop eating and drinking is essential, so go through these instructions carefully as soon as you receive them. This helps avoid confusion and delaying the surgery as the date approaches.
A crucial step in preparation is discussing your complete medical history and every substance you take with your surgeon. Make notes about the pills you take before your surgery. This will give your surgeon enough time to recommend any required changes, like stopping blood thinners or other particular drugs for a specific period before the surgery to reduce any bleeding risks.
Logistics planning is another component of pre-surgery planning. If you will be sedated, ensure you have a ride to and from the procedure early. Arrange for someone responsible who can safely take you home afterward to plan this ahead of time and not stress before the procedure. Requesting some time off work or school for the surgery and recuperation could be helpful.
Your surgeon will likely guide you on mouth care beforehand. To reduce the bacteria in the mouth and cut infection risks, the surgeon could ask you to do something specific, like using an antiseptic mouthwash for some days before the surgery. If you are undergoing a procedure like removing wisdom teeth, expect specific eating or cleaning guidelines to use beforehand.
Planning also involves post-surgery considerations, and one aspect is your food choices. Therefore, you should prepare to stock your pantry with soft food options after the surgery. Before your surgery date, look at any checklist lists and ask clarifying questions well before your surgery date to ensure you are fully prepared.
The Day of the Procedure
Please arrive at the appropriate check-in time on your oral surgery day. There is enough time left to finish the final administrative steps and preparations. When you arrive at the clinic, the clinical team will brief you on what will happen. They will confirm key aspects of your medical history, reassuring everyone that proceeding is safe.
Before the surgery begins, the clinical team will check and record your vital signs, usually heart rate, blood pressure, and oxygen saturation. This establishes a baseline to monitor the process continuously. After checking your vital signs, we will use a suitable anesthetic. They could choose any of the following:
- Local anesthesia — This is injected directly at the surgery site. You remain fully awake and aware but will not feel pain at the site.
- Nitrous oxide — Also known as laughing gas. It is a substance that you breathe in through a mask. It makes you feel relaxed and calmer. You stay conscious but calm. Effects wear off quickly afterward.
- Intravenous (IV) sedation — This sedation is administered through the vein. It will give you deep relaxation or twilight sleep. You will largely be unaware of the procedure. There is often little or no memory of the event.
- General anesthesia — With this option, you sleep and are unaware of what happens during surgery. It is usually used for lengthy surgeries.
The type of sedation selected is based on your medical requirements and the complexity of the surgery. The aim is to help you stay comfortable and relaxed.
You will be monitored closely as part of your surgical procedure, primarily if sedation or general anesthesia is being used. If you wish to use sedation or general anesthesia, the team will use monitoring equipment on you that constantly monitors your vitals throughout the surgery. Most approved dental clinics have well-trained teams with experience handling anesthesia safely and effectively. Though it is not exactly like a hospital operating room, the environment must follow the safety rules.
How long the surgery takes varies significantly depending on how many teeth are involved and how complex your case is.
After the procedure, you will be transferred to a recovery area. The team will continue monitoring you here as the anesthesia wears off. You will receive postoperative instructions for pain relief, diet, oral hygiene, activity, and follow-up. If you received IV sedation or general anesthesia, it is a good idea to arrange for a responsible driver to accompany you, as you will not be able to drive yourself.
Note: As part of the informed consent process, the medical team will discuss any rare anesthesia risks associated with the procedures with you.
Post-Operative Care and Recovery
After your oral surgery, you must follow your surgeon’s post-operative instructions for a successful recovery. Taking care during this phase will help healing time and decrease complications.
After the procedure, the first thing to deal with is bleeding. It is okay for the surgical site to ooze a little for the first one or two days (24 to 48 hours). You should apply light and continuous pressure with the sterile gauze supplied to you as instructed. Controlling swelling and bleeding is necessary. To reduce swelling after oral surgery, apply ice packs to the outside of your face (always covered with a cloth) for 20 minutes for the first day or two.
Managing pain is important for comfort while you start healing. You would likely begin your day with the prescribed pain pill and surgeon-approved OTC (over-the-counter) pill. Maintaining good oral hygiene is imperative so you do not get an infection. However, make sure to be gentle around the surgical site. Your surgeon will tell you when and how to brush and rinse safely after the surgery.
Your first meals, along with gentle hygiene, are crucial. Surgeons will initially recommend a soft food diet to prevent surgical site irritation. You can slowly return to hard, crunchy, or chewy foods as you heal to keep the area from irritation. Moreover, you should not push your body to allow it to heal by avoiding strenuous physical activity after surgery.
Watch for signs that healing is not proceeding as it should. Contact your oral surgeon immediately if you notice excessive bleeding, severe or worsening pain unrelieved by medication, or signs of infection like increased swelling, redness, warmth, or pus. Watch out for signs of a dry socket, specifically a dull, aching pain that travels to the ear.
Do not forget your follow-up appointments. These appointments allow the surgeon to monitor your situation, fix any problems early on, and keep your recovery on track. Remember that the expected recovery times could change depending on the type of surgery. You will also be given personal instructions if you have surgery along the lines of dental implant placement or corrective jaw surgery.
Key Things to Avoid After Oral Surgery
After your surgery, in addition to crunchy foods, you want to avoid the following to heal:
- Avoid eating anything hard, chewy, or sticky, like tough meat, caramel, hard candy, and very chewy bread, as they are tough to eat and will pull at the surgical site.
- Food with small particles could become lodged in the surgical site and cause irritation or infection. This includes sesame seeds, poppy seeds, and popcorn.
- Steer clear of hot foods and drinks after the surgery to avoid causing irritation and bleeding. It may dislodge the blood clot. Let things cool down first.
- Food items containing spice or acid can irritate the wound area
- Use straws because when you suck through a straw, it can pull out the blood clot covering the hole in your mouth, which can lead to a dry socket
- Spitting or rinsing vigorously can disrupt the blood clot, like straws. The surgical team could instruct you to do gentle rinsing later on but not do any forceful action
- Tobacco and vape use significantly slows healing, increases infections, and is a significant cause of dry sockets. Avoid completely.
- Alcohol is not good because it will interfere with your medicine
- Do not lift heavy objects, work out hard, or bend a lot for some days, as advised. This can make bleeding and swelling worse.
Key Things to Avoid After Oral Surgery
After your surgery, in addition to crunchy foods, you want to avoid the following to heal:
- Avoid eating anything hard, chewy, or sticky, like tough meat, caramel, hard candy, and very chewy bread, as they are tough to eat and will pull at the surgical site.
- Food with small particles could become lodged in the surgical site and cause irritation or infection. This includes sesame seeds, poppy seeds, and popcorn.
- Steer clear of hot foods and drinks after the surgery to avoid causing irritation and bleeding. It may dislodge the blood clot. Let things cool down first.
- Food items containing spice or acid can irritate the wound area
- Use straws because when you suck through a straw, it can pull out the blood clot covering the hole in your mouth, which can lead to a dry socket
- Spitting or rinsing vigorously can disrupt the blood clot, like straws. The surgical team could instruct you to do gentle rinsing later on but not do any forceful action
- Tobacco and vape use significantly slows healing, increases infections, and is a significant cause of dry sockets. Avoid completely.
- Alcohol is not good because it will interfere with your medicine
- Do not lift heavy objects, work out hard, or bend a lot for some days, as advised. This can make bleeding and swelling worse.
The Potential Risks Associated With Oral Surgery
Oral surgery performed by professional experts is considered safe. However, like all surgeries, it comes with some risks. Your surgeon will discuss the risk factors most applicable to your surgery and health beforehand. Some of the risks include:
Excessive Bleeding
Initially, you should be ready for bleeding, swelling, bruising, and pain after your surgery. Always mention excessive bleeding or pain and swelling beyond what is expected, even though your surgeon would expect some degree.
Infections at the Surgical Site
You can also suffer an infection after the procedure. Though precautions are always taken, bacteria could still enter the site. It is necessary to look for changes like redness or warmth, swelling that does not decline, pus, fever, and increasing pain.
Nerve Problems
There are chances of nerve problems. These chances are exceptionally high near a significant nerve pathway in the lower jaw. This could lead to temporary or, on rare occasions, a permanent lack of feeling, tingling, or change in the lip, chin, or tongue area. Although it will often go away, it can also persist.
During upper jaw surgery, nerve problems could affect nearby teeth, existing dental restorations, or even perforation into the maxillary sinus cavity. The issue could heal or may require treatment.
Risks Associated With Anesthesia Use
Anesthesia carries risks that depend on the type of anesthesia. The risks are separate from those of surgical work. Local anesthesia complications are minimal and rare. Sedation and general anesthesia are more complex. Patients could experience nausea, vomiting, and allergic reactions, while, although rare, more serious cardiorespiratory incidents are carefully avoided or mitigated with oversight and assessment.
Dry Socket
After the first effects of anesthesia wear off and the healing process begins, you could experience a dry socket or alveolar osteitis. This happens especially following tooth extraction. This painful condition occurs when the blood clot in the socket is lost too soon, exposing the bone underneath, which needs treatment.
Delayed Healing
Your recovery could also be hindered by other issues, including:
- Smoking
- Diabetes
- Reaction to the medicines prescribed, and
- Temporary joint pain due to the surgical procedure
It is rare to experience serious complications from any oral surgery, especially if done by a specialist. Carefully discussing your health history and promptly following all pre-operative and post-operative instructions will help decrease the risk of these complications and support your recovery.
Find an Oral Surgeon Near Me
Undergoing oral surgery can provide many benefits, like pain relief, functional restoration, and better well-being. Oral and maxillofacial surgery eases chronic pain and makes it easy to chew and breathe. Expert evaluation and personalized treatment plans are needed to achieve optimal oral health. A good oral surgeon can set the stage for a healthy future.
At The Hawthorne Dentist, we are ready to help. Call us at 310-775-2557 to schedule your next appointment.
