Oral surgery

Overview

Oral surgery involves a variety of surgical procedures performed on teeth, gums, jaws, and other oral structures, including tooth extractions, implants, gum grafts, and corrective jaw surgeries. Typically carried out by specialized dental professionals such as oral and maxillofacial surgeons or periodontists, who have advanced training in oral surgery. 

Types

Oral surgery operations come in many different forms every year. A few of the more common ones are the following:

• Tooth extraction (tooth removal): Tooth extractions are the most common type of oral surgery, and they are frequently advised in cases of severe tooth decay, gum disease (periodontitis), dental trauma, or issues involving wisdom teeth. Sometimes extractions are required in order to make dentures or other prosthetic devices fit properly.

Extractions are sometimes necessary to preserve overall oral health, even though dentists prefer to save natural teeth wherever possible. To further reduce the chance of cavities, bone loss, and other possible problems, many dentists recommend wisdom tooth extractions as a preventive step.

• Dental bone graft: When bone loss occurs in the jaw, which can happen for a number of causes, a dental bone graft is required. When your natural teeth are intact, their roots stimulate the nerves in your jaw, prompting your brain to send nutrients that maintain jaw strength and health. However, if a tooth has been missing for an extended period, the absence of roots leads to a lack of nerve stimulation, which can result in bone deterioration in that area. A dental bone graft is a procedure used to restore the volume and density of your jawbone, making it possible to place dental implants later.

During periodontal surgery, your healthcare provider may opt to place a bone graft. Advanced gum disease can lead to the erosion of bone around the teeth. A bone graft stabilizes your teeth by reducing mobility and creating a solid foundation, helping to maintain the strength and health of your teeth. 

• Dental implants: Dental implants are widely regarded as the most dependable and durable option for replacing missing teeth. These small threaded posts, typically made from medical-grade titanium or zirconia, are surgically placed into the jawbone to serve as artificial tooth roots. After the implants have integrated with the bone, they can support dental crowns, bridges, or dentures, providing a stable and long-lasting solution for tooth replacement.

• Periodontal surgery: For individuals with moderate to severe periodontitis, a gum specialist may suggest gum disease treatment. This procedure involves making incisions along the gum line and gently pulling back the tissue from the teeth. The surgeon will thoroughly clean the tooth roots, removing plaque and bacteria that have built up beneath the gums. After cleaning, the gum tissue is carefully repositioned and stitched back into place to promote healing.

Periodontitis can sometimes lead to gum recession, which may necessitate a gum graft procedure. Using donor tissue, the surgeon strengthens the area where tissue has been lost during this procedure. You can get this tissue from a licensed tissue bank or from the roof of your mouth.

• Corrective jaw surgery: Skeletal abnormalities in the jaw bones are addressed with corrective jaw surgery, which is also referred to as orthognathic surgery. To improve the ability to chew, realign teeth, or treat facial asymmetry, this procedure might be recommended. Furthermore, pain brought on by TMJ dysfunction (TMD) can be reduced with corrective jaw surgery.
• Sleep apnea surgery: When the tissues in the back of the throat fall back and block the airway while you sleep, you have obstructive sleep apnea, or OSA. While conservative treatments like oral appliance therapy or CPAP machines are often effective, severe cases may necessitate surgical intervention.
• Cleft lip and palate repair: A cleft lip occurs when there is an opening in the upper lip, whereas a cleft palate involves an opening in the roof of the mouth. Some babies may be born with both conditions. These conditions arise when the facial structures do not fully develop in the womb. Oral and maxillofacial surgeons frequently perform cleft lip and palate repair surgeries to restore normal eating function and aid in the development of proper speech patterns as the child grows.

Reasons for undergoing the procedure

Oral surgery may be necessary for a number of reasons. It may be recommended by your dentist if you have:

• Benign oral pathology (noncancerous lumps).
• Oral cancer.
• Bone loss in your jaw.
• Temporomandibular joint disorders (TMD).
• Gum disease.
• Impacted teeth.
• Missing teeth.
• Extensive tooth decay.
• Severe broken teeth.
• Sleep apnea.

Risks

It is important to be aware of potential risks associated with oral surgery, which may include the following:

• Infection.
• Injury to adjacent teeth.
• Numbness.
• Dry socket (a condition that may develop after a tooth extraction if the blood clot is disrupted or fails to form correctly).
• Tooth root fragments.
• Sinus issues.

It is important that you follow your post-operative instructions closely and take all prescription medications as indicated in order to minimize the risk. Get in touch with your healthcare provider immediately if you encounter any of these side effects so they can advise you on what to do next.

Before the procedure

Your healthcare provider will perform a comprehensive evaluation of your teeth, gums, jaw joints, and surrounding structures. This assessment involves taking dental X-rays and scans to capture detailed images of your tooth roots, jawbone, nerves, and other essential oral features. Using this information, they will create a personalized treatment plan tailored to your individual needs.

During the procedure

In some cases, oral surgery is performed as an outpatient procedure in a dental office. To ensure your comfort, your surgeon may offer sedation options such as nitrous oxide, oral medications, or intravenous moderate to deep sedation. In certain situations, oral surgery may be conducted in a hospital setting under general anesthesia.

The duration of the procedure varies based on factors such as the type of oral surgery, the number of teeth involved, and the sedation method used. For example, a single-tooth extraction usually takes about 30 minutes, while more complex procedures, like corrective jaw surgery, may last two to three hours or more.

After the procedure

After your oral surgery procedure, you will receive detailed post-operative instructions. It is important to follow these guidelines carefully to minimize the risk of bleeding, infection, and other potential complications.

Outcome

The primary goal of oral surgery is to address issues that could impact your overall health or quality of life. Your teeth, gums, and jaw joints work together to maintain optimal oral health and functionality.

Recovery times can vary individually, with most people feeling back to normal within approximately one week. Many individuals can resume work or school within one to three days after their procedure. However, for more extensive treatments like corrective jaw surgery, the recovery period may extend beyond this timeframe. The duration of your recovery period will usually depend on how extensive your oral surgery was. Your healthcare provider will give you medication to keep you comfortable during this time.

After oral surgery, it’s best to avoid hard, crunchy meals to promote healing. Rather, fill up on soft food options like rice, eggs, salmon, pudding, yogurt, soup, and mashed potatoes. Popsicles, ice cream, or milkshakes are great options for a cool treat because they can help reduce pain in the postoperative area.

If you experience tooth, gum, or jaw pain, it’s important to promptly schedule an appointment with your healthcare provider.

After oral surgery, contact your surgeon immediately if you experience:

• Persistent pain not relieved by medication
• A fever of 100.4°F or higher
• Drainage at the surgical site 

These indications may indicate an infection requiring immediate attention.