Oral and Maxillofacial Surgery

Tooth Extraction

Tooth extraction or tooth removal is the surgical removal of a tooth from its socket within the bone.

When will you require tooth extraction?

Grossly decayed tooth.
Loose teeth due to gum disease.
Repeated infections to the tooth.
Fracture to the tooth within the bone due to trauma.
A tooth cannot be saved by doing root canal treatment.
Presence of baby teeth that block the way the other permanent teeth bite together

Impacted teeth removal

What is impacted teeth removal?

Impacted teeth are those that are not visible within the oral cavity and are completely embedded within the bone.

Why are teeth impacted?

Due to developmental defects
Lack of space for the tooth to erupt completely

Which teeth are commonly impacted?

Wisdom teeth or third molars in the lower and upper jaw.

Wisdom teeth removal

Wisdom teeth, or third molars, are the last teeth to erupt in the mouth usually around the late teens or early twenties.

Most adults have four wisdom teeth, but due to the small size of the mouth or other genetic factors, it is normal to have more, fewer, or even none at all.

If the presence of a wisdom tooth does not cause any discomfort to you it can be left untreated but most times wisdom teeth do not grow properly as jaws do not have room to accommodate wisdom teeth’s late arrival.

Due to this, the wisdom teeth become stuck underneath the gum line, resulting in “impacted wisdom teeth.” This can cause swelling, severe pain, and infection in the gums. As they try to erupt, wisdom teeth apply pressure on the adjacent teeth causing a shift in the existing teeth in your mouth.

When is Wisdom teeth extraction advised?

Pain or infection
Cysts or tumors
Gum infection around the wisdom tooth area
Tooth decay cannot be repaired by fillings or root canal treatment.
For effective orthodontic, restorative, or periodontal treatment (as the presence of a wisdom tooth might hinder a good outcome).

Dental cysts and tumors

What are dental cysts?

It is a fluid-filled sac of tissue in your gums and/or jawbone. Most of the times cysts are found on routine dental checkups and may not be painful.

The most common types are

Periapical cysts: arise from a long-standing neglected tooth infection.
Dentigerous cysts- form around impacted wisdom teeth.

What problems can dental cysts cause?

Cysts formed around infections cause pain and/or swelling.
Weakening of the jawbone due to expansion of the cyst.
Migration of teeth due to pushing force by the growing cyst.

Symptomless dental cysts can remain undetected for months or years.

How will you know if you have a dental cyst?

Small cysts are seen on the X-ray.
Larger cysts may cause-
Facial swelling
Migration of teeth in the mouth.
After initial diagnosis, a confirmation may be obtained with the help of a biopsy.

Space infections

What are fascial spaces?

These are tissue spaces that are present between muscles and underlying bone and organs.
Under healthy conditions, these spaces do not exist but these spaces arise due to pus accumulation due to long-standing infections.

How do you identify a space infection?

Swelling on the face that is gradually increasing in size.
Swelling under the chin leads to difficulty in eating, breathing, and swallowing.

How can this be treated?

Pus drainage
Removal of the source of infection – extraction of the tooth/ root canal treatment.

Orthognathic Surgeries

Jaw surgery / orthognathic surgery includes collective procedures that aim at correcting the functional and esthetic irregularities of the jaws and teeth using a combination of surgical, orthodontic, and restorative dentistry.

This improves the overall facial appearance.

What are the problems of having misaligned jaws and/teeth?

Difficulty in chewing food
Speech difficulties
Obstructive sleep apnea.
TMJ problems
Cosmetic disharmony in your facial profile and your smile.

When is it done?

Gummy smile
The acceptable overall health of the candidate.
When only braces will not improve the alignment and your overall appearance
Chin abnormalities (excessively protruding chin/chin that is too inside).
Forwardly placed upper front teeth / Small lower jaw

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