Oral and maxillofacial surgery is a specialty involved with diagnosing and treating diseases, injuries, and defects of both the hard and soft tissues of the jaws. An oral surgeon is required for procedures such as the extraction of impacted wisdom teeth, corrective jaw surgery to address bite misalignment, and reconstruction of the jaw using bone grafts to support dental implants. They also treat and diagnose oral pathologies.
The main aim of these surgical procedures is to fix underlying issues, relieve pain, and restore normal functioning. Oral surgery significantly enhances a patient's health and quality of life by meeting complicated dental demands. To start your oral surgery process, contact SoCal Dental of Valencia and book an appointment for a complete assessment.
Understanding Oral Surgery and Its Purpose
Oral surgery is a branch of dentistry that deals with diagnosing and treating diseases, injuries, and defects of the hard and soft tissues of your mouth, jaw, and face. Although your regular dentist could handle your routine dental health, including cleanings and fillings, some conditions are more invasive or complex. These fall under the care of an oral and maxillofacial surgeon.
An oral surgeon handles various operations, including removing wisdom teeth and the more complex procedures like reconstructing facial bones after an injury. Oral surgery involves resolving underlying issues, relieving pain, enhancing functionality, and improving oral health and quality of life.
The first step to being comfortable and confident in your treatment plan is to understand that oral surgery is a particular, needs-based specialty.
When is Oral Surgery the Ideal Solution?
When nonsurgical treatments cannot resolve your dental issue, your dentist might refer you to an oral surgeon. A complicated dental problem might need a specialized surgical treatment. An oral surgery referral is founded on a definite clinical need for intervention beyond general dentistry's scope.
Knowing the signs and symptoms that necessitate surgical intervention can help you understand the next step in your dental treatment. Oral surgery is best if it is the only or most effective treatment.
Impacted or Damaged Teeth
A complex tooth extraction is one of the most common causes of a referral to an oral surgeon. Although your regular dentist can perform simple extractions on fully erupted and easily accessible teeth, more complex cases need the services of an oral surgeon. An example of this category is impacted teeth, specifically wisdom teeth, which cannot erupt in their normal positions.
An impacted tooth may be lodged below the gum line, partly erupted at an inconvenient angle, or even growing sideways into the roots of the surrounding molars. This may cause many issues, such as pericoronitis, an inflammatory and painful infection of the gum tissue covering the affected tooth.
Moreover, an affected tooth may cause pressure on the neighboring tooth, causing root damage, decay, or shifting of other teeth. To safely remove the tooth, often in bits, a surgeon must make a small incision in the gum, sometimes removing a small portion of the overlying bone, to avoid damaging nearby nerves and structures.
Also, in case of a tooth that has been severely broken off at the gum line or has an abscess that a root canal cannot treat, a surgical extraction must be done to ensure that all fragments and infected tissue are carefully removed from the jawbone.
Jaw and Bite Misalignment
Your jawbone's composition, not just your teeth' alignment, may cause your bite or facial asymmetry. When severe skeletal discrepancies cannot be corrected by orthodontics alone, corrective jaw surgery, also called orthognathic surgery, is necessary.
You may have a problem with getting your lips to fit together comfortably, chewing or biting food, or a sore jaw joint. A severe underbite, overbite, or open bite may result in excessive and uneven wear on your teeth, which may cause fractures and permanent damage. In such instances, an oral surgeon will closely collaborate with your orthodontist.
Surgery is usually done in two stages:
- Braces are used to straighten the teeth in each jaw
- Surgery is performed to move the jawbones themselves
This precise surgery enhances your chewing, speaking, and even breathing, especially in patients with obstructive sleep apnea, and also provides a more balanced and harmonious look to the face.
Bone Loss in the Jaw
Sufficient jawbone density and volume are essential to support your natural teeth and are a non-negotiable condition for the success of dental implant placement. When you lose a tooth, the alveolar bone, or part of the jawbone that supported the tooth, loses the stimulation it requires to keep its shape and starts to resorb, or shrink. This use-it-or-lose-it principle can cause severe bone degeneration as time goes by, and advanced gum disease or physical trauma can speed up the process.
A bone grafting procedure is necessary when the bone is too thin or soft to fix an implant firmly. This procedure is done by an oral surgeon who augments the deficient area. This may be performed with:
- Your own bone (autograft)
- Donated bone (allograft),
- Special synthetic bone replacement (alloplast)
The grafted material is a scaffold that stimulates your body to produce new, healthy bone in that area.
In the case of the upper jaw, a special operation known as a sinus lift might be required to develop bone height below the sinus cavity. This reconstruction process provides the stable and sound base needed to make dental implants successful in the long run.
Oral Pathology Diagnosis
When you visit your dentist for a regular check-up, they inspect the soft tissues of your mouth to identify any abnormalities. If they find an abnormal growth, lesion, pigmented spot, cyst, or tumor within your mouth, lips, or jaw, you will be sent to an oral surgeon to make a final diagnosis.
The surgeon performs a biopsy, a minor surgical operation in which a small piece of the suspicious tissue is carefully excised and sent to a special laboratory to be studied under the microscope. The diagnostic step diagnoses a broad spectrum of conditions, including benign conditions, such as fibromas or mucoceles, and more serious ones, such as precancerous lesions or oral cancers, such as squamous cell carcinoma.
The most important thing is the accurate and timely diagnosis. By determining the nature of the pathology, the surgeon may:
- Remove the whole lesion if it is benign.
- If the lesion is malignant, begin the proper treatment plan in collaboration with other medical experts.
Popular Oral Surgery Procedures Explicated
Oral and maxillofacial surgeries are the final solutions to complicated problems in the mouth and facial features. They solve problems that non-surgical procedures cannot solve. Although there is always a certain level of fear associated with any type of surgery, a clear understanding of the reason, procedure, and advantages of these common types of surgery can make you feel more ready and confident in the kind of treatment you are recommended.
Dental Implants
Dental implants are primarily regarded as the gold replacement standard for missing teeth because of their durability, functionality, and natural appearance. It is a surgical process in which a small, screw-shaped titanium post is placed directly into your jawbone. This post is created as a permanent substitute for the natural tooth root. After it is placed, a biological process known as osseointegration takes place.
Within a few months, your living bone cells will grow onto and fuse with the titanium surface, forming a firm and stable foundation that becomes a part of your body. When this is done and the implant is firmly in place, the surgeon attaches a part that sticks out through the gum line, known as an abutment.
This abutment is attached to your last restoration, be it a single custom-made crown, a bridge to restore more than one tooth, or a complete denture to replace all the teeth. The end product is a tooth replacement that cannot be removed and lets you eat, speak, and smile confidently.
Wisdom Tooth Removal
One of the most common oral surgeries that is carried out is wisdom tooth extraction. These third molars that usually come out during the late teens or early twenties often create issues since modern jaws do not have the space to house them. This may result in different types of impaction, in which the teeth are caught in the jaw at an angle.
A wisdom tooth may be impacted:
- Vertically (straight, but trapped)
- Mesially impacted (angled towards the front of the mouth)
- Distally impacted (angled towards the back)
- Horizontally impacted (lying entirely on its side)
All these cases pose a different surgical dilemma. Your oral surgeon administers anesthesia to make you comfortable before carrying out the removal. They will make a small cut in the gum tissue to reveal the affected tooth and the bone.
Commonly, a little bone will have to be removed to gain access, and the tooth itself might have to be cut into smaller sections to enable its removal without causing harm to the nearby nerves or other teeth. The site is then washed and stitched off to aid healing.
Corrective (Orthognathic) Surgery of the Jaw
An orthognathic or corrective jaw surgery is a life-changing operation to treat severe functional and aesthetic jaw problems caused by skeletal and dental abnormalities. This operation is performed when the upper and lower jaws fail to fit properly, resulting in an incorrect bite that orthodontics cannot correct.
This surgery is planned with the help of high-tech 3D imaging and computer-aided surgical simulation to guarantee the accuracy and predictability of the outcomes. In the process, the oral surgeon will incise the inside of the mouth to reach the jawbones. Depending on your needs, they can also do a Le Fort I osteotomy to move the upper jaw or a Bilateral Sagittal Split Osteotomy (BSSO) to move the lower jaw forward or back.
The bones are precisely cut, repositioned in their new, corrected location, and fixed there with small plates and screws. This surgery creates a functional and healthy bite and fixes other associated problems, such as sleep apnea, TMJ pain, and speech impediments, while enhancing facial symmetry.
Pre-Operation, Recovery, and Post-Operative Care
An oral surgery has several specific and significant steps that lead to a safe and successful result. From the moment you are referred to a specialist up to your last follow-up appointment, a clear vision of what to expect can make a big difference in the levels of anxiety. It could make you feel like a participant in your own care.
Your experience is a partnership between you, your surgeon, and their clinical team, and it should be as smooth, comfortable, and predictable as possible. Being aware of what to expect at every stage, from the first assessment to the specifics of postoperative treatment, helps you be prepared and recover without issues.
What to Expect During Your Check-Up
The initial visit with the oral surgeon involves consultation and examination, not surgery. The visit is devoted to conducting a detailed evaluation of your state and creating an effective strategy.
Your surgeon will start by discussing with you in detail your medical and dental history, any chronic diseases, allergies, and medications you take. After this discussion, the surgeon will perform a detailed physical examination of your mouth, teeth, gums, jaw, and temporomandibular joints.
Diagnostic imaging is necessary to have an accurate picture of your underlying anatomy. This will include X-rays and, in many cases, a 3D Cone Beam CT (CBCT) scan, a detailed, three-dimensional representation of your facial skeleton.
Imaging helps the surgeon precisely see nerves, sinuses, and bone quality. All this information will be collected, and your surgeon will discuss what they have found, your diagnosis, all the possible treatment options, and the risks and benefits of each. This is the time to ask questions regarding anesthesia, recovery time, and costs so that you can fully consent to your care.
Preparing Your Surgery Day
After you have booked your surgery, they give you a comprehensive preoperative guide. Following the instructions in the guide to the letter keeps you safe and your procedure successful. If you are undergoing IV sedation or general anesthesia, you should fast for at least eight hours before your appointment. You cannot take food or drink of any kind, including water.
A full stomach avoids the danger of aspiration, a grave complication in which stomach contents may enter the lungs during anesthesia. The surgeon will also inform you of the medications you could take or should omit on the morning of surgery.
In addition, you should plan to have a responsible adult drive you to the clinic, wait with you during your procedure, and drive you home. The post-anesthetic effects are so severe that you cannot safely drive or be alone right after surgery. During the day, dress in loose-fitting, comfortable clothes with short sleeves to enable access to the IV and its monitoring.
During the Procedure
The whole clinical team is concerned with your safety, comfort, and excellent surgical outcome on the day of your surgery. The process will start with the administration of anesthesia. During your consultation, these will be discussed with you and can include a local anesthetic to numb the area or different degrees of sedation.
Standard options include nitrous oxide, oral sedatives, or intravenous (IV) sedation to put you in a state of deep relaxation, during which you will be awake but relaxed and usually have no recollection of the procedure. In more complicated surgeries, general anesthesia can be used, and you are totally unconscious.
During the process, you will be attached to sophisticated monitoring instruments that constantly measure your heart rate, blood pressure, and oxygen levels. When you are anesthetized, the surgeon will carry out the intended procedure. Once the surgery is done, the surgeon will seal the incisions using sutures that could be dissolvable or require removal during a follow-up appointment. You will then be taken to a recovery area where you will be resting under supervision as the anesthesia wears off.
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Is Oral Surgery Painful?
This is usually the greatest worry of the patients, and the solution is in the process itself and the healing time. You will not feel pain during the actual surgical procedure. With the anesthetics and methods of sedation, your surgeon ensures that the area of treatment is numb or that you are asleep.
The main aim of anesthesia, be it local anesthesia, IV sedation, or general anesthesia, is to remove all feelings of pain and control anxiety during the procedure. It is natural to feel discomfort, soreness, and swelling after the surgery as the anesthesia wears off. It is a natural process in the healing of your body.
Nevertheless, this pain after surgery is highly treatable. The surgeon prescribes pain relievers during the initial few days and gives suggestions on over-the-counter anti-inflammatory medications such as ibuprofen. Adhering to all your postoperative instructions, particularly ice packs and sufficient rest, will also help greatly alleviate discomfort and ensure a more comfortable recovery.
Post-Surgery Care and Follow-Up
The recovery phase starts as soon as your surgery is completed, and, just as important as the surgery itself, it contributes to a successful outcome. Some swelling, bruising, and discomfort during the initial few days are normal. Your surgeon will prescribe pain medication and perhaps antibiotics to avoid infection.
During the first 24 hours, you will focus on bleeding control by biting gauze packs and swelling through ice packs on your face at 20-minute intervals. You should only eat liquids and very soft foods and not smoke or use a straw, since the suction may remove the blood clot that develops in the surgical site, which causes a painful condition known as dry socket.
You may gradually advance to softer food during the next week as you can comfortably do so, and you must remember to keep your mouth clean with mild saltwater rinses. Follow-up appointments are essential; they enable your surgeon to check on your recovery, to remove any non-dissolvable stitches, and to verify that your recovery is going as planned, without any complications.
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How Long Is the Recovery Period After Oral Surgery?
The recovery time following oral surgery is highly variable and depends directly on the complexity of your procedure and your body's individual healing response. For a straightforward procedure like a single tooth extraction, you may only need to take it easy for a day or two before feeling back to normal.
For more involved procedures, such as the removal of multiple impacted wisdom teeth or corrective jaw surgery, the recovery will be more extensive. Generally, the initial recovery phase should last about one week. During the first 24 to 72 hours, you must focus on resting, managing swelling with ice, and adhering to a liquid or very soft diet.
Most patients plan to take two to five days off from work or school to get through this initial period. While you will likely feel much better after the first week, it is essential to remember that complete healing of the underlying bone and tissues takes much longer. You will need to avoid strenuous physical activity for a period recommended by your surgeon, and it may be several weeks before you can return to a completely normal diet.
Following all your surgeon's postoperative instructions is crucial to ensuring a swift and complication-free recovery.
Does Dental Insurance Cover Oral Surgery?
Oral surgery insurance may be complicated because it usually includes dental and medical insurance policies. The coverage is all a matter of your particular policy and the medical necessity of the procedure. Most oral surgery procedures, including removing impacted wisdom teeth that are painful or infected or a biopsy of a suspicious lesion, are often medically necessary and might be covered, at least partially, by your medical insurance plan.
Other operations, such as the surgical insertion of dental implants, are more commonly covered by dental insurance plans, but coverage may be diverse. Because corrective jaw surgery is a procedure that aims to correct skeletal discrepancies that may interfere with breathing and general health, it is often a claim to your medical insurance.
Your oral surgeon will have an administrative team to guide you before your procedure. They will send a pre-authorization request to your insurance carriers with all the required diagnostic information. This will lead to a pre-determination of benefits, providing you with a precise estimate of what your plan will cover and what your out-of-pocket costs will be, enabling you to plan your finances before committing to treatment.
Schedule an Expert Oral Surgery Consultation Near Me
Resolving your complicated dental problems needs specialized knowledge and a patient-centered approach. The basis of a successful and positive experience is learning the reasons behind the surgery, the specifics of the procedures, and the road to recovery. The most significant stage is a comprehensive consultation with a qualified oral and maxillofacial surgeon.
They should help you develop a treatment plan that meets your health requirements and personal comfort. When you need oral surgery, you can rely on our experienced and caring team at SoCal Dental of Valencia to make your surgery a safe and successful experience. Our mission is to help you through diagnosis to a healthy recovery. Call us today at 661-554-4545 to schedule your appointment.