Dental & Soft Tissue Surgery

Tooth Extractions

You may need to have a tooth extracted for a number of reasons such as decay, injury, or as part of orthodontic treatment. Whatever the reason, you will most likely be referred to an oral and facial surgeon who will remove your tooth in the office using an anesthetic that is appropriate for your procedure.

Apicoectomy

While most root canals are successful, there are times when a root canal alone isn’t sufficient. If the infection from the dead nerve inside a tooth spreads beyond the tooth root and into the surrounding bone, your dentist may refer you to an oral and facial surgeon for an apicoectomy. During an apicoectomy, the surgeon removes the infected portion of the tooth’s root in order to clean the infection from the tooth and surrounding bone and then fills the root to prevent future infections.

Exposing Impacted Teeth as Part of Orthodontic Treatment

It is not uncommon for teeth other than wisdom teeth to be impacted, or blocked from entering the mouth. Fortunately, your orthodontist and oral and facial surgeon can bring the impacted tooth through the gum and into the correct position – giving you a beautiful healthy smile.

Frenectomy Surgery

A frenum is a small folds of tissue located in the mouth: under the tongue, inside the upper lip, inside the lower lip, and connecting the cheeks to the gums. A frenectomy is a simple procedure performed in the oral and facial surgeon’s office to loosen the frenum’s connection and extend the range of motion in that part of the body.

Dental Hemi Section and Root Amputation

If, even after a root canal, one or more of the tooth’s roots should become infected or there is significant bone loss around the tooth, your dentist may refer you to an oral and facial surgeon for a hemi section or root amputation. During a hemi section, your surgeon removes one-half of the tooth, leaving a serviceable one-rooted tooth. The term “root amputation” refers to the surgical removal of one root of a multi-rooted tooth.

Soft tissue grafts

Soft-tissue grafts in the mouth can be important to maintaining oral health. Soft tissue grafts are used to add more tissue in a certain area and may be used to prevent further gum recession over an exposed root, top sensitivity in the affected area, improve the look of the tooth and/or prevent problems in the future.

Temporary Anchorage Devices (TADS)

Temporary anchorage devices (TADS) are occasionally used for a short time during orthodontic treatment. TADS are small titanium screws that orthodontists use to help reposition teeth. TADS are usually placed by the oral and facial surgeon in their office. When the TADS are no longer needed, they are removed and the site is usually fully healed in a couple of days. Gingivectomy and Gingivoplasty Gingivitis, an inflammation of the gum tissue surrounding the teeth, is caused by bacteria that, if left unchecked, may lead to periodontitis. A gingivectomy surgically removes diseased or excess gum tissue and the bacteria that can cause periodontitis. Gingivoplasty, which is the surgical reshaping of the gum tissue, is often performed in combination with a gingivectomy for cosmetic or functional purposes. Your dentist may refer you to an oral surgeon for a crown lengthening procedure to ensure that enough of the tooth’s structure is available to securely hold a crown.

When is the best time for Wisdom Tooth Removal?

Your general dentist, orthodontist and surgeon may recommend extraction of your wisdom teeth to prevent the problems above. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure. With an oral examination and x-rays of the mouth, Dr. Casey can evaluate the position of the wisdom teeth and predict if there may be present or future problems and make recommendations on the best timing for removal of teeth.

Current research shows that early evaluation and treatment result in a superior outcome and recovery for the patient. Patients are generally first evaluated in the mid- teenage years by their dentist, orthodontist or by an oral and maxillofacial surgeon.

If your child is in orthodontic treatment it is common for the orthodontist to refer to an oral and maxillofacial surgeon for an evaluation for wisdom tooth extraction as it is part of their recommended protocol for completion of orthodontic treatment and long term stability of teeth.

Tooth Removal Procedure

All procedures performed in the office are performed under appropriate anesthesia to maximize patient comfort. Dr. Casey is licensed and has excellent training and experience to provide various types of anesthesia for patients to select the best alternative.

In most cases, the removal of wisdom teeth is performed under local anesthesia, laughing gas (nitrous oxide/oxygen analgesia) and/or I.V. anesthesia. Our services are provided in an environment of optimum safety that utilizes the most modern monitoring equipment and JCAHO accredited techniques to maximize your safety.

Once the teeth are removed, you will rest comfortably under our supervision in our recovery suite until you are comfortable and are ready to be taken home. Upon discharge, your post-operative kit will include postoperative instructions, a prescription for pain medication, antibiotics if needed and a follow-up appointment.

Implant Replacement of Extracted Tooth

In some situations, teeth can be extracted and implants can be positioned in their place. This is a great way to avoid cost of future anesthesia and additional surgical recovery time. An immediate implant is a great and easy way to replace the tooth that needs to be extracted. Please ask Dr. Casey if you are a candidate for this procedure.

How serious is an Impacted Wisdom Tooth?

If left in the mouth, impacted wisdom teeth may damage neighboring teeth, or become infected. Because the third molar area of the mouth is difficult to clean, it is a site that invites the bacteria that leads to gum disease. Oral bacteria may travel from your mouth through the bloodstream, where it may lead to possible systemic infections and illnesses that affect the heart, kidneys and other organs. Research has shown that once periodontal disease is established in the third molar areas, the problem is persistent and progressive, but may improve following extraction of the teeth. In some cases a fluid-filled cyst or tumor may form around the base of the untreated wisdom tooth. As the Cyst grows it may lead to more serious problems as it hollows out the jaw and damages surrounding nerves, teeth and other structures.

Please schedule a consult to discuss any questions or concerns you may have at 239-947-6637.