FAQ - Oral Surgery
Q. At a recent dental exam, my general dentist noticed an area on my gums which concerned him. He has recommended that I see an oral and maxillofacial surgeon for evaluation and possible treatment. Why?
A. Oral and maxillofacial surgeons are well trained in the identification and treatment of pathologies of the oral and perioral hard and soft tissues. After taking your history and a careful clinical exam, they can advise you on the need for further tests or observation or the need for a biopsy to determine the exact diagnosis and need for treatment of the lesion. Their training and expertise can provide evaluation, management and possible surgical care for all the pathologies which present in the oral cavity and perioral tissues.
Q. Does the oral surgeon always use sutures when removing impacted wisdom teeth (3rd molars)?
A. The use of sutures depends on the type of tooth impaction. Sutures are used to hold the tissue in place until initial healing occurs (usually around 7 days). Most impacted teeth require some suturing. These sutures are commonly resorbable(dissolve in the mouth) and do not need removal in the office. Your oral surgeon will explain if sutures were used in the surgery, and how to manage them in the healing period.
Q. I have osteoporosis and I take a bisphosphonate drug to help strengthen my bone structure. Recently I heard these drugs can interfere with bone healing in some people. Is that true?
A. Bisphosphonate drugs have been used intravenously to help cancer patients and orally for patients with osteoporosis. These drugs have improved the quality of life forpatients with metastatic cancer that involves the skeletal system. They have also been extremely effective in the prevention of bone fractures in patients with osteoporosis. Unfortunately,there have been reports of an increasing number of cases of osteonecrosis of the jaw. This condition is characterized by an area of nonhealing, exposed jaw bone which can lead to severe loss or destruction of the jaw bone. The majority of these cases have been related to the injectable form of bisphosphonate however there has been a small percentage related to the oral form. Most cases of osteonecrosis have been diagnosed after dental procedures such as tooth extraction however the condition can occur spontaneously. Patients who have been taking bisphosphonates and are considering elective dental surgery should speak with their prescribing physician, family dentist, or oral and maxillofacial surgeon about the risks and benefits of continuing treatment.
Q. My dentist recommended that I have my wisdom teeth extracted. Will I have to stay home from school?
A. Usually the postoperative course is influenced by the complexity of the extractions. In most situations the patient is advised to stay home for a couple of days following the removal of the wisdom teeth. This is due to the occurrence of post op discomfort and swelling which often tends to reach its peak within forty-eight to seventy-two hours after surgery. Ultimately the recuperative period will depend on the individual's ability to heal.
Q. I lost a tooth sometime ago and now worry that I do not have enough bone to allow dental implant placement. Do I have options if bone is missing?
A. Your Oral Surgeon can advise you if there is sufficient bone to allow dental implant placement by examining you and reviewing your x-rays. Bone grafting is an option to make you an implant candidate. Various bone grafting materials can be used including your bone, bank bone, bovine bone mineral or other bioactive substance that promotes bone growth. Bone grafting for dental implants has become common and quite successful, enabling you to move ahead with dental implants versus conventional restorations such as a bridge.