Extraction of Teeth

A diseased tooth can be caused by many different reasons.  It is most commonly caused by dental caries (cavities), periodontitis (gum disease) and periapical disease (jaw bone inflammation).  A tooth is extracted when traditional conservative dental therapy has failed to limit the disease process.  Extraction of teeth is the most commonly performed surgical procedure worldwide.

Management of Infections

Oral cavity infections are a common occurrence and generally classified into odontogenic and non-odontogenic causes.  Odontogenic infections are treated with antibiotics and a variety of surgical procedures.  Most infections are mild and can be treated with office procedures by a general dentist and primary care physicians with antibiotics.  Many times infections will not respond to the initial therapy and require a higher level of care.  Oral and maxillofacial surgeons are uniquely trained to diagnosis rapidly progressing and chronic infections.  Symptoms such as facial and mouth swelling, limited mouthing opening (trismus) and painful swallowing (dysphagia) are most commonly associated with an infected, diseased or impacted tooth.

Non-odontogenic infections of the face and oral cavity occur to both children and adult alike.  Typically these infections are bacterial or viral in nature and respond to a variety of therapies.  Bacterial infections related to extensive bony infections (osteomyelitis), paranasal sinus and salivary gland disease require antibiotics and surgical drainage as needed.  From time to time oral antibiotics will not be sufficient to treat the infection and a higher and more concentrated dose of antibiotics is recommended as a hospitalized patient. Less often, infections require prolonged intravenous antibiotics provided with supervision by an infectious disease specialist-physician.

Osteonecrosis of the jaw is a condition that requires knowledge, training and experience in its diagnosis and management.  Two separate types of osteonecrosis exist, radiation induced osteonecrosis and bisphosphonate induced osteonecrosis.  Both have odontogenic and non-odontogenic considerations related to their management and require a team approach.  Life long management is essential in limiting the extent of these two inflammatory/infectious-like conditions.         


Impacted Teeth and Third Molars (Wisdom Teeth)

All teeth are intended to develop in the jaw and enter the mouth through the gums.  When a tooth is blocked in the jaw it becomes impacted.  A tooth commonly becomes impacted when its path becomes blocked by other teeth, a malocclusion (unbalanced bite relationship), jaw bone disease or a jaw bone growth disturbance.  Third molars, also called wisdom teeth are the most commonly impacted teeth.  Impacted third molars commonly cause chronic inflammatory jaw disease, caries and gum disease and frequently are associated with cysts of the jaw and rarely, jaw tumors. 

Dental Implants and Preprosthetic Surgery

Bony Reconstruction

Combined Surgical/Orthodontic Surgery

A malocclusion (unbalanced bite) is a dentofacial disorder that is diagnosed and treated by orthodontists.  It commonly causes an uneven bite that may affect mouth function (biting and chewing) and contribute to an unbalanced facial appearance.  Many maloccusions can be treated by your orthodontist with braces to move teeth to a more functional and cosmetic position.  In some cases, an oral and maxillofacial surgical procedure may be recommended to assist with orthodontic care.

Malocclusions occur for many of the following reasons: cleft lip and palate, developmental growth disorders, trauma (lower jaw and facial fractures), infections of the teeth and supporting structures, facial bone and jaw tumors, cysts and radiation therapy and chronic degenerative bone disorders such as juvenile rheumatoid arthritis, osteoarthritis, osteoarthritis and endocrine disorders.

After an evaluation of a malocclusion by an orthodontist, a consultation may be recommended to coordinate your care with our practice.  Surgical care of malocclusions range from extraction of teeth and implant reconstruction, exposure of impacted teeth and orthodontically guided eruption (movement of teeth through the jawbone to a functional/cosmetic position) and complex upper and lower jaw surgery (orthognathic surgery).  All treatment options can be discussed with your orthodontist and surgeon to help choose the treatment best suited for your specific problem.  

Diagnosis and Management of Temporomandibular Disorders (TMD)

Diagnosis and Excision of Aerodigestive (Oral Cavity) and Maxillofacial Disease

Oral pharyngeal cancer is diagnosed in the United States approximately 30,000 times annually.  The survival rate is 59% at the five year period and 45% at the ten year period.  Treatment usually consists of surgery, radiation therapy and chemotherapy. Risk factors include smoking, smokeless tobacco and excessive alcohol consumption. 

Currently, oral pharyngeal cancer is the six most common form of cancer.  Early detection and treatment greatly increases the chances of complete recovery. Listed below are many of the commonly encountered signs or symptoms of a potential lesion requiring care:   

•reddish patch (erythroplasia)

•white patches (leukoplakia)

•a sore that fails to heal and bleeds easily

•a lump or thickening of the tissues

•chronic sore throat or hoarseness

•difficulty in chewing, swallowing and/or limited mouth opening

Oral and maxillofacial surgeons are uniquely trained to recognize and treat various disease conditions of the mouth, face and jaws.  Many of these conditions can be painless, such as lumps and sores, or have a white, red or mixed appearance.  Some lesions will cause a loss of sensation called a paresthesia also known a "numbness".  Should the oral and maxillofacial surgeon agree that something looks suspicious,a biopsy may be recommended.  This is a procedure that involves the removal of a piece of the suspicious tissue.  The piece is then sent to a pathology laboratory for microscopic examination in order to make an accurate diagnosis of the problem.

Your problem may require coordinated care with other healthcare providers such as primary care providers, hematologist/oncologist, radiation oncologist and other surgical specialists.  Our practice will assist you with your care and provide the necessary consultation to promote the most favorable outcome.      

Facial Trauma Management-Repair of Injuries (lacerations, upper/lower jaw fractures, dental fractures)

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