Oral Surgery Procedures

 

Extractions


Tooth extraction is the removal of a tooth from its socket in the bone. If a tooth has been broken or damaged by decay, your dentist will try to fix it with a filling, crown or other treatment. Sometimes, though, there's too much damage for the tooth to be repaired. In this case, the tooth needs to be extracted. A very loose tooth also will require extraction if it can't be saved, even with bone replacement surgery (bone graft).

Here are other reasons:

  • Some people have extra teeth that block other teeth from coming in.
  • Sometimes baby teeth don't fall out in time to allow the permanent teeth to come in.
  • People getting braces may need teeth extracted to create room for the teeth that are being moved into place.
  • People receiving radiation to the head and neck may need to have teeth in the field of radiation extracted.
  • People receiving cancer drugs may develop infected teeth because these drugs weaken the immune system. Infected teeth may need to be extracted.
  • Some teeth may need to be extracted if they could become a source of infection after an organ transplant. People with organ transplants have a high risk of infection because they must take drugs that decrease or suppress the immune system.
  • Wisdom teeth, also called third molars, are often extracted either before or after they come in. They commonly come in during the late teens or early 20s. They need to be removed if they are decayed, cause pain or have a cyst or infection. These teeth often get stuck in the jaw (impacted) and do not come in. This can irritate the gum, causing pain and swelling. In this case, the tooth must be removed. If you need all four wisdom teeth removed, they are usually taken out at the same time.

This practice varies by the dentist or oral surgeon. Antibiotics are more likely to be given if:

  • You have infection at the time of surgery 
  • You have a weakened immune system 
  • You will have a long surgery 
  • You have specific medical conditions 

There are two types of extractions: 

  • A simple extraction is performed on a tooth that can be seen in the mouth. General dentists commonly do simple extractions. In a simple extraction, the dentist loosens the tooth with an instrument called an elevator. Then the dentist uses an instrument called a forceps to remove the tooth.
  • A surgical extraction is a more complex procedure. It is used if a tooth may have broken off at the gum line or has not come into the mouth yet. Surgical extractions commonly are done by oral surgeons. However, they are also done by general dentists. The doctor makes a small incision (cut) into your gum. Sometimes it's necessary to remove some of the bone around the tooth or to cut the tooth in half in order to extract it. 

During a tooth extraction, you can expect to feel pressure, but no pain. If you feel any pain or pinching, tell your doctor.

 

Bone and Gum Reconstructive Surgery


Periodontal plastic surgery is designed to restore form and function to the gum tissue, periodontal ligament, and the bone that supports your teeth or an individual tooth. The real long-term goal of any periodontal surgery is to increase the life expectancy of the teeth and their usefulness; it is not a cure for periodontal disease. Basically, periodontal surgery removes tissue that has been transformed by the disease and then reconstructs the gums and surrounding tissues to better support the teeth and to recreate a normal appearance.

Periodontal Disease

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Periodontal disease is diagnosed when gingival or gum tissue attachment to the teeth is abnormal and bone changes may be evident through x-rays. A dentist will determine the degree of periodontal disease by examining “pockets” between the gum and tooth to see how much detachment exists and then will thoroughly examine the x-rays. Your dentist and you can discuss treatment procedures once a periodontal disease diagnosis has been made, beginning with conservative behavioral changes and extending to periodontal plastic surgery.

Treating Periodontal Disease

Behavioral Change– When periodontal disease is detected, your dentist will first recommend a few behavioral changes including an enhanced oral hygiene program,quitting smoking, and possibly some additional lifestyle changes.

Tartar Removal– A regular and thorough professional tartar or calcified plaque removal program will become an essential part of your oral hygiene routine. Typically this is a painless procedure but, in some extreme cases, pain medication may be required for a few days.

Surgical Therapy– In cases of severe periodontal disease, surgery will be necessary to repair and regenerate the soft and hard tissues and replace any missing teeth. The goal of surgery is to eliminate pockets between the gum and tooth and attempt to encourage reattachment and normal function and esthetics to the patient. There have been many advances in this field in both soft-tissue and hard-tissue replacement and regeneration, and a skilled periodontal plastic surgeon can restore an affected mouth to a pre-disease appearance.

Preventing Periodontal Disease

While steps can be taken to alleviate the ravages of periodontal disease, the best step is prevention. Remove plaque and bacteria through daily brushing, flossing, and regular oral hygiene. Routine visits to a dental professional for cleanings are also essential. Quitting smoking has proven to be very helpful in preventing the onset of periodontal disease. 

 

Plastic Surgery Procedures:

Gummy Smile Or Uneven Gum Line

Do you feel your teeth look too short and your smile is too gummy or your gums cover too much of some teeth while leaving the others the right length? If so, dental crown lengthening might be the solution for you. During this procedure, excess gum tissue is removed to expose more of the crown of the tooth. Then your gumline is sculpted to give your new smile just the right look.

Long Teeth/Exposed Roots

Sometimes gum recession causes the tooth root to become exposed, which makes your teeth look long and can make you look older than you are. This recession can happen as a result of a variety of causes, including periodontal diseases.

Gum graft surgery and other root coverage procedures are designed to cover exposed roots, to reduce further gum recession and to protect vulnerable roots from decay.

Indentations In The Gum and Jawbone

Tooth loss can cause an indentation in the gums and jawbone where the tooth used to be. This happens because the jawbone recedes when it no longer is holding a tooth in place. Not only is this indention unnatural looking, it also causes the replacement tooth to look too long compared to the adjacent teeth.

Ridge augmentation can fill in this defect recapturing the natural contour of the gums and jaw. A new tooth can then be created that is natural looking, easy to clean and beautiful.

I've been seeing Hayley, the dental hygienist for over a year and she has always been fantastic - gentle and sensitive to my teeth cleaning needs! Last week I was in excruciating pain over a wisdom tooth and they were able to get me in for an evaluation later in the day. Dr. Rai was also exceptionally gentle with my aching tooth, and they were able to schedule me for an extraction just three days later. Pretty happy now, if you ask me! Update- I've now had my wisdom teeth removed, and I have to say it was a rather pleasant experience. I was incredibly nervous and Dr. Rai and his dental assistants really took care of me - from making sure my feet weren't cold to explaining what he was doing along the way. The three hours passed really quickly! The evening after my extractions, Dr. Rai personally called me to check in, see how I was feeling and ask if I had any questions for him. I really feel I've been well taken care of.
Christina Alexandra E. - Santa Barbara, CA

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We Are Open And Taking Appointments!

By BK Rai in Important Announcements

Due to COVID 19 we have had to make changes in our schedule. Hygiene days are now Wednesdays and Thursdays. For the meantime, any appointment made for routine care will have to be kept and we will handle cancelations on a case by case basis. A fee will be applied to appointments canceled with less than 48 hours notice. Please contact our office about this policy if you have any questions.


  • All patients will be prescreened before appointment.

  • Call/Text upon arrival, we will meet you at the door when it is ok for you to come in.

  • Shoes will be sanitized at the door.

  • Wear a mask at all times unless advised otherwise.

  • Oxygen levels and/or temperature will be taken upon arrival. 

  • We have designated "Sanitation Stations" throughout the office to be used freely.

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