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 maxillofacial surgeon who will remove your tooth in the office using an anesthetic that is appropriate for your procedure.
Wisdom teeth, or third molars, are the last teeth to develop and appear in your mouth. They come in between the ages of 17 and 25, a time of life that has been called the “Age of Wisdom.”
Wisdom teeth may not need to be extracted if they grow in completely and are functional, painless, cavity-free, disease-free and in a hygenic environment with healthy gum tissue. They do, however, require regular, professional cleaning, annual check-ups and periodic X-rays to monitor for any changes.
When a tooth doesn’t fully grow in, it’s “impacted”–usually unable to break through the gums because there isn’t enough room.
An impacted wisdom tooth can damage neighboring teeth or become infected. Because it’s in an area that’s hard to clean, it can also invite bacteria that lead to gum disease. Oral bacteria can also travel through your bloodstream and lead to infections and illnesses that affect your heart, kidneys and other organs. In some cases, a cyst or tumor can form around the base of the impacted tooth, which can lead to more serious problems as it hollows out the jaw and damages surrounding nerves, teeth and other parts of your mouth and face.
Generally, wisdom teeth should be surgically removed when there are:
- Infections and/or periodontal (gum) disease
- Cavities that can’t be restored
- Cysts, tumors or other pathologies
- Damage to neighboring teeth
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 maxillofacial 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.
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 maxillofacial surgeon can bring the impacted tooth through the gum and into the correct position – giving you a beautiful healthy smile.
Frena are 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 maxillofacial surgeon’s office to loosen the frenum’s connection and extend the range of motion in that part of the body.
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 maxillofacial surgeon for root end surgery, also known as apicoectomy. This is a surgical procedure whereby a tooth’s root tip is removed and a root end cavity is prepared and filled with a biocompatible material so that you can keep the tooth without having to remove it.
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;
- Cover an exposed root;
- Stop 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 maxillofacial 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.
Crown Lengthening Procedures
Before placing a crown on a tooth that has been weakened by decay, is cracked or broken, or severely worn down, your dentist may refer you to an oral and maxillofacial surgeon for a crown lengthening procedure to ensure that enough of the tooth’s structure is available to securely hold a crown.