Oral and Maxillofacial Surgery

Surgical interventions are applied to the soft tissues (such as cheeks, tongue, palate or lips) and hard tissues (teeth and bones) in the oral cavity.

Wisdom teeth are the third molars at the back of the dental arch. They usually erupt by the age of twenties; however, they often partially erupt or remain impacted in the jaw bone due to teeth crowding and displacement of the eruption position or depending on the bone density in the respective region of the oral cavity.

It will be easier to extract wisdom teeth before the formation of their root ends is completed. To extract the wisdom teeth, the gingiva and the bone over the impacted tooth crown needs to be retracted. There is no need to extract a wisdom tooth when it has completely erupted. They may be used as abutments to fix a dental bridge in the future if the teeth in front of them are lost. Because they are located at the most rear end of the dental arch, they are the most difficult teeth to brush. This causes accumulation of food particles and germs over them, leading to gingival inflammation and foul mouth odour. Wisdom teeth erupting towards the cheek or the tongue at an angle should be extracted if they cause the patient to bite his cheek and tongue involuntarily.

Bleeding is normal after the extraction for a duration of 3-5 minutes. This is necessary for the formation of a blood clot in the empty cavity created by the extracted tooth. Then pressure is applied to the area of intervention using a piece of gauze. To stop the bleeding, the gauze should be bitten approximately for half an hour. Hot drinks and foods, as well as acidic foods, should not be consumed and patients should not smoke or drink alcoholic beverages within the first 24 hours after the extraction. In the night after the tooth extraction, patients should sleep using a thick pillow and should definitely not take painkillers (analgesic medications) like aspirin with blood thinning (anticoagulant) effects. If a surgical extraction was performed or if the extraction process was very difficult or if the incision site was sutured, cold packs should be applied onto the respective area on the face at regular intervals for a duration of 24 hours. During the cold application, the respective area on the face should be covered with a piece of paper towel or a piece of clean cloth to lie under the cold packs in order to prevent a skin injury.

The oral cavity (inside the mouth) is one of the places, where the initial findings of several kinds of systemic diseases occur. Therefore, these lesions should be carefully monitored. If these lesions indicate a disease, treatment should be initiated without delays. It should be remembered that only an experienced dentist can identify malignant lesions in the mouth. Furthermore, an early diagnosis saves lives.

In some patients, surgical intervention to the soft tissues might be needed in order to provide a sufficient area of bone, where the dentures will be placed. In patients using dentures, soft tissue injuries should be treated with a surgical intervention before taking measurements.

General anaesthesia is a deep state of narcosis, which is induced by administering medications intravenously or by inhalation of anaesthetic gases. It is mostly preferred in patients with fear and anxiety, in mentally handicapped people, and when local anaesthesia will not be sufficient. Sedation is a type of anaesthesia, which induces a sleepy state by intravenous drugs. Sedation has no narcotic effects. Therefore, in order to provide anaesthesia to the area of intervention, local anaesthesia by giving anaesthetic medication injections should also be performed in the oral cavity in sedated patients.

Teeth with angulated root ends, impacted teeth, wisdom teeth in the lower jaw, and teeth with root ends containing bone invasion in between or teeth having osseo-integrated roots to the jaw bone are most difficult to extract. But today’s technology allows for appropriate and easy to administer analgesia, eliminating pain. Therefore, it is possible to extract these types of teeth readily and comfortably using specific instruments.

Impacted wisdom teeth exert pressure to the teeth in front of them causing a crooked appearance. They also cause inflammation of the gums covering themselves, abscess formation and bone tissue loss between the first molar and themselves, development of cysts, and foul mouth odour.

No. Teeth that do not cause any harm as monitored by taking panoramic dental X-rays, teeth that do not inflict any pain, and teeth having roots close to the lower jaw canal and nerve may not be extracted upon dentist’s discretion.

A high fever, continuing bleeding, foul odour, a painful red swelling after the extraction; or persisting bleeding into the saliva, sustained swelling, and difficulties in opening the mouth require an emergency dental visit.

No. Cysts at the root ends of the teeth can be treated without the need for tooth extraction if they are identified at earlier stages. For the treatment of this kind of conditions, root canal treatment is performed initially. Then, under local anaesthesia, surgical intervention is made to the root end and the problem is resolved. These interventions allow for sparing the tooth.

Yes. However, it is wrong to use antibiotics for days or weeks because of inflammation and swelling. Sometimes an antibiotic taken several hours ago may be sufficient. Your dentist will make the appropriate decision depending on the condition of the tooth.