Procedure Information| Dentistry and Oral Surgery

Teeth erupt into the mouth in a specific sequence and pattern during childhood and adolescence. Our jaws, in most cases, are only large enough to accommodate 28 teeth. However, there are 32 teeth in the normal adult mouth. The last four teeth to develop are called the third molars, but most people refer to them as “Wisdom Teeth”. The wisdom teeth typically begin to erupt in the mouth between the ages of 13 and 16 years. Because there is often inadequate room for these teeth, the wisdom teeth rarely grow in to assume a normal position within the jaws to become functional teeth that are useful in chewing. It is more often the case that these teeth come in crooked, leaning in different abnormal directions, or they fail to erupt completely through the jawbone or gums, (“impacted” wisdom teeth).

These poorly positioned wisdom teeth can result in negative complications to the overall dental health. These problems include:

Tooth decay

Periodontal disease (gum disease)

Damage to adjacent teeth, possibly resulting in tooth loss

Dental crowding

Cysts or tumors within the jaw bones

The only predictable way to prevent problems with wisdom teeth is to have them removed before these problems occur.

If you, or your dentist, have concerns regarding your wisdom teeth, an accurate evaluation of the status of these teeth can be provided to you by Dr. Thorpe, The American Association or Oral and Maxillofacial Surgeons recommends timely removal of indicated wisdom teeth between the ages of 13 and 18. The longer you delay the removal of poorly positioned wisdom teeth, the more likely you are to experience unfavorable complications from the wisdom teeth themselves or from the surgery required to remove them.

For your surgical procedure, you may choose intravenous sedation or general anesthesia to be used to provide you with a comfortable and safe surgical experience. With the intravenous anesthesia option, the anxiety and fear of undergoing surgery is removed, and, best of all, your procedure is completely painless! All anesthetics are performed with an emphasis on patient safety, utilizing state-of-the-art equipment and monitoring systems. Dr. Thorpe underwent nearly an entire year devoted specifically to anesthesia training during his surgical residency and is fully certified and qualified to provide this service to you.

WISDOM TEETH EXTRACTIONS

IV SEDATION

DENTAL IMPLANTS

Dental implants are available for patients who are seeking a permanent and predicable solution to replace missing teeth. Patients who desire the ability to eat and smile as they once did with their natural teeth will select dental implants for a new sense of confidence and a lifetime of dental satisfaction.

Dental Implants placed by Dr. Thorpe can replace single or multiple missing teeth. They can be placed individually or used together for an implant-supported “bridge”, They can also be used to stabilize and retain ill-fitting or loose dentures for the patient who is missing all their teeth.

There are multiple different dental implant options to treat any particular missing tooth situation.

BONE GRAFTING

When a patient is missing a single tooth or multiple teeth, the jawbone around these areas will shrink in size (height and width) over time due to lack of stimulating forces from chewing. The longer the tooth or teeth have been absent, the more pronounced the bone shrinkage can become. When this occurs, there often is inadequate bulk of bone to support the place of dental implants to replace the missing teeth. These patients will not be acceptable candidates for dental implants treatment unless the amount of bone in these areas is increased by grafting procedures. Your bone can be “bulked up”, so to speak. Other grafting options include using sterile cadaver bone form human donors, or chemically-engineered synthetic “bone substitutes” that are commercially available and work well in certain situations.

ORAL PATHOLOGY

The evaluation and diagnosis of growths and lesions within the mouth and jaws is an important aspect of the practice of oral and Maxillofacial surgery. Patients referred for evaluation undergo a thorough examination of their head and neck areas.

Not all growths within the mouth are oral cancer. However, the prevention and early diagnosis of cancer is important to the increased survival and prognosis of the patient. Biopsies and/or other tests are performed, when required, to arrive at a diagnosis and to allow the development of an appropriate treatment plan.

NEW DENTURE STABALIZATION SYSTEM

Undoubtedly the lower denture presents the most difficulty for patients adjusting to dentures for the first time, or even for experienced denture wearers. It can be frustrating as you attempt to eat certain foods, or even to speak with confidence without fear that your lower denture will begin to float in your mouth.

We have recently introduced a new treatment procedure called a DENTURE STABILIZATION SYSTEM . Essentially it is a mini dental implant system that in most cases can be placed and attached to your lower denture. There is no need for any incision or stitches. Within a couple of hours you can be on your way with a secure lower denture, and able to eat and speak much more comfortably and with renewed self-confidence. For all these reasons, people with dental implants often say they feel better... they look better... they live better.

The most effective use of this unique dental product is stabilization of a mandibular denture. There are approximately 50,000,000 people in the United States who are "edentulous"- literally meaning "lacking teeth" - who struggle daily with prosthetic devices. A majority suffers a great deal of discomfort as a result of loose or ill-fitting dentures that may be caused by poor bone structure. The denture wearers' quality of life can be gravely affected.

Benefits of denture stabilization

Restores proper chewing, allowing a better diet and improved health

Improves speech and confidence

Increases comfort with less irritation of gum tissue

Ends the cost and inconvenience of denture adhesives

Often can utilize your existing denture

Minimally invasive procedure

In the procedure titanium screws (implants) with integrated ball-tops are inserted into the jaw, where they will fuse into the bone. The procedure typically takes about an hour, and can be done under local anesthesia or general anesthesia.

Discomfort from the procedure is usually minor. Your dentist can prescribe medication to alleviate pain and will suggest a modified diet during the initial healing phase.

After the implants have healed, your denture is modified to snap onto the ball-tops. The denture will be secure until you remove it for cleaning. Simply apply upward pressure to the front of the denture with your thumbs to unseat the denture. Follow-up restorative care is required by your general dentist.

A successful implant requires that all parties involved — the patient; the restorative dentist, who makes the denture; and the oral Maxillofacial surgeon, who surgically places the implant, follow a careful plan of treatment. All members of the implant team stay in close contact with each other to make sure everyone clearly understands what needs to be done to meet the patient's expectations.

What to expect afterwards.

Daily cleaning consists of removing your denture at night and brushing around your implants to remove any food and plaque. Brushing also stimulates blood flow in the surrounding gum tissue. Following your doctor’s post-operative instructions and maintaining your dental hygiene are important factors in ensuring the long-term success of your treatment.

IMPACTION UNCOVERING

In cases where the cuspid tooth will not erupt spontaneously, the orthodontist and oral surgeon work together to get these unerupted teeth to erupt. Each case must be evaluated on an individual basis but treatment will usually involve a combined effort of the orthodontist and the oral surgeon. The most common scenario will call for the orthodontist to place braces on the teeth. A space will be opened to provide room for a impacted tooth to be moved into it’s proper position in the dental arch. The orthodontist will then refer the patient to the oral surgeon to have the impacted cuspid exposed and a bracket is placed on the tooth.

In a simple surgical procedure performed in the oral surgeon’s office, the gum on top of the impacted tooth will be lifted up to expose the hidden tooth underneath. Once the tooth is exposed, the oral surgeon will bond an orthodontic bracket to the exposed tooth. The bracket will have a miniature gold chain attached to it. The surgeon will guide the chain back to the orthodontic arch wire where it will be temporarily attached. Sometimes the surgeon will leave the exposed impacted tooth completely uncovered by suturing the gum up high above the tooth or making a window in the gum covering the tooth. Most of the time, the gum will be returned to it’s original location and sutured back while only the chain remains visible as it exits a small hole in the gum.

LACERATIONS

When soft tissue injuries, such as lacerations, occur on the face, they are repaired by “suturing”. In addition to the obvious concern of providing a repair which yields the best cosmetic result possible, care is taken to inspect and treat injuries to the structures such as facial nerves, salivary glands and salivary ducts. Dr. Thorpe is a well-trained Oral and Maxillofacial surgeon and is proficient in diagnosing and well trained in facial trauma.

Oral and Maxillofacial Surgeons are well trained in the emergency care, acute treatment and long-term reconstruction and rehabilitation of facial trauma patients.

FRACTURED JAW

Fractures of the bones of the face are treated in a manner similar to the fractures in other parts of the body. The specific form of treatment is determined by various factors which include to location of the fracture, the severity of the fracture, and the age and general health of the patient. When an arm or a leg is fractured, a “cast” is often placed to stabilize the bone and allow for proper healing. Since a cast cannot be placed on the face, other means have been developed to stabilize facial fractures.

One of these options involves wiring the jaw together for certain fractures of the upper and/or lower jaw. However, certain other types of fractures of the jaw are best treated and stabilized by the surgical placement of small “plates and screws” at the involved site. This technique of treatment can often allow for healing and obviates the necessity of having the jaws wired together. This technique is called “rigid fixation” of a fracture. The relatively recent development and use of “rigid fixation” has profoundly improved the recovery period for many patients by allowing them to return to normal function more quickly.

The treatment of facial fractures should be accomplished in a thorough and predictable manner. Importantly, the patient’s facial appearance should be minimally affected. An attempt at accessing the facial bones can usually be accomplished by making a few small incisions inside the mouth, but if necessary they may need to be made on the outside. Care is taken to place them so that the resultant scar is “hidden”.