Do You Need Oral Surgery?

The pain in your tooth has been getting worse for weeks and is now unbearable. You may also have soreness in your jaw or have recently lost a tooth. Is it time to see a dentist or an oral and maxillofacial surgeon?

Talk to Your Dentist First

If you have any problems with your teeth, gums, or jaws, you should see your dentist as soon as possible. If it's an emergency and you can't see a dentist right away, go to an urgent care clinic instead of the ER. However, it's best to try to avoid both of these options if possible. The only thing they will do at the ER or urgent care is give you medication for the symptoms and tell you to see a dentist. They may also charge three to four times more than what it would cost to fix the problem with a dentist. Your dentist can handle most oral problems. If they think you need to see an oral surgeon, they will recommend one.

The Oral and Maxillofacial Surgeon

If your dentist recommends maxillofacial surgery, they are talking about a specialty of dentistry that relates to your face and jaws. It’s surgery that treats disease and injuries of the areas around your mouth. Oral and maxillofacial surgeons have extra training and education beyond what’s expected for a dentist. Some get a medical degree (an MD) along with their oral surgery diplomas. They put in at least 4 years of training in a hospital-based surgical program alongside medical residents in many different specialties, including anesthesia. That includes various types of IV sedation, including "twilight sleep" and general anesthesia, where you're unconscious and can't feel any pain. It can also include local anesthesia, where only a small area of your body is numbed for your procedure. An oral surgeon can help you out of several situations, such as with impacted teeth. Impacted teeth mostly happen with wisdom teeth, also called third molars. But it can happen in other places in your mouth, too. Sometimes these teeth emerge from the gum line and the jaw is large enough to allow room for them, but most of the time, this is not the case. When the teeth come through the gums for the first time, it might be crowded, so they either don’t come out at all or don’t come out completely. This can cause sore gums and infections of the gum tissue surrounding the wisdom teeth. In addition, impacted wisdom teeth can cause permanent damage to nearby teeth, gums, and bone and can sometimes lead to the formation of cysts or tumors that can destroy sections of the jaw.

Jaw-joint issues

If your dentist or surgeon thinks it would be beneficial, they may recommend that you get your wisdom teeth pulled even if they aren't causing any problems yet. Other teeth, like the cuspids and bicuspids, can also become impacted and cause similar issues. For example, jaw joint problems. The temporomandibular joint (TMJ) connects your jaw to your skull right in front of your ears. If it isn't working properly, it can cause pain in your jaw, stiffness, popping, and headaches. Most people with TMJ disorders can be treated successfully with a combination of oral medications, physical therapy, and splints. However, for more advanced cases or when the diagnosis points to a specific problem with the joint, joint surgery may be an option. Oral devices, pain medication, and ice packs can also help. But people with recurring problems may need oral surgery.

Overbite/underbite

If your jaw or teeth aren’t aligned properly, your dentist may recommend orthognathic surgery. It’s an option for people with excessive overbites or underbites, trouble chewing or swallowing, certain birth defects, or sleep apnea. Orthognathic surgery is a type of corrective jaw surgery that is performed to fix a wide range of minor and major misalignment issues of the jaw and teeth. These problems can cause difficulty in speaking, eating, swallowing, and breathing. While some of these problems -- like improper teeth alignment -- can be corrected with braces and other orthodontic appliances, more serious problems require oral surgery to move all or part of the upper jaw, lower jaw, or both, into a new position that is more balanced, functional, and healthy.

Sleep and breathing issues

This section covers conditions that affect your ability to breathe properly while you sleep, such as snoring and sleep apnea. If you have sleep apnea, it means that you stop breathing for brief periods during sleep. A doctor with special training may recommend using a CPAP machine or other appliance to keep your airway open. In some cases, surgery may be necessary. There are different types of surgery depending on what is blocking your breathing. It could be that your airway just needs to be made bigger, or it could mean that a specific part of your mouth or nasal passages needs to be adjusted. Surgical procedures involve removing the soft tissues of the oropharynx (an area in the back portion of the mouth) or the lower jaw. Laser surgery is a newer treatment option. You could have a procedure in a doctor’s office and go home the same day. If the surgery you need is a bit more involved, you may have to spend a few days in the hospital and maybe have your jaw wired shut.

Cancer treatment. Oral surgeons also treat cancers, not just of the mouth, but also of the head and neck, like of the salivary glands, sinuses, throat, larynx, and lips.

Oral surgeons can also help with:

  • Nerve repair

  • Cleft lips and cleft palate surgery

  • Removal of lesions on the face or inside the mouth

  • Facial injury repair

  • Biopsy

  • Facial infections

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