If teeth do not emerge out of the gums like they are supposed to, they can cause problems such as crowding, infections or diseased tissue. However, this can be fixed with a simple tooth extraction. Your dentist, or in some cases, your orthodontist, will monitor your mouth and recommend if any misaligned or crowded teeth should be removed to preserve the full integrity of your mouth.
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 (OMS) who will remove your tooth in the office using an anesthetic that is appropriate for your procedure.
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, many of these teeth can be brought into proper position rather than removed. By working together, your oral and maxillofacial surgeon and orthodontist can often bring the impacted tooth through the gum and into the correct position through a procedure known as expose and bond. The OMS will expose the impacted tooth and bond an orthodontic bracket and chain to the tooth. This bracket will then be connected to the patient’s braces. The patient’s orthodontist will then work to gradually bring the tooth into the proper position – resulting in 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 by an oral and maxillofacial surgeon to loosen the frenum’s connection and extend the range of motion.
After a root canal, if one or more of the tooth’s roots becomes infected – or there is significant bone loss around the tooth – your dentist may refer you to an oral and maxillofacial surgeon for a hemisection or root amputation. During a hemisection, your surgeon removes one half of the tooth, leaving a serviceable one-rooted tooth. The term root amputation refers to the surgical removal of one root of a tooth with multiple roots.
The trigeminal nerve, which is responsible for sensation in the face and such functions as biting and chewing, may be at risk for injury during some oral and maxillofacial surgical procedures. OMSs are able to diagnose and manage these injuries with both non-surgical and surgical treatments to restore sensation and function.
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:
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 oral and maxillofacial surgeons in their office. When the TADs are no longer needed, they are removed and the site is usually fully healed in a couple 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 functional or cosmetic purposes.
Before placing a crown on a tooth that has been weakened by decay or is cracked, 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.