Oral & Maxillofacial Surgery
Oral and maxillofacial surgery is used to correct a wide spectrum of diseases, injuries, and defects in the head, neck, face, jaws, and the hard and soft tissues of the oral and maxillofacial region. A recognized international surgical specialty, it is also one of the specialties of dentistry recognized by the American Dental Association.
Oral Surgeons: Changing Lives with a Smile
Oral and maxillofacial surgeons are the only dental specialists who, after completing dental school, are surgically trained in an American Dental Association-accredited hospital-based residency program for a minimum of four years. They train alongside medical residents in internal medicine, general surgery, and anesthesiology; and also spend time in otolaryngology (ear, nose, and throat), plastic surgery, emergency medicine, and other specialty areas.
Their training focuses almost exclusively on the hard and soft tissue of the face, mouth, and jaws, and their knowledge and surgical expertise uniquely qualify them to diagnose and treat functional and aesthetic issues in this part of the body.
Conditions and Treatments
Your oral and maxillofacial surgeon has many years of education and hands-on training to provide treatment for a wide range of conditions.
Corrective Jaw Surgery
Corrective jaw surgery moves your teeth and jaws into positions that are more balanced, functional, and healthy. Whether your needs include improving your bite and function, appearance, or speech, corrective jaw surgery can have a dramatic and positive effect on your outlook on life. Your oral surgeon will work with you to help you achieve a beautiful, functional, and pain-free smile that will last for the rest of your life.
Who needs corrective jaw surgery?
In some cases, your upper and lower jaws may have grown at different rates. Injuries and birth defects may also affect jaw alignment. Though orthodontics can usually correct problems when only the teeth are misaligned, corrective jaw surgery with an oral surgeon may be necessary to correct misalignment of the jaws.
If you suffer from any of the following conditions, you may be an excellent candidate for corrective jaw surgery:
- Difficulty chewing, biting food, or swallowing
- Chronic jaw or jaw joint (TMJ) pain and headache
- Excessive wear of the teeth
- Open bite (space between the upper and lower teeth when the mouth is closed)
- Unbalanced facial appearance from the front or side
- Facial injury or birth defects
- Receding chin
- Protruding jaw
- Inability to make the lips meet without straining
- Chronic mouth breathing and dry mouth
- Sleep apnea (breathing problems during sleep, including snoring)
Receiving treatment to correct any of the above conditions is a commitment not only to your health, but to your happiness as well. Treatment may include surgery and orthodontic treatment, and may take several years to complete, but the results will last a lifetime.
Cleft Palate
Cleft lip and cleft palate result when all or portions of the mouth and nasal cavity do not grow together properly during fetal development. The result is a gap in the lip or a split in the opening in the roof of the mouth.
Until it is treated with surgery, a cleft palate can cause problems with feeding, speech, and hearing. Oral and maxillofacial surgeons work as part of a team of healthcare specialists to correct these problems through a series of treatments and surgical procedures over many years.
Facial Trauma
Maxillofacial injuries or facial trauma encompass any injury to the mouth, face, and jaw. One of the most common types of serious injury to the face occurs when bones are broken. Fractures can involve the lower jaw, upper jaw, palate, cheekbones, eye sockets, or combinations of these bones.
These injuries can affect sight and the ability to breathe, speak, and swallow. Because of this, the expertise of the oral and maxillofacial surgeon is indispensable. Avoiding injury is always best, so it’s vital for anyone who participates in athletics, at any level, to use seat belts, protective mouthguards, and appropriate masks and helmets.
Temporomandibular Joint Surgery
The temporomandibular joint (TMJ) is located in front of the ear where the skull and lower jaw meet. It allows the lower jaw to move and function. If you experience jaw pain, earaches, headaches, a limited ability to open or close your mouth, clicking, or grating sounds, you may have Temporomandibular Disorder (TMD).
TMJ treatment may range from conservative dental and medical care to complex surgery. If non-surgical treatment is unsuccessful or there is clear joint damage, surgery may be indicated, which can involve either arthroscopy or repair of damaged tissue by a direct surgical approach.
Traumatic Dental Injuries
Most traumatic dental injuries occur among children and teenagers, but people of any age can be affected, typically as a result of sports mishaps, automobile accidents, or bad falls. Regardless of the cause, you may need to visit an oral surgeon if you’ve experienced a traumatic dental injury.
Any dental injury, even if apparently mild, requires immediate examination by a dentist or oral surgeon. Sometimes, neighboring teeth suffer an additional, unnoticed injury that will only be detected during a thorough exam.
Depending on the extent of your dental injury, the oral surgeon may work as a team with endodontists and restorative dentists to return your mouth, jaw, and teeth to proper form and function. It’s essential to take traumatic dental injuries seriously. If you suspect that your or a loved one’s jaw is broken, go to the emergency room immediately.
Soft-Tissue Trauma
Injuries that extend past the teeth and bones into the soft tissue (gums, cheeks, and lips) need to be corrected by an oral surgeon. Taking aesthetics into consideration, your oral surgeon will repair your gums with sutures, and will take special care not to disturb salivary ducts and glands.
Dislodged (Luxated) Teeth
During an injury, a tooth may be pushed sideways, out of, or into its socket. Your oral surgeon will reposition and stabilize your tooth. Root canal treatment with an endodontist is usually necessary for permanent teeth that have been dislodged, and should be done a few days following the injury.
Children between seven and 12 years old may not need root canal treatment, since their teeth are still developing. For those patients, your oral surgeon will monitor the healing carefully and intervene immediately if any unfavorable changes occur.
Knocked-Out (Avulsed) Teeth
If a tooth is knocked completely out of your mouth, time is of the essence. It should be handled very gently; avoid touching the root surface itself. If it is dirty, quickly and gently rinse it in water. Do not use soap or any other cleaning agent, and never scrape or brush the tooth.
If possible, the tooth should be placed back into its socket as soon as possible. The less time it’s out of its socket, the better the chances for saving it.
Once the tooth has been replaced in its socket, the oral surgeon will evaluate it and check for any other dental and facial injuries. If the tooth has not been placed back into its socket, your oral surgeon will clean it carefully and replace it. A stabilizing splint will be placed for a few weeks.
Depending on the stage of root development, we may recommend that an endodontist start root canal treatment a week or two after your surgical procedure.
Root Fractures
A traumatic injury to the tooth may also result in a horizontal root fracture. The location of the fracture determines the long-term health of the tooth. If the fracture is close to the root tip, the chances for success are much better. The closer the fracture is to the gum line, the poorer the long-term success rate. Sometimes, stabilization with a splint (wiring or bonding teeth together) is required for a period of time.
Bone Injuries
In theory, a fractured facial bone is treated just like any other bone in the body: The fracture together is held together for a period of time to enable it to heal. However, in practice, a cast can’t be applied to the face in the same way it can to an arm or a leg. For fractures of the upper and lower jaw, your oral surgeon may recommend wiring the jaws together or placing stabilizing plates to allow the bones to heal.
Traumatic Dental Injuries in Children
Chipped primary (baby) teeth can be aesthetically restored. Dislodged primary teeth can, in rare cases, be repositioned.
However, primary teeth that have been knocked out should not typically be replanted. The replantation of a knocked-out primary tooth may cause further (and potentially permanent) damage to the underlying permanent tooth that is growing inside the bone.
Children’s permanent teeth that are not fully developed at the time of an injury need special attention and careful follow-up, but not all of them will need root canal treatment. In an immature permanent tooth, the blood supply to the tooth and the presence of stem cells in the region may enable your oral surgeon to stimulate continued root growth.
