Wisdom teeth, or third molars are the last permanent teeth to form and to move into the mouth. Wisdom teeth usually erupt between 16 to 18 years of age and are fully developed by age 22 or 23. This was assumed to be the "age of wisdom" which is where the term wisdom teeth originated. There are usually four wisdom teeth, located behind each of the 12 year molar teeth. If the jaw bone is long enough, the wisdom teeth will grow in with no resultant problems. Often times, however, the jaws are not long enough and the wisdom teeth do not have enough room to erupt. They become trapped within the jaw bone. These teeth are known as impacted wisdom teeth. Teeth which have partially erupted are also considered to be impacted.

Indications for the Removal of Wisdom Teeth

Naturally occurring bacteria in the mouth can work their way down to the impacted wisdom teeth, causing infection in the surrounding gum tissue and bone. Repeated soreness around wisdom teeth is often mistaken as an effort of the wisdom teeth to erupt. This soreness, however, could be a sign of infection. Surrounding bone, tooth roots and adjacent teeth may be harmed if this situation is left untreated.

You may not be having symptoms at the present time, however, headaches, earaches, and pain in the face, neck, throat and other teeth can occur if impacted wisdom teeth are not removed. Cysts can also develop around impacted wisdom teeth. The sac or follicle which surrounds the developing wisdom teeth may remain when the teeth are impacted. The sac can fill with fluid and become a cyst which may destroy bone surrounding adjacent teeth. In rare instances, if the cyst is not treated, a tumor may develop and more extensive procedures may be required for removal.

Advantages to Early Removal of Wisdom Teeth

The surgical procedure to remove impacted wisdom teeth at an early stage in their development is usually less involved than waiting until symptoms develop. The ideal time to remove the wisdom teeth is before the roots are fully formed and before any symptoms develop. As the teeth develop, the roots lengthen and become more firmly anchored within the jaw. It becomes more difficult then to remove wisdom teeth as a person ages.

Also, waiting until the wisdom teeth are symptomatic may increase the possibility of complications. The procedure and recovery time may be more involved than if the wisdom teeth are removed electively.

All dental extractions require some type of anesthesia. Prior to surgery, anesthesia options and recommendations will be discussed, and a plan for an appropriate anesthetic technique will be decided upon by you and your surgeon.

Aesthetic techniques used in our office include:

1. Local anesthesia - an injection which numbs or freezes the surgical area
2. Oral premedication - a medication taken by mouth prior to the procedure which helps to relieve anxiety

Service: Oral Surgery
Corrective Jaw Surgery or Orthognathic Surgery

Orthognathic Surgery is used to correct a wide spectrum of major and minor jaw deformities. "Orthognathic" means "straight jaws" and this surgery is used to reposition one or both jaws which are misaligned.

When the jaws are moved, the teeth also move. For this reason, orthognathic surgery is performed in conjunction with orthodontics so that the teeth and bite as well as the jaws are aligned correctly after surgery. After orthognathic surgery, the teeth and jaws will fit together correctly and function properly. This may also improve chewing, speaking and breathing as well as enhance facial appearance.

Any of the following symptoms may indicate a need for Corrective Jaw Surgery:

• Difficulty chewing or biting food
• Difficulty swallowing
• Chronic jaw pain
• Excessive wearing of teeth
• Open bite (a space between upper and lower teeth when the mouth is closed)
• Overbite (upper and lower teeth overlap too much)
• Unbalanced facial appearance
• Facial injury or a defect from birth
• Chronic mouth breathing
• Sleep apnea

Unequal growth of the jaws may exist at birth or may be acquired after birth as a result of hereditary or environmental factors or facial trauma. To best evaluate your specific condition and to achieve optimal results, a team approach is necessary. The team includes an oral and maxillofacial surgeon, an orthodontist and a general dentist. With this combined effort, the teeth and jaws can be moved into a new position which is balanced, functional and healthy.

Services: Oral Surgery

Dental Implants
Dental Implants may be a suitable replacement for missing teeth in healthy individuals and often are a superior alternative to more conventional techniques. Dental Implants are used for several different purposes. They can be used to replace one or more missing teeth, to provide an anchor for an upper or lower denture or to replace a full or partial denture with fixed bridgework.

It is important to replace missing teeth. Obvious cosmetic problems may be associated with missing teeth. Additionally, however, other oral and general health problems may result when teeth are not replaced. Shifting or movement of adjacent teeth into the empty space may occur over time. This malalignment may make these teeth more susceptible to decay and gum disease, eventually causing more tooth loss. Missing teeth may also decrease chewing efficiency and may also affect speech. Dental Implants are used to restore the dentition and prevent these consequences of longstanding missing teeth.

Services : Oral Surgery : Bone Grafts

Bone grafting procedures are usually necessary if there is not enough bone available to place Dental Implants or if any vital anatomy is in the way.

Today, bone grafting procedures have become almost an integral part of implant reconstruction. In many instances, a potential implant site in the upper or lower jaw does not offer enough bone volume or quantity to accommodate a Rootform Implant of proper size or in the proper place. This is usually a result of bone resorption that has taken place since one or more teeth (if not all) were lost. Bone Grafting procedures usually try to re-establish bone dimension, which was lost due to resorption.

Many years ago the lack of bone posed a considerable problem and sometimes implant placement was impossible because of that. Today, however, we have the ability to grow bone where needed. This not only gives us the opportunity to place implants of proper length and width (and for Rootform Implants we always try to go for as long and wide as possible), it also gives us a chance to restore the esthetic appearance and functionality better.

Type of Bone Grafting Materials

With respect to the Bone Graft material used, we have to differentiate between several choices. All materials can be categorized into five different categories:

1. Autograft or autogenous bone graft
2. Allograft or allogenic bone graft
3. Xenograft or xenogenic bone graft
4. Alloplast or alloplastic bone graft
5. Growth Factors

Each of the bone graft materials is usually developed with a specific purpose or advantage in mind. Your surgeon will make a decision with respect to the bonegraft material, based on your individual needs and the latest research in that field.

Effects of Missing Teeth

When a tooth is missing its neighboring teeth will tend to shift, sometimes significantly, which in turn can have a major impact on your dental health. Even the removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, and the problem of a possibility that the surrounding teeth of predispose the teeth may shifted.

To avoid these complications, in most cases, we will probably recommend to you to replace the tooth that has been extracted. Restorations for missing teeth includes:

• Dentures
• Dental Bridges
• Dental Implants