Adelaide MaxFax - Dentoalveolar surgery specialists
Dentoalveolar Surgery is a broad term referring to surgery carried out on the “tooth bearing” (dento) parts of the jaw bones (alveolar bone). Dentoalveolar surgery may be carried out by a dentist or a specialist oral and maxillofacial surgeon (OMS, OMFS) or sometimes other dental specialists (endodontist, prosthodontist, paediatric dentist).
Certain types of dentoalveolar surgery may be carried out to aid other procedures such as orthodontics (tooth alignment), endodontics (root canal treatment) or pre-prosthetic surgery (surgery prior to making dentures).
Common dentoalveolar procedures
Tooth extractions, which may be necessary for a number of reasons, including:
– If the tooth is dead, badly decayed, diseased or damaged beyond repair.
– If the tooth is misplaced or impacted (including wisdom teeth).
– If there is a buried retained tooth root.
– If a tooth or root has been inadvertently displaced into the maxillary sinus (large air cells in the upper jaw bone).
– If there is tooth crowding and space is needed to re-align other teeth (orthodontics).
– If the tooth is an “extra” permanent tooth (supernumerary tooth).
Cyst enucleation (surgical excision), when a fluid filled sac forms around an impacted tooth in the jawbone.
Removal of the labial frenum (frenectomy), which joins the centre of the inside of the upper lip and the middle of the upper gum between the two front teeth. Excision may be required if the labial frenum is abnormally large or long, causing a gap between the two front teeth. Removal will improve the outcome of any proposed orthodontic treatment to close this gap.
Biopsy and removal of abnormal tissue, whether cancerous, pre-cancerous or benign.
Removal of excess gum tissue, scar tissue or bony outgrowths to aid in the fitting of dentures.
Unrestorable split tooth
Submerged or impacted tooth
Grossly carious or a broken unrestorable tooth
Impacted wisdom tooth
Deciding when to have dentoalveolar surgery
Your oral and maxillofacial surgeon will only undertake procedures after careful discussion with you about your specific needs, allowing you to weigh up the advantages and disadvantages of going ahead with surgery. Your surgeon will discuss the risks, benefits and potential complications of surgery with you, and also discuss any other options that may be available to you. If you are unsure about your surgeon’s advice, you should seek a second opinion form another oral and maxillofacial surgeon.
Factors that may affect your treatment
Your surgeon will discuss your dental and medical history in detail with you to ascertain the best way forward for you. Aspects of your health such as current medical conditions, medications you may be taking, allergies you may have to medications such as antibiotics or anaesthetics or whether you may be pregnant may affect your treatment.
Other factors that may affect your treatment include your current social circumstances, living circumstances etc.
Where to have dentoalveolar surgery
Your surgeon will advise whether you will need to have your procedure in our office or in a private hospital. Your surgeon will also advise what kind of anaesthesia they recommend for the procedure and it will usually be one of three types:
- Local anaesthesia alone – Administered into the surgical site to numb the area. Usually used for straight forward procedures.
- Local anaesthesia with conscious intravenous sedation – In addition to the local anaesthetic agent, you may benefit from having a sedative drug administered intravenously. This will help relieve anxiety and is great for nervous patients or more invasive procedures. We use specialist anaesthetists from Adelaide Anaesthetic Services (AAS) to administer intravenous conscious sedation in our rooms.
- General anaesthesia – For more complicated procedures you may be “put to sleep” in hospital for the duration of the procedure with a general anaesthetic administered by a specialist anaesthetist (Adelaide Anaesthetic Services).
After dentoalveolar surgery
After you have recovered from the anaesthetic and returned home, rest is important and you should avoid driving, operating machinery and strenuous exercise. You may need several days off work and avoid alcohol while you are taking pain medication or antibiotics. Any pain, swelling and bleeding should start to subside a few days after your procedure. You may need a follow-up appointment to review the surgery and your surgeon will advise you if this is required.
Possible risks and complications of dentoalveolar surgery
Any surgical procedure can have complications despite the highest possible standards of practice and the many steps taken to minimise risk. The vast majority of patients will not experience complications, but your surgeon will be happy to discuss any concerns you may have. Your surgeon will discuss the various options, risks, benefits and possible complications of surgery. You will be required to sign a consent form that indicates you understand the procedure prior to having surgery.