Oral surgery is an area of dentistry concerned with diagnosing and treating conditions in the mouth which require a surgical procedure.
Oral surgery includes the following areas (see below for explanations):
- tooth extraction,
- root resection (apicoectomy),
- frenectomy and
- recontouring of endentulous alveolar ridge.
Modern dentistry increasingly favours minimally invasive approaches to treating teeth which are aimed at preserving every tooth. However there are some situations in which treatment cannot resolve the problem and the tooth needs to be removed.
Tooth extraction is a dental procedure in which the tooth is removed from the jaw. The procedure is performed under local anaesthetic and so is completely painless.
Tooth extraction can be:
- simple tooth extraction – a procedure performed under local anaesthetic in which the tooth is completely removed from the jaw in a single action;
- complicated tooth extraction – most common with multi-rooted teeth where the crown is broken and where a lack of tooth tissue means that the roots need to be separated so that they can be removed one by one;
- surgical tooth extraction.
Surgical tooth extraction
In surgical tooth extraction, performed under local anaesthetic, the oral surgeon accesses the tooth by freeing it from the surrounding gums and bone, removes the tooth and then closes the gums with surgical stitches which are removed after 7 days. The procedure takes between half an hour and an hour and is completely painless. Recovery is quick, and no sick-leave or absence from work or school is necessary.
Root resection (apicoectomy)
Root resection (apicoectomy) is an oral surgery procedure performed in order to remove infection from the root tip (apex) as well as part of the root tip itself in order to preserve the tooth.
If a tooth is not treated in time, or a complication resulting from unsuccessful treatment leads to ongoing irritation in the bone around the apex of the tooth’s root, the body defends against the irritation by forming a granuloma or cyst around the tip of the root. These can remain painless even for an extended period of time. But when they become inflamed they can cause intense pain and swelling.
This condition requires surgical treatment. The procedure is performed under local anaesthetic by a specialist oral surgeon, using sterile instruments, and is quite painless. The tooth is preserved in place during this procedure and can continue to serve its primary purpose.
The frenulum is a fold of soft tissue connecting the lips, cheeks and tongue to the jawbone, limiting excessive movement. However if it is overdeveloped it can cause aesthetic and functional problems. In children a hypertrophic frenulum is most commonly the cause of a gap between the front incisors, while in older patients the most common problem it causes is difficulty in fitting partial and complete dentures.
A frenectomy is an oral surgery procedure in which the frenulum is removed under local anaesthetic. Stitches are put in which are removed after seven days, all quite painlessly.
Recontouring the alveolar ridge
After a tooth extraction the bone at the site is resorbed (it melts away) through disuse. Where multiple teeth have been removed, or all the teeth have been removed at different times, an uneven surface is left on the alveolar ridge. If pronounced, this condition can cause problems with fitting dentures.
The procedure is carried out under local anaesthetic: sharp portions of bone are levelled out and then the gums stitched closed.