Jul 25, 2020

Impacted wisdom teeth problems are listed and explained by Lutherville oral and maxillofacial surgeon Dr. Leonard Spector.

Not all wisdom teeth need to be removed. The wisdom teeth that are healthy or positioned correctly with other teeth and are able to be kept clean are the ones that may not need to be removed. Many times, however, the wisdom teeth – the third molars in the very back of the mouth – do not have room to grow properly and they can cause problems. These teeth can grow at various angles to the jaw, sometimes horizontally.

Problems Caused by Wisdom Teeth

  1. Partially erupted wisdom teeth tend to collect food. It is difficult for the patient to get access to these areas and keep them clean and the result can be gum disease and tooth decay.
  2. Possibility of repeated infections which cause pain.
  3. Formation of cysts, which are fluid-filled sacks around the impacted teeth.
  4. Impacted teeth can encroach on the mandibular canal, which is the nerve that gives you feeling to your lower lip, chin, and tongue on both sides of your lower jaw.
  5. Impacted teeth can encroach on or damage adjacent teeth and cause other teeth to be pushed out of alignment. Sometimes impacted wisdom teeth are removed in advance of orthodontic treatment so that the orthodontist can move other teeth and teeth roots into proper alignment.
  6. Tumors can form around these teeth.

Best Age to Remove Impacted Wisdom Teeth

I recommend that patients bring in children who may have impacted wisdom teeth for an evaluation. I have removed wisdom teeth in the office for patients as young as 12 or 13 years old when the lower wisdom teeth are preventing the second molar teeth from erupting, but typically people have wisdom teeth removed sometime during their high school years.

Patients of any age can have their wisdom teeth removed if an examination reveals a need for the procedure.

Dr. Leonard Spector
www.chesapeakeimplants.dentist

Aug 5, 2020

Wisdom teeth removal by an oral and maxillofacial surgeon is recommended for three main reasons: training, general anesthesia, and lower risk of complications.

There are three main reasons why patients should consider having wisdom teeth removed by an oral and maxillofacial surgeon.

The first reason is that we have advanced training in the removal of impacted wisdom teeth. This procedure is a very extensive part of our training in our hospital-based residency programs. The removal of wisdom teeth is also one of the most common procedures that we perform in our office, so we gain extensive experience in this procedure. Most oral surgeons have removed many thousands of wisdom teeth.

Secondly, we are  able to provide general anesthesia to our patients. This is a procedure that most people do not want to be aware of as they are having it performed. Patients prefer to be asleep during the procedure. The specialty of oral and maxillofacial surgery includes advanced training in general anesthesia and we can provide it in our office in a private practice setting. After the procedure, patients recover very quickly and they are often surprised that the procedure is over.

Thirdly, oral surgeons, due to our advanced training, are much less likely to cause damage to the inferior alveolar nerve. We can perform the procedure in a much shorter amount of time. There is a reduced risk of complications because we make very small incisions which result in less swelling and less pain. If complications do occur, we are able to attend to these complications with skill and competence. Finally, because of our advanced training, we are able to get the procedure done in less time. With shorter procedures, there tends to be faster recovery and a shorter post-op course for our patients.

There are many dentists who can and do extract third molars. However, patients would be well advised to seek the services of a specialist in oral and maxillofacial surgery for this procedure, because training and experience are very important.

Dr. Leonard Spector
www.chesapeakeimplants.dentist

Aug 5, 2020

Havre de Grace Oral and Maxillofacial Surgeon Dr. Leonard Spector explains what to expect before, during, and after wisdom teeth removal.

A typical patient who has been referred to our office for wisdom teeth removal is a teenager whose wisdom teeth are beginning to erupt into the mouth or have not erupted and may be impacted and indicated for removal.

Prior to Surgery

Prior to treatment, we schedule a 30-minute pre-surgical consultation with the patient (and parent or guardian if the patient is a minor). I go over all the risks, benefits, and concerns related to the removal of the wisdom teeth. I review with them the dental x-ray and their medical history.

We discuss the means of how the wisdom teeth will be removed as well as the type of anesthesia to be used. Will it be just local anesthesia or IV sedation or local anesthesia with laughing gas?  My goal is always to keep the patient comfortable during procedures.

At the consultation appointment, we review all their pre-op instructions with them. If  they will be going to sleep, the patient is instructed not to have anything to eat or drink after midnight and to have someone who is at least 18 years old accompany them to the office and drive them home.

Day of Surgery

We typically do wisdom teeth extractions in our office for the convenience of the patient. The procedures usually last between 30 and 45 minutes. After the procedure, we allow the patient some recovery time in our office, but the anesthesia wears off quickly. The patient wakes up and we review follow-up instructions.

After Surgery

There tends to be minimal post-op discomfort or swelling after these procedures. Due to my advanced training in wisdom tooth removal, we can keep the incisions extremely small and the procedure times short.

Any post-op discomfort can be managed with prescription medication. Patients who have some difficulty opening their mouth widely will be on a soft diet. There may be some swelling of the jaw, particularly the lower jaw, after surgery, and we give the patient medicine and instructions to keep swelling to a minimum. Most people take a few days off from work or school to rest and recover after surgery.

Dr. Leonard Spector
www.chesapeakeimplants.dentist

Aug 5, 2020

Orthodontic treatment often involves close cooperation with an oral surgeon to expose impacted canines and remove other teeth to create proper space.

The canine teeth, also called eye teeth, are longer and pointier than other teeth. A common procedure is to expose and place a bracket on impacted canine teeth when these teeth are impacted. As an oral and maxillofacial surgeon, I perform this procedure when it is requested by an orthodontist. Once there are brackets placed on these teeth, the orthodontist can guide the teeth into position as part of overall orthodontic treatment.

Orthodontists also like to refer to our office because we have advanced cone beam technology, which means three-dimensional imaging technology. We are able to evaluate the position of the teeth in relation to other teeth and roots in the mouth so we can safely and very efficiently expose these teeth knowing exactly where they are located in the anatomy of the jaws.

Other common things we do in concert with orthodontists is to remove teeth in patients where there is dental crowding and teeth have to be removed in order for the orthodontist to straighten and place all the teeth correctly and functionally in the mouth.

Many times the teeth are just too large to be accommodated in the space that nature provides. For example, wisdom teeth can sometimes block the second molars from erupting. Once the wisdom teeth are removed, then there is space for the second molars to come in.

Removing wisdom teeth solves problems and no one misses having them. Even when wisdom teeth come in properly, we usually do not chew that far back in our mouth and so wisdom teeth are not functional.

Additionally, in younger patients, we are often asked by the orthodontist to remove some of the primary teeth to accelerate the eruption of the permanent teeth.

The key to proper treatment is close collaboration between the orthodontist and the oral and maxillofacial surgeon.

Dr. Leonard Spector
www.chesapeakeimplants.dentist