Milford Oral Surgery & Implants
Comprehensive Oral and Maxillofacial Surgery Care

FAQ

Comprehensive oral and maxillofacial surgical care.

Services & FAQ

 

WISDOM TEETH

WHAT ARE WISDOM TEETH?

Third molars are commonly referred to as wisdom teeth. They are usually the last teeth to develop and are located in the back of your mouth, behind your second molars. Their development is usually completed between the middle teenage years and early twenties, a time traditionally associated with the onset of maturity and the attainment of wisdom.


IMPACTED WISDOM TEETH

WHAT IS AN IMPACTED TOOTH?

Although most people develop and grow 32 permanent adult teeth, many times their jaws are too small to accommodate the four wisdom teeth. When inadequate space prevents the teeth from erupting they are called impacted. This indicates their inability to erupt into the proper position for chewing and cleaning.

TYPES OF IMPACTIONS

We will need to see you for a consultation to determine if you will benefit from wisdom tooth removal. A special x-ray of your mouth and jaws (panorex) will be taken to determine if your wisdom teeth are impacted, if there is room for them to erupt, and how difficult it will be to have them removed.

  • Soft Tissue Impaction: There is not enough room to allow the gum tissue to retract for adequate cleaning of the tooth.

  • Partial Bony Impaction: There is enough space to allow the wisdom tooth to partially erupt. However, the tooth cannot function properly in the chewing process, and creates cleaning problems, among others.

  • Complete Bony Impaction: There is NO space for the tooth to erupt. It remains embedded in the jaw bone or if even partially visible requires complex surgical techniques for removal.The impacted wisdom tooth may also be in an unusual position and difficult to remove. This situation can also arise when the shape or size of the jaw bone and other facial structures make removal of this tooth significantly more complex.


BONE GRAFTING FOR IMPLANTS

DO I HAVE ENOUGH BONE?

After tooth extraction, if the walls of the socket are very thick, they will usually fill naturally with bone in two to three months. However, when the walls of your socket are very thin (such as in your upper and lower front teeth), this type of healing will not be as predictable. In these situations, a bone graft is often placed at the time of tooth extraction to help your body fill in the empty socket with bone. This step will maintain the width and volume of bone you will need for implant placement several months later.

There may be inadequate bone for implant placement if your tooth was removed many years ago and your bony ridge is extremely thin. In this case, a bone graft can be placed next to the thin bone and allowed to heal for up to six months. After the graft has fused to your pre-existing bone, the ridge will be re-entered and the implant placed. Bone grafting is usually a relatively comfortable office procedure. Many different bone-grafting materials are available, including your own bone.

You may also need bone grafting if the sinus cavities in your upper jaw are very large, or very low, and extend into the tooth-bearing areas. This often occurs when teeth in the back of a person’s upper jaw have been removed many years before, and the amount of bone available for implant placement is limited. A “sinus grafting procedure” is then required. Most often, it is performed in the office with local anesthesia and perhaps sedation. During this procedure, the membrane that lines the sinus will be located and elevated. Bone will then be added to restore the bone height and ensure that dental implants of an adequate length can be placed. This procedure often can be performed at the time of implant placement.



DENTAL IMPLANTS

WHAT ARE DENTAL IMPLANTS?

A natural tooth consists of a root and a crown. If you compare natural teeth to implant-supported replacement teeth, you’ll see they have the same basic parts. Both have a crown (the visible part used to chew food). Both have a root that holds the tooth securely under the gum and is anchored into the jaw. The difference is that the implant is made of titanium – the same time-tested material used by surgeons for artificial joints. When you lose a tooth, you lose both the root and the crown. To replace the tooth, the surgeon first replaces the root with a small dental implant.

Time is allowed for bone to heal and grow around the dental implant. The bone bonds with the titanium, creating a strong foundation for artificial teeth.  A support post (abutment) is then placed on the implant and a new replacement tooth (crown) is placed on top of the abutment. In many cases a temporary replacement tooth can be attached to the implant immediately after it is placed. If all of your teeth are missing, a variety of treatment options are available to support the replacement teeth.


IMPLANT SUPPORTED OVERDENTURE

An Implant Supported Overdenture is a contemporary restoration that has revolutionized the way surgeons and dentists think of replacing a full set of teeth. Standard dentures are unsecured prostheses with inherent limitations. Most often, dentures are painful, inconvenient and unstable. Such dentures can make chewing foods difficult, limiting the foods that you once enjoyed. Modern dentistry can help with implant supported dentures. The Implant Supported Overdenture treatment concept replaces your missing teeth with a full dental bridge supported by dental implants. Fewer implants are needed and overall treatment time and cost is reduced. An Implant Supported Overdenture solution also ensures greater stability in the bone, reducing the need for bone graft surgery to increase bone volume. Implant-supported overdentures stay connected with bar and clip attachment methods or use a variety of abutment-based attachments (ball, magnets, and resilient stud attachments such as Locators). The most appropriate attachment system for your individual needs relates to a variety of factors that is determined early in the treatment. Typically, a temporary set of teeth can be placed on the same day of surgery. The temporary teeth allow you to lead a normal life immediately after surgery. After a short healing period, your dentist will place the final bridge. Your quality of life is improved, and you can start enjoying your favorite foods again with renewed confidence.

IMPLANT SUPPORTED OVERDENTURES OFFER YOU MANY ADVANTAGES:

  • A cost effective solution. When compared to some other implant supported restoration methods, your new replacement teeth require fewer implants for each jaw. With fewer implants required, the cost is lowered.

  • Reduced need for bone grafting. The special angled placement of two of the implants ensures a secure and stable anchorage for the replaced arch, often making bone grafting unnecessary.

  • Faster treatment and healing time. Your replacement arch can be attached to your implants immediately after insertion.

Scientifically proven and documented. Implant Supported Overdentures have had good clinical outcomes from decade long studies with favorable results.



INTRAVENOUS SEDATION (“TWILIGHT SEDATION”)

Our office offers our patients the option of Intravenous Sedation or Dental Intravenous Anesthesia or to some it is referred to as “Twilight Sedation” for their dental treatment. Intravenous Sedation or “twilight sleep” helps you to be comfortable and calm when undergoing dental procedures. Your treatment can be completed under intravenous sedation. Intravenous sedation or “IV sedation” (twilight sedation) is designed to better enable you to undergo your dental procedures while you are very relaxed; it will enable you to tolerate as well as not remember those procedures that may be very uncomfortable for you. IV sedation will essentially help alleviate the anxiety associated with your treatment. You may not always be asleep but you will be comfortable, calm and relaxed, drifting in and out of sleep – a “twilight sleep”.

If you choose the option of intravenous sedation your IV sedation/anesthesia is administered and monitored by the doctor therefore eliminating the costly expense of having your treatment carried out in an operating room or same day surgical facility.

HOW IS THE IV SEDATION ADMINISTERED?

A catheter will be introduced into a vein in your arm or hand through which medication will be given to help you relax and feel comfortable. Once again some patients may be asleep while others will slip in and out of sleep. Some patients with medical conditions and/or on specific drug regimens may only be lightly sedated and may not sleep at all.

The goal of IV sedation is to use as little medication as possible to get the treatment completed. It is very safe, much safer than oral sedation. With IV sedation a constant “drip” is maintained via the intravenous tube. At any time an antidote can be administered to reverse the effects of the medications if necessary. Along with IV sedation there are also other different “levels” of sedation available to you in our office. 

NITROUS OXIDE (LAUGHING GAS)

Nitrous oxide is a sweet smelling, nonirritating, colorless gas which you can breathe. Nitrous oxide has been the primary means of sedation in dentistry for many years. Nitrous oxide is safe; the patient receives 50-70% oxygen with no less than 30% nitrous oxide. Patients are able to breathe on their own and remain in control of all bodily functions. The patient may experience mild amnesia and may fall asleep not remembering all of what happened during their appointment.

There are many advantages to using Nitrous Oxide

  • The depth of sedation can be altered at any time to increase or decrease sedation.

  • There is no after effect such as a “hangover”.

  • Inhalation sedation is safe with no side effects on your heart and lungs, etc.

  • Inhalation sedation is very effective in minimizing gagging.

  • It works rapidly as it reaches the brain within 20 seconds. In as few as 2-3 minutes its relaxation and pain killing properties develop.


SPECIALISTS & the dental team 

Oral surgeons work in tandem with a number of dentists and specialists to manage your dental treatment. Dr. Ho recognizes many outstanding dentists in Milford & Highland and recommends these dentists to provide services including root canals, implant restoration, family dental care and periodontal care