Oral and Maxillofacial Surgery
Oral and maxillofacial surgery is surgery to correct a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. It is a recognized international surgical specialty, and it is one of the nine specialties of dentistry recognized by the American Dental Association.
Oral Surgeons: Changing Lives With a Smile
Oral and maxillofacial surgeons are the only recognized dental specialists who, after completing dental school, are surgically trained in an American Dental Association-accredited hospital-based residency program for a minimum of four years. They train alongside medical residents in internal medicine, general surgery and anesthesiology and also spend time in otolaryngology (ear, nose and throat), plastic surgery, emergency medicine and other specialty areas. Their training focuses almost exclusively on the hard and soft tissue of the face, mouth and jaws, and their knowledge and surgical expertise uniquely qualify them to diagnose and treat the functional and esthetic conditions in this part of the body.
Conditions and Treatments
Your oral and maxillofacial surgeon has many years of education and hands-on training to provide treatment for a wide range of conditions.
Corrective Jaw Surgery
Corrective jaw or orthognathic surgery is performed in which the upper jaw, lower jaw and chin may be repositioned to correct minor and major skeletal and dental irregularities, including the misalignment of jaws and teeth which can improve chewing, speaking and breathing. Difficulty chewing or biting food, excessive wear of teeth, a receding chin, a protruding jaw or sleep apnea may indicate the need for corrective jaw surgery.
Wisdom teeth are the last set of teeth to develop. Sometimes they emerge from the gum line, and the jaw is large enough to allow room for them, but more often than not, they fail to emerge and become impacted. When a wisdom tooth is impacted, it may need to be removed. Impacted wisdom teeth that are partially or fully erupted tend to be quite difficult to clean and are susceptible to tooth decay, recurring infections and even gum disease. The American Association of Oral and Maxillofacial Surgeons strongly recommends that wisdom teeth be removed by the time the patient is a young adult in order to prevent future problems and to ensure optimal healing.
Cleft lip and cleft palate result when all or portions of the mouth and nasal cavity do not grow together properly during fetal development. The result is a gap in the lip or a split in the opening in the roof of the mouth. Until it is treated with surgery, a cleft palate can cause problems with feeding, speech and hearing. Oral and maxillofacial surgeons work as part of a team of health care specialists to correct these problems through a series of treatments and surgical procedures over many years.
Maxillofacial injuries or facial trauma encompass any injury to the mouth, face and jaw. One of the most common types of serious injury to the face occurs when bones are broken. Fractures can involve the lower jaw, upper jaw, palate, cheekbones, eye sockets or combinations of these bones. These injuries can affect sight and the ability to breathe, speak and swallow. Because of this, the expertise of the oral and maxillofacial surgeon is indispensable. Avoiding injury is always best, so it is extremely important to use seat belts, protective mouth guards and appropriate masks and helmets for everyone who participates in athletic pursuits at any level.
Temporomandibular Joint Surgery
The temporomandibular joint (TMJ) is a small joint located in front of the ear where the skull and lower jaw meet and allows the lower jaw to move and function. If you experience jaw pain, earaches, headaches, a limited ability to open or close your mouth, clicking or grating sounds, you may have Temporomandibular Disorder (TMD). TMJ treatment may range from conservative dental and medical care to complex surgery. If non-surgical treatment is unsuccessful or if there is clear joint damage, surgery may be indicated which can involve either arthroscopy or repair of damaged tissue by a direct surgical approach.
Oral and maxillofacial surgeons recommend that everyone perform an oral cancer self-exam each month. If you notice white or red patches, an abnormal lump, chronic sore throat or hoarseness or difficulty chewing or swallowing, you should contact your oral and maxillofacial surgeon. They will remove a section of tissue to perform a biopsy and accurately diagnose the problem.
Dental implants are long-term replacements for missing teeth that your oral and maxillofacial surgeon surgically places in the jawbone. Composed of titanium metal that fuses with the jawbone through a process called osseointegration, dental implants never slip and never decay. Because dental implants fuse with the jawbone, bone loss is generally not a problem.
Oral and maxillofacial surgeons have the ability to provide patients with safe, effective outpatient anesthesia including local anesthesia, nitrous oxide, IV sedation and general anesthesia. During their surgical residency, residents must complete a rotation on the medical anesthesiology service where they become competent in evaluating patients for anesthesia, delivering the anesthetic and monitoring post-anesthetic patients.
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Dentistry is the diagnosis, treatment, and prevention of conditions, disorders, and diseases of the teeth, gums, mouth, and jaw. Often considered necessary for complete oral health, dentistry can have an impact on the health of your entire body.
A cavity is a small hole that forms inside the tooth because of tooth decay. Cavities are formed when plaque buildup on the outside of the tooth combines with sugars and starches in the food you eat. This produces an acid that can eat away the enamel on your tooth. If a cavity is left untreated, it can lead to more serious oral health problems. Cavities can be prevented by remembering to brush your teeth at least two times a day and floss between teeth at least once.
The American Academy of Pediatric Dentistry (AAPD) recommends that children first see a dentist as early as six months of age and no later than one year of age. During this time, your child's baby teeth will be coming in and your dentist can examine the health of your child's first few teeth. After the first visit, be sure to schedule regular checkups every six months.
A dentist is a specialist who works to diagnose, treat, and prevent oral health problems. Your dentist has completed at least eight years of schooling, and received either a DDS (Doctor of Dental Surgery) degree, or a DMD (Doctor of Dental Medicine) degree. If your doctor is a pediatric dentist, this means that he or she specializes in caring for children from infancy through their teen years. A pediatric dentist has received the proper education and training needed to work with young kids. Other specializations include:
- Endodontics (root canals)
- Oral and maxillofacial (including pathology, radiology, and surgery)
- Orthodontics and dentofacial orthopedics
- Periodontics (gum disease)
- Prosthodontics (implants)
Choosing a dentist who “clicks” with you and your family is important, and you may wish to consider several dentists before making your final decision. During your first visit, you should be able to determine whether the dentist is right for you. During your appointment, consider the following:
- Is the appointment schedule convenient?
- Is the office easy to get to and close by?
- Does the office appear to be clean and orderly?
- Was your medical and dental history recorded and placed in a permanent file?
- Does the dentist explain techniques for good oral health?
- Is information about cost presented to you before treatment is scheduled?
- Is your dentist a member of the ADA (American Dental Association)?
Also known as periodontal disease, gum disease is mostly caused by plaque and bacteria buildup that is not treated in its early stage. Other causes of periodontal disease include tobacco use, teeth grinding, some medications, and genetics. Gingivitis is the beginning stage of gum disease, and, if detected, is treatable. Gingivitis left untreated may turn into gum disease. Advanced gum disease will lead to tooth and bone loss, and is a permanent condition. Brushing your teeth regularly and visiting the dentist every six months will help prevent gingivitis and more severe cases of periodontal disease. Common signs of gum disease:
- Red, irritated, bleeding, or swollen gums
- Chronic bad breath
- Loose teeth, or loss of teeth
- Extreme tooth sensitivity
- Receding gum line
- Abscessed teeth