Oral & Maxillofacial Surgery

Wisdom teeth are the third set of molars in the back of your mouth. They usually come in between the ages of 17 and 25. 

Most people have them removed for one of these reasons:

• They’re impacted. Because they're so far back in your mouth, wisdom teeth may not surface correctly. They can get trapped in your jawbone or gums, which can be painful.
• They surface at the wrong angle and may press against your other teeth.
• Your mouth isn’t big enough. Your jaw has no room for an extra set of molars.
• You have cavities or gum disease. You may not be able to reach your wisdom teeth with your toothbrush or dental floss.

If one or more of your teeth are missing, dental implants are one way to restore the look of your smile. At Fraser Valley Dental Specialists in Abbotsford, we provide placement and maintenance of dental implants.

A dental implant is an artificial root made of titanium metal. It is inserted into your jawbone to replace the root of your natural tooth. An artificial replacement tooth is attached to the implant. The implant acts as an anchor to hold the replacement tooth in place.

Dental implants may be right for you if: 

• you are in good general health
• have healthy gums
• have enough bone in your jaw to hold an implant

If your jawbone has shrunk or if it has not developed normally, you may be able to have a bone graft to build up the bone. A bone graft is a way of adding new bone to your jawbone.

Your dental specialist will tell you if bone grafting can be done.

A misaligned jaw is the result of upper and lower teeth not meeting comfortably. Two of the most noticeable types of jaw misalignment are overbite, where the upper teeth protrude, and underbite, where the lower teeth sit in front of the upper teeth. 

Dentists call a mismatched bite, "malocclusion", and treatment may include oral surgery, orthodontic, or cosmetic work, depending on the severity of the malocclusion.

The inside of the mouth is normally lined with a special type of skin (mucosa) that is smooth and coral pink in colour. Any alteration in this appearance could be a warning sign of a pathological process. The most serious of these is oral cancer.

These changes can be detected on the lips, cheeks, palate, and gum tissue around the teeth, tongue, face, and/or neck. Pain does not always occur with pathology and is not often associated with oral cancer. However, any patient with facial and/or oral pain without an obvious cause or reason may also be at risk for oral cancer.

At Fraser Valley Dental Specialists, we provide examinations and preventative treatment in the event oral cancer is detected.  

Bone Grafting

Bone grafting is necessary to build up the jaw bone. If you’ve had one or several missing teeth for a long time, the bone located below these teeth can break down.

A breakdown in bone structure can be caused by the following:

• Infection
• Facial trauma
• Growth deformity
• Periodontal (gum) disease
• Untreated cavities

The jaw must have sufficient bone length and width to support dental implants. To regenerate bone and facilitate new growth, grafting is performed with bone tissue taken from your own body or a donor source.

Often, the tissue is taken from healthy areas of your jaw or chin. The bone is then placed or “grafted” onto the area of your jaw that needs regeneration. Over time, it will fuse with your existing bone and the cells will work together to create adequate tissue to support dental implants.

Gum Grafting 

Gum grafting is necessary to rebuild lost gum tissue. 

Gum (periodontal) disease can cause the gum line around your teeth to recede. Over time, your gums may recede enough to expose the roots of your teeth. This also exposes nerves, which can cause discomfort. Cold/hot foods and drinks, and even breathing cold air can be uncomfortable if your roots and nerves become exposed.

Exposed roots can also elongate the tooth, giving you an older, less aesthetically appealing appearance. Additionally, some people have naturally thin gum tissue, which increases the chances for gum breakdown over time.

Gum grafting works to help rebuild gum tissue around your teeth and make necessary activities, such as eating and drinking, more comfortable.

A sinus lift adds bone to your upper jaw in the area of your molars and premolars. The bone is added between your jaw and the maxillary sinuses, which are on either side of your nose. To help make room for the bone, the sinus membrane has to be moved upward or "lifted".

A sinus lift is recommended when there isn't enough bone height in the upper jaw, or the sinuses are too close to the jaw, for dental implants to be placed.

There are several reasons for this:

Many people who have lost teeth in their upper jaw (particularly back teeth) do not have enough bone for implants to be placed. Because of the anatomy of the skull, the back of the upper jaw has less bone than the lower jaw.

Bone may have been lost because of periodontal (gum) disease.

Tooth loss may have led to a loss of bone as well. Once teeth are gone, bone begins to be absorbed back into the body. If teeth have been missing for a long time, there often is not enough bone left to place implants.

The maxillary sinus may be too close to the upper jaw for implants to be placed. The shape and the size of this sinus vary from person to person. The sinus also can get larger as you age.

The preparation of your mouth before the placement of a prosthesis is referred to as pre-prosthetic surgery.

Some patients require minor oral surgical procedures  before receiving, for example, a partial or complete denture, in order to help maximize the level of comfort. A denture sits on the bone ridge, so it is very important that the bone is the proper shape and size.

If a tooth needs to be extracted, the underlying bone might be left sharp and uneven. For the best fit of a denture, the bone might need to be smoothed out or reshaped. Occasionally, excess bone would need to be removed prior to denture insertion.

Facial injuries resulting from lacerations, fractured teeth, fractured jaws, fractured facial bones, knocked-out teeth, and intraoral lacerations, require treatment to repair damage to the face and teeth. Depending on the exact location of the injury, respiration, speech, and swallowing can be greatly impaired.

Failure to treat dental and facial trauma can lead to the following long-term concerns:

• Loss of Functionality: When a tooth is damaged, it may become loose in its socket and make eating and speaking much more difficult.
• Appearance of Smile: Chipped, broken, or missing teeth can be detrimental to the aesthetic look of a smile. The dentist is able to help repair chips, fractures, and missing teeth.
• Bite/Jaw Irregularities: After trauma, it is possible that teeth may become badly aligned. The poor alignment of the teeth can lead to TMJ, uneven teeth wear, and other complications.

The temporomandibular joint is the joint that connects your jaw to your skull. When this joint is injured or damaged, it can lead to a localized pain disorder called temporomandibular joint (TMJ) syndrome. 

Causes of TMJ include injury to the teeth or jaw, misalignment of the teeth or jaw, teeth grinding, poor posture, stress, arthritis, and gum chewing.

You may have TMJ if you experience any of the following symptoms:

• An aching pain in or around your ear
• Aching facial pain
• Jaw tenderness or pain
• Difficulty chewing
• Hear a clicking sound when you chew or open your mouth
• Joint that locks when you open and close your mouth

After a thorough examination and, if needed, appropriate x-rays, the dentist will suggest an appropriate treatment plan to relieve TMJ symptoms.