Oral Surgery Services

+ General Anesthesia

There are several ways we prepare you for your procedure. We will discuss each option during your initial consultation so you are aware of your options and condition following surgery. Oral and maxillofacial surgeons (OMSs) are trained in all aspects of anesthesia administration. Following dental school, they complete at least four years of training in a hospital-based surgical residency program alongside medical residents in general surgery, anesthesia and other specialties. During this time, OMS residents serve on the medical anesthesiology service, where they evaluate patients for anesthesia, deliver the anesthetic and monitor post-anesthetic patients.

As a result of their extensive training, every OMS is well-prepared to appropriately administer local anesthesia, all forms of sedation and general anesthesia. They are experienced in airway management, endotracheal intubation, establishing and maintaining intravenous lines, and managing complications and emergencies that may arise during the administration of anesthesia.

Before your surgery, your OMS will review the type of anesthetic to be used, as well as the way you're likely to feel during and after the operation. This is the time to discuss any concerns you may have about any facet of the operation. Usually, patients describe their feelings during surgery as comfortable and surprisingly pleasant. After surgery, you may be prescribed a medication to make you as comfortable as possible when you get home.

+ Wisdom Teeth

Wisdom teeth are the last teeth to erupt within the mouth. When they align properly and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen. The extraction of wisdom teeth is necessary when they are prevented from properly erupting within the mouth. Read more here.

+ Dental Implants

Dental implants are changing the way people live. They are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything, knowing that teeth appear natural and that facial contours will be preserved. Patients with dental implants can smile with confidence. Read more here.

+ Bone Grafting

In areas of the jaw where teeth are missing or there has been gum disease or injury, many individuals will see significant bone loss and the jaw bone is reabsorbed. This often results in a condition where there is not the quality and quantity of bone required to place dental implants. Bone grafting provides the ability to grow bone where it is needed for successful implant placement. It also allows an OMS to restore functionality and aesthetics of the jaw.

In a bone graft, the bone is either obtained from a tissue bank or your own bone is taken from the jaw, hip or tibia (below the knee).

Sinus bone grafting may also be performed to replace bone in the posterior upper jaw. In addition to the grafting, specialized membranes may be utilized to protect the bone graft and encourage bone regeneration. These membranes dissolve independently. This technique is called bone regeneration or guided tissue regeneration.

+ Facial Trauma and Reconstruction

Oral and Maxillofacial Surgeons (OMSs) are experts in treating and repairing facial injury and trauma, including fractures of the upper and lower jaws and the orbits surrounding the eyes, and facial lacerations. Their knowledge of how jaws come together (dental occlusion) is critical when repairing complex facial fractures.

There are a number of possible causes of facial trauma such as motor vehicle accidents, accidental falls, sports injuries, interpersonal violence, and work-related injuries. These injuries can range from injuries of teeth to extremely severe injuries of the skin and bones of the face.

The American College of Surgeons' guidelines for optimal care in Level I and II trauma centers, the centers that treat the most serious and complex facial trauma patients, recommend that an oral and maxillofacial surgeon be included as a member of the centers' trauma team.

Many of the techniques that are standard in today's hospital emergency rooms were developed by OMSs in combat hospitals during World War II, Korea, Vietnam and today's international conflicts.

If you or a loved one suffer a facial or mouth injury that requires a trip to the emergency room, be sure to ask that an OMS is called for consultation. With their background and training, OMSs are the specialists most qualified to deal with these types of injuries. In some cases, they may detect a “hidden” injury that might otherwise go unnoticed.

+ Orthognathic (Jaw) Surgery

Corrective jaw surgery – also called orthognathic surgery – is performed by an oral and maxillofacial surgeon (OMS) to correct a wide range of minor and major skeletal and dental irregularities, including the misalignment of jaws and teeth. Surgery can improve chewing, speaking and breathing. While the patient's appearance may be dramatically enhanced as a result of the surgery, orthognathic surgery is performed to correct functional problems.

Following are some of the conditions that may indicate the need for corrective jaw surgery:

  • Difficulty chewing or biting food
  • Difficulty swallowing
  • Chronic jaw or jaw joint (TMJ) pain and headaches
  • Excessive wear of the teeth
  • Open bite (space between the upper and lower teeth when the mouth is closed)
  • Unbalanced facial appearance from the front or side
  • Facial injury
  • Birth defects
  • Receding lower jaw and chin
  • Protruding jaw
  • Inability to make the lips meet without straining
  • Chronic mouth breathing
  • Sleep apnea (breathing problems when sleeping, including snoring)

Your dentist, orthodontist and OMS will work together to determine whether you are a candidate for orthognathic surgery. The oral and maxillofacial surgeon determines which corrective jaw surgical procedure is appropriate and performs the actual surgery. It is important to understand that your treatment, which will probably include orthodontics before and after surgery, may take several years to complete. Your OMS and orthodontist understand this is a long-term commitment for you and your family, and they will try to realistically estimate the time required for your treatment.

+ Pre-Prosthetic Surgery

The preparation of your mouth before the placement of a prosthesis such as a partial or complete denture is referred to as pre-prosthetic surgery. This type of surgical procedure can ensure the maximum 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.

One or more of the following procedures might need to be performed in order to prepare your mouth for a denture:

  • Bone smoothing and reshaping
  • Removal of excess bone
  • Bone ridge reduction
  • Removal of excess gum tissue
  • Exposure of impacted teeth

We will review your particular needs with you during your appointment.

+ Oral Pathology

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

Your oral and maxillofacial surgeon (OMS) is the expert for diagnosing and surgically treating cancer of the head, neck and mouth.

The Oral Cancer Foundation estimates that close to 42,000 Americans will be diagnosed with oral or pharyngeal cancer this year. Oral cancer’s mortality is particularly high, not because it is hard to detect or diagnose, but because the cancer is often discovered late in its development. Your dentist or OMS is in the best position to detect oral cancer during your routine dental examinations.

Please contact us if you notice any of the following:

  • White patches of the oral tissues — leukoplakia
  • Red patches — erythroplakia
  • Red and white patches — erythroleukoplakia
  • A sore that fails to heal and bleeds easily
  • An abnormal lump or thickening of the tissues of the mouth
  • Chronic sore throat or hoarseness
  • Difficulty in chewing or swallowing
  • A mass or lump in the neck

Your mouth is one of your body's most important early warning systems. Don't ignore any suspicious lumps or sores. Should you discover something, make an appointment for a prompt examination. Early treatment may well be the key to complete recovery.

+ TMJ Disorders

TMJ stands for temporomandibular joint, which is the name for each joint (right and left) that connects your jaw to your skull. It permits the lower jaw to move and function and is the most constantly used joint in the body. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.

Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals with a TMJ disorder may experience a variety of symptoms, such as earaches, headaches and limited ability to open their mouth.

When symptoms of TMJ trouble appear, consult an oral and maxillofacial surgeon (OMS). A specialist in the areas of the mouth, teeth and jaws, your OMS will be able to correctly diagnose the problem. Diagnosing TMJ disorders can be complex and may require different diagnostic procedures. Special imaging studies of the joints may be ordered and appropriate referral to other dental or medical specialists or a physical therapist may be made.

Treatment may range from conservative dental and medical care to complex surgery. Depending on the diagnosis, treatment may include short-term non-steroidal anti-inflammatory drugs for pain and muscle relaxation, bite plate or splint therapy, and even stress management counseling. If non-surgical treatment is unsuccessful or if there is clear joint damage, surgery may be indicated. Surgery can involve either arthroscopy (the method identical to the orthopaedic procedures used to inspect and treat larger joints such as the knee) or repair of damaged tissue by a direct surgical approach.

Once TMJ disorders are correctly diagnosed, your OMS can provide appropriate treatment to relieve the problem.

+ Cone Beam CT

Dr. Salamen utilizes a state-of-the-art cone-beam CT (computed tomography) technology that provides highly accurate 3-D radiographic images for the diagnosis, planning and treatment of oral surgery problems. Many of our dental implant patients have this imaging completed so that their implants are the exact size needed for their teeth for more beautiful results.

The 3-D Cone Beam Scan is like getting an X-ray. There is no pain associated with this imaging and it is quick. An imaging team member will produce the comprehensive imagery of your skull, jawbone, neck, and teeth in 20 – 40 seconds. The machinery has the capability to take images of your features with you sitting in a chair or laying down in a prone position as it takes a 360° image. Dr. Salamen will then review the images, and discuss with you how to proceed with treatment.

For more information, please visit the website of AAOMS (American Association of Oral and Maxillofacial Surgeons) at myoms.org.