Oral Surgery

ORAL SURGERY

At Sachem Dental Group we have 4 different oral surgeons on staff. Most of our Oral Surgery is done in our Broadway Ave. office in Holbrook, but we also have an oral surgeon in our Selden Office. Conscious sedation is available to make your oral surgery experience even more comfortable and less stressful.

Top Procedures:

Routine Dental Extractions & Wisdom Teeth Removal:

Wisdom teeth usually erupt in one’s late teens. They generally appear as the last teeth behind the upper and lower second molars. Frequentally, there is limited “room” in the jaw to accommodate the 3rd molars or “wisdom” teeth and they can become a problem. Bacteria can accumulate in the tissue surrounding these teeth and cause infection and swelling. This can also be further complicated by the angle with which these teeth erupt.

Frequently, the best solution for Wisdom teeth or 3rd molars that are causing problems is removal by an oral surgeon.

Apicoectomy:

Generally, a root canal is all that is needed to save teeth with an injured Pulp. However, occasionally this non surgical procedure will not be Sufficient to heal the tooth and your endodontist will recommend surgery. Endodontic surgery can be used to locate fractures or hidden canals that do Appear on x-rays but still manifest pain in the tooth. Damaged root Surfaces or the surrounding bone may also be treated with this procedure. The most common procedure used to save damaged teeth is called an Apicoectomy or Root-end resection.

What is an Apicoectomy?

An incision is made in the gum tissue to expose The bone and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. A root-end filling is placed to prevent reinfection of the root and the gum is sutured. The bone naturally heals around the tooth over a period of months restoring full function.

Following the procedure, there may be some discomfort or slight swelling while the incision heals. This is normal for any surgical procedure. To alleviate any discomfort an appropriate pain medication will be recommended.

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. The most serious of these is oral cancer. The following can be signs at the beginning of a pathologic process or cancerous growth.

-reddish patches or whitish patches in the mouth
-a sore throat that fails to heal & bleeds easily
-a lump of thickening on the skin lining the inside of the mouth
-chronic sore throat or horseness
-difficulty in chewing or swallowing

We would recommend performing an oral cancer self-examination monthly and recommend that your mouth is one of your body’s most important warning symptom. DO NOT IGNORE suspicious lumps or sores. Please contact so we may help.

Bone Grafting:

Over a period of time, the jawbone associated with missing teeth atrophies or is resorbed. This often leaves a condition in which there is poor quality & quantity of bone suitable for placement of dental implants. Today we have the ability to grow bone where it is needed. This not only gives us the abililty to place implants of proper length and width but also gives us a chance to restore functionality and esthetic appearance.

Sinus Lift Procedure:

The maxillary dental sinuses are hollow spaces above the upper teeth. When upper teeth are removed, there is often just a thin wall of bone separating the maxillary sinus and the mouth. There is not enough bone to hold dental, implants in place.
A sinus graft or sinus lift is a procedure during which the oral surgeon enters The sinuses from where the teeth used to be. The sinus membrane is then Lifted up and donor bone is inserted into the floor of the sinuses. After Several months of healing, the bone becomes part of the patients jaw and Dental implants can be inserted and stabilized in this new sinus bone. The sinus graft makes it possible for many patients to have dental implants When years ago there was not other option other than wearing loose dentures.

Dental Implants:

A patients tooth or teeth can be lost by several causes, injury, periodontal disease or tooth decay. We now have the ability to permanently replace missing teeth via the placement of dental implants. Essentially a dental implant is a man-made tooth root. The implants resemble the natural form of a tooth root and a conventional crown or fixed denture can be placed on top of them.

Aftercare For Existing Patients

Oral Surgery

Bleeding: Is to be expected following extractions and other surgical procedures. This can last anywhere from 1-6 hours. If excessive bleeding occurs (Do as follows)

Wipe off excessively large blood clots with sterile gauze.
Bite firmly on gauze and maintain gentle pressure for 1 hour.
Place folded gauze over the bleeding area.

If bleeding has not subsided, use fresh gauze or tea bags for an additional hour. Repeat as needed every hour.

Contact this office if excessive bleeding persists beyond six hours.

Pain: Some discomfort is normal following surgery. 2 Aspirin or Tylenol every 3 hours usually relieves minor discomfort. If pain medication is prescribed take as directed. Don’t drive, operate machinery or drink alcoholic beverages (For at least six hours after taking medication). If you have any reaction to the medication, stop the medication and call the office. Dizziness and sedation is normal with narcotic pain medication.

Antibiotics: If antibiotics are prescribed, take as directed. Be sure to take all tablets prescribed. If any reactions occur such as a rash or itching, discontinue and call the office immediately. (Today)

Swelling: Following surgery some swelling is expected. It will reach its peak on the second day following the surgery. To minimize swelling start applying ice packs to your face for 20 minutes intervals. Remove for 10 minutes and then repeat. Continue ice packs for 4-8 hours after surgery. (Today and Tomorrow)

Rinsing, Spitting, Brushing: Do not rinse, spit, brush or use mouthwash today. Tomorrow use a warm, saltwater solution 4-5 times a day for 1 week. In the morning, after meals and before bed.

Temperature: Following surgery it is quite common to have a slight elevation in temperature. Rest and take Aspirin, Tylenol or Advil and drink plenty of fluids to help return temperature to normal. If you are taking pain medication, they will also aid in controlling fever and additional medication for fever will not necessary.

Eating: A well balanced diet is important for proper healing. A soft bland diet is suggested for the first few days. Drink plenty of fluids as soon as possible. Avoid hot foods and hot liquids (As they will promote bleeding). No sipping through straws and avoid smoking for 24 hours. A soft non-chewing diet is especially recommended following removal of impacted teeth.

Impacted Teeth: The removal of impacted teeth is quite different from the extraction of erupted teeth. The following conditions may occur. All of which are considered “Normal”

Swelling and bruising can be expected. Minimize by using ice packs the day of surgery.

Moderate to severe pain can be expected. Don’t wait until pain is severe to take medication. Have the prescription filled and take the first dose at once.

Trismus (tightening) of the muscles may cause difficulty in opening the mouth. Moist heat applied to the area may help.
A sore throat may lop. This is normal.

The corners of your mouth may dry and crack. Keep moist with ointment or petroleum jelly.
If sudden increase in swelling or fever occurs after the fourth day, Please call the office and arrange to be seen.

Root Canal Therapy

You may experience moderate pain and sensitivity to pressure when biting immediately after Root Canal Therapy. The healing process takes some time but the discomfort should subside within a few days.
Take all prescribed medication as directed.

Take pain medication as soon as possible, before the local anesthetic begins to wear off. This allows for more effective pain control.

Continue with normal oral hygiene procedures involving brushing and flossing.

When possible, try to chew on the opposite side of you mouth until the permanent restoration is placed. Until this time you tooth is susceptible to fracture.

Call the office immediately if you are experiencing pain, swelling, the temporary material is dislodged, or if you have any questions at all.

Denture Delivery

You will experience some discomfort with any new denture initially. Dentures may need several adjustments to fit comfortably.

Take the dentures out every night and soak them in a container containing water or denture cleaning solution.
Clean dentures thoroughly before putting them back in you mouth.

You may notice that you speech sounds different with the new denture for a few days. Read a book or newspaper out loud everyday. Your tongue and muscles will get used to the new denture and your speech will improve rapidly.
Call our office if you are experiencing pain, discomfort, or if you have any questions.

Scaling and Root Planning (Deep Cleaning)
Do not eat until the anesthesia wears off.
Your gums and teeth may be sensitive for 2-3 days.
You should perform normal brushing and flossing.
Avoid very hot or cold foods and liquids until sensitivity subsides.

If the sensitivity continues take over the counter pain medications such as Motrin or Tylenol, and use toothpastes for sensitive teeth.

If you have other symptoms or questions please call the office.

Fillings

Do not eat anything for at least 1 hour or until numbness has worn off.
Sensitivity to temperature and some slight discomfort is normal for 5-7 days.
If your bite does not feel normal, please call the office. Your new filling may need adjustment.
You should brush and floss normally.

If you have any questions or concerns please call the office.

Crowns and Bridges

You may feel slight temperature and pressure sensitivity when your temporary restoration is first placed. This should subside after placement of the permanent crown.

If you have a temporary in place be careful not to displace it. If a temporary comes off, it should be replaced within 24 hours. Failure to replace a temporary can damage the tooth or allow other teeth to shift.
Do not use anything other than an over the counter denture adhesive cream to replace a temporary until you can return to the office.

Your bite may feel different for 2-3 days. If you symptoms do not subside, please call the office.

Maintain regular preventative care including brushing and flossing. It is very important to keep the new restoration healthy.

Call the office if you are in pain or if you have any questions.