When oral surgery is required, the patient is dealing with a situation that is critical to their dental health. In the case of treatment for oral cancer, the skills of our dentists can be vital for maintaining your life! The comprehensive Sacramento dental office of the Sacramento Dentistry Group is prepared to deal with your oral and maxillofacial surgery needs with the utmost concern for your comfort, safety and convenience. Use this section of our website to review some of the procedures available through our comfortable, advanced and calming downtown office.
Temporomandibular Joint (TMJ) Disorders
The temporomandibular joints (TMJ) are located where your lower jaw meets your skull. On either side of your jaw, these joints are responsible for allowing movement up, down, forward, back and side-to-side. They deal with tremendous forces when you chew and are used many times every day. As a result, TMJ disorders are common. Tens of millions of Americans suffer from pain caused by TMJ problems. The dentists at the Sacramento Dentistry Group are prepared to help you solve the discomfort caused by TMJ.
Symptoms of TMJ Disorders
Jaw locking when open or closed,
Popping or clicking noises from the jaw,
Pain in either or both joints,
Inability to open the mouth without pain.
In addition to these symptoms, there are other considerations before diagnosing a patient with TMJ Syndrome. Your Sacramento dentists make a complete and comprehensive examination to rule out other causes of your symptoms before progressing with TMJ specific treatments.
Causes and Treatment of TMJ
TMJ is caused by various factors. Arthritis, stress, gum disease, tooth decay — all of these could be causing or mimicking TMJ disorders. Likewise, for every series of causes, there are multiple possible treatments. Our dentists guide you through the many treatment options — from simple to surgical.
Don’t live with the pain of TMJ pain! Solutions can be found with the Sacramento Dentistry Group!
Wisdom Teeth Extraction
Wisdom teeth are the last teeth to emerge, or erupt, from the jaw. They are your third set of molars and, if healthy, should be left alone. In many of our Sacramento dentistry patients, however, there are problems with the wisdom teeth. The wisdom teeth need to be removed (extracted) if the conditions are unhealthy.
When a wisdom tooth is impacted, it is very difficult to clean since the tooth does not erupt (dental-speak for “grow out of the jaw”) properly. This can lead to decay on the wisdom tooth and the tooth next to it. If left untreated, this decay will lead to further issues by causing the bone to dissolve thereby weakening the jaw. If these issues are allowed to develop, it will be considerably more expense to fix the problem. In contrast, removing the wisdom teeth at the first sign of trouble is the least expensive and safest course of action.
Wisdom teeth are best removed if any of the following conditions are present:
Impacted wisdom teeth damaging nearby second molars
Crowding resulting in twisted or misaligned teeth
Cysts forming due to impaction, causing bone loss or infection.
Periodontal disease caused by wisdom teeth impaction.
Procedures necessary for extraction depend upon the patient and the circumstances. Our Sacramento dentists will assess the health of your wisdom teeth during your regular dental visits and advise you accordingly. Panoramic x-rays, revealing the entire mouth at once, are used in diagnosing wisdom teeth problems and providing recommendations for treatment.
With local anesthesia and sedation, removal of the wisdom teeth takes about one hour. Some patients delay the procedure because their jaw “doesn’t hurt right now.” Your dentist, however, can help prevent greater damage, and expense, that will likely come if impacted wisdom teeth are left in place. Also, the younger the patient, the faster the bone and gums heal from the procedure. So be wise and do not procrastinate when it comes to medically advised wisdom tooth extraction!
Onlay Grafts for Dental Implants
Jaws without teeth tend to deteriorate. Bones subject to periodontal disease can do the same. The result is a jawbone ridge without sufficient mass to support dental implants. In these situations, the best type of graft is an onlay graft, with material taken from the patient’s own body.
We choose from three sites for onlay graft material: your chin, ramus (the back of the jaw) or hipbones. A fairly simple procedure takes small amounts of bone from these areas and transfers it to your jaw, usually to be temporarily held in place with bone screws. After the graft has healed and fused with your jaw, implants can be installed.
While the procedure sounds complicated, the benefits of implants cannot be overstated. Repairing bone loss with grafting and placing implants in the resulting bone tissue improves your appearance, your speech and your ability to eat and do all the things you used to do with a full set of teeth. Patients almost universally agree that the final result is worth the time and effort.
The Sacramento Dentistry Group does its best to provide you with a relatively pain-free, comfortable experience during all of our dental procedures, including bone grafts. If a bone graft is necessary, but sounds intimidating, why not consider the benefits of sleep dentistry in connection with this procedure? The dentists of the Sacramento Dentistry Group do their utmost to answer your questions, handle your concerns and give you the best appearance and dental health possible.
Sleep apnea and related sleep disorders are a major cause of health problems for millions of Americans. The Journal of the California Dental Association reports, “90 million Americans who have sleep problems are undiagnosed.” Such disorders can lead to high blood pressure (hypertension) and associated heart disorders, making it a potential killer. The Sacramento Dentistry Group may be able to assist you with your sleep apnea problem.
Obstructive sleep apnea occurs when abnormalities in the shape of the air passages cause the soft tissues and tongue to block the breathing airways. This prevents your body from getting necessary oxygen. As a result, your brain sends your body signals to “wake up” and open the blocked air passage throughout your sleeping periods. Since they’re unconscious, most patients do not even realize this is happening.
Mild cases might involve apnea episodes every four minutes on average, while severe cases can cause apneas during every minute of “sleep.” Physiological problems, sleeping on the back, obesity and alcohol or tranquilizer consumption have all been connected to sleep apnea.
Symptoms of sleep apnea include:
Drowsiness during the daytime,
The sensation that you never get a good night’s sleep,
Snoring or choking while sleeping,
Lack of REM sleep or dreaming.
Testing for sleep apnea involves your medical doctor. With the help of our dentists, you can receive a referral for sleep testing to determine if you are having apnea episodes — periods when you stop sleeping. This may be done at home or at a sleep center. If testing determines you have a sleeping disorder, further examination may determine that a simple dental appliance can help prevent apneas. Serious cases may be solved with oral surgery on the jaw, changing the orientation of the tongue.
Dental Therapy for Sleep Apnea
While many patients may be familiar with Continuous Positive Airway Pressure, a treatment that forces air through the nasal passages during sleep, reports show that sixty percent of sleep apnea sufferers stop using this treatment after one year. This dangerous decision imperils their long-term health. Nevertheless, dental science has developed convenient appliances that restore free breathing without requiring attachment to machines at night. Internal Medicine News states that such oral appliances are more effective than surgery or over-the-counter-products for solving sleep apnea.
When appropriate, a dental device is specifically designed for your mouth. Only used during sleep, it alters the shape of the oral cavity to prevent the tongue from falling back into the airway. Mark Friedman, DDS and professor of Clinical Dentistry at the University of Southern California states: “For some people, it changes their life instantly. They wake up feeling good and can spend the day not having to sleep. Their spouse will sleep with them again. Their blood pressure goes down and it probably increases their longevity. Dentists have this whole new realm of people to treat.”
Visiting the Sacramento Dentistry Group for solutions to your sleep disorder may be the first step to a good night’s sleep, improved health, better relationships and a sound body. Let our dentists help you with the latest improvements in oral science for sleep apnea.
Oral Appliance Therapy
The Sacramento Dentistry Group uses the DNA appliance® system for many patients suffering from sleep apnea. As reported in The Journal of Craniomandibular & Sleep Practice, DNA appliances® can successfully resolve sleep apnea symptoms. DNA appliances® represent a new therapy that combines the comfort of a mouthguard with the mechanics of orthodontic treatment. While older oral appliances for sleep apnea have been associated with TMJ disorders, the DNA appliance® is designed to avoid this complication.
How the DNA Appliance® Works
After taking impressions of your teeth, a thorough set of dental x-rays and pictures of your mouth, a specialized dental lab combines these images to construct your personal oral appliance. The appliance features a series of springs and clasps, anchored in a comfortable acrylic mold, that fits perfectly to your teeth. The gentle pressure exerted by the mechanism gradually opens your airway to prevent the blockages characteristic of sleep apnea. Generally worn only later in the day and/or at night, the appliance painlessly accomplishes what other doctors only attempt with oral surgery.
How Can I Start Oral Appliance Therapy for Sleep Apnea?
To use the DNA appliance® system for sleep apnea, a consultation with one of our Sacramento dentists is necessary. We must first determine if you suffer from sleep apnea, the nature of your sleep disorder, and its likely cause. If a consultation, examination and sleep testing determine that oral appliance therapy is right for you, the Sacramento Dentistry Group will fit you for the appropriate DNA appliance®. Call our office at (916) 538-6900, contact us through the link below or visit us at 1105 E Street in downtown Sacramento for a sleep apnea consultation.
Most patients are familiar with the problem of impacted wisdom teeth, a situation common to most young people. Wisdom teeth, however, are lodged at the very back of the jaw and seldom seen, so they are little missed when removed or if they fail to erupt. This is not so with canines. The canines, located in the front of the jaw, are essential teeth and impacted canines are best treated as soon as possible.
The canines are also known as cuspids or “eye teeth,” since they align visually with the eyes. In animals, they form the fangs. You have two canines in both your upper and lower jaw. Since they deal with strong tearing forces while chewing, they have the longest roots of all teeth. The canines are essential to your bite and dental health for the following reasons:
The Bite – due to their length, the canines guide your other teeth together when chewing and biting. Canines are essential for maintaining a proper bite.
Appearance – without canines, large gaps appear in your smile. This can lead to other front teeth becoming twisted or misaligned.
Why do Canines Become Impacted?
Since they are amongst the last teeth to erupt, the healthy progress of your other permanent teeth is vital to the development of the canines. Canines fail to erupt for many reasons. The most common are:
Overcrowding – extra teeth or a small jaw can cause the space where your canines are supposed to erupt to be too small. The result is impaction.
Abnormal growths – tissue develops in the jaw that prevents the canine from reaching the surface of the gum.
Both of these problems highlight the need for regular dental visits when young teeth are developing. X-rays and examinations can identify the problem of impacted canines early, when treatment is easier.
Treatment of Impacted Canines
Every situation is different, so treatment for impacted canines varies. Typically, any abnormal extra teeth are removed and the hidden canine is exposed by oral surgery. Local anesthetic and post-operative pain medication are usually sufficient to keep the patient comfortable. If you have particular anxieties or concerns about the procedure, sleep dentistry is also an option. Orthodontics are often needed to bring the canine into its proper place over time.
The end result of an impacted canine procedure — and important tooth in place where it belongs and the healthy smile you were meant to have!
Oral diseases include problems with the tongue, jaw and cheeks in addition to the teeth. Typical difficulties include oral cancer, cysts and various forms of infection. Your regular dental visit includes an examination for such pathological problems by your Sacramento dental professionals.
Infections by bacteria — which may cause rashes, hairy tongue and halitosis — are treated with antibiotics and prescription strength mouthwashes. Other problems can include syndromes such as xerostomia, the absence of saliva, or “dry mouth.” Left untreated, xerostomia can lead to serious periodontal disorders, since saliva is essential to maintaining the enamel of your teeth. The offices of the Sacramento Dentistry Group deal with all such diseases discreetly and efficiently.
Oral Surgery Post-operative Care
Proper care and attention after your oral surgery ensures a successful procedure and a speedy recovery. While you may not experience all of the following, preparation and knowledge are key to a good post-operative experience.
The gauze pad that was placed in your mouth after surgery acts as a protective dressing. It should be left in place for 2 hours while applying gentle pressure. Some oozing is to be expected, so covering your pillow with a towel is suggested. If the seeping or oozing becomes excessive, apply firm pressure with a clean gauze pad for one hour directly over the site of surgery. Uncontrolled bleeding is a matter that should be brought to our attention, so do not hesitate to call our Sacramento dental office at 916-538-6900 if you are concerned.
When your numbness wears off, some pain is to be expected. Fill your pain control prescription at your local pharmacy and use as directed. It is recommended to start your pain pills 1-2 hours after your oral surgery and continue as needed. If you experience nausea from the medication, taking it with a 7-Up® or ginger ale may help. Grinding up the pill and taking it with food may also help with nausea. Over-the-counter medication may also be advised, usually 800 mg of ibuprofen (for adults) to reduce pain and inflammation. Ibuprofen is recommended every 6 hours for up to a week after surgery. Remember that it is easier to maintain pain control when it’s kept under control, so keep to your advised schedule of pain management.
If you experience nausea after oral surgery, it is likely due to pain medications such as hydrocodone, oxycodone, and codeine. Nausea is not typical of ibuprofen. Remember to take your prescription pain medication with some food in your stomach if possible. Drinking 7-Up®, ginger ale or some baking soda in water can help alleviate nausea. Mild tea, broth and soft foods are the first foods to try as you reintroduce meals into your diet.
Expect swelling and stiffness following your oral surgery. These are normal and should not alarm you. The worst swelling occurs over the first two days, and then it subsides. Treat any swelling with a combination of ice and heat as follows:
Apply an ice pack on your cheeks for the first 12-24 hours. Remove and reapply in 20 minute intervals.
Use moist heat on your cheeks and jaw on the 2nd and 3rd day to relieve stiffness.
Moderate gum chewing and gentle stretching exercises starting the day after surgery relieves stiffness.
Your hydration and nourishment needs should not be neglected.
On the day of surgery, a light liquid diet is recommended (breakfast drinks, Jello®, smoothies, soups, milk shakes, broth, etc.).
Do not use a straw because the muscles required may disturb the healing process.
On the following day, try a variety of soft foods and then continue to slowly work up to your normal diet.
Avoid chewy, sticky or very hard to chew foods while your mouth is healing.
Remember that jaw movement is good to keep the swelling and stiffness down, so an entire week of ice cream (as good as that sounds) is not doctor’s orders.
Starting on the day after your oral surgery, gently rinse your mouth with warm salt water. Do not perform any aggressive rinsing or tooth brushing on the first day or so. If you have been provided a syringe (Monojet®), use it to flush food and debris from your healing tooth socket. When you resume brushing, avoid your surgery site for two days. Be careful and gentle, but remember that good oral hygiene is important for proper healing.
After surgery, lie quietly with your head elevated the remainder of the day and continue resting for the first 24 hours.
Don’t expect to return to work or normal activities immediately — two to three days of rest is advised.
Smoking should be discontinued for at least 7 days. It does not promote healing and the sucking action can compromise the surgical area.
Do not use a straw to eat or drink! The motions required prevent proper healing in your mouth.
Vigorous physical activities and sports should not be resumed until your surgical areas are comfortable, the swelling is down and a normal diet is possible.
Contact sports should not be resumed for approximately 1 week post-operatively.
Musical wind instruments should not be played for at least 1 week to 10 days after most oral surgeries.
Do not be alarmed if you have bruising on your face after oral surgery. Some discoloration, often quite noticeable, is to be expected for a week after oral surgery.
If you had a tooth removed near a nerve during oral surgery, numbness may result in that area of your jaw. Do not be alarmed if you experience numbness or tingling, as this consequence is rarely permanent.
Taste and Odor
Because your dental hygiene should be limited and gentle in the days following your surgery, you may experience a bad taste or odor in your mouth. Using hydrogen peroxide to rinse and resuming your normal routine of brushing and flossing will soon get rid of this unpleasant after effect of oral surgery.
Uncommon Oral Surgery Problems
While oral surgery won’t ever make your Top Ten Fun Things in Life list, it most likely won’t be the worst thing you ever experience either. Extreme pain, excessive swelling, pain in your ear, difficulty swallowing or opening your mouth, developing a very painful dry socket – these are all rare occurrences, but should be reported to us so you can be evaluated. Most likely your milder symptoms will go away with good home care, but please do not hesitate to call us at 916-538-6900 with your concerns or worries.
If you experience difficulty in breathing, develop a sudden high fever, have excessive bleeding that cannot be stopped or any other disturbing problems following your surgery, you should call our office immediately (916-538-6900) or go to your nearest emergency room. The Sacramento Dentistry Group has a 24-hour answering service after hours that can reach your dentist.
Remember Your Follow-up Visit
A follow-up visit to check on your progress should be kept, even if you think there are no problems. Your Sacramento dentist is here to assess your healing process and keep you on track for improved dental health in your future. When your oral surgery is over and done with, you can celebrate by buying yourself a fancy new toothbrush, some good tasting toothpaste, a new packet of floss and a bottle of minty fresh mouthwash. And if you really want and need a pat on the back, our staff provides those too.