Keith Sherwood, D.D.S

Diplomate, American Board of Oral and Maxillofacial Surgeons
Fellow, American Board of Oral and Maxillofacial Surgeons
Associate Professor, Boston University

Procedure Definitions

 

 

Definitions for various procedures

What Are Dental Implants?

Dental implants are replacement tooth roots. Implants provide a strong foundation for fixed (permanent) or removable replacement teeth that are made to match your natural teeth.

What Are the Advantages of Dental Implants?

There are many advantages to dental implants, including:

  • Improved appearance. Dental implants look and feel like your own teeth. And because they are designed to fuse with bone, they become permanent.
  • Improved speech. With poor-fitting dentures, the teeth can slip within the mouth causing you to mumble or slur your words. Dental implants allow you to speak without the worry that teeth might slip.
  • Improved comfort. Because they become part of you, implants eliminate the discomfort of removable dentures.
  • Easier eating. Sliding dentures can make chewing difficult. Dental implants function like your own teeth, allowing you to eat your favorite foods with confidence and without pain.
  • Improved self-esteem. Dental implants can give you back your smile and help you feel better about yourself.
  • Improved oral health. Dental implants don’t require reducing other teeth, as a tooth-supported bridge does. Because nearby teeth are not altered to support the implant, more of your own teeth are left intact, improving long-term oral health. Individual implants also allow easier access between teeth, improving oral hygiene.
  • Implants are very durable and will last many years. With good care, many implants last a lifetime.
  • Removable dentures are just that; removable. Dental implants eliminate the embarrassing inconvenience of removing dentures, as well as the need for messy adhesives to keep them in place.

How Successful Are Dental Implants?

Success rates of dental implants vary, depending on where in the jaw the implants are placed but, in general, dental implants have a success rate of up to 98%. With proper care, implants can last a lifetime.

Wisdom Teeth

The third molars, known simply as your wisdom teeth, are the last permanent teeth to erupt into your mouth sometime between the ages of 17 and 21 years old. It is thought that the third molars were given the name “wisdom teeth” because they erupt at a time when a child becomes wiser — as they enter adulthood.

The average person will develop four wisdom teeth, but that’s not always the case for others. Many people develop supernumerary (extra) wisdom teeth or, if you’re lucky, others fail to develop some or all of their wisdom teeth altogether.

The average mouth will only comfortably hold 28 of the 32 teeth we are predisposed to have. Since the wisdom teeth are the last teeth to erupt, there is often little room left to accommodate their size and anatomy, which often causes the wisdom teeth to either:

  • Become impacted under the gum tissue and bone
  • Partially erupt into the mouth, resulting in only part of the tooth exposed above the gumline
  • Fully erupt into the mouth in an undesirable position — usually tilting forward, pushing on the tooth in front of it.

It is quite possible that each one of your wisdom teeth will erupt differently from one another, for example you could have only one impacted wisdom tooth, and the rest could fully erupt.

Extractions

A dental extraction (also referred to as tooth extraction, exodontia, exodontics, or historically, tooth pulling) is the removal of teeth from the dental alveolus (socket) in the alveolar bone. Extractions are performed for a wide variety of reasons, but most commonly to remove teeth which have become unrestorable through tooth decay, periodontal disease or dental trauma; especially when they are associated with toothache. Sometimes wisdom teeth are impacted (stuck and unable to grow normally into the mouth) and may cause recurrent infections of the gum (pericoronitis). In orthodontics if the teeth are crowded, sound teeth may be extracted (often bicuspids) to create space so the rest of the teeth can be straightened.

Tooth extraction is usually relatively straightforward, and the vast majority can be usually performed quickly while the individual is awake by using local anesthetic injections to eliminate painful sensations. Local anesthetic blocks pain, but mechanical forces are still vaguely felt. Some teeth are more difficult to remove for several reasons, especially related to the tooth’s position, the shape of the tooth roots and the integrity of the tooth. Dental phobia is an issue for some individuals, and tooth extraction tends to be feared more than other dental treatments like fillings. If a tooth is buried in the bone, a surgical or trans alveolar approach may be required, which involves cutting the gum away and removal of the bone which is holding the tooth in with a surgical drill. After the tooth is removed, stitches are used to replace the gum into the normal position.

Corrective jaw surgery

Corrective jaw, or 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 their surgery, orthognathic surgery is performed to correct functional problems.

Jaw Surgery can have a dramatic effect on many aspects of life

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 headache
  • 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 corrective jaw, or orthognathic, surgery. The OMS 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 that this is a long-term commitment for you and your family, and will try to realistically estimate the time required for your treatment.

extractions

surgery

wisdom

implants

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