In My Book: Health
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BracesIn cases where the eyeteeth will not erupt spontaneously, the orthodontist and oral surgeon work together to get these unerupted eyeteeth to erupt. Each case must be evaluated on an individual basis but treatment will usually involve a combined effort between the orthodontist and the oral surgeon. The most common scenario will call for the orthodontist to place braces on the teeth (at least the upper arch). A space will be opened to provide room for the impacted tooth to be moved into its proper position in the dental arch. If the baby eyetooth has not fallen out already, it is usually left in place until the space for the adult eyetooth is ready. Once the space is ready, the orthodontist will refer the patient to the oral surgeon to have the impacted eyetooth exposed and bracketed.
OrthodonticsWith a Kodak 9300 CT machine, our practice utilizes state-of-the-art, cone-beam CT ( computed tomography ) imaging technology. This special imaging technique provides highly accurate 3-D radiographic images for the diagnosis, and treatment planning of orthodontics, implantology, TMJ analysis, airway assessment, facial and jaw surgery and other dental procedures. Undistorted, anatomically correct views of the jaws, teeth and facial bones along with cross-sectional, axial, coronal, sagittal, cephalometric and panoramic views are easily generated. Three-dimensional images enable a level of anatomical accuracy and predictability to patient care not possible with older 2-D technologies.
Dental Implants“ Teeth In A Day ” is a fantastic, innovative way to transition from complete edentulism or failing teeth to fixed, non-removable teeth mounted on implants, all in one day. Dental implant surgery often requires multiple surgical procedures and numerous visits. However, electing the “Teeth In A Day” procedure, the process is much simpler. The patient first comes to the office for a consult with the oral surgeon and a CT scan. A prosthesis is then fabricated, usually by the referring dentist, followed by the surgical placement of the implants and the fixed teeth. A checkup two weeks after the implant surgery is performed and, several months later, the final bridge is made.
BridgesThe older the patient, the more likely an impacted eyetooth will not erupt by nature’s forces alone even if the space is available for the tooth to fit in the dental arch. The American Association of Orthodontists recommends that a panorex screening x-ray, along with a dental examination, be performed on all dental patients at around the age of seven years to count the teeth and determine if there are problems with eruption of the adult teeth. It is important to determine whether all the adult teeth are present or are some adult teeth missing. Are there extra teeth present or unusual growths that are blocking the eruption of the eyetooth? Is there extreme crowding or too little space available causing an eruption problem with the eyetooth? This exam is usually performed by your general dentist or hygienist who will refer you to an orthodontist if a problem is identified. Treating such a problem may involve an orthodontist placing braces to open spaces to allow for proper eruption of the adult teeth. Treatment may also require referral to an oral surgeon for extraction of over-retained baby teeth and/or selected adult teeth that are blocking the eruption of the all-important eyeteeth. The oral surgeon will also need to remove any extra teeth (supernumerary teeth) or growths that are blocking eruption of any of the adult teeth. If the eruption path is cleared and the space is opened up by age 11-12, there is a good chance the impacted eyetooth will erupt with nature’s help alone. If the eyetooth is allowed to develop too much (age 13-14), the impacted eyetooth will not erupt by itself even with the space cleared for its eruption. If the patient is too old (over 40), there is a much higher chance the tooth will be fused in position. In these cases the tooth will not budge despite all the efforts of the orthodontist and oral surgeon to erupt it into place. Sadly, the only option at this point is to extract the impacted tooth and consider an alternate treatment to replace it in the dental arch (crown on a dental implant or a fixed bridge).
CrownsA single prosthesis (crown) is used to replace one missing tooth – each prosthetic tooth attaches to its own implant. A partial prosthesis (fixed bridge) can replace two or more teeth and may require only two or three implants. A complete dental prosthesis (fixed bridge) replaces all the teeth in your upper or lower jaw. The number of implants varies depending upon which type of complete prosthesis (removable or fixed) is recommended. A removable prosthesis (over denture) attaches to a bar or ball in socket attachments, whereas a fixed prosthesis is permanent and removable only by the dentist.
Root Canal TreatmentThe sooner the tooth is re-inserted into the dental socket, the better chance it will survive. Therefore, the patient should see a dentist or oral surgeon as soon as possible. Never attempt to wipe the tooth off, since remnants of the ligament that hold the tooth in the jaw are attached and are vital to the success of replanting the tooth. Other dental specialists may be called upon such as endodontists, who may be asked to perform root canal therapy, and/or restorative dentists who may need to repair or rebuild fractured teeth. In the event that injured teeth cannot be saved or repaired, dental implants are often now utilized as replacements for missing teeth.
DenturesA small amount of bleeding is to be expected following the operation. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 minutes. If bleeding continues, a moist tea bag can be used for 30 minutes. If bleeding occurs, avoid hot liquids, exercise, and elevate the head. If bleeding persists, call our office immediately. Do not remove immediate denture unless the bleeding is severe. Expect some oozing around the side of the denture.
General DentistryDr. Fulton D. Lewis III is a native of Darlington, South Carolina, He attended Clemson University and graduated with a Bachelor of Arts in English. Dr. Lewis then attended the Medical University of South Carolina in Charleston, from which he received the degree of Doctor of Dental Medicine. He completed a two year residency in general dentistry at Richland Memorial Hospital in Columbia, South Carolina, where his primary focus was Oral and Maxillofacial Surgery. Dr. Lewis then completed a four year residency in Oral and Maxillofacial Surgery at the Hospital of St. Raphael and Yale-New Haven Hospital in Connecticut. Both medical centers are teaching hospitals for the Yale University School of Medicine.
Oral and Maxillofacial Surgery
Oral SurgeryOur online videos are presented in order to help you understand more about the oral surgery procedures we perform. Please choose a specific video of your interest.
Jaw SurgeryThrough his training, Dr. Gray has seen a wide variety of medical and dental disorders. He has been educated in basic Oral and Maxillofacial Surgery, and received excellent training in the treatment of TMJ, orthognathic surgery, trauma, and pathology. His continued desire is to provide the highest standard of patient care.
Gum SurgeryShortly after surgery (1-14 days) the patient will return to the orthodontist. A rubber band will be attached to the chain to put a light eruptive pulling force on the impacted tooth. This will begin the process of moving the tooth into its proper place in the dental arch. This is a carefully controlled, slow process that may take up to a full year to complete. Remember, the goal is to erupt the impacted tooth and not to extract it! Once the tooth is moved into the arch in its final position, the gum around it will be evaluated to make sure it is sufficiently strong and healthy to last for a lifetime of chewing and tooth brushing. In some circumstances, especially those where the tooth had to be moved a long distance, there may be some minor “gum surgery” required to add bulk to the gum tissue over the relocated tooth so it remains healthy during normal function. Your dentist or orthodontist will explain this situation to you if it applies to your specific situation.
Maxillofacial SurgeryDr. Steven D. Pollack received his Bachelor of Science degree in Biology from the University of California in 1990 and his D.D.S. from the UCLA School of Dentistry in 1994. Immediately following these degrees, Dr. Pollack completed an internship in Oral and Maxillofacial Surgery at Harbor/UCLA Medical Center and received Certification in Oral and Maxillofacial Surgery from Los Angeles County/University of Southern California Medical Center in 2000. Subsequently, Dr. Pollack spent the next four years in the U.S. Navy with appointments as Department Head at Camp Lejeune, USS Kitty Hawk, and the U.S. Naval Academy at Annapolis.
Tooth ExtractionsAfter tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. That’s why we ask you to bite on a gauze pad for 30-45 minutes after the appointment. If the bleeding or oozing still persists, place another gauze pad and bite firmly for another 30 minutes. You may have to do this several times.
Bone GraftingHaving been in private practice since 1985, Dr. Going specializes in the restoration of patients’ smiles with dental implants and bone grafting. He practices the latest methods and techniques, placing zygomatic and pterygoid implants with CT (CAT) scan guided surgery known as teeth in an hour/teeth in a day (TIAH-TIAD). Usually, Dr. Going completes these procedures on patients in our outpatient setting under general anesthesia.
Oral Cancer Screening
Dental ExaminationWith an oral examination and x-rays of the mouth, the doctors of Oral Surgery Associates can evaluate the position of the wisdom teeth and predict if there are present or may be future problems. Studies have shown that early evaluation and treatment result in a superior outcome for the patient. Patients are generally first evaluated in the mid-teenage years by their dentist, orthodontist or by an oral and maxillofacial surgeon.
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