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Dental and Soft Tissue Surgery

  • This is the surgical management of diseases of the teeth and their supporting hard and soft tissues. This does not typically include the restoration of teeth and application of crowns, bridges, and other dental prostheses. These procedures include pre-prosthetic surgery to prepare the bone within the mouth for final restoration with either removable or non-removable dental appliances. Others include the following procedures as well.

There are many reasons why your dental professional may recommend that you have one or more teeth removed.  For example, the tooth may need to come out as part of your orthodontic treatment in order to allow space for your remaining teeth to move; your tooth may have been injured beyond repair; the tooth may be damaged by decay, or the tooth may be loose as a result of periodontal disease.

Whatever the reason, one of our oral surgeons will remove your tooth or teeth using an anesthetic that is appropriate for your procedure.

We know that third molars, or wisdom teeth, are often impacted, or blocked, from entering the mouth normally.  But did you know that other teeth may be impacted as well?  For example, it is not uncommon for one or both canine teeth, also known as “eyeteeth,” to be impacted.  The good news is that your orthodontist, with the help of one of our oral surgeons, can bring the impacted tooth through the gum and into the correct position – giving you a beautiful and healthy smile.

Before the orthodontist can reposition the impacted tooth, you must be fitted with braces so that enough space may be opened up to allow the tooth to come down into the proper position.  When the orthodontist determines the time is right, they will refer you to our office and we will surgically expose the impacted tooth and affix a special brace that the orthodontist will attach to your braces to move the tooth into position.

The surgical procedure to expose and bracket an impacted tooth is usually performed in our office using an anesthetic that is appropriate for your procedure(s).  Once the surgical site has healed, you can return to your orthodontist to have the tooth repositioned into its proper place in your mouth.

Impacted Cuspid

The word “frenum” is defined as a small fold of tissue that secures or restricts the motion of a movable organ in the body.  Frena may be found in the brain, digestive tract and, most notably, in the mouth.  Several frena are located in the mouth:  under the tongue, inside the upper lip, inside the lower lip, and connecting the cheeks to the gum.

Frena can affect speech, tooth position and gum health.  In addition, they may cause gums to recede and keep teeth apart.  In these cases, your dentist, orthodontist or pediatrician may refer you to our office.  We can determine whether a procedure called a frenectomy is necessary to correct the problem and restore proper function to the tongue and lips.

Using a scalpel, electrocautery or a laser, we can cut the frenum to loosen the connection and extend the range of motion or remove the frenulum entirely.  This surgery can be done in as little as 10 to 15 minutes.

Labial Frenectomy

If the pulp, or connective tissue in the center of a tooth becomes infected, your dentist may recommend a root canal to remove the bacteria and infected pulp and save the tooth.  While the majority of root canals are generally successful and allow the tooth to remain functional for years, sometimes a root canal may fail.  One or more roots may become infected, or there may be significant bone loss around the tooth as a result of periodontal disease.

In general, most dentists will recommend removing the affected tooth and replacing it with a dental implant; but there are occasions where it may be prudent to keep the tooth in place and allow the site to heal until an implant may be placed.  This option may be a wise choice, particularly if one root of the affected tooth is intact.  In this instance, your dentist may refer you to our office for a hemisection or root amputation.

When performing a hemisection, one of our surgeons will remove one-half of the tooth, leaving a serviceable one-rooted tooth.  The term “root amputation” refers to the surgical removal of one root of a multi-rooted tooth.

In general, soft tissue grafts are used to add more tissue in areas where your gums have receded, the gum tissue is too thin, there is evidence of periodontal disease, an injury has affected the tissue, or where the roots of a tooth are exposed.  Soft-tissue grafts are important procedures to maintain a health mouth.  They may be used to:

  • Prevent further gum recession
  • Cover an exposed root
  • Stop sensitivity in the affected area
  • Improve the look of the tooth
  • Prevent problems in the future

Connective Tissue Graft

If you or someone in your family is undergoing orthodontic treatment, your orthodontist may refer to our office for a relatively minor surgery.

Known as temporary anchorage devices, or TADS, these devices serve as “anchors” that the orthodontists may connect to various areas of your mouth to help reposition your teeth.  TADS allow orthodontists to overcome the limitations presented by holding arches and headgear.  They allow the orthodontist to predictably perform difficult tooth movements.

Once placed, the orthodontist is immediately able to use the TAD as an orthodontic anchorage.

Typically, these devices are only used for a short period of time during orthodontic treatment.  When they are no longer needed, they are removed and the site is usually fully healed in a couple of days.

TAD Molar Protraction Elastic

Gingivitis is an inflammation of the gum tissue surrounding your teeth that is caused by bacteria.  While the disease may be controlled by good dental hygiene and regular visits to your dentist, gingivitis can lead to periodontitis, a stage of the disease where pockets of infection may lead to loose teeth and even tooth loss.  If conventional treatments like scaling and root planning have been unsuccessful in returning your gum tissue to a healthy, firm state, a surgical procedure known as a “gingivectomy” may be appropriate.  A gingivectomy may also be appropriate for patients with excessive gum tissue, or in cases of gingival hyperplasia, which may occur from the use of certain drugs, such as Dilantin.  In an effort to stop the progression of the disease, a gingivectomy surgically removes and eliminates the microbial factors that create periodontitis.

Gingivoplasty, the surgical reshaping of the gum tissue, is often performed in combination with gingivectomy for cosmetic or functional purposes.  After a gingivectomy procedure, one of our surgeons may perform a gingivoplasty that thins the remaining gum tissue so it looks natural.

Has you dentist advised you to have a crown placed on a tooth that has been weakened by decay, is cracked or broken, or severely worn down?  Your dentist may refer you to our office for a crown lengthening procedure to ensure that enough of the tooth’s structure is available to hold a crown.

Crown lengthening is usually performed in our office using an anesthetic that is appropriate for your needs.  Depending on your case, we may remove a small amount of gum tissue to provide enough room for the crown placement.  Once the site has healed, about 4 to 6 weeks following surgery, your dentist will complete the restorative work.

All these procedures are usually performed in our office using an anesthetic that is appropriate for your procedure.

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