Pre-prosthetic surgery refers to surgery that is meant to help improve a patient’s oral health or prepare a patient to wear a denture. This includes the exposure of an impacted tooth, alveoplasty, removal of maxillary tori (torus palatinus), removal of mandibular tori (large bone lumps in the jaw), removal of hypermobile or hyperplastic tissue, and vestibuloplasty.
Impacted Canines and Their Management for Orthodontic Therapy
The canines, or cuspids, are typically some of the last teeth to fully develop. They are crucial components of a healthy bite and should be monitored for normalcy throughout their development. One or more impacted canines can lead to a number of potentially complex issues and abnormalities in the dental arch, affecting all teeth adjacent to the unerupted tooth.
Canine impaction can be defined in more than one way and its specific definition varies from patient to patient. The tooth may be prevented from erupting by adjacent teeth that have grown too close together or may be embedded in the bone of the jaw. The tooth may simply fail to emerge after the root has formed completely. Approximately one to two percent of the general population suffers from impaction of one or more permanent canines.
Complications of Impacted Canines
In most cases of impacted canine teeth, the problem is first discovered during a routine visit to the dentist. Impaction of these vital teeth can be detected by a dentist or oral surgeon as early as the age of eight using a combination of physical and radiographic examination. If, however, the patient is not seen by a dental professional regularly and the impaction is not detected in a timely manner, there is an increased likelihood that the patient will experience some undesirable complications. These include:
- Pain and pressure in the gum at the expected eruption site
- Uneven spacing and malocclusion of adjacent teeth
- Gum recession and periodontal disease
- Dull ache or sharp pain in the teeth surrounding the affected area
- Decay of partially erupted or impacted tooth due to inability to clean properly
- Spread of decay from affected canine to healthy adjacent teeth
- Tumor or cyst formation potentially leading to alveolar bone and pathologic fracture
Canine Impaction Management for Orthodontic Therapy
Proper management of impacted canines must involve the work and cooperation of both an oral surgeon and an orthodontist. Though each individual and each case will prove unique, treatment typically consists of the placement of orthodontic braces first and then a referral to the oral surgeon. The oral surgeon will make an incision along the gum above the empty cuspid’s space and lift a flap of tissue to reveal the impacted tooth beneath. When a primary tooth is present and impacted as well, it is removed to make room for the permanent tooth.
The oral surgeon then places an orthodontic bracket to the tooth, attaching the bonded and bracketed tooth with a small chain to the arch wire of the braces. In some cases, the gum tissue is repositioned over the impacted canine, leaving the chain visible. In others, the surgeon sutures the gum tissue higher up above the once hidden tooth. The oral surgeon and orthodontist will continue to work together as necessary throughout the full development and proper growth of the canine tooth or teeth treated. The ultimate result of this type of therapy is a complete set of teeth that function properly and are aesthetically pleasing.
Ankyloglossia and Its Release: Correcting Tongue Tie (Frenuloplasty)
Ankyloglossia, more commonly known as “tongue tie,” is a relatively common abnormality of the corded tissue structure beneath the tongue. This band of oral mucosa is called the lingual frenum or c and derives its name from the Latin “little bridle of the tongue.” The translation of the name is particularly apt in cases of ankyloglossia. When a patient is tongue tied, the lingual frenum actually does serve as a restricting bridle, preventing the tongue from extending as far out as it should.
Correcting Tongue Tie
Though most infants’ frena recede naturally over the course of their first year, up to two percent of babies experience ankyloglossia that affects their ability to develop normally in the areas of speech and feeding. In severe cases, the extended frenum may even contribute to the formation of a visible gap between the two bottom teeth.
To correct ankyloglossia in babies, the simple frenectomy is performed with or without anesthesia, depending on the severity of the tongue tie itself, the parents’ preferences and the informed recommendation of the attending doctor. Because there are very few nerve endings in the lingual frenum, pain is minimal and most children recover from the rapid snip very quickly. In fact, in the majority of cases, a baby can begin breastfeeding immediately after the procedure is completed. The tongue is free from its excessive attachment to the floor of the mouth and is capable of forming a proper latch, allowing the child to receive sufficient sustenance and preventing maternal discomfort.
Alveoplasty
Alveoplasty is the reshaping of the bone underneath the gums. Sometimes the bone may be too sharp causing irritation from a denture. The oral surgeon would simply smooth the bone for better comfort.
Tori removal
Tori are bone bumps which may interfere with the seating of a denture. They can be present on the top or bottom jaw. Their removal may become necessary for a better denture fit.
Vestibuloplasty
If a patient’s jaw bone is too short for a denture, a vestibuloplasty may be the appropriate procedure for you. This procedure lowers the floor of the mouth and muscle attachments to allow for more room for a denture.
Face & Jaw Surgery Center
Patient Review
We had a great experience at Face & Jaw in Grand Forks with Dr. Chahal and his staff. Very genuinely kind people.
- Hayley A
Patient Review
Everyone was so kind, respectful and helpful! You felt as tho they all were your friend, I can’t say enough about Dr. Chahal…so calm, quiet and gentle! I HIGHLY recommend the Face & Jaw surgery center to anyone that needs their care!!
- Donnabelle W
Patient Review
Front staff was very helpful and friendly, put all my worries at ease. Everyone did a great job especially the Dentist.
- Paul P
Patient Review
If you need oral surgery, Dr Chahal is the best you will ever find. He leaves nothing in question, makes sure you understand what he will be doing and he is extremely analytical with what procedure he will use to address your problem. You will not find a better surgeon anywhere. He is the BEST!!!
- Greg J
Patient Review
The staff was very reassuring and helpful. Helped me relax before and after the procedure and kept me comfortable. They answered all the questions I had to the best of their knowledge.
- Katelyn M
Patient Review
Very professional. Every single employee did their job with speed and efficiency while being very polite to me. They also worked well together as a team. I would not be able to come up with even one complaint.
- Joan H
Patient Review
We have a very good experience from arrival to departure. My son had 3 teeth pulled and he had hardly any pain and no swelling afterwards! The staff was very friendly and explained everything they were doing to my son which helped put him at ease, especially when they were putting in the IV.
- Val S
Patient Review
I really appreciated how comfortable they made me feel. It was nice that the nurse called my mom to see how I was doing. Everyone was very nice.
- Izhavel N
Patient Review
Great service and very friendly staff!
- Abigail O
Patient Review
Dr. Gray and his team is amazing. I was super nervous but they answered all my questions which made me feel better. Everyone was extremely nice and understanding. I had to get ahold of Dr. Gray over the weekend for pain and he texted me since the office was closed. And I had to go in a second time for dry socket since the pain medicine wasn’t working. He put the dressing on the bothersome tooth and I felt instantly better even though it tastes gross! Dr. Gray and his team listened to my concerns and let me decide what measures I wanted to take for my healing. They are a very respectful team! I am super impressed with them. I am currently still healing but so happy with Face And Jaw. Thank you!
- Asia R
Patient Review
They did a great job And caring about there Patience
- Brian G
Patient Review
If I need anymore teeth pulled or dental work that requires me to be put under I will definitely be back! 10/10 for patient care.
- Shelby C
Patient Review
From the staff at the desk all the way to the nurses and the doctor were very informative and profession but also personal and considerate to my needs I have a horrible case of dentophobia and they were very accommodating to my needs and made me feel comfortable as possible Thank you very much
- William B
Patient Review
Everyone was great and caring. It’s hard to go into a situation that tends to come with high anxiety and then let them sedate you and still be made to feel comfortable. Even with all the Covid protocols it was good.
- Lauren N
Patient Review
Every one that works at The Face and Jaw Surgery place in Grand Forks, North Dakota are the absolute best. They have always treated me with respect and all are so compassionate about their job! I wish I knew all there names because I would definitely like to give them a standing ovation for the great job they do.
- Jan M
Patient Review
Highly recommend Face and Jaw. Beautiful wait area. Plenty of help at the front desk(s) to get all your paperwork and billing done fast and efficiently. Nice clean rooms with beautiful scenery looking out towards North Bismarck.
- Kelly B
Patient Review
Great service and comfortable from someone who just had all her teeth out for dentures yesterday. Thank you for the great service and positive environment🥰🥰
- Dr Geri M
Patient Review
I had a pleasant experience on a not so pleasant task. I thank all of you for a totally professional and pleasant experience.
- Wayne P
Patient Review
I had been trying to get my last two wisdom teeth out for the past 3 years. I 've always been extremely anxious and somewhat terrified about doing the surgery all over again. I'll admit I cancelled a few times. I was very nervous that morning, but as soon as I walked in at the Bismarck location, I became less tense. The lobby was calm & relaxing. I loved the fireplace and there was a good view from the 3rd floor windows. The staff was welcoming, friendly and professional. The nurses knew what they were doing. Dr. Knoll was also friendly and professional. He explained eveything clearly and answered my questions. I was hooked up to machines with ease and put to sleep right away. He told me my wisdom teeth were like regular teeth, so he pulled them out and there was no need for stitches or medication. I can't believe the procedure only took 30 minutes. I arrived 7am (mountain time) and left by 8am. A couple of days have gone by and I am just so relieved that Face & Jaw was available in Bismarck. I would certainly go back...the whole experience was great. Thank you!
- Ann R
Patient Review
I went to the Fargo location for wisdom teeth extraction, and I am sorry to say I have no memory for names so I can't give the credit I wish I could to the individuals. I do not like needles and have never been put under anesthesia prior. I'm also prone to fainting symptoms with medical procedures. The receptionists were friendly and patient. When I was taken to the back (10 minutes early even since I arrived early) the woman was kind and listened to my concerns. The anesthesiologist listened to my concerns about needles since my veins tend to disappear and I had to fast (including water) before the surgery and she even got the IV in the first time and I dare say it was the least painful one I've ever had done. The doctor took good care of me even when I started feeling faint and had to lie back and cool down. After the surgery, the ones monitoring me were kind and helpful even after I threw up the medicine they tried to give me and gave me plenty of time to recover. I am very happy with the service I received. It was well worth the cost!
- Samantha D