Face & Jaw Surgery Center

Millions of Americans are familiar with wisdom tooth impaction and the treatment needed to remedy the potentially uncomfortable situation. The various causes for impacted wisdom teeth, however, are not as well-known. If you or someone you know is affected by this common condition, the factors that lead to its development may prove both interesting and important.

Angle of Growth

The most common cause of one or more impacted wisdom teeth involves growth of the third molars at an abnormal angle relative to the adjacent teeth in the upper, lower or both jaws. For some individuals, the third set of molars do not negatively affect the angle of other teeth in the mouth and do not, therefore, present any problem that necessitates removal. In the majority of cases, however, crowding of adjacent molars and other teeth does occur. If removed in a timely manner, or before eruption occurs, these molars may not impact the position of other teeth. Your oral surgeon may utilize equipment that produces a panoramic image of your entire mouth to determine likely displacement of adjacent molars before deciding to perform one or more extractions.

Though impacted wisdom teeth often present themselves in a relatively painless manner, failure to remove them may result in future complications that cause discomfort, pain and even infections. Wisdom teeth may grow and develop in any direction, be it slanted toward the second molars, rearward toward the back of the mouth, at or near a right angle to other teeth, or simply straight up or down while failing to emerge properly through the gum. X-rays help your surgeon to develop a treatment plan that suits your best interests regarding comfort, jaw structure and aesthetic appearance in the future.

Orthodontic Devices During Childhood

While every individual’s jaws and teeth grow differently, a baseline for eruption and jaw development does exist. When it becomes necessary to place braces, spacers, retainers or a combination thereof before the age of 17, the patient’s orthodontist considers the length of time necessary to fully complete the correction of gaps, misalignment and other circumstances requiring orthodontic intervention. Because wisdom teeth generally begin to erupt between the ages of 17 and 21, it is important that orthodontists consider all factors before commencing treatment. The use of braces may affect the impact that wisdom teeth have on surrounding teeth and jaw structure overall.

Dietary Influences

The normal wear and tear to which upper and lower molars are exposed may have an impact on the development and growth of wisdom teeth in adolescents and adults. When posterior teeth, or teeth located in the back of the mouth, are utilized sufficiently to produce a normally worn surface area, erupting wisdom teeth are more able to surface without issue. The grinding motion involved in the repetitive chewing of grains, meats and roughage tends to wear the rearmost molars in a way that is conducive to normal wisdom tooth growth. This research does not, however, pertain to all individuals, particularly to those who suffer from genetic conditions or congenital malalignment of the jaws.

Correction of Impacted Wisdom Teeth

Fortunately for the many individuals in need of wisdom tooth extraction, modern advances in oral surgery make the process relatively simple and painless. Patients are placed under the necessary anesthesia for the required procedure and provided with ample relief for swelling and discomfort following surgery. Barring any complications, recovery time is typically minimal and daily routines can be resumed within 48 to 72 hours.

Face and Jaw Surgery Center serves all of North Dakota and Northwest Minnesota including Moorhead, MN and East Grand Forks, MN

Bismarck, ND office

Fargo, ND office

Grand Forks, ND office

Minot, ND office

While the third molars, more commonly known as the wisdom teeth, are not necessary and are frequently removed, the canines are essential components of a strong, healthy bite. They serve a fundamental purpose in biting food and are a highly noticeable part of an aesthetically pleasing smile. If you are affected by impacted canines and are concerned with the way this makes you look or feel, your oral surgeon can help.

Understanding Impacted Canines

The canines are the last of the permanent teeth to erupt and possess the longest roots in the entire mouth. This means that, when they develop properly, canines have a stronger connection to the bone of the jaw than do other teeth. When they do erupt, usually around the age of 13, canines help to push surrounding teeth together, closing any gaps that exist between them or, in some cases, causing crowding of the front teeth that may require orthodontic intervention. In either case, the development and growth of the canines is important to the structure of the entire bite.

When canine teeth fail to erupt properly or in a timely manner, an x-ray can help to determine the problem. The canine tooth may fail to erupt as it should due to insufficient space between surrounding teeth. In other cases, it may be growing beneath the gum at an improper angle. Depending on the nature of the issue, an oral surgeon will frequently work with the orthodontist taking care of the patient, each of them contributing to a treatment plan aimed at resolving the problem. Treatment may involve a minor, in-office procedure in which the oral surgeon makes an incision along the gum line where the impacted canine is located. This allows for the removal of any primary canines that have yet to erupt as well as the placement of necessary orthodontic devices.

Complications of Canine Impaction

In some cases of one or more impacted canine teeth, complications that require further treatment may arise. The most effective method of preventing these problems involves early detection and treatment. Some common issues associated with untreated impacted canine teeth in children and adults are:

•  Infection that may spread to surrounding gum tissue
•  Pain and swelling in the affected area
•  Advanced gum disease
•  Development of cysts in the gums and jaws

Fortunately, modern dental technology allows your oral surgeon to detect, evaluate and treat impacted canines and other potentially serious problems quickly and efficiently, giving you the healthy, attractive smile you’ve always wanted.

Face and Jaw Surgery Center serves all of North Dakota and Northwest Minnesota including Moorhead, MN and East Grand Forks, MN

Bismarck, ND office

Fargo, ND office

Grand Forks, ND office

Minot, ND office

Missing front teeth are highly noticeable when a person talks or smiles, so their replacement is typically considered a high priority. The aesthetic drawbacks of the gaps in a smile can cause a considerable decrease in self-esteem and major self-image problems. Posterior teeth, or the teeth located in the back of the mouth, are not generally visible when an individual speaks, smiles or laughs. This leads many people to believe that waiting to replace them or avoiding replacement altogether is acceptable. On the contrary, failure to replace posterior teeth can lead to a number of serious issues that can affect both your daily life and your future.

Health Issues

When any tooth is dislodged or extracted, the hole that remains in its place leaves the gum tissue there more susceptible to disease and deterioration. This can spread to other healthy teeth in the area, causing even more potential problems like advanced periodontitis. Depending on the severity of the disease or tissue degeneration, surgical procedures may be the only measures effective in fighting further damage.

Other problems that directly affect your health in the event of missing posterior teeth include the following:

• Inability to chew certain foods, leading to unhealthy dietary restrictions
• Chronic pain in the extraction site if food particles or debris become lodged there
• Drifting or rotation of healthy teeth surrounding the remaining hole
• Loss of jaw bone material in the area
• Excessive or uneven wear of other teeth
• Potential development of TMJ (temporomandibular joints) disorders

Aesthetic Importance

Many people figure that if the holes left by their missing teeth in the back aren’t visible to the people around them, they don’t need to be replaced. In addition to all of the other important reasons to replace missing posterior teeth, it is worth noting that their absence can, in fact, affect your outwardly appearance. The loss of teeth and supporting bone material in the back of the mouth can lead to a weak-looking jaw line and actually alter facial height in general. As the patient ages, the problem only continues to grow worse over the years.

Remedying the Problem

Fortunately for people who have suffered the loss of a single tooth or multiple teeth in the back of the mouth, dental implant technology offers the opportunity to correct the issue relatively quickly and easily. Your oral and maxillofacial surgeon will assess the affected area and any damage that has been sustained, then develop a treatment plan involving prosthetic devices tailored to your individual needs.

Face and Jaw Surgery Center serves all of North Dakota and Northwest Minnesota including Moorhead, MN and East Grand Forks, MN

Bismarck, ND office

Fargo, ND office

Grand Forks, ND office

Minot, ND office

Pathology refers to the in-depth study of the origin and nature of all types of disease. Oral and maxillofacial pathology encompasses all aspects of maladies of the mouth, jaw and facial tissues. This includes research and analysis of cause, stages of development, complications, diagnosis and avenues of treatment that will work most effectively for the patient.

Detecting Oral and Maxillofacial Disease

In some cases, the surgeon will be able to determine what type of disease is affecting a patient through evaluation of symptoms and the patient’s medical history. This is one of the most commonly utilized elements of oral pathology. There are some cases, however, in which a biopsy of the affected area must be taken in order to accurately determine the nature of the disease present. A biopsy is the sole manner in which a diagnosis can be considered definitive.

During the biopsy, a small portion of tissue is removed from the area in which signs or symptoms are suspected to denote disease. Depending on the nature of the suspected problem, this tissue may consist of soft tissue, bone from the jaw or a combination of both. The biopsy is generally performed with the assistance of local or general anesthesia to ensure patient comfort during the brief procedure. The specimen is then examined in a pathology lab, a process that typically takes about ten days to complete. Results are delivered to the surgeon for assessment and review.

When the surgeon has completed the review of the lab results, the patient returns to the office to discuss the findings. The surgeon will use the results to make a definitive diagnosis of the disease as well as a treatment plan.

Prevention Tips for Patients

In many cases, avoiding cancers and other severe medical conditions of the mouth is possible. Early detection is a key factor in the success of treatment. Patients are encouraged to regularly perform self-checks at home, keeping an eye out for the common indicators of oral cancer. This simple home exam can be performed as follows:

• Remove oral prosthetic devices such as dentures, removable bridges, retainers, etc.
• Using a mirror and a bright light, examine the inside surfaces of the lips and the fronts of the gums.
• Examine the roof of the the mouth and feel for any abnormalities in shape.
• Gently but firmly pull the corners of the mouth outward to examine the inside of the cheeks and the areas at which they connect to the gums.
• Examine all surfaces of the tongue, sticking it out as far as is comfortable.
• Any unusual bumps, enlargements, discolorations or lesions should be reported to a qualified oral and maxillofacial surgeon immediately.

Other symptoms of conditions that may be associated with oral cancer include red or white patches, persistent bleeding of open sores in the mouth, sore throat that does not go away and pain while chewing food or swallowing.

If a problem is detected in its early stages and a treatment plan is implemented soon thereafter, the patient’s risk of serious complications is decreased significantly. Staying informed regarding oral pathology, its various components and the signs of potential disease is one of the most effective ways of reducing your risk.

Face and Jaw Surgery Center serves all of North Dakota and Northwest Minnesota including Moorhead, MN and East Grand Forks, MN

Bismarck, ND office

Fargo, ND office

Grand Forks, ND office

Minot, ND office

Elderly men and women generally require more specialized oral care than their younger counterparts, due largely to complications associated with their aging bodies. Some of the most common of these are arthritis and osteoporosis, both of which can dramatically affect the bones and joints of the jaw. In addition, decades of gradual wear to teeth and gums can result in uneven surfaces, a receding gum line and even tooth loss.

Types of Restorative Treatment for Older Patients

1. Dental Implants

Tooth loss is a common occurrence in elderly patients. As the bones and tissue of the mouth degenerate over time, teeth become loose and may drift from their proper position. Gaps form and the structural integrity of tooth formations is compromised.

Whereas dentures and bridges were once the only tooth replacement options available dental implants now make it possible for elderly patients to regain the complete use of their teeth in a way that looks and feels natural. Check-ups at regular intervals following the placement of implants will ensure that the bone to which the implant is anchored continues to hold it in its proper location.

Implants are the strongest and longest-lasting options for people of all ages and provide a particularly substantial advantage for older people. The ability to speak normally and eat foods that would otherwise be restricted becomes increasingly more important as they age. The confidence that accompanies a healthy, complete smile is often critical to mood and self-esteem as well.

2. Solutions for Tooth Wear

For a variety of reasons, the production of saliva decreases in older age. The most common of these reasons are rooted in side effects of necessary medications and natural degeneration of the glands that produce the saliva itself. Without the buffer of saliva that serves to protect tooth surfaces from acid wear, teeth are more susceptible to erosion and decay.

When the enamel of a tooth is eroded, it cannot grow back. The softer, more vulnerable dentin that lies beneath the enamel is left exposed, leading to possible tooth loss or need for extraction. Advanced composite resin components make it possible to build up a new layer of durable, aesthetically pleasing material over the tooth’s surface. This is particularly useful in cases in which the tooth itself is currently healthy enough to retain but susceptible to eventual loss due to erosion, abrasion or attrition. A few millimeters of composite resin added to one or more surfaces of a tooth allows the patient to enjoy the use of his or her natural teeth without pain or fear of future damage.

3. Dental Bonding

Restorative bonding can drastically improve the appearance of teeth and the smile as a whole. Composite materials are used to fill in gaps between teeth, correct discoloration and repair minor fractures in the enamel. The result is a stronger, more aesthetically pleasing smile that can last for years when proper oral hygiene practices are observed.

Your family dentist and oral surgeon can help you achieve your ideal smile, even when the effects of time and normal wear have been visible for years. At your initial consultation, you’ll learn how advanced restorative dental techniques have helped innumerable elderly men and women like you regain the full use of their teeth all while improving their quality of life in general.

Face and Jaw Surgery Center serves all of North Dakota and North West Minnesota including Moorhead, MN and East Grand Forks, MN

Bismarck, ND office

Fargo, ND office

Grand Forks, ND office

Minot, ND office

Anyone who has ever undergone any type of surgical procedure understands the importance of a full recovery. The faster you are able to get back to a state of normalcy in your daily life, the better. The recovery period following oral surgery is no different. Taking care of yourself properly in the hours, days and weeks after your procedure can significantly reduce the time that you find yourself out of commission as well as ensure that you experience the least amount of pain and inconvenience possible.

The Do List: Guidelines for Oral Surgery Patients

The following list includes tips provided by experienced dental professionals regarding what to do after your procedure to ensure a successful recovery.

1. Stay on Top of Your Pain

Pain and mild discomfort are generally to be expected during the first days following your surgery. Any intense pain that lasts for more than these few days should be reported to your oral surgeon immediately. Moderate pain, however, should be controlled with either a prescription given to you by your surgeon or over-the-counter painkillers.

Keep to a regular schedule, following directions that come with the medication. It is highly recommended that aspirin not be used, as this can cause the blood to thin and lead to excessive bleeding at the surgical site. Remember to take your medication before pain becomes a problem, as it is much easier to prevent pain than relieve it.

2. Get Plenty of Rest

This may seem like a given for anyone who has recently had any kind of surgery, but many oral surgery patients neglect to give their bodies enough time and rest to recuperate before returning to normal activities. Exercising should be limited to moderate levels and should not be performed before at least 24 hours have passed. Avoid bending over and lifting heavy objects for a minimum of three days.

3. Remember Your Rinse

After the initial 24 hours, rinse your mouth gently with warm, cleansing salt water. Your surgeon may provide you with a plastic syringe specially designed to carefully irrigate the site four times per day and after eating. This will ensure that any food particles are completely removed from the area. Be careful not to spit out the solution forcefully, as this may result in the removal of the clot that is needed in the healing process.

4. Take Care with Your Diet

Your surgeon will give you some ideas of foods that you should eat in the days following your procedure. Some good examples are soft foods like yogurt and mashed potatoes as well as liquids such as broths and soups.

The Don’t List: What to Avoid After Oral Surgery

1. Don’t Irritate the Surgical Site

Aggressive rinsing and brushing can lengthen the amount of time required for a full recovery significantly and may result in increased pain or bleeding. Avoid touching the site with your fingers or your tongue. For the first few days, resist the temptation to smoke cigarettes, blow your nose, suck anything through straws and spit, as these may dislodge the blood clot.

2. Don’t Wait to Report Severe Pain

While some swelling, pain and lingering discomfort are normal and to be expected after your surgery, increased bleeding and pain should be reported to your surgeon as soon as is possible. These may be signs of a worsening condition or an infection and should be evaluated in order to determine the source of the problem. Additional treatment or medication may be required and delaying a visit to your dentist for any extended period of time may result in the need for more comprehensive care.

Gum tissue should fully heal in approximately one month, depending on the surgery performed. Be sure to contact your surgeon with any questions you have regarding the procedure and recovery.

Face and Jaw Surgery Center serves all of North Dakota and North West Minnesota including Moorhead, MN and East Grand Forks, MN

Bismarck, ND office

Fargo, ND office

Grand Forks, ND office

Minot, ND office

Inherited oral abnormalities are the result of genetic mutations that occur during fetal development. An affected infant is not always diagnosed at birth, as some of these abnormalities are not immediately noticeable and may only become apparent as the child matures. In some cases, the visible effects of a genetic deformity are indicative of other underlying disorders and must be diagnosed by a qualified medical professional in a field specific to the condition.

Cleft Palate and Cleft Lip

Cleft palate and cleft lip are the two most common deformities of the craniofacial type. A cleft in the lip or palate occurs when the tissues of the affected area fail to develop fully while the fetus is in utero. Research shows that clefts tend to appear more frequently in children of Asian descent and in boys, but may occur in individuals of any ethnicity and gender.

Cleft lip generally affects only one side of the lips and can range from minor (involving a minute separation of the tissue) to more severe, when the cleft reaches entirely into the nostril. In more rare cases, clefts can occur on either side of the mouth and nose, exposing the gums and portions of the nasal cavity.

Cleft palate often results in feeding difficulties and should be surgically corrected as soon as is possible following birth. Cosmetic corrections are optional, but field experts suggest opting for some form of surgery when the child is young so as to promote effective healing and minimal scarring. A history of cleft palate or cleft lip in the family increases the chances that a child will be born with the deformity.

Anodontia, Hypodontia and Hyperdontia

Anodontia is an inherited oral condition that presents itself in the absence of all teeth, either primary or permanent. This genetic disorder is relatively rare and is typically not detected until the affected individual is of the age at which “baby” teeth are expected (between four and eight months). The majority of children who are affected by the disorder generally experience normal eruption of primary teeth, only to discover that permanent teeth fail to replace them. The most common occurrence of anodontia presents itself as a singular missing tooth, usually a permanent lateral incisor or another tooth near the front of the mouth.

Hypodontia typically affects males more than females and has been noted in children of all genetic backgrounds. This condition is responsible for the failed development of second bicuspids, maxillary lateral incisors and third molars. If left uncorrected, this condition may lead to severe malocclusion (bad bite) and other associated problems with bite and speech.

Hyperdontia is an oral condition in which an individual develops excess, or supernumerary, teeth. It can present itself in the eruption of one extra tooth or many, depending on the severity of the condition. In most cases, supernumerary teeth are removed in order to ensure proper growth and spacing of other teeth in the area.

Malocclusion

More commonly referred to as a bad bite, malocclusion includes misalignment of the jaws or teeth in a way that may negatively impact speech, ability to chew and the physical appearance of the face as a whole. Generally an inherited condition, malocclusion can typically be corrected with specialized surgical procedures and/or orthodontic treatment. Early detection of all oral abnormalities and immediate intervention by a qualified maxillofacial surgeon are key factors in restoring the mouth of the patient to its most ideal state.

Face and Jaw Surgery Center serves all of North Dakota and North West Minnesota including Moorhead, MN and East Grand Forks, MN

Bismarck, ND office

Fargo, ND office

Grand Forks, ND office

Minot, ND office

Millions of people in America have experienced the loss of one or more of their permanent teeth. Whether caused by poor oral care, injury, old age or professional extraction, tooth loss affects every aspect of your daily life in a number of negative ways.

Immediate Consequences of Missing Teeth

A person with missing teeth, regardless of the extraction site, is immediately aware of sensitivity and pain in and around the socket from which it the tooth was lost. Eating, drinking and even speaking can prove incredibly uncomfortable as well as difficult.

Reluctance to smile, laugh or speak in social and professional settings can lead to relationship troubles and lost friends. If the area where the teeth were extracted is highly visible, the individual may find it difficult to feel confident and comfortable in a business environment. The inability to speak clearly and coherently may even result in the loss of employment.

Long-term Effects of Missing Teeth

Every day after a tooth has been removed, the teeth that surround it shift slightly. Over a period of time, this slow process of shifting results in visibly tilted or crooked teeth. The bite continues to change, making eating and speaking properly a challenge faced many times per day.

If a large number of teeth are missing, particularly in the front of the mouth, the person’s profile can change dramatically. Due to bone loss and loss of muscle tone in the face, the chin and cheeks begin to sag without support. This slack appearance serves to make the individual seem years, if not decades, older than their biological age. In severe cases, only correction of the missing teeth and jaw surgery can restore a look of normality.

Nutritional health is another long-term consideration for people with missing teeth. When the variety of foods that can be eaten is narrowed substantially, the body doesn’t typically receive the vital nutrients it needs to function properly. Vitamin and protein supplements must be taken to ensure continued health and well being.

The psychological impact of missing teeth, over an extended period of time, is substantial. Many people feel that they are better off staying home and out of public, even on important occasions like weddings or family reunions.

Implants: A Permanent Solution

Over the past decade, the use of dentures has steadily declined as patients opt for dental implants, the increasingly preferred method of tooth replacement. Implants look and feel exactly like natural teeth and they are permanently affixed to the bone of the jaw. This allows for natural speaking, freedom to eat a wider selection of foods and the ability to smile with genuine confidence.

Face and Jaw Surgery Center serves all of North Dakota and North West Minnesota including Moorhead, MN and East Grand Forks, MN

Bismarck, ND office

Fargo, ND office

Grand Forks, ND office

Minot, ND office

Overbite is a common orthodontic condition experienced by millions of people around the world. In cases of excessive overbite, the mandibular (or bottom) teeth are partially or completely overlapped by the maxillary (top) teeth.

While the majority of individuals possess a minor overbite to some degree, excessive overbite can lead to a variety of problems, including difficulty eating or speaking properly. Normal overbite, which is measured at approximately three to five millimeters, does not impair an individual’s ability to function in any way. When problems with the development of speech are noted, however, a consultation with a licensed oral and maxillofacial surgeon is highly recommended. As with other types of malocclusion, early diagnosis is key to successful correction.

There are two major types of overbite. Vertical overbite refers to a condition in which the patient’s upper teeth noticeably cover those of the bottom jaw. Horizontal overbite occurs when the patient’s teeth would otherwise fit properly together were it not for the fact that the upper teeth jut forward significantly. Though most overbite patients suffer from only one of these conditions, it is possible for both of them to be present simultaneously.

Causes and Complications of Excessive Overbite

There are a variety of observed causes of excessive overbite. One or a combination of the following may cause the condition:

• Malformation of the jaw during fetal development
• Hereditary factors
• Persistent chewing of the nails or other objects
• Extended use of pacifiers or bottles during young childhood
• Tongue thrusting
• Sucking of the thumb, which puts pressure on the roof of the mouth for extended periods of time during growth

The majority of symptoms associated with excessive overbite are noticeable in early childhood, even before permanent teeth erupt.

The complications of major overbite vary from case to case and depend on the severity of the condition and the age at which treatment is sought. The most commonly cited complications include the following:

• Difficulty in chewing food
• The development of a lisp or similar speech impediment due to the position of the teeth
• Severe wearing down of tooth enamel
• Soreness and general discomfort of the jaw and gums
• Injury to the roof of the mouth behind upper teeth due to constant resting over bottom teeth
• Unpleasant altering of the face’s appearance
• Increased risk of gum disease and tooth loss

Treatment and Correction

After a thorough exam, comprehensive evaluation and x-rays have been performed, the dentist issues a diagnosis. If the overbite is relatively minor, the maxillofacial surgeon may refer the patient to an orthodontic specialist for assessment, as braces are sometimes used to correct certain overbites. If, however, the problem lies in the patient’s jaws themselves, orthodontic braces will do little to help align the teeth. In these cases, orthognathic surgery is required to correct the condition.

If a patient suffering from overbite and its related complications has lived with the condition for many years, the damage caused over the course of a lifetime must be addressed as well. After recovery from surgery, the patient attends follow-up visits with his or her oral surgeon in order to correct any remaining issues that affect the teeth, gums and palate.

Face and Jaw Surgery Center serves all of North Dakota and North West Minnesota including Moorhead, MN and East Grand Forks, MN

Bismarck, ND office

Fargo, ND office

Grand Forks, ND office

Minot, ND office