Mouth surgery is a surgical procedure to treat abnormalities of the oral cavity. Through the procedurethis, abnormalities that occur in the jaw, both the upper and lower jaw, can also be handled. On the other hand,bOral surgery can also treat abnormalities that occur in the teeth and gums.
Oral surgery is performed by a dentist who specializes in oral surgery. The scope of the diseases treated and the procedures performed by oral surgeons is quite extensive. However, the most frequently used include:
- Dental implants. Dental implants are surgical procedures that aim to replace the roots of missing teeth and teeth with artificial tooth roots (implants) that are implanted into the gums. With the implanted artificial tooth root, patients can replace their missing teeth with artificial teeth that will be attached to the implant. Dentures and dental implants will function like natural teeth, and can last longer than dentures.
- Wisdom tooth surgery. Wisdom teeth are molars that are located at the back of the mouth, and generally will grow at the age of 17-25 years. Wisdom tooth surgery aims to remove wisdom teeth that are trapped in the gums (impacted), grow in the wrong direction, or the patient's jawbone does not have sufficient space for wisdom teeth to grow. With wisdom tooth surgery, patients will avoid various complications due to wisdom teeth that grow incorrectly, such as infections, cysts, and gum disease.
- Jaw surgery. Jaw surgery aims to correct abnormalities in the patient's jaw, either in the upper jaw (maxilla) or in the lower jaw (mandible). With jaw surgery, the jawbone and teeth can be positioned so that they can function better, especially dental or jaw abnormalities that cannot be treated through orthodontic surgery. Jaw surgery can also improve the shape of the patient's face.
Oral Surgery Indications
Patients will be recommended to undergo oral surgery if they have certain diseases. Patients undergoing jaw surgery are patients who have a disease or condition, such as:
- Abnormalities in the jaw, such as a protruding jaw (protruding jaw).
- Headaches that interfere with daily activities due to jaw deformity.
- Chewing and speech disorders, such as overbite, underbite andcrossbite.
- Sleep disturbances (sleep apnea) caused by blockage of the respiratory tract due to jaw deformity.
Patients can undergo wisdom tooth surgery if they have diseases or conditions, such as:
- Impacted wisdom teeth.
- Suffering from gum disease.
- Cavities in wisdom teeth.
- Wisdom teeth that grow in an incorrect position.
- The emergence of cysts or abscesses in the gums around wisdom teeth.
- The occurrence of cellulitis on the cheeks, tongue, or throat.
For dental implants, patients who have one or more missing teeth can undergo dental implants. However, dental implant procedures have requirements, including:
- Have healthy gum and mouth tissue.
- Have a healthy and strong jawbone, and allow for bone grafting.
Oral Surgery Warning
Not all patients can undergo oral surgery procedures. Several conditions can prevent a patient from undergoing oral surgery because it can lead to postoperative complications.
A patient should not undergo dental implants if:
- Have diabetes or heart disease.
- Are undergoing radiotherapy to the neck or head area.
- Is a heavy smoker.
- Not having healthy enough gums and jawbones for dental implants.
Wisdom tooth surgery also has several conditions that cause patients not to be recommended or postponed to undergo wisdom tooth surgery, and if it is still carried out, it requires special treatment and supervision from a doctor. Some of these conditions are:
- The occurrence of infection in the tooth to be operated on.
- History of radiotherapy on the part of the tooth that will undergo surgery.
- Diabetes.
- Have advanced liver or kidney disease.
- Hypertension.
- lymphoma.
- Have a blood clotting disorder, such as hemophilia.
- First or last trimester of pregnancy.
Just like wisdom tooth surgery, jaw surgery also has some conditions that cause the patient to be given special treatment or supervision during surgery to prevent complications. Some of these conditions include:
- Patients who have poor oral hygiene.
- Blood disorders.
- Experiencing blood vessel disorders in the area that will undergo surgery.
Oral Surgery Preparation
Prior to undergoing oral surgery, the patient will undergo an examination first as part of the patient's preparation before surgery. This examination includes scanning the condition of the mouth and teeth with dental X-rays, CT scans, or MRIs, as well as making a model of the patient's mouth and teeth based on the results of these scans. Patients who are about to undergo jaw surgery will be put on braces from 12 to 18 months before surgery, to adjust the position of the teeth to suit the jaw to be operated on.
If the patient needs a bone graft, especially for dental implant surgery, the doctor will plan to take the bone graft with the patient. Patients who are experiencing an infectious disease will be given antibiotics before undergoing surgery to prevent postoperative complications. Patients are also required to inform their doctor about their health conditions before undergoing surgery, including any medications they are currently taking. If necessary, the patient will be asked to stop taking these drugs a few days before undergoing surgery.
Patients undergoing jaw surgery will undergo surgery under general anesthesia. Patients who will undergo dental implant surgery and wisdom tooth surgery can be given local or total anesthesia. Patients who are given a local anesthetic may also be given a sedative to help them relax during surgery.
Oral Surgery Procedure
The patient will first be asked to change into a surgical gown. After that, the patient will be placed on the operating table in a position according to the need for action. The patient will then be given anaesthesia, either local or general anaesthesia, and sedation may be added if needed.
Dental implant surgery and wisdom teeth will begin with making an incision (incision) in the gums to open the gum tissue and jawbone. Patients undergoing wisdom tooth surgery will undergo removal of the jaw bone that blocks the wisdom tooth area to make the wisdom tooth extraction process easier. The doctor will then cut the wisdom tooth into several pieces and remove the wisdom tooth from the gums. The gums that were previously occupied by wisdom teeth will be cleaned to prevent infection and remove any remaining tooth fragments and jawbone. The gums are then sutured using sewing thread that can blend with the gums. If needed, the doctor will place a bandage on the gums to help stop the bleeding and help the gums heal.
Unlike wisdom tooth surgery which generally takes place in one day, dental implant surgery usually takes place several times and on different days. The first step is to remove the root of the tooth from the gums to provide space for the dental implant to be placed in the jawbone. After that, a dental implant will be placed on the jawbone which can be started with a jawbone graft or not.
If the dental implant has been fused with the jawbone through the process osseointegration, the implant that has been implanted will be installed abutments as a link between dental implants and denture crowns. The dental crown will then be placed on the abutments as the final step in placing dental implants. The time lag from one stage to another in the installation of dental implants can last from several weeks to several months, because each stage must go through a recovery phase before moving on to the next stage. Therefore, patients who will undergo dental implant surgery must have a commitment to undergo the implant installation process for several months.
Jaw surgery begins with making an incision around the part of the bone to be repaired. Slices are generally made on the inside of the mouth, but incisions can also be made on the outside of the mouth if needed. After the incision is made, the doctor will reconstruct the jawbone as needed, either the upper jaw bone, lower jaw bone, or chin bone. Reconstruction can take the form of cutting or adding bone. If bone addition is required, the patient will undergo a bone graft which can be taken from the femur, hipbone, or ribs.
Bone that has been reshaped by cutting or adding, will be kept so that the repaired bone remains in that position, the doctor will connect it with the help of bone plates, bolts, adhesive, or wire. The bone grafting tool used will be fused to the bone so no surgery is needed to remove the tool.
After the operation is complete, the patient will be taken to a special room for recovery. Generally, patients who have wisdom tooth surgery and dental implants are allowed to go home after the procedure is complete. However, if necessary, the patient will be asked to rest first to undergo recovery. Patients undergoing jaw surgery will be taken to the recovery room before being allowed to go home. If necessary, the patient can be hospitalized before undergoing outpatient treatment.
After Oral Surgery
The recovery period for each operation varies from one another. During the recovery period, patients may experience pain, swelling, and bruising in the area that underwent surgery. Patients undergoing dental implant surgery and wisdom teeth may also experience bleeding from the gums that were operated on. The doctor will provide pain medication, antibiotics, and mouthwash for the patient to use during the recovery period. To relieve swelling and bruising, the patient can apply cold compresses to the bruised area with cold water or ice.
Patients should rest and avoid strenuous physical activity for a few days after surgery. Foods that should be consumed by patients during the recovery period are soft, not hard, not spicy, and not hot because it can cause the surgical wound to become painful. Patients are advised to drink plenty of water during recovery and avoid fizzy, caffeinated or alcoholic beverages.
If brushing teeth still causes pain in the surgical area, the patient can clean his mouth using the mouthwash that has been given by the doctor. Patients who have a smoking habit should stop smoking during the recovery period. If the patient is sutured with sutures that are not absorbed by the body, the patient will be scheduled to undergo suture removal by the doctor. The doctor will also arrange the schedule check up to monitor the patient's recovery period.
Oral Surgery Risks
Some of the risks of complications that can arise from undergoing oral surgery include:
- Bleeding.
- Nerve tissue damage.
- Infection.
- Jaw fracture.
- Loss of jawbone.
- The jawbone returns to its preoperative position.
- Jaw joint pain.
- Injury to the tissues around the gums, especially blood vessels and nerves.
- Disorders of the sinuses, especially if the operation was performed on the jaw or upper gums.
