Dr M P BRAVERMAN & Dr R P GREWAL - Certified Specialists in Oral and Maxillofacial Surgery  
  • Dental Implants
  • Wisdom Teeth
  • Extractions
  • Dentoalveolar Surgery
  • Pre-Prosthetic Surgery
  • Bone Grafting
  • Sinus Lift
  • Socket Grafting
  • Soft Tissue Grafting
  • Corrective Jaw Surgery
  • Facial Trauma
  • TMJ Disorders
  • Anesthesia
The last molars to erupt in the back of your mouth are commonly known as Wisdom Teeth (Maxillary and Mandibular Third Molar). Normally a person will develop four wisdom teeth, but some people may have more or less.
Early humans had larger jaws and a rougher diet which caused wear on their teeth making it spatially possible for them to keep and use their wisdom teeth. However, with our current jaw structure and diet there is less space for the wisdom teeth and very little use for them.
  Wisdom Teeth in  12 Years   Wisdom Teeth in  14 Years  
  Wisdom Teeth in  17 Years   Wisdom Teeth in  25 Years  
When and Why Should My Wisdom Teeth Be Removed?
A tooth becomes impacted because there is a lack of space in the dental arch, causing the tooth to grow on an angle towards the other molars and their roots. This impaction can cause pain, lead to infection, or cause other pathologic conditions (See Figure 1).
The wisdom tooth may also crowd or damage the adjacent molar and its roots (See Figure 2), or damage the jaw bone and its nerves. Also, when the wisdom tooth is growing toward adjacent teeth, it can trap plaque and debris making your teeth more vulnerable to decay.
Wisdom teeth will likely cause problems as the patient ages. Approximately 85% of wisdom teeth will need to be removed. Early removal of wisdom teeth is recommended before the wisdom teeth begin to cause problems in your mouth and to avoid more complicated procedures in the future.
  Figure 1: Infection Caused By Impacted Tooth   Figure 2 : Damage to Adjacent Tooth Caused By Impacted Tooth  
What Does Removing My Wisdom Teeth Require?
The ease of the wisdom teeth removal depends on the position of the tooth and root development. A wisdom tooth that has fully cut through the gum can be extracted much like any other tooth.
A wisdom tooth that is underneath the gums and pushed into the jawbone will require an incision into the gums and removal of the portion of bone that lies over the tooth. In this case, the tooth will be extracted in smaller portions to minimize the amount of bone that is removed.
Wisdom teeth can be removed using local anesthesia or some form of sedation. The anesthesia options will be discussed with you to determine what type of anesthesia is best for your needs.
What Does Recovery Involve?
After your wisdom teeth are removed you may experience some swelling and mild discomfort, which are normal symptoms and are part of the healing process.
Dentoalveolar Surgery
What is Dentoalveolar Surgery?
Dentoalveolar surgery is the removal of impacted teeth and difficult extractions, and the treatment of diseases of the teeth, soft tissue, and the jawbone.
What are Dentoalveolar Procedures?
The most common dentolalveolar procedure is the extraction of teeth which are either badly decayed or impacted. Other dentoalveolar procedures include:
Adding, reshaping or removing hard and soft tissue supporting teeth
Biopsy and removal of lesions, and simple cysts of the mouth
Controlling oral infections
Removal of impacted teeth (ie. Wisdom Teeth)
Pre-prosthetic Surgery
What is Pre-prosthetic Surgery?
Pre-prosthetic Surgery is a procedure to prepare your mouth before the placement of a prosthesis (complete or partial dentures).
Your denture will sit on the bone ridge. In order to ensure the denture fits well in your mouth and feels comfortable, the bone and tissue area must be the appropriate shape and size. When a tooth is extracted, the area beneath the extracted tooth may be left uneven or jagged. This bone may need to be reshaped or leveled. Sometimes, the bone may need to be removed.
What are Pre-prosthetic Procedures?
The following procedures may need to be completed in order for your denture to fit well within your mouth:
Removal of excess bone
Removal of excess gum tissues
Bone ridge reduction
Bone leveling and reshaping
We will determine the appropriate procedure during your evaluation.
Will I be Asleep during the Procedure?
You have several anesthetic options when receiving pre-prosthetic surgery.
Local anesthesia
General anesthesia (where you are put to sleep)
Conscious intravenous sedation
Nitrous Oxide Gas (laughing gas)
Oral Sedation (“happy pills”)
Dr. Braverman and Dr. Grewal will discuss with you the various anesthetic options during your evaluation.
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