SteeleDental

Extraction of wisdom teeth should be accomplished between the ages of 13-18.  Sixteen is a good average age to consider extraction of the wisdom teeth.  The exact timing depends on the root development of the wisdom teeth.  Waiting too long can increase the risk of numbness due to nerve damage during the extraction and can be permanent.  If over 40, we carefully consider the need for elective extraction.  Generally, people over 40 do not heal as well as those in their teens.

Once the need for surgery is certain, it is usually done under intravenous anesthesia in the office.  If the patient has medical issues or special considerations either an anesthesiologist can be brought in or the surgery can be done in an outpatient surgery center.

All patients need to come in for the surgery appointment without anything in their stomach.  NOTHING TO EAT OR DRINK FOR AT LEAST 6 (SIX) HOURS BEFORE SURGERY.  The surgery usually takes 30-40 minutes with additional time for recovery from the anesthesia.  The entire surgery appointment can be completed in about one hour.  Dr. Steele's staff will monitor vital signs, check to make sure bleeding is controlled, make sure pain is controlled and ensure the patient can walk with assistance before discharge.

Postoperative pain medications and antibiotics are prescribed at the consultation appointment.  These should be administered to the patient within about one hour after the surgery to control postoperative pain.  All patients who are taking a narcotic pain medication will need to eat shortly after surgery.  Usually a milk shake, fruit smoothie, ice cream, yogurt or apple sauce eaten with a spoon (no straws) is the first food after surgery and before the pain medicine is given.  Some patients will experience nausea and possibly vomiting after surgery or more commonly after the narcotic pain medication.  Typically Ibuprofen only will be prescribed for pain control.  With an adequate dose and taken at the appropriate time interval, Ibuprofen can control postoperative pain in most patients.

Ice packs used for the first 24-36 hour after surgery are useful to minimize swelling.  Most patients however will have significant swelling the day after surgery.  The more difficult the extractions the more swelling is a good rule-of-thumb.  Starting at about 48 hours after surgery, moist heat can be applied to the face, jaws and neck to help reduce swelling, bruising and sometimes reduce pain.

Dr. Steele will schedule a follow-up appointment to see that healing is progressing well.  If you should have problems or questions after surgery, Dr. Steele will give you his home and cell phone numbers for your unlimited use.  Dr. Steele will call you the night of surgery to check on your pain control, bleeding, oral intake, and general well-being.  A member of the staff will call during the first few days after surgery to check on your progress.  Our hope is that all patients treated here will feel they have recieved the very best of care.  We in turn will work our hardest to make you feel comfortable with us and your overall treatment.
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There are multiple reasons for the extraction of teeth.  Dental abscess, dental decay, periodontal disease, fracture, root canal failure, orthodontic considerations, and extra teeth are a few of these. 

Modern dental techniques should make uncomfortable extractions a thing of the past.  If intravenous sedation is allowed by the patient, these extractions can be done without the patient knowing anything has been done.  If adequate postoperative pain control is acheived, extractions can be no more unpleasant than a tooth filling.

Dental implants are root shaped titanium posts placed where the root of an extracted, missing, or needed tooth is desired.  Sometimes the dental implant can be placed immediately after the extraction.  Other times, the extraction site needs to heal for 3 months before the implant is placed.

After the implant is placed and it is allowed to heal undisturbed, the crown is placed by your restorative dentist.

The entire process can take as long as 6 months from extraction to tooth.  Even longer if bone grafting is needed.

It is more common now for dental insurance to pay a portion of the cost for replacement of a tooth with dental implants.  Also, since dental implants are elective and take time to complete, many will use medical savings accounts to pay the cost with pre-tax dollars.

Orthognathic surgery means 'surgery to straighten the jaws'.  This is a complex array of surgical treatment options to correct deformity of the jaws.  Sometimes it is used to correct problems with normal jaw development like severe sleep apnea.  More commonly it is used to correct growth deformities which prevent the teeth from making meaningful contact for chewing, swallowing, speaking, or allowing space for the tongue.

Orthognathic surgery is generally accomplished under the direct supervision and consultation of an Orthodontist.  Orthodontic therapy is initiated and completed before, during and after the surgical treatment is performed.  Dr. Steele will work with multiple healthcare practioners to complete the overall process.  Orthodontists, anesthesiologists, internal medicine doctors, nurses, and other surgeons will sometimes be brought in to get the best possible outcome.

Occasionally there is a need to help an impacted tooth erupt into the mouth.  Many times these teeth will need orthodontic help to come in where needed.  Dr. Steele carefully exposes the tooth, bonds an orthodontic bracket to the tooth and sends the patient back to their orthodontist for completion of the tooth movement.  This process may take several months for the tooth to be in a normal position and other times the tooth may not be able to be moved at all.  When this happens Dr. Steele will usually extract the tooth at no additional cost to you.

When the teeth are not able to be saved or if a patient cannot get comprehensive dental care for whatever reason, it may be neccesary to extract all of the remaining teeth or most of the remaining teeth.  Dr. Steele will work closely with your dentist to be able to place an immediate denture at the time of surgery. Under intravenous anesthesia, the teeth are removed, the ridges are prepared and the dentures are placed, usually a soft liner is used to improve the comfort and fit initally.  This liner will be removed and replaced by your dentist sometimes as early as your first visit with them.