Do you need to replace an entire row of teeth? In many cases our doctors at Seattle Jaw Surgery can replace an entire row of teeth in one surgical appointment. There are several ways to replace your teeth and each situation is different. Some options allow for a removable denture that is held more tightly in place by dental implants. Other options allow for a denture that is permanently fixed to the dental implants and can be removed for cleaning by a dental professional. Learning about the best option for your individual case starts with a consultation appointment with one of our doctors at Seattle Jaw Surgery. Once a method for replacement of your teeth is established, we will obtain a CT scan of your dental arches and a digital impression of your teeth. This data is used to plan for and make your new dentures. After the planning phase you are ready for surgery. Often your teeth can be removed, implants placed, and a temporary set of dentures inserted all in the same appointment.
What are my options for replacing a full arch of teeth?
It is important to realize that the following options will not work for all patients. Each treatment plan is custom tailored to the specific situation. With that in mind the general categories for full arch replacement are as follows.
Replacing teeth with implants and dentures is possible for many patients. Implants can be placed on an angle permitting use even in patients with significant bone loss. This also minimizes the need for bone grafting. If you would like to explore your options, contact our office for a consultation with one of our doctors.
The specifics of what to expect with be discussed at the consult appointment. Often sedation is used during the surgery. If this is the case, you will have to refrain from eating or drinking after midnight the night before your procedure. The duration of the surgery varies from about one hour to a few hours.
Yes. You will be on a soft diet for several weeks after surgery. It is also very important to keep the surgical area clean. You will be prescribed medications. These medications vary but often antibiotics and pain medication are prescribed. Your doctor will go over the specific instructions for medications on the day of surgery. Any questions that you may have will also be answered on the day of your surgery.
There are several pathologic processes that can be associated with the soft tissue, teeth, and bones of the mouth. Thankfully, many of these processes are benign. If your or your dentist notice changes to the soft tissue in your mouth or something abnormal on x-ray, evaluation for a biopsy should be considered. If biopsy is performed your oral surgeon may remove the entire lesion or just a portion depending on size and location. The results of your biopsy will determine what further treatment is indicated, if any. Malignant processes such as squamous cell carcinoma can also appear in the oral cavity. Biopsy of any suspicious lesion should be completed in a timely manner so that a definitive treatment plan can be rapidly developed. When a diagnosis comes back positive for malignancy, a referral to a head and neck cancer surgeon will likely be made.
Depending on the location and size of your lesion, your procedure may be completed with local anesthesia or sedation. There are many factors that contribute to this decision and the type of anesthesia is determined on a case by case basis. Your surgery may involve complete removal of your lesion or taking a small sample of the lesion to send to a pathologist for a diagnosis. After a diagnosis is made, a final treatment plan is formulated.
The treatment for pathology varies greatly based on diagnosis and so does the recovery process. You will be given post-operative instructions on the day of your appointment and a general idea of what to expect can be determined at your consultation.
Our goal is always to preserve teeth but there are circumstances where it is just not possible to save a tooth. If you need to have a tooth or multiple teeth removed, our doctors at Seattle Jaw Surgery will guide you through the process in the most comfortable way possible. We will work with your restorative dentist to formulate the best plan to replace the newly missing tooth (see our dental implants section for more). Ever situation is different, and your tailored treatment plan will be discussed at the consultation appointment.
The removal of your tooth or teeth may be done with local anesthesia, much like you would expect during a filling or under sedation. The type of anesthesia used will be discussed during your consultation appointment. Our primary concern is for your safety and to make the procedure and comfortable as possible. Once the teeth are removed gauze will be placed in your mouth to apply pressure at the surgical site. Depending on the situation, your gums may be closed with a stitch. It is important to keep in mind that if you are sedated for the surgery, you will need a responsible driver to take you home.
Yes. You will need to keep the extraction site clean and free of debris for the first couple of weeks after the tooth removal. You will also need to take all medications exactly as prescribed by your surgeon. Avoid sucking through a straw for the first several days after surgery and notify your surgeon if you experience fever or discomfort that worsens after a few days.
After wisdom teeth, the canine teeth are the next most common teeth to be impacted. The treatment for this condition varies and is often determined by your orthodontist. In some cases, the canine tooth may need to be removed. In other cases when there is space the tooth will need to be surgically exposed. An orthodontic bracket can be bonded to the tooth and a chain connected to the bracket will allow your orthodontist to aid in its eruption.
This procedure is most commonly completed under sedation in the office. After you are asleep the tooth is accessed surgically. An orthodontic bracket is bonded to the tooth and an attached chain is secured to your braces with a wire or stitch. Any incisions are closed with stitched that do not have to be removed. Later, your orthodontist with put traction on the tooth to help it erupt.
It is common to have a small amount of swelling and soreness in your mouth after this procedure. These will begin to improve after about three days in most cases. You may be prescribed medications and should take them exactly as they are written. Your oral surgeon will recommend eating only soft foods during the first several days following your procedure. It is also important to follow all instructions for post-surgical care, including cleaning the surgical site. Be sure to contact your surgeon if you experience any fever or discomfort that worsens after about three days.
Jaw alignment is an important part of oral health. When the jaw is out of alignment, it can negatively affect the bite, as well as the function of the mouth. Some misaligned jaws are so problematic; they cause abnormal wear on the teeth and other secondary symptoms, such as headaches. Also known as orthognathic surgery, jaw alignment surgery is meant to address irregularities that impair the normal function of the jaws. By undergoing corrective jaw surgery, patients can improve their bite, speech, and appearance – not to mention alleviate other side effects.
Though only an oral surgeon can let you know if jaw surgery is right for you, there are some signs and symptoms that the procedure could be right for you:
You may be a candidate for corrective jaw surgery if you have a malocclusion (bad bite) that is caused by poorly aligned jaws. Only a complete consultation with an oral surgeon can help you determine whether jaw surgery is right for you.
You’ll be evaluated by an oral surgeon to determine if oral surgery is right for you. In some cases, a bad bite can be treated with orthodontics alone. In others, a combination of orthodontics and jaw surgery, or jaw surgery alone is used to correct alignment issues. If you require orthodontic treatment, treatment will occur prior to jaw surgery.
X-rays will be taken of your teeth in a pre-surgical consultation. On the day of your operation, you’ll be placed under general anesthesia. An incision will be made on the inside of your mouth, through which your surgeon will reposition your jaws. Some jaw surgeries involve bone shaping, which may include shaving some bone away or grafting new bone into the jaw. A combination of plates, screws or wires may be used to hold the jaw in place before your incision is closed.
Yes. The initial healing phase is usually a few weeks long. During this time, you’ll be placed on a modified diet and instructed to avoid certain activities. It is important to take all medications as prescribed and to keep the incision site clean and free of debris. Your jaw may be swollen and sore for several days after surgery. Be sure to contact your doctor if you experience fever or any discomfort that worsens with time. Keep in mind that your jaw will continue to heal over the course of several months – a process that can take up to one year to complete.
The wisdom teeth are the final four teeth to erupt from the gums – usually sometime between age 17 and 25. Also known as third molars, these teeth can emerge and function without complication. Unfortunately, for many people there is not enough room in their jaws for the teeth to erupt and function normally. If this is the case, they can cause pain, infection, swelling or pathology. Other times they are removed to facilitate straightening of your teeth or jaw surgery. For these reasons, many people have their wisdom teeth removed.
Did you know that wisdom teeth may need to be removed even if they have not yet caused any problems? Even wisdom teeth that erupt normally may still be vulnerable to decay over time. Because of the location of wisdom teeth at the back of the mouth, many patients find it difficult to clean and floss all surfaces of the teeth each day. Although complications may not appear immediately, wisdom teeth may begin causing problems in middle to late adulthood.
You may need your wisdom teeth removed if you have one or more impacted wisdom teeth or if you are having difficulty adequately cleaning those that have emerged. It is recommended that all young adults be evaluated by an oral and maxillofacial surgeon. A consultation and x-ray can reveal impaction, damage to neighboring teeth, signs of decay, gum disease, or perceived complications with future wisdom tooth eruption.
Your wisdom teeth removal will likely be performed in your oral surgeon’s office. Most removals take only minutes to perform, but you’ll be under anesthesia or sedation to prevent discomfort. Once the teeth are removed, the gums are sutured shut. Keep in mind that you will need a responsible driver to take you home following the extraction, as it will not be safe for you to drive after being heavily sedated.
Yes. You’ll need to keep the extraction site clean and free of debris for the first couple of weeks after the wisdom teeth removal. You’ll also need to take all medications exactly as prescribed by your surgeon. Avoid sucking through a straw for the first several days after surgery, and notify your surgeon if you experience fever or discomfort that worsens after a few days.
Sleep apnea is a dangerous sleep disorder that interferes with healthy breathing patterns during sleep. It is characterized by snoring, which may be so loud that it affects the sleep quality of bed partners. Having sleep apnea can put a strain on relationships, cause daytime fatigue, and even lead to other secondary conditions like depression. Worse, severe cases of sleep apnea can be life-threatening.
Though snoring is a primary symptom of sleep apnea, not all people who snore actually have sleep apnea. As much as 50 percent of Americans snore at some time, whether occasionally or chronically. However, only 20 percent of American adults have sleep apnea. So how do you know the difference? Harmless snoring does not interfere with breathing patterns. Sleep apnea, on the other hand, causes breathing cessations and sometimes ‘gasping’ during sleep.
You may need to see a doctor if you or your partner have been awakened by your chronic snoring and/or gasping for air. Though this condition can be very dangerous, your doctor can help you discover ways of managing sleep apnea and protecting healthy breathing during sleep.
Our first goal will be to determine whether your snoring is benign or a symptom of sleep apnea. This may be determined by speaking with you and your partner about your symptoms. If you do not have a partner who can confirm snoring or breathing interruptions, your doctor may request a sleep study.
There are many ways of treating the symptoms of sleep apnea. This may include conservative approaches, such as a new sleeping position or the use of an oral appliance. If your apnea symptoms are severe or conservative treatments are not working, you may be prescribed a continuous positive airway pressure device (CPAP) to open the airway. In severe cases, surgery may be necessary. Keep in mind that a diagnosis of sleep apnea is not always permanent. Many patients find that losing weight can be an effective way of opening the airway during sleep.
The temporomandibular joint is the area where the jaw meets the skull. These joints are are some of the most used in the body. When they cause pain or limit function, they can severely impact a persons overall quality of life.
We are here to help.
Did you know that TMJ problems are often exacerbated by stress? It is not uncommon for people under chronic or significant stress to clench their teeth worsening pre-existing symptoms. By adopting stress-minimizing habits, it may be possible to reduce the severity of TMJ problems and prevent them from worsening.
A TMJ disorder is something that interrupts the normal functioning of your jaw joints. This definition includes a broad variety of things as this area in the human body has complex anatomy and function. Millions of people suffer from TMJ disorders but fortunately most recover with conservative interventions. For those patients that experience persistent pain or limited function a further evaluation by a specialist is warranted.
The most common symptom that drives treatment is pain. This is because pain occurs with functions that are central to our lives. Many people notice worsening of their pain with speaking, chewing, swallowing, or yawning. The location of pain can be variable, but locations include the jaw joints, jaw muscles, neck, ear, or teeth. Other symptoms include limited mechanical movement of the jaw. This can be limited opening, crooked opening, locking of the jaw, or even chronic dislocation. Other symptoms include headaches, ringing in the ears, swelling in front of the ear, and changing in the way your teeth match when your mouth is closed.
Luckily most people respond to conservative measures such as jaw rest (not chewing), massage, or mild pain relievers. After a few weeks, if those measures do not improve the situation, prescription medications, physical therapy, or dental splints might help. These treatments are usually prescribed by your primary care doctor, general dentist or ENT specialist. A small percentage of people need further intervention and surgery is a consideration.
We primarily offer surgical solutions to your TMJ problems but are eager to recommend nonsurgical techniques if those are most appropriate.
Surgery is usually reserved as a last line treatment for many TMJ disorders. There are some disorders where this is not true. Here are some situations where you should visit us first for treatment:
1. Ankylosis – fusion of your jaw to your skull
2. Tumors – some benign tumors form in the jaw joint. These include osteochondromas, synovial chondromatosis, pigmented villonodular synovitis, or benign jaw cysts that include the condyle
3. Failed TMJ replacement device
4. Fracture – this is particularly true in fracture dislocations
5. Development abnormality – things such as Hemifacial Microsomia, Condylar Hyperplasia or a patent foramen of Huschke
6. Acute closed lock – this is a jaw joint that locks closed suddenly. Arthrocentesis is a minimally invasive solution to this and can be done in an office setting with relatively little risk.