Oral & Maxillofacial Surgery – Farrer Park Hospital
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What is Oral & Maxillofacial Surgery?
​Oral & Maxillofacial Surgery is a surgical specialty of dentistry, which involves the diagnosis and management of a variety of problems involving both the bones and tissues of the oral and facial region. Oral-maxillofacial surgeons had a dual qualification in medicine and dentistry, treating conditions that require expertise from both backgrounds.
Conditions
​Impacted Teeth
If a tooth fails to emerge or emerges only partially, it is considered to be impacted. This could be due to various reasons. Other teeth might be in the way or the jaw may be too small to accommodate wisdom teeth, which are the last teeth to emerge, usually between the ages of 17 and 21.
 
Some impacted teeth might push against the next tooth and there could be a misalignment of the bite. A partially emerged tooth can also trap food, plaque, and other debris in the soft tissue around it, which can lead to inflammation and tenderness of the gums. This can cause tooth decay. There have been cases of an impacted tooth causing pain in the mouth or swelling in the gums from accumulation of pus.

Impacted teeth that cause pain or other dental complications are usually removed by an oral-maxillofacial surgeon.
 
Missing Teeth
When a tooth is lost, the underlying bone is likely to shrink with time because of the absence of the tooth. Bone defects from root canal infection, missing teeth, falls or accidents, may also create a situation where bone needs to be added by means of grafting for implants to be inserted.

Furthermore, when upper back teeth are lost, the sinus cavity located just above tends to expand and drop down into the jaw bone in the area of the missing teeth. Sometimes, even if the teeth are still there, there is not enough height between the sinus floor and gum to allow correct sized implants to be placed.
 
Dental and Facial Deformity
This include skeletal and dental irregularities, ranging from receding lower jaw and chin, and protruding jaw, to the misalignment of jaws and teeth due to facial injury or birth defects.
 
Dental and Facial Trauma
Dental trauma is injury to the mouth, including teeth, lips, gums, tongue and jawbones. It can be sustained in sports where there is bodily contact, motor vehicle accidents, by eating hard food, drinking hot liquids, or other mishaps. As the tissues in the mouth are highly sensitive, injuries can be very painful and you should seek prompt medical attention . The most common dental trauma is a broken or lost tooth. While a broken tooth may not cause pain, it often has a sharp edge that may cut the tongue and cheek. When a tooth is knocked out, the socket is swollen, painful and bloody.

Cysts and Tumours
There are a number of cysts and tumors that affect jaws and organs that are related to the development of teeth. You may experience pain in the jaws and loosening of teeth, but in most cases, no symptoms appear. Once there is suspicion of a cyst or tumor, a biopsy is often performed and sent to a pathologist to determine if it is non-cancerous (benign) or malignant (cancerous).
 
Multi-Disciplinary Management of Obstructive Sleep Apnea
Obstructive sleep apnea is a condition in which the muscles of the upper airway relax as the patient is entering the deeper stages of sleep, causing a blockage. No air enters the lungs and there is a reflex rise in heart rate and blood pressure. The brain will arouse enough to allow the muscles in the upper airway to open up and allow air into the lungs. Most people with sleep apnea do not realize that they are awakening repeatedly to breathe throughout the night. This is because the arousal is slight and most people become accustomed to this. However, even this slight arousal is enough to disrupt your sleep pattern and you are drowsy and tired the next day.
Treatments

Impacted teeth that cause pain or other dental complications are usually removed by an oral-maxillofacial surgeon.

For missing teeth, sinus lifting procedures can surgically lift up the floor of the sinus cavity and place bone graft materials that will stimulate adequate growth of bone for dental implants, such as crowns, bridgework and dentures to be placed.

Corrective jaw surgery can be performed to correct skeletal and dental irregularities. It improves chewing, speaking and breathing.

In dental and facial trauma, other means have been developed to stabilize facial fractures since a cast cannot be placed on the face. One of these options involves wiring the jaws together for certain fractures of the upper and/or lower jaws. Some fractures of the jaw are best treated and stabilized by the surgical placement of small plates and screws at the affected site. This technique of treatment has significantly reduced the recovery period for many patients.

The majority of cysts and tumors are benign and treatment can range from simple removal of these tumors to more extensive surgery requiring reconstruction of the jaw after the tumors have been removed.

Treatment of obstructive sleep apnea with an oral appliance requires a multi-disciplinary approach, involving a sleep physician and a dental practitioner with expertise in the management of sleep disorders. An initial medical assessment is needed to confirm the diagnosis of the condition, determine its severity and to decide which oral appliance is appropriate. As part of the evaluation, overnight monitoring of breathing patterns should be performed. This is followed by a dental assessment and selection and fitting of a device. Surgery by an oral-maxillofacial surgeon could also be required.

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