Jimmy Kayastha

If you haven't noticed any visual symptoms, such as an open bite, look for other clues you may need corrective jaw surgery. These include chronic mouth breathing and sleep apnea, which may be present with severe snoring.

Only in very severe cases will an open bite require oral surgery. Usually, it can be corrected with regular orthodontic intervention, such as braces or Invisalign.

This surgery is performed under general anesthesia, so there is no pain during surgery. Patients usually experience pain after the anesthesia wears off, which can last for a few days.

Repeat small mouth-opening and mouth-closing movements several times as a warm-up. Then, place your fingers on the top of your front four bottom teeth. Slowly pull down until you feel slight discomfort on the tight side of your jaw. Hold for 30 seconds, and then slowly release your jaw back to the staring position.

Outcomes of temporomandibular joint (TMJ) surgery, including TMJ arthroscopy, use both subjective and objective criteria based on changes in pain and maximum interincisal opening (MIO). TMJ arthroscopy has reported success rates of 80% to 90%.

If it is very large or has caused damage, the surgeon may also remove some teeth, roots, and a section of jawbone. Afterward, the cyst will be sent to a special pathologist for analysis. The whole procedure usually takes up to 1 hour.

The cyst is removed through a window in the bone under a local anesthetic. You may also choose to be sedated for the entire procedure to ensure an anxiety-free experience. If there is a tooth embedded within the cyst, it might also be removed.

Typically dry socket patients experience a dull ache or throbbing pain in the gum area and they may also experience an unpleasant taste or smell emanating from the tooth extraction site.

Your jaw may be wired shut for six weeks following jaw surgery, so your jaw bones can heal.

In many cases, a loose adult tooth or teeth can be stabilized by attaching them to neighboring teeth through a procedure called splinting. This is usually a temporary procedure lasting a few weeks or months that allows gums to heal and helps the ligaments to strengthen around the tooth.

Jaw surgery is performed by oral and maxillofacial surgeons. Surgery is usually done under general anesthesia.

Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body's normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively.

Dry socket (alveolar osteitis) is a painful dental condition that sometimes happens after you have a permanent adult tooth extracted. Dry socket is when the blood clot at the site of the tooth extraction fails to develop, or it dislodges or dissolves before the wound has healed.

Normally, a blood clot forms at the site of a tooth extraction. This blood clot serves as a protective layer over the underlying bone and nerve endings in the empty tooth socket. The clot also provides the foundation for the growth of new bone and for the development of soft tissue over the clot.

Exposure of the underlying bone and nerves results in intense pain, not only in the socket but also along the nerves radiating to the side of your face. The socket becomes inflamed and may fill with food debris, adding to the pain. If you develop dry socket, the pain usually begins one to three days after your tooth is removed.

Dry socket is the most common complication following tooth extractions, such as the removal of third molars (wisdom teeth). Over-the-counter medications alone won't be enough to treat dry socket pain. Your dentist or oral surgeon can offer treatments to relieve your pain.

Considering that orthognathic surgery promotes changes in orofacial structures constituting the resonating system, functional changes secondary to surgery are expected to affect speech, leading to the need for further speech and voice adjustments.

Initial jaw healing typically takes about six weeks after surgery, but complete healing can take up to 12 weeks. After initial jaw healing — at about six weeks — your orthodontist finishes aligning your teeth with braces. The entire orthodontic process, including surgery and braces, may take several years.

OTC pain relievers such as ibuprofen and acetaminophen may help relieve TMJ pain. Muscle relaxers may be prescribed for severe pain. In our practice, we may also recommend mouth guards to prevent teeth grinding and jaw clenching. Although the causes of TMJ disorders are often unclear, discomfort in this joint can be caused by an injury to the jaw, arthritis, teeth grinding, excessive gum chewing, or a misaligned bite. Some of these self-care remedies may help reduce soreness and tension in the joint:

-Eat soft foods
-Try relaxation techniques
-Do TMJ stretches and exercises
-Avoid chewing gum
-Avoid clenching or tensing your jaw
-Apply moist heat to the area
-Anti-inflammatory medication and muscle relaxants can also help to relieve tenderness. A mouth guard may be a treatment option if your TMJ pain is caused by teeth grinding.
-Orthodontic appliances are a great way to correct the upper and lower teeth, as misalignment can result in problems with the temporomandibular joint.

It is abnormal if bleeding continues without clot formation, or lasts beyond 8 to 12 hours; this is known as post‐extraction bleeding (PEB). Such bleeding incidents can cause distress for patients, who might need emergency dental consultations and interventions.

There are several key steps to facilitating clot formation:
1. Apply firm (slightly uncomfortable) pressure with gauze. The gauze must be directly over/under the extraction site. Pressure should be applied for 15 minutes continuously. The gauze must be the proper size to apply pressure (not too small) while enabling the mouth to be closed most of the way so the jaw doesn’t get fatigued (not too big).

2. “Bleeding has stopped” doesn’t mean there is no more blood in the mouth or saliva. It is normal to have some blood in saliva for a few days after an extraction. The key is blood is not welling up or dripping and making it difficult to talk, eat, breathe. Often the gauze will be somewhat pink but not deeply red and saturated. If it is somewhat pink this indicates bleeding is well controlled.

3. Maintain the blood clot. Once a clot has formed it is important to not disrupt it. This is accomplished by avoiding vigorous rinsing, sucking through a straw, or spitting. If bleeding resumes you can apply pressure again and the clot will re-form.

4. Black tea bag. Dipping a black tea bag in cold water, rolling it in a gauze or paper towel, and applying it over an extraction socket can facilitate clot formation due to the tannin in tea.

5. If you run out of gauze you may use a paper towel cut to the appropriate size.

If after trying these things you are still concerned about post-extraction bleeding you should contact your doctor. If your doctor isn’t available or if you develop symptoms of lightheadedness, shortness of breath, dizziness, chest pain, or other concerning symptoms, you should go to the Emergency Department.

This blog is meant to be a source of educational material on bleeding after a dental extraction. It is not intended to be clinical advice. Real clinical scenarios require doctor-patient discussion, exams, and assessment.

If you're experiencing TMJ pain, you should see a dentist. Dentists don't just treat your teeth—they're specialists who are trained in the anatomy of the jaw and diagnosing dysfunction in the bite.

Of course, not all dentists have the necessary knowledge and experience required to diagnose and treat TMJ pain. Some use a one-size-fits-all approach, giving all of their patient's bruxism appliances and sending them on their way. This may work for some patients, but not all. Invasive treatments may worsen symptoms.

Gum/Gingival surgery is a painless procedure due to local anesthetics. There may be some discomfort associated with the procedure. However, if tissue is removed, you may experience some mild to moderate discomfort following the procedure. Pain may occur following a periodontal surgery that involves the opening of a flap, gingival grafts, or gingivectomy/frenectomy procedures. Postoperative pain experienced within the first 3 days after surgery is considered normal and should progressively diminish throughout the healing phase. Postoperative pain can be the result of extensive and long surgical procedures; poor tissue handling, poor infection control, or poor knowledge of surgical anatomy.

Most of the time, tonsillectomy is performed in children, and it is a routine and minor procedure. In some cases, children are sent home the same day as the operation and recovery time is one to two weeks.

In adults, tonsillectomy is still a routine procedure, but patients make take longer to recover and may experience some postoperative discomfort.

Many of our patients have asked us if it would be best to space out wisdom tooth extractions. We are often asked, “Why have all 4 wisdom teeth extracted at the same time?”.

In our practice, we believe removing all four wisdom teeth at once (if indicated) is the best option for most patients for the following reasons.

Safety
Why remove a wisdom tooth that seems healthy and to be growing in properly? Unfortunately, things aren’t always as they seem. Most people do not have room for their wisdom teeth/third molars. Third molars are notorious for causing a variety of dental problems despite a lack of symptoms. They have the potential to not fully erupt, and when this happens, they are impacted and can damage adjacent teeth and their roots, causing pain, infections, cysts, and misalignment. Overcrowding also makes it difficult to clean teeth which can lead to cavities and gum disease. Play it safe and seek a consult to determine if you should have your wisdom teeth removed before they end up causing havoc down the road.

Convenience
It’s always a challenge to find time in your schedule for things like dental procedures, not to mention the aftercare required for a successful recovery. You probably read in last month’s blog that we recommend a soft diet and lots of rest for several days after surgery. In fact, if you are doing anything other than relaxing the first 72 hours after your procedure, you are likely to impede the healing process, and it’s wise to refrain from strenuous activity for a week. When you have the opportunity to have all four wisdom teeth removed at once and save time, the choice for a one-and-done seems like a no-brainer. It takes the same time to recover from one tooth as it does from four.

Comfort
We have found that the number of teeth that are removed at one time does not affect the level of discomfort our patients experience. Even though our practice is known for comfortable, seamless surgeries, any procedure, by nature, can be a bit uncomfortable, and the overall discomfort in this surgery does not increase when four teeth rather than two are removed. On the other hand, undergoing two surgeries doubles the discomfort. Why put yourself in a mildly unpleasant situation more than once if you don’t have to?

Affordability
For obvious reasons, it’s more expensive to have a separate surgery for each tooth extraction than one for all four. When priced out individually, you’ll be paying for multiple office visits, more surgical expenses, and doubled or tripled anesthesia costs. Why pay fees for two, three, or four procedures when you can have all four teeth removed in one?

Remember that no matter how nicely your wisdom teeth seem to be coming in, make sure to get regular cleanings so your dentist can keep an eye on them. Wisdom teeth are more susceptible to decay, due to their location in the back of your mouth, and can be a source of gum disease, spreading to the rest of your teeth. If you’re unsure of the status of your wisdom teeth and have more questions about the process of having them removed, call us today. We’d love to discuss your concerns and examine your teeth at a consult.