ORAL SURGERY

ANESTHESIA: Typically, our office will give the patient medications to take before surgery with a set of instructions on how they should be taken.

Oral Sedation: This is administered by Dr. McConnell himself. Pre-operative sedatives are usually given to the patient to be taken on the day of surgery before arrival at the office. Instructions for diet, liquids, medicines, etc. are also given.
During surgery, nitrous oxide (laughing gas) is administered thru a mask over the nose, and local injections are given in the mouth to effect an adequate level of numbness and comfort. This is very effective for many people and may be all you would need for your surgery.

IV Sedation: This office uses an outside service of nurse anesthetists, or CRNA's (certified registered nurse anesthetists) who administer anesthesia to a level called "twilight sleep", with the patient being just 'awake' enough to cooperate during surgery, but not awake enough to know it! This is not general anesthesia, but given in the same way, and is felt to be safer for an office procedure.
There is a separate set of instructions on diet before surgery, as well as pre-operative meds. The patient is prepared for surgery and an IV line is put into a vein in the hand or wrist; nitrous oxide and local injections are also used during the procedure, with the patient generally being unaware of it. This option is a little more expensive, but some people may either require it or want it.

THIRD MOLARS ( Wisdom Teeth ): These large molar teeth are located in the back of the mouth behind all the other teeth. They typically come in 4's, but some patients have more or less than that number; the most we have seen is 8! These teeth are often not needed for chewing and are sometimes difficult to keep clean. They also erupt and cause crowding of the other teeth, especially if the wisdom teeth are lying at odd angles or fully covered with bone or impacted. This condition could lead to infection, pain, jaw cysts, etc.

Wisdom teeth usually start acting up in the late teen years or the beginning of the "age of wisdom", thus their nickname. A general dentist will usually refer to a specialist for removal, but a referral is not needed.

xray example

IMPLANTS: There may be spaces in your mouth where teeth were lost due to accident, periodontal disease, extracted or just never grew in. Perhaps you don't want to remove a complete or partial denture at night. Whatever the reason, placement of dental implants are one of the most popular dental procedures, and implants can look and feel like the real teeth that were lost.

The patient is evaluated to see if they are a candidate for implants: amount of existing jawbone and can it be replaced; medical/dental history, shape of mouth and bite, toothbrushing & hygiene, current and past medications, age and other factors.

If a candidate is willing to be patient during the process, which can take many months to complete, they will be rewarded with a great smile! xray example

The Process: A screw or cylindrical implant is placed into the jawbone where the tooth used to be, and may or may not need a build-up of artificial or freeze-dried bone. Healing membranes may also be placed at the site. After this area heals (3-6 months), the abutment or cap is placed on top of the implant. Finally, your general dentist will have made a crown that looks just like a tooth to be placed at the very final stage.

DENTURE PLACEMENT - We are here to assist your general dentist in the placement of your immediate denture right after tooth extraction. We work closely as a "dental team" to evaluate your specific extraction needs: the dentist will take impressions and study models of your future denture, which is then sent to us for checking by Dr. McConnell. The denture is made by your general dentist and delivered to our office for us to place at time of surgery. You will visit either us or your dentist the day after surgery for crucial adjustments.

BIOPSIES - If the patient has bumps, raised areas, white or red patches, pain and/or swelling in the face, jaws, lips or tongue or any suspicious lesions or questionable mouth tissue, that area needs to be investigated by removing a small piece (excisional biopsy) or the entire area (incisonal biopsy) and sending it to the pathology lab for diagnosis. This surgical procedure is often done in this office with a laser. Don't put off a visit; early detection and treatment is the key.   The Warning Signs of Oral Cancer

LASER SURGERY - A laser is a high intensity beam of light, which cuts with precision, with little blood loss, pain, or chance of infection as it seals as it works!

In 1994, our office had the first laser in a dental office in the area, so Dr. McConnell is very experienced in its use, especially in soft tissue work involving the mouth, lips, tongue and gums. The laser is especially effective for: biopsies, lichen planus, uncovering implants, frenectomies, incision or excision of lesions, mucoceles, removing undesirable, excess or diseased tissue, and shaping.

Who needs a laser? Anyone! but especially young children as there is no dental drill noise, cardiac patients and those with bleeding disorders, and people who have a higher than ordinary fear of dental procedures.

SALIVARY STONES - Sometimes a salivary (saliva) duct becomes blocked with the residue of calcium which can build up and block it, which in turn makes the area inflamed, enlarged and infected as well as leading to possible painful facial swelling (cellulitus)! A relatively simple surgical procedure can remedy this situation.

INCISION AND DRAIN - A area around a tooth may become infected due to dental caries (cavity), or a cracked, broken tooth, or an ulcer on the gum. The oral surgeon makes an incision to drain the infected fluid from the tissues; it may take more than one visit to make sure that the infection continues to drain and is resolving. The surgeon may recommend antibiotics, corticosteroids and/or pain meds.

EXPOSE,CHAIN & BRACKET - Teeth don't always erupt into the mouth in a timely manner, and they may be blocked also by another tooth in the way! In order to get a tooth that is 'piggybacked' on top of another to come out into the mouth so that braces can be put on, the lower tooth may have to be extracted and a gold chain affixed to the 'buried' one to pull it down into place. Your orthodontist will advise you.

TMD PAIN - The temporomandibular joint that is on either side of your jaws by the ears where the lower jaw attaches to the skull, can become very painful and makes clicking and popping noises while you chew, talk, yawn or sneeze. Your general dentist may make a splint or nighttime mouth appliance, recommend soft foods for awhile, or give you a series of exercises to help alleviate the situation. There are dentists who specialize in disorders (TMD) of this joint, and may recommend more stringent measures such as microsurgery.

TRAUMA - Head, neck and facial injuries can occur at any age under any circumstances. Jaw fractures whether they are of the upper mandible (maxilla) or lower mandible (mandible) may be repaired by the oral surgeon utilizing all manner of plates, screws, pins and wires in order to immobilize the jaws so the fracture can heal. The OMS may also be a part of a team which consists of a head and neck surgeon (ENT), neurosurgeon and/or plastic surgeon. These injuries usually take a long time to heal, and there will be accompanying instructions for being gentle on yourself and sticking to liquid or soft foods as well as repeated visits for adjustments, re-checks, further x-rays and possible other surgeries.

ORTHOGNATHIC SURGERY - Irregularity of the jaws: too far forward, backwards, sideways; birth and accident deformities can be addressed by this surgery whereas the jaws are cut and adjusted and then pinned into place, in order for the patient to look better or have better mandibular function. This office has been a part of orthognathic teams in the past and will continue to be in the future, though this is not a major part of our practice.