Dentoalveolar Surgery


Wisdom teeth

Wisdom teeth are the third and last molar tooth on either side of both jaw. They are useless for us. In the prehistoric ages, when human diet comprised of raw meat and vegetables we needed more teeth and the jaws were bigger to accommodate them. With time, as the modern man became smaller, so did the jaws and there is not enough space for the third molars. They are vestigial organs like the appendix. Due to unavailability of space, often the “wisies” never erupt completely and become a source of recurrent infections. Sometimes they gradually destroy the adjacent second molar (which is an important tooth for chewing). In some cases, the residual bud of the unerupted wisdom tooth can grow inside the bone, forming a cyst that grows at the cost of bone destruction and can lead to a fracture of the jaw. There are reported cases of cancer developing on the wall of such cysts.

AN EXPANDING CYST ARISING OUT OF THE WISDOM TOOTH

Thus, it often becomes prudent to get rid of the wisdom tooth/teeth. This of course, is for pure benefit to the host and causes no harm when done properly. I have met people anxious of damage to the eyes or to the brain due to wisdom tooth surgery. They must have heard stories of the days of witch doctors. At the present day and age, the surgery performed under general anaesthesia in the largest number is….. SURGICAL REMOVAL OF ALL WISDOM TEETH and there is no report in the literature of such damage as a direct result of “wisies” removal.

If somebody needs more than two separate courses of antibiotics for wisdom tooth infection; if the adjacent second molars are being destroyed; if jaw-joint pain and dysfunction can be directly related to the “wisies” and if there is a clinical/radiological sign of a cyst formation related to the 8s…… THEY MUST BE REMOVED.

Most wisdom teeth can be removed under local anaesthesia (one at a time), but if more than one are problematic and there is no other co-morbidity, it is often suggested to get all 4 “wisies” removed surgically under general anaesthesia in a single go. Sometimes, wisdom teeth are technically too difficult to be removed under LA, and even in such cases, we suggest GA or sedation, as it is unfair to subject you to the “primitive dental struggle” on the chair in the days of such safe anaesthetic pharmacology. LA procedures for these teeth one by one, means the agony, the aftermath of swelling and pain and the working days lost all multiplied 4 times. Remember, whether you need an admission for surgical removal of all 4 wisdom teeth under GA or not is the discretion of your surgeon alone and not that of your insurance officials.

Important points to note:

  • There are two nerves running very close to the wisdom teeth and there is a possibility of damaging them and giving numbness to lip and/or tongue in wisdom tooth surgery. However, in good hands, the possibility of such unfortunate event is less than 1 in 500.
  • Done well, the post operative pain and swelling of wisdom teeth surgery is far less than is suggested by the horror stories of the past.
  • Removed wisdom teeth do not need to be replaced ever.

Facial Space Infections

All these are results of untreated dental infections. See your dentist regularly. However, we provide a service for the advanced situation on an emergency basis when needed.

This diabetic lady had a longstanding untreated dental infection. She needed an artificial airway (tracheostomy) to save LIFE

Implant Dentistry and other Surgical Dental Work

IMPLANT
Implant dentistry is now a day to day reality and not astronomically expensive any more. This is the best way of replacing lost tooth/teeth with an artificial substitute that emerges out of the gum itself.

APICECTOMY
A minor surgery to preserve a dead tooth; usually performed under local anaesthesia; near total success rate.

PERIO FLAP SURGERY
Another minor surgery performed to preserve teeth that are on the way to be lost due to gum disease. Also performed under local anaesthesia only.

DENTAL CLEARANCE under GA and IMMEDIATE DENTURES
Unfortunately, there are situations sometimes where remaining teeth cannot be saved. It is extremely bothersome to get teeth out one by one under local anaesthesia on several visits to the dentist. Each time there would be some work loss etc. afterwards. Also, the status after loosing few or all teeth may be quite socially compromising for the victims. To solve this problem altogether, we offer a complete dental clearance in such situations in a single hassle free setting under general anaesthesia. What is more important is that, the person wakes up with a nice full set of false teeth already inserted. This set however, needs replacement in 6 months. But, there is not a single day of edentulosity in the process.

TOOTH EXTRACTION for the MEDICALLY COMPROMISED
There are many medical conditions related to heart, blood pressure, diabetes, kidney or kidney transplant, epilepsy, liver problems, bleeding disorders etc. where a dental surgeon at the private chamber would not be too happy to perform a dental extraction. We have known far too many people running from pillar to post for such a simple affair. We will perform such necessary extractions in almost all cases, with necessary precautions and arrangements.

Fellowship Programs

    Fellowship programs started for
  • One year residential fellowship programme for MDS (OMS), MS (ENT) and MS (General Surgery). Details
  • Short postings as OBSERVER Details
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