Extractions/Wisdom
Teeth Wisdom Teeth (Third Molars)
Wisdom teeth or third molars are the last teeth to erupt within the mouth.
When properly aligned, and gum tissue is healthy, wisdom teeth do not
have to be removed. Unfortunately, this does not generally happen.
When they are partially erupted, the opening around the tooth allows bacteria
to grow and will eventually cause an infection. The infection results
in swelling, jaw pain and illness.
The extraction of wisdom teeth is necessary when they
Grow sideways
Partially emerge from the gums
Remain trapped beneath the gum and bone, referred to as impacted wisdom
teeth
Impacted wisdom teeth can cause many problems:
Pain is the most common complaint. The pressure from
the erupting wisdom tooth pushing on the roots of adjacent second molars
or the gum can be unbearable.
Displacement of other teeth and disruption of the
orthodontic or natural alignment of teeth.
The most serious possibility is tumors or cysts forming
around the impacted wisdom tooth, resulting in the destruction of the
jawbone and healthy teeth.
Removal of the impacted tooth or teeth usually resolves these problems.
Early removal is recommended. Younger patients heal faster and avoid the
increased risk of infection found in older patients.
Decayed teeth
Even with all that dentistry has to offer patients today, sometimes the
amount of decay is beyond repair. When this happens, your dentist will
recommend its removal to avoid future problems and suggest several options
for tooth replacements, such as a dental implant.
Anesthesia Because oral surgery can be a stressful experience, we offer a
variety of anesthetic options to our patients for a more comfortable experience.
Choices include general anesthesia, intravenous (IV) sedation, nitrous-oxide
sedation, and local anesthesia. Depending on your comfort level, your
medical condition and the procedure’s complexity, Dr. Bloom will
help you determine the method that’s optimal for you.
General Anesthesia is designed to enable you to sleep
during a surgical procedure. It is a deep, comfortable level of anesthesia
that keeps you unaware of the surgery.
Intravenous (IV) Sedation is considered a “twilight
sleep”. This method enables you to undergo a conventional surgical
procedure in a comfortable and relaxed manner. IV sedation allows a feeling
of well-being during the procedure.
Nitrous-Oxide, also known as “laughing gas”
is a light anesthetic gas that creates a sense of euphoria. This method
relaxes the patient and is most effective for patients who need just a
little help to reduce their anxiety.
Local Anesthesia is often referred to as Novocaine or
“numbing medication”. Used to induce numbness, it allows for
localized pain-free manipulation of the surgical area. It is often not
adequate for patients with a high level of anxiety.
The highest level of patient safety is maintained at all times. Dr. Bloom
has advanced training from an accredited oral surgery program in the administration
of anesthesia, patient monitoring and emergency care.
NOTE: Patients undergoing sedation and general anesthesia
must have an escort present on the day of treatment. Review pre-operative
instructions for anesthesia.
Dental
Implants DENTAL IMPLANTS ARE CHANGING THE WAY WE LIVE! IMPLANTOLOGY IS
THE MOST EXCITING AND REVOLUTIONARY TOOTH REPLACEMENT SYSTEM AVAILABLE.
Whether you’re self-conscious about missing teeth, desire more stability
for your dentures, or do away with certain dietary restrictions, dental
implants may be the dental restoration solution for you.
Traditional Techniques Have Limitations
The conventional forms of tooth replacement offered today are dentures
and bridges. Although both are good alternatives, they are not without
drawbacks and limitations.
Dentures can feel uncomfortable and require daily removal.
Dentures can slip out despite the best adhesives and don't afford
the biting force necessary to enjoy certain foods.
Bridges offer excellent chewing force and esthetics, but they come
at the expense of shaving down adjacent teeth called “abutments”
to support the bridge.
Bridges are cemented in place and offer limited access for hygiene.
Flossing can be difficult to perform. Without proper flossing, teeth
are more prone to developing decay.
Freedom With Dental Implants
A tooth is made up of two portions: a crown and a root. A dental implant
is a titanium fixture that is surgically placed into your jaw bone to
replace the root portion of a prosthetic tooth.
During
the typical 4-6 month healing phase, bone will fuse to your implant, anchoring
it in place. Once your dental implant has achieved stability, your restorative
dentist will fabricate a crown which will be fastened to your implant to
create your prosthetic tooth.
Advantages of dental implants:
Dental implants look and feel like your own natural teeth. You
can laugh and live your life with renewed confidence.
Eat your favorite foods again. Dental implants are secure and
will improve chewing function.
Dental implants will minimize further bone loss and resorption
because they are integrated into your jaw bone.
Your adjacent teeth will also be spared from the cutting down
required in traditional bridgework.
Dental implants can last a lifetime.
Oral surgeons work closely with your restorative dentist as a team to ensure
a successful implant tooth replacement. Discover how dental implants can
relieve your worries about loose dentures, bridges and missing teeth.
Contact Fairfield Oral Surgery to schedule an implant consultation and
let Dr. Bloom help restore your quality of life.
Bone
Grafting
Today we have the ability to grow bone where needed. Bone grafting makes
available treatments, such as dental implants, which in the past might
not have been an option for some patients.
We don’t have to look far to find suitable bone for grafting. Bone
can be harvested from within the oral cavity in areas of the chin and
posterior third molar areas of the jaw. Larger quantities of bone can
be harvested from the hip and outer aspect of the tibia, the so-called
“shin bone.”
Most bone grafting procedure can be performed safely in our office under
IV sedation or general anesthesia. Depending on the medical condition
and amount of bone needed for grafting, the procedure may be performed
in a hospital.
Sinus Lift
The main purpose of the bone in your alveolus is to support your dentition.
When you lose teeth, over time, the bone dissolves away. This leaves an
inadequate ridge thickness to place dental implants. In the upper jaw,
the level of the bone can be manipulated by placing bone into the sinus
above the ridge by a process we called a sinus lift. This stacking of
bone from above will facilitate the placement of implants into an area
that otherwise would not be amendable to supporting dental implants.
Ridge Preservation
When you lose teeth, the natural process for the bone is to dissolve away
leaving a ridge with decreased height and/or width. If dental implants
are to be considered as future replacement for the missing teeth, ridge
preservation should be considered. Ridge preservation is a bone grafting
technique that maintains and preserves the ridge architecture for future
support of dental implants and is performed at the time of dental extractions
or within a short time thereafter.
Ridge Augmentation
If the ridge has undergone severe resorption, a bone graft can be placed
in the defect to augment the height and/or width for support of dental
implants or dentures.
Platelet-Rich Plasma (PRP)
Also known as Autologous Platelet Concentration, PRP is the latest technique
in bone grafting technology. Platelets are best known for their ability
to create blood clots at the site of a wound to stop bleeding. However,
researchers have found that they do much more than that. They also have
the ability to stimulate bone growth. With recent advancement in platelet
concentration techniques, we can now offer the treatment in our office
at minimal cost to you. The concentrated platelet is incorporated with
the bone graft resulting in a denser graft and shortened treatment time.
Each patient will present with a unique situation. Only after a thorough
evaluation will Dr. Bloom recommend a technique or techniques suitable
to your situation. Please contact our office to arrange a bone grafting
consultation with Dr. Bloom.
Oral
Pathology (Biopsies) A normal healthy mouth is lined with specialized skin (mucosa)
that is smooth and coral pink in color. Any deviation from this appearance
could be a sign of pathology. The most serious of these is oral cancer.
Those that use tobacco products and/or consume alcohol on a regular basis
should be most concerned. Dr. Bloom recommends following the guidelines
outlined by the American Association of Oral & Maxillofacial Surgery
on oral cancer screenings. A monthly self-examination oral cancer screening
should be performed by you. Things to look for are:
Reddish patches (erythroplasia)
Whitish patches (leukoplakia)
Reddish-whitish patches (erythroleukoplakia)
A lump or thickening of the mucosa
Chronic sore throat or hoarseness
Difficulty in chewing or swallowing
Sudden onset of numbness or tingling sensation to lip, chin,
tongue or teeth
Ulcers that don't disappear
If you have any of these signs, contact our office to schedule an evaluation.
Dr. Bloom will perform a thorough evaluation and, if necessary, he will
recommend a biopsy of the suspicious lesion. The tissue or sample will
be sent to the lab for analysis to obtain an accurate diagnosis. The results
can be used to determine the proper management of the lesion in question.
Do not ignore any of the warning signs. Early detection and treatment
is our best defense against oral cancer.
Facial
Trauma Dr. Bloom is well trained, skilled and uniquely qualified to manage
and treat maxillofacial injuries. Dr. Bloom amassed broad experience during
his surgical training in the Bronx, NY, where maxillofacial trauma cases
were numerous.
Dr. Bloom treats a wide-range of injuries including:
Facial lacerations (cuts)
Intraoral lacerations
Avulsed (knocked out) teeth
Fractured facial bones (cheek, nose, or eye socket)
Fractured jaws (upper and lower jaw)
Dentoalveolar fractures (bone and teeth)
Whatever the cause of facial trauma, optimal outcome is achieved when
surgical care is focused on restoring both function and appearance. Surgical
results around the maxillofacial region are unique in that success is
judged both on esthetic, as well as, function. Dr. Bloom takes great pride
in treating maxillofacial injuries to yield the best cosmetic results
possible, while restoring optimal function.
Avulsed (knocked out) teeth
If an adult tooth is "knocked out", it should be handled only
by the crown (top of the tooth), and placed immediately in cold salt water
or cold milk. Do not allow the tooth to dry out. The sooner the tooth
is re-inserted, the better chance it will survive. Therefore, the patient
should see a dentist or oral surgeon as soon as possible.
Never attempt to "wipe the tooth off", since specialized cells
on the surface of the root responsible for attachment of the tooth to
bone could be damaged.
Your dentist or oral surgeon will prepare the tooth for implantation.
The tooth may require root canal therapy after being implanted. Therapy
will involve wiring teeth together (splinting) or gluing (bonding) the
avulsed tooth to adjacent stable teeth.
In the event that injured teeth cannot be saved or repaired, dental implants
are often now utilized as replacements for missing teeth.
Fractured facial bones and jaws
Fractures of the bones of the face are treated in a manner similar to
the fractures in other parts of the body. When an arm or a leg is fractured,
a "cast" is often applied to stabilize the bone and allow for
proper healing. Since a cast cannot be placed on the face, other means
have been developed to stabilize facial fractures.
Injuries to the jaw bone can result in isolated jaw fractures, dentoalveolar
(bone and teeth) fractures, and/or avulsed (knocked out) teeth. A non-surgical
option involves wiring teeth together, which prevents movement of the
jaw bone and teeth, to allow for healing.
However, more displaced fractures of the jaw are best treated and stabilized
by the surgical placement of small titanium "plates and screws"
at the fractured site. This technique of treatment, called "rigid
fixation" of a fracture, allows for healing and can circumvent the
need to have the jaws wired together. The development and use of "rigid
fixation" has profoundly improved the recovery period for many patients
by allowing them to return to normal function more quickly.
Access to the fractured bones can be made within the mouth and/or outside
on the face. An attempt at accessing the facial bones through the fewest
incisions necessary is always made. Dr. Bloom utilizes incisions used
in plastic surgery to access the facial bones. These incisions, when necessary,
are designed to be small and discreet, whenever possible, to minimize
resultant scarring.
Surgical Root
Canal Apicoectomies are most often performed upon teeth which have already
had root canal fillings. Failures of the root canal treatment usually
results in pain, swelling and/or infection. The cause of the infection
is often the result of a failure of the seal of a conventional root canal.
When there is a void at the apex (end of root) of the conventional root
canal then the bacteria has a place to grow. If another conventional root
canal can not be done then a surgical root canal is done.
surgical root canal is approached from the root end. By means of an
opening through the gum and jawbone a small window is made so the root structure
can be examined. Many times the failure of a root canal is due to a fracture
of the root. The surgical approach will allow examination of the roots and
often will find a fracture. If the tooth is fractured then an apicoectomy
can not be done and the tooth needs to be removed. If a fracture is not
found, the infection is cleaned and the apex of the root is prepared for
a retrograde (root end) seal of the apex. The retrograde filling or sealing
of the roots end is placed as often the original root canal material may
have shrunken, fallen out or have been a material which no loner adequately
fills and seals the nerve canal.
Surgical root canals are usually the last procedure done on an endodontically
treated tooth before it is removed. Often this procedure will give a tooth
at least 10 years or more years of function.
If the tooth has other problems such as periodontal concerns or restorative
concerns it may be wise for removal and consideration of a bridge or implant.
At consultation Dr. Bloom will review your case and advise you of the
appropriate treatment.
No surgical procedure is more rewarding for both patient and surgeon than
corrective jaw surgery or orthognathic surgery.
Sometimes it takes more than braces
In some people, the upper or lower jaw may grow too much or too little,
too wide or too narrow. The difference in the size of the jaws can create
alignment problems in your bite, joint pain, and facial asymmetry. Whatever
the cause, you don’t have to live with the difficulties that may
result from this disparity.
An improper bite can usually be corrected by orthodontic treatment. However,
corrective jaw surgery is recommended when the improper bite is a result
of incorrect jaw position.
Orthognathic surgery will realign your jaw, improve your chewing and
speaking functions, and restore your facial symmetry. Corrective jaw surgery
can be performed before or after orthodontic treatment. One or both jaws
may undergo surgery to correct the facial imbalance and restore function.
Diagnosis and treatment
A thorough clinical examination, along with diagnostic radiographs and
models of your teeth, will allow Dr. Bloom to determine the best surgical
approach to give you the desired results. Our facility is equipped with
digital imaging technology to further enhance treatment planning.
Dr. Bloom feels that an open line of communication between all those
involved in your treatment is a must to ensure success. That is why from
day one, Dr. Bloom will closely coordinate your treatment with you, your
family, and your orthodontist.
Orthognathic surgery is performed in a hospital setting under general
anesthesia. You will usually require at least a 24 hour stay in the hospital
before you can be discharged.
To learn more about this surgical procedure, please contact our office
to arrange for an orthognathic evaluation with Dr. Bloom.
TMJ Disorder TMJ (temporomandibular joint) disorders are a family of problems
related to your complex jaw joint. If you have had symptoms like pain
or a "clicking" sound, you'll be glad to know that these problems
are more easily diagnosed and treated than they were in the past. Since
some types of TMJ problems can lead to more serious conditions, early
detection and treatment are important.
No one treatment can resolve TMJ disorders completely and treatment takes
time to become effective. Dr. Bloom can help you have a healthier and
more comfortable jaw.
Trouble with Your Jaw?
TMJ disorders develop for many reasons. You might clench or grind your
teeth, tightening your jaw muscles and stressing your TM joint. You may
have a damaged jaw joint due to injury or disease. Whatever the cause,
the results may include a misaligned bite, pain, clicking or grating noise
when you open your mouth or trouble opening your mouth wide.
Do You Have a TMJ Disorder?
Are you aware of grinding or clenching your teeth?
Do you wake up with sore, stiff muscles around your jaws?
Do you have frequent headaches or neck aches?
Does the pain get worse when you clench your teeth?
Does stress make your clenching and pain worse?
Does your jaw click, pop, grate, catch, or lock when you open
your mouth?
Is it difficult or painful to open your mouth, eat or yawn?
Have you ever injured your neck, head or jaws?
Have you had problems (such as arthritis) with other joints?
Do you have teeth that no longer touch when you bite?
Do your teeth meet differently from time to time?
Is it hard to use your front teeth to bite or tear food?
Are your teeth sensitive, loose, broken or worn?
The more times you answered "yes," the more likely it is that
you have a TMJ disorder. Understanding TMJ disorders will also help you
understand how they are treated.
Treatment
There are various treatment options that Dr. Bloom can utilize to improve
the harmony and function of your jaw. Once an evaluation confirms a diagnosis
of TMJ disorder, Dr. Bloom will determine the proper course of treatment.
It is important to note that treatment always works best with a team approach
of self-care joined with professional care.