Wisdom Teeth Removal

Teeth erupt into the mouth in a specific sequence and pattern during childhood and adolescence. Our jaws, in most cases, are only large enough to accommodate 28 teeth. However, there are 32 teeth in the normal adult mouth. The last four teeth to develop are called the third molars, but most people refer to them as “Wisdom Teeth”. The wisdom teeth typically begin to erupt into the mouth between the ages of 16 and 20 years.  Because there is often inadequate room for these teeth, the wisdom teeth rarely grow in to assume a normal position within the jaws to become functional teeth that are useful in chewing. It is more often the case that these teeth come in crooked, leaning in different abnormal directions, or they fail to erupt completely through the jawbone or gums (“impacted” wisdom teeth).

These poorly positioned wisdom teeth can result in negative complications to the overall dental health. These problems include:

  • Tooth decay
  • Periodontal disease (gum disease)
  • Damage to adjacent teeth, possibly resulting in tooth loss
  • Infection 
  • Cysts or tumors within the jaw bones

The only predictable way to prevent problems with wisdom teeth is to have them removed before these problems occur.  If you, or your dentist, have concerns regarding your wisdom teeth, an accurate evaluation of the status of these teeth within your jaws can be provided to you by our doctor.  The American Association of Oral and Maxillofacial Surgeons recommends timely removal of indicated wisdom teeth between the ages of 15 and 25.  The longer you delay the removal of poorly positioned wisdom teeth, the more likely you are to experience unfavorable complications from the wisdom teeth themselves.

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TMJ Disorder

The TMJ (temporomandibular joint) is a hinge and gliding joint and is the most constantly used joint in the body.  The TMJ is responsible for a large portion of your lower facial activity. This joint is located in front of your ears and is the connection between your lower jawbone (the mandible) and skull. Determining the cause of a TMJ problem is important, because it is the cause that guides the treatment. 

Symptoms

Stress may trigger pain in the jaw muscles that is very similar to that caused by TMJ problems.  Affected patients frequently clench or grind their teeth at night causing painful spasms in the muscles and difficulty in moving the jaw.  Pain and/or a “clicking” sensation in the jaw are the common signs of TMJ Disorder. Other causes of TMJ include arthritis and trauma to the jaw joint.  If you are experiencing any of the symptoms or believe you are having problems relating to your TMJ, please give us a call so we can discuss your occurrences. 

Treatment

Depending on the diagnosis, treatment may include short-term non-steroidal anti-inflammatory drugs for pain and muscle relaxation, and a bite appliance. Special imaging studies of the joints may be ordered for diagnostic purposes.  Our office has Cone Beam Computed Tomographic Digtial Radiography that can create 3-Dimensional images of the jaw joint for a more in-depth review of any bone concern.

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Corrective Jaw Surgery

Corrective Jaw Surgery (orthognathic surgery) may be required or requested when a person’s upper and lower jaws grow at different speeds. At the speed that your jaws grow (very slowly), an under-bite or over-bite can be noticeable early on or it could take many years to develop. This procedure is available and practiced on those whose jaws do not fit together correctly. Comprehensive evaluation and discussion regarding what kind of surgery or when the surgery should be undertaken is necessary for patients who have jaw alignment concerns.

Consultative evaluation and Cone Beam Computed Tomographic 3-dimensional Digtial radiographic reconstruction are utilized by this office to assist in developing a comprehensive treatment protocol.

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Dental Implants
Dental Implants are available for patients who are seeking a permanent and predicable solution to replace missing teeth.  Patients who desire the ability to eat and smile as they once did with their natural teeth will select dental implants for a new sense of confidence and a lifetime of dental satisfaction.

Dental Implants placed by our experienced doctor can replace single or multiple missing teeth. They can also be used to stabilize and retain ill-fitting or loose dentures in the patient who is missing all their teeth.

There are usually multiple different dental implant options to treat any particular missing tooth situation. If you have an interest in dental implant treatment to restore your smile, please contact our office.

Dr. Rogel has been involved in dental implant placement since 1988. He has used the NobelBioCare Implant system since 1991 and currently continues to use that system.

Utilizing the Sirona Galileos Cone Beam Computed Tomographic Digital Imaging system, 3-Dimensional Radiographic Data regarding possible implant site placement within upper and lower jaw bone has become more accurate regarding bone volume and morphology. In other words, you will know if a bone graft will or will not be needed before placing a dental implant since the 3-D digital radiographic information will allow that pretreatment decision to be made.

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Bone Grafting

When a patient is missing a single tooth or multiple teeth, the jawbone around these areas will shrink in size (height and width) over time due to lack of stimulating forces from chewing. The longer the tooth or teeth have been absent, the more pronounced the bone shrinkage can become. When this occurs, there often is inadequate bulk of bone to support the placement of dental implants to replace the missing teeth. These patients will not be acceptable candidates for dental implant treatment unless the amount of bone in these areas is increased by grafting procedures. Your bone can be “bulked up”, so to speak, by grafting pieces of your own bone harvested from another area of your jaws or another part of your body. If your bone cannot be harvested other bone grafting options are possible.

Our doctors evaluate each patient individually, and will discuss specific grafting options with you if bone grafting is determined to be necessary in your particular case prior to implant placement. Please contact our office if you have any questions about bone grafting.

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Apicoectomy

Apicoectomy or Apical Surgery is performed on a patient to surgically remove the root tip of a tooth and the surrounding infected tissue. This procedure consists of a small incision to the gum tissue, exposing the inflamed area. The tip of the root is removed and a filling is placed over the end of the root so that further infection can be prevented.

The healing process of Apical surgery is generally uneventful with most patients returning to work the next day. Most tenderness subsides within 3-5 days. Bone healing continues for 5-6 months after the procedure and digital radiographic review is necessary to confirm that appropriate bone healing has occurred.  

If you have any questions regarding this process, please contact us.

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Facial Trauma

Facial Trauma, also called maxillofacial injury, is any type of injury or damage that has occurred to the face and upper jawbone. Injuries most commonly associated with this type of trauma are cuts on the face and around the mouth, bruises around the eyes, breaks in the skin, difficulty in breathing because of swelling and bleeding, loss of teeth, fractures of the jaw or jaws, and changes in feelings to the facial region. These symptoms of facial trauma are typically due to physical interactions with the face and head in automobile accidents and violence.

When working with a patient with facial trauma, we strive to emphasize both our care in restoring complete functionality to the face and jaws, and the importance of re-establishing appearance and identity. We understand the physical and emotional side effects that come with this type of experience and want to restore that which may have been compromised..

If you have questions regarding this procedure and/or would like to talk to someone here at the office, please contact us.

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Oral Pathology

The evaluation and diagnosis of growths and lesions within the mouth and jaws are an important aspect of the practice of oral and maxillofacial surgery. Patients referred for evaluation undergo a thorough examination of their head and neck areas.

Not all growths within the mouth are oral cancer. However, the prevention and early diagnosis of cancer is important to the increased survival and prognosis of the patient. Biopsies and/or other tests are performed, when required, to arrive at a diagnosis and to allow the development of an appropriate treatment plan.

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Anesthesia

Local anesthesia, Nitrous Oxide (laughing gas),  intravenous sedation and general anesthesia allow you, the patient, options to reduce anxiety and surgical discomfort.  Risks and benefits of all anesthetics are discussed with regard to one’s current medical history.  Consultation may be undertaken with your primary care provider, if needed, or medical specialist.

Patient safety is our utmost concern with state of the art monitoring and equipment.  Dr. Rogel has been providing anesthesia services in New Mexico since 1984 and is currently permitted to provide Nitrous Oxide, Conscious Sedation I and II, Deep Sedation and/or General Anesthesia. 

Dr. Rogel is a Diplomate of the National Dental Board of Anesthesiology. 

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