Articles on oral surgery

Jaw Surgeries for a Proportional Face

Dr. N Srinivas, Dentist
It may take more than a new smile to help you look your very best.Having a great smile is undoubtedly an asset, regardless of other aspects of your appearance. However, your smile is only one part of the whole composition of your face. Once you have improved your smile, you may be inspired to make a few other changes to look your very best, and it may be necessary to look beyond your dentist to help.If you are unhappy with your facial profile,the condition of your skin, or specific facial features such as your lips, nose or chin. An oral and maxillofacial surgeon reveals how repositioning the jaws can improve not only your bite but also your entire facial appearance, especially in profile.What is orthognathic surgery?Orthognathic surgery involves dividing and repositioning the jawbones to bring them into better alignment. It is typically used to correct bite problems that cannot be fixed by orthodontics alone.Often bone or soft tissues may be removed or augmented to further enhance facial esthetics. Orthognathic surgery can bring about significant changes in your appearance.Is orthognathic surgery right for me?Orthognathic surgery is typically performed by an oral and maxillofacial surgeon and can achieve dramatic improvement in facial esthetics. Orthognathic surgery may be the best option if you:1. Have jaw problems that can be treated only by surgery.2. Can pay for the procedure, as its a bit expensive.3. Feel strongly that your condition is inhibiting your success and happiness.4. Are willing to experience some discomfort and inconvenience.5. Understand and accept all associated risks.Communication is critical to success!1.It's important that you tell your doctor exactly what you want to correct.He or she may zero in on a particular problem,and you need to be sure that problem is also your primary concern.2. Your surgeon will design a highly specialized treatment plan for you based on information gathered by obtaining casts of your teeth, photographs,video images,and special x-rays.3. It's highly important that you know what results to expect from treatment.Some surgeons will use digital imaging to give you a good idea of what you'll look like after surgery;others may show you tracings of your new profile based on your x-rays.4.It's also essential that you understand each step of the surgical procedure that you're to undergo.The main risks and possible outcomes should be explained thoroughly, and it's then up to decide which procedures you wish to have performed.What can orthognatic surgery do?Problems that can be addressed using orthognathic surgery include. Recessive or protruding lower jaw and/or chin.. Chin that is too short,too long,or otherwise unattractive.. Open bite(teeth do not meet). Lower and/or upper jaw positioned to one side or a narrow arch. Discrepancies in upper and lower facial height (gummy smile or lack of enough tooth or gums showing)What does an oral and maxillofacial surgeon do?Oral and maxillofacial surgeons do more than just tooth extractions and jaw surgeries.If  you're interested in cosmetic procedures to enhance the appearance of your face and neck,talk to your surgeon about including them your overall treatment plan.

3 Reasons Why You Shouldn’t Be Nervous About Implant Surgery

Dr. Ishwari Bhirud, Dentist
Dental implants have gained a popular reputation for their life-like appearance and longevity. Much of the latter is attributable to the titanium post embedded in the jawbone. Because titanium has a natural affinity with bone, new cells will grow and adhere to the dental implant over time, making their connection strong and durable.Of course, to achieve that requires implant surgery — a prospect that gives many people pause before choosing this replacement option. But implant surgery is a routine undertaking, causes very little discomfort and in trained hands has a very high success rate.Here are 3 reasons why implant surgery is nothing to be nervous about.The procedure is precisely planned. Implant surgery is a relatively minor procedure, mainly because all the placement details are often mapped out ahead of time. For complex situations your dentist can use x-ray or CT imaging to determine the exact location for each implant and create a surgical guide to use during the procedure to make incisions and create the small channel that will hold the implant.Implant surgery can be performed with local anaesthesia. Implantation is usually easier than tooth extraction — if you’re healthy enough for that procedure you should have no problem undergoing implant surgery. With a local anaesthetic, your dentist will numb only the implant site and surrounding tissues while you remain conscious. If, however, you have any anxiety your dentist can also include a sedative or anti-anxiety medication before proceeding.There’s minimal discomfort afterwards. Thanks to the pre-planned surgical guide and advanced implantation techniques, there’s very little tissue disruption and incised tissues are normally stitched with self-absorbing sutures. While some cases may require stronger pain relievers, most of the time a mild non-steroidal anti-inflammatory drug (NSAID) such as aspirin or ibuprofen is sufficient for discomfort afterwards.The implant site heals fairly quickly and predictably with a 95-97% success rate. A few weeks after bone integration your dentist will attach the permanent like-like crown, and you’ll be ready for many years of full function and a confident smile.

What is orthognathic surgery?

Dr. N Srinivas, Dentist
Having a great smile is undoubtedly an asset, regardless of other aspects of your appearance. However,your smile is only one part of the whole composition of your face. Once you have improved your smile,you may be inspired to make a few other changes to look your very best,and it may be necessary to look beyond your dentist for help.If you are unhappy with your facial profile, the condition of your skin,or specific facial features such as your lips, nose or chin, surgeon reveals how repositioning the jaws can improve not only your bite but also your entire facial appearance, especially in profile.What is orthognathic surgery?Orthognathic surgery involves dividing and repositioning the jaw bones to bring them into better alignment. It is typically used to correct bite problems that cannot be fixed by orthodontics alone. Often bone or soft tissue may be removed or augmented to further enhance facial esthetics. Orthognathic surgery can bring about significant changes in your appearance,particularly as you are seen in profile.What can orthognathic surgery do?Problems that can be addressed include:Recessive or protruding lower jaw and or china chin that is too short, too long, or otherwise unattractiveOpen bite (teeth do not meet)Lower or upper jaw positioned to one side or a narrow archDiscrepancies in upper and lower facial height Communication is critical to success!It's important that you tell your doctor exactly what you want to correct. The doctor may zero in on a particular problem and you need to be sure that problem is also your primary concern.The surgeon will design a treatment plan based on information gathered by obtaining casts of your teeth, photographs, video images, and special x rays.It's highly important to know what results to expect from treatment, either by digital imaging or tracings of your new profile based on x-ray.It's essential to understand each step of surgical procedure that you undergo.

Having a Dental Implant Placed Is So Much More Comfortable

Dr. Himani Sanwaria, Dentist
“Sometimes I wonder why people spend their lives with missing teeth when a wonderful painless missing tooth replacement option- Dental Implant is available.”One day, during one of the many times I was working with Professor in Gurgaon, I asked him this question, and asked if the people in Gurgaon Sector 22  reported their painless experience with dental implants. He said yes, they did. Which prompted me to ask why? He said initially it may be a problem with semantics. The way things are described. He said that when people talk about extracting teeth, they just say having a tooth “removed." As if it were as simple as having a hair cut. He went on to say that this is not the case, if we think of it from a medical perspective. He said when we extract a tooth we are performing a procedure in which we remove a part of the human body which was not intended to come out, or off. The tooth is torn from its bony housing as the ligament which attaches the root to the bone is ripped apart. An amputation is far more “violent” than “Just remove a tooth,” as if the process was merely as simple as pressing the delete button on a keyboard. Alternatively, he went on to say, a dental implant must be inserted into the bone gently. Not violently. And if done so, gently, the bone will grow onto the surface of the dental implant, over a period of weeks.So, are dental implants painless? Of course yes!Placement of dental implants into the jaw bone is relatively pain-free as the procedure is carried out under local anaesthesia. Ample time is given to the bone and the gums to heal before an abutment and restoration is placed after few months. Once stable, the implant is uncovered and a restoration often referred to as a crown is placed on top. Since the healing is completed, crown placement is again a painless part of dental implant procedure. In a number of cases, a temporary crown is placed on dental implant on the very first day of surgery. Today’s modern dental implant treatment plans can replace everything from a single missing tooth to a completely missing arch, and that too painlessly. With painless dental implants you can enjoy foods you love. Dental Implants are the only proven painless procedure to prevent bone loss after the natural teeth is lost. Dental Implants look much better and feel better, and apply the same force for chewing as natural teeth. So, pain should not be a matter of concern while taking a decision to get a dental implant placed. Some discomfort can be expected during recovery and that’s why I do prescribe pain relief medication, but most of my patients reported that they did not require any pill and this left a grin on my face.

Cosmetic and Plastic Surgeries

Dr. Parthasarathi Dutta Roy, Dermatologist
Being beautiful and charming is very important in every stage of today’s life. Most of people become upset for not receiving attractive physical structure, nose alignment, slim physic and many more. But medical science creates revolution for establishing two significant surgeries named cosmetic surgery and plastic surgery. These are very helpful for treating any kinds of physical disorders.Effectiveness of Cosmetic and Plastic SurgeryThrough cosmetic surgery anybody can change their facial or body structure which is not desired. Plus from ageing lines to wrinkles can be reduced through method of cosmetic surgery.Plastic Surgery is basically used for reconstructing the facial or body features. Any kinds of birth defects, injury imperfection and disease feature can beautifully be repaired by plastic surgery.Features of Cosmetic SurgeryTwo types of cosmetic surgery are categorized in medical science- addition and deletion. Through cosmetic surgery with collagen injection something can be added for giving proper shape and size of the body parts if one is not satisfied with their parts, size and shape of the body. Breast augmentation and lips plumping are the best examples. Alternatively excess mass on some parts looks ugly; the cosmetic surgery helps to delete the volume to give the perfect shape.Procedures of Plastic Surgery:Many procedures can be performed through plastic surgery. But here are some most popular procedures which is remarkable possible to treat are described below.Breast Augmentation: The women having small breast can get beautiful and attractive big breast through breast augmentation procedure of plastic surgery.Rhinoplasty: Defect of nose can be treated through rhinoplasty.Blepharoplasty: To give redesign and shape of the eye lids, blepharoplasty is just incomparable plastic surgery.Liposuction: Excess fat is cut down through this liposuction procedure for giving attractive body structure.

Do You Know the Importance of Oral Health?

Dr. Ruchit Thakar, Dentist
Regular dentist visits can do more than keep your smile attractive – they can tell dentists a lot about your overall health, including whether or not you may be developing a disease like diabetes.New research suggests that the health of your mouth mirrors the condition of your body as a whole. For example, when your mouth is healthy, chances are your overall health is good, too. On the other hand, if you have poor oral health, you may have other health problems.Research also shows that good oral health may actually prevent certain diseases from occurring.Gum disease and health complicationsAccording to the Academy of General Dentistry, there is a relationship between gum (periodontal) disease and health complications such asa stroke and heart disease. Women with gum disease also show higher incidences of pre-term, low birth-weight babies.Other research shows that more than 90 percent of all systemic diseases (diseases involving many organs or the whole body) have oral manifestations, including swollen gums, mouth ulcers, dry mouth and excessive gum problems. Such diseases include:DiabetesLeukemiaOral cancerPancreatic cancerHeart diseaseKidney diseaseSince most people have regular oral examinations, their dentist may be the first health care provider to diagnose a health problem in its early stages.Poor oral health can lead to other problemsIf you don't take care of your teeth and gums, your poor oral hygiene can actually lead to other health problems, including:Oral and facial pain. According to the Office of the Surgeon General, this pain may be largely due to infection of the gums that support the teeth and can lead to tooth loss. Gingivitis, an early stage of gum disease, and advanced gum disease affect more than 75 percent of the population.Problems with the heart and other major organs. Mouth infections can affect major organs. For example, the heart and heart valves can become inflamed by bacterial endocarditis, a condition that affects people with heart disease or anyone with damaged heart tissue.Digestion problems. Digestion begins with physical and chemical processes in the mouth,and problems here can lead to intestinal failure, irritable bowel syndrome and other digestive disorders.What you can do-Seeing a dentist regularly helps to keep your mouth in top shape and allows your dentist to watch for developments that may point to other health issues. A dental exam can also detect poor nutrition and hygiene, growth and development problems and improper jaw alignment. Provide your dentist with a complete medical history and inform him or her of any recent health developments, even if they seem unrelated to your oral health.At home, you can practice good oral hygiene:Brush for two to three minutes, at least twice a day, with fluoridated toothpaste.Floss daily to remove plaque from places your toothbrush can't reach.Eat a healthy diet to provide the nutrients necessary (vitamins A and C, in particular) to prevent gum disease.Avoid cigarettes and smokeless tobacco, which may contribute to gum disease and oral cancer.Exercise preventive care and schedule regular dental checkups — the surest way to detect early signs of periodontal disease.

Do You Know These Facts About Oral Health?

Dr. Aishwarya Chatterjee, Dentist
Here are some facts about oral health you might not know:Lt Gen (Retd) Dr Vimal Arora who was honorary dental surgeon to the President of India says that the age old statement that brushing twice is enough for good oral health is no longer true. If it was so, it would have eradicated the dental diseases in at least over 50% of the population.Dentistry today is a part of the overall health of a person. "Pregnant women with gum disease generally give birth to low birth weight babies. Patients with gum diseases and diabetes together are said to suffer from periodontal advanced gum disease and it gets difficult to control diabetes. There is also a positive correlation between poor oral health and heart diseases," said Dr. Arora.Wisdom Teeth, the third molar-There are three molars in each side of our oral cavity for the upper jaw and lower jaw. Of these three, the first molar erupts in the oral cavity at 6 yrs of age.It is an important tooth so we should take care of it as soon asit erupts in our mouth that is at 6 yrs of age.The most problematic of these molarsis the Third molar. It is also called as the "Wisdom Tooth" though no wisdom comes out of it.Usually Third molars or Wisdom tooth erupts at 20 - 25 yrs of age and is usually associated with considerable pain and swelling.Sometimes they don't erupt at all and at times they erupt half way through into the oral cavityand stay as it is.These Half Erupted Third molars are called Impacted Third Molars and may cause destruction of the adjacent Second molars due to caries or bone loss.Most symptomatic (that is pain and swelling) Third molars canbe treated with Antibiotics and Analgesics but some do require a Minor Surgery.Third Molar Impaction Surgery is very safe and is carried out under Local Anaesthesia without pain.Dentures or False TeethComplete Dentures are generally known as "False Teeth".Dentures are important when a person loses her/his complete set of teeth due to old age or other reasons.When natural teeth are lost, dentures take their position.Dentures can be removable or fixed.Fixed Complete Dentures are worn on implants that are placed surgically in the jaw bone in the mouth. Removable Dentures should not be worn while going to sleep as it may harm the gums.Removable Dentures should be cleaned each day in the morning and after every meal to reduce accumulation of germs.For Healthy TeethMake sure to rinse thoroughly after every meal. This will reducethe acid producing food particle and keep dental caries at bay.Brushing at night and after breakfast will rid you of dental caries

Do I Have Appendicitis? Do I Need Surgery?

Dr. Maruthesh Gowda, Bariatric Surgeon
First thing we need to understand is that appendicitis is an surgical emergency. When treated appropriately complications are very few.What are the symptoms of appendicitis?It has dull aching pain around the umbilicus and slowly localises to right lower side. It is associated with vomiting and anorexia (patient does not feel hungry). If ignored then might lead to temperature, high heart rate (tachycardia).How is appendicitis diagnosed? It's based on history and clinical examination. Blood tests will reveal infection (Increased WBC, CRP). Ultrasound of abdomen might help to confirm the diagnosis but negative ultrasound scan does not rule out possibility of appendicitis. Ultrasound is more important in females as problems in ovaries, fallopian tube and uterus might present in the similar way and ultrasound helps to rule out those possibilities. What is the treatment of appendicitis?  In short treatment of appendicitis is immediate surgery. It is not I am busy for next few days and will have surgery later and this might lead to serious complications.Now a days surgery is done laparoscopically (Key hole) and involves three small cuts which will be barely visible with time. Most patients go home 24 hours later being able to do regular activities. There will be no food restrictions. Only restriction being not to lift weights for 1 month. Can appendicitis be treated with medicines? if so what are the complications?There are times when patients want antibiotics and not surgery. While this is proven treatment it is logistically difficult to apply in Indian settings unless patients and affordable and ready to take risks.Medical proof so far tells us to treat appendicitis with antibiotics we need to do CT scan and prove that there is no collection of pus inside abdomen. Once this is done admit patient for Intravenous antibiotics (IV) for 48 hours. Regularly review patient to make sure infection is not spreading. If infection does not settle down or patient suffers complication then do complicated surgery with more risks involved.What we have to be very careful is young females with appendicitis as untreated or poorly treated appendicitis might lead to infertility in the future by affecting the movements of fallopian tubes.In all patients treated with antibiotics there is small risk of long term abdominal pain and very rarely appendicitis might recur needing surgery.

How Do I Behave When I Am Undergoing Cataract Surgery?

Dr. Manoj Rai Mehta, Ophthalmologist
Cataract Surgery nowadays is usually performed under 'topical anaesthesia' that involves instillation of drops of the anaesthetic agent on the eye surface.  The patient retains the power to close the lids and move the eyeball during surgery, feel no pain but touch and pressure sensations are unaffected.  A peribulbar block anaesthesia may be used at times on surgeon's discretion that involves an injection of anaesthetic agent around the eyeball with a short needle.  This takes away lid and eye movements to a large extent but some control may remain with the patient.     Operating Surgeon expects the patient to follow the instructions for a smooth surgery.  It is important to have a surgical counselling session with the doctor to understand the procedure and expected sounds/conversation during the operative procedure.  The sequence of events should be understood and played in your mind while you move through the surgical suite.You should be wearing loose, comfortable hospital pyjama suit.  Do not hesitate to change it if it is tight around your neck.  Some hospitals have the policy to allow you to wear your own loose clothes and give you a hospital gown over them.  Please ensure you are not wearing tight fitting clothes and your neck is free.  Ladies to tie their hair in a ponytail with a band or a soft bun with no clips or claspsSit quietly in the pre-operative area and use the washrooms before going to the OR.  You may take sips of water if your mouth feels dry but do not hydrate yourself too much.You may be given a cap and eye marked for surgery.  The antiseptic solution will be painted around the eye.  Let the solution dry and do not touch your eye. OR assistant will help you lie down on the OT table with a rubber ring under the head to prevent rolling from side to side. You should be comfortable and be able to breathe rhythmically while lying down.  Ask for a head raise if neck extension is hurting you and get the ring adjusted to your comfort and if it is hard for you to ask for a softer ring.When you are comfortable allow the staff to put monitoring devices which could be a pulse oxygen meter alone or additional cardiac electrodes.  Breath rhythmically and try to relax.Sterile Drapes will be placed around your head and an adhesive eye drape on the eye to be operated upon.  Please maintain your head in a position as required and adjusted by the surgeon.  Do not move your head or lower your chin.  The surgeon works under a microscope and any movement shifts the focus and obstructs in smooth surgery.There will be several sounds in the OR that you should ignore-beep of monitors, hum of air circulation unit, trolley wheels, the doctor would be giving instructions to staff and asking for instruments etc.  Try to keep your attention focused towards surgery only.Coughing and snorting during surgery can create complications, always ask the surgeon to stop the surgery if you feel like doing so.  Do not try to suppress a cough or sneeze by holding breath.  Do not bear down or move.Follow instructions of a surgeon and do not start a conversation. Answer only when a question is directed towards you.  The surgeon may ask you to look in a particular direction.  You have to follow the command by moving your eyes and not head unless the specific instruction is made. The first touch of the instrument will increase your confidence.  Do not wince, squeeze your lids or make a jerky movement if you feel some pain.  Inform the doctor, who will reinforce anaesthesia.Cataract Surgery machines also produce different types of sounds during different phases of surgery and also have synthesised verbal outputs.  Do not get distracted by the same.You will see movements in front of the eye during surgery and also perceive vibrations.  Light intensity will increase towards the end of surgery.  A calm patient who is having a regular rhythmic breathing and a regular normal pulse rate makes a surgeon's job easy.(In case of specific problems additional monitoring and specialised anaesthetic cover may be required which the operating surgeon will discuss before hand).