Navigating Oral Health: Orange County’s Premier Surgeons Revealed

1. Introduction

The introduction is an overview that expresses the importance of oral health and the role of surgeons in prevention of health deterioration. It initiates the awareness of the general public, oral and dental care professionals as well as members of parliament on the need to implement a National Oral Health Plan with defined goals and objectives. The general disparity with overall health and well-being has resulted in oral health being a low priority area in comparison to other health issues.

The onus of responsibility lies not only in the government and the general public but also with the oral health and dental professionals. They must be proactive in addressing the importance of oral health which is the key to quality of life as an individual age. The National Oral Health plans serves as a strategic plan of action. A roadmap that identifies priority areas and effective ways to address them. It demonstrates improvement in oral health and set out a clear approach to health in its broadest sense. By utilizing the roadmap, Australia can prevent oral diseases and improve general health and well-being. The surgeons play a critical role in health maintenance, stopping the spread of disease and prevention.

Their skill in surgery is as relevant today as it has ever been. Findings over the next decade have confirmed that oral and maxillofacial surgery is cost-effective and one of the best ways to prevent the progression of disease. Dental and medical practitioners should be encouraged to seek surgical opinion when definitive surgery is available to provide effective treatment of a condition. Surgeons must be actively involved in implementation of the national oral health plan. In prevention of disease it is a surgeon’s primary role to correct an acute condition that will recur if not treated.

This is most prevalent in the area of public health where the medical surgical initiative must be promoted. The Australian Government will provide increased funding for research focusing on public health. An area where surgeons can monitor and evaluate the incidence and prevalence of oral conditions and measure their success in providing intervention. With clear objectives and increased opportunities, surgeons can promote evidence-based initiatives and ensure tangible outcomes in improved oral health for all Australians.

1.1. Importance of Oral Health

It is apparent that increased research at a molecular and genetic level is the key to developing an accurate way to determine the risk of lesions. This will enable patients to receive the appropriate treatment for their condition and will eventually lead to prevention of the lesion before it becomes cancer. There are many ways in which the lesion of the mouth can be prevented from developing into cancer.

The most common oral disease is dental caries, but providing patients with regular dental check-ups will result in early stage prevention. One method for preventing cancerous lesions will be targeted at specific high-risk groups, for example, smokers or areca nut chewers. These patients can be monitored regularly for any changes in their oral mucosa, and any suspicious lesions can be tested using the methods described above. Early detection of lesions is vital in the prevention of oral cancer.

It is essential to maintain good oral health as it affects the overall state of the body. Oral health includes all aspects of health and functioning of the mouth, especially the teeth and gums. At present, surgeons have little biological information about which lesions will progress to cancer and which will not. This means that currently severe lesions may be treated less aggressively than they should be since it is not possible to determine the risk of the lesion. Usually, the treatment of a lesion involves its surgical removal.

This is typically a last resort due to the high level of invasive surgery and the risk of changing the form and function of the mouth for what could be a low-grade lesion. The problem with this is that at present there is no accurate way to determine if a lesion is high or low grade without removing part or all of it and checking the pathology.

1.2. Surgeons’ Role in Oral Health

Expertise of the oral surgeon is often best used in diagnosing a particular condition of the mouth or jaws with which a patient is suffering. This includes determining the precise cause of the condition, whether the condition can be treated and what it would involve to do so. The oral surgeon can then explain this to the patient and discuss various treatment options that are available. At times, diagnosis of a condition may require investigation such as taking x-rays or arranging for other special tests. The oral surgeon is experienced in interpretation of these and can usually carry them out himself.

The role of oral surgeons differs from that played by general dental practitioners. The specialist oral surgeon, by virtue of his particular expertise, is best suited to treating those conditions which require oral surgery techniques, and as such is usually referred patients by general dental practitioners. The most important role of an oral surgeon is to relieve suffering by correcting conditions of the mouth and jaws.

Many of these conditions can affect general health and are more comfortable to the patient if treated surgically. In that oral surgeons are specialists in surgery, their main role is to treat conditions in the most effective and least traumatic way as is possible. They are also involved in preventing conditions from occurring by using their knowledge and experience to decide if a particular condition can be treated sufficiently with what is available to the patient under general dental care.

2. Understanding Oral Health Issues

Proper oral health is vital for everyone, but it is often overlooked. Understanding oral health issues is the second step behind getting the full capabilities of one’s oral health back. Not understanding the semantics of this issue often leads to tooth decay on a normal basis. This can either be from a stored energy “fuel” known as sugar or saliva in the mouth. Frequent acid attacks on the teeth break down the enamel, thus creating cavities.

A cavity is a hole that can grow deeper and bigger over time, and it is important to get it repaired to ensure the vitality of the tooth. The longer a cavity is allowed to exist, the more damage it can cause. This can lead to a chronic toothache and infection of the tooth’s pulp. The pulp is the core of the tooth and it consists of nerves and blood vessels. Damage to the pulp can lead to abscesses, systemic infections, and loss of the tooth itself. Gum disease is another common problem. A sticky film of bacteria known as plaque is always forming on teeth, and if it is not removed, it can harden and form what is known as tartar, usually in areas where brushing cannot occur.

2.1. Common Dental Problems

Of the various oral cancer presentations, squamous cell carcinoma is the most common primary malignant tumor of the oral cavity, making up to 90% of all oral malignancies. The most frequent sites of involvement are the lower lip, the anterior tongue, and the floor of the mouth. It appears initially as a white lesion which can transform into a long-lasting ulcer. If not detected early, oral cancer can require radical surgery, radiation therapy, or chemotherapy and may still result in severe disfigurement or death.

Gingivitis and periodontitis are diseases that affect the gums. Gingivitis is the inflammation of the gums, while periodontitis is the degeneration of the alveolar bone around the teeth. Both diseases are caused by bacterial infections and if not treated, they can lead to tooth loss. With a 60-90% occurrence rate among the population, it is said to be one of the most prevalent disease conditions worldwide.

Dental caries, or tooth decay, is a common dental ailment in which bacteria erode the enamel on teeth. These bacteria feed on sugar and simple carbohydrates to produce acids that eat away at the hard tissues of the tooth. If not treated, it can lead to pain, infection, and tooth loss. Tooth decay is said to affect 97% of the population, and it is said to be more prevalent than asthma in children.

2.2. Impact of Oral Health on Overall Well-being

Severely decayed teeth are often associated with pain and discomfort, which can have a detrimental effect on quality of life. Pain from untreated dental disease can restrict the ability to eat certain foods, leading to a less nutritious diet and adversely affecting both weight and health. The link between dental disease and malnutrition in older people has been reported by numerous studies, and poor diet can lead to obesity. Dental pain from cavities and gum disease also seems to affect major life activities in some people.

A study in the Journal of the American Dental Association found that people with painful teeth were more likely to have missed work due to oral health issues, and those who were employed experienced a decreased ability to perform work tasks. Collectively, the evidence suggests that oral pain and disease have an influence on functional limitation and productivity during a lifetime.

Key components of overall well-being include physical and mental health, productivity, social relationships, and perceptions of self. Numerous national and international medical studies have provided evidence that poor oral health can be associated with reduced quality of life. The burden of oral disease is significantly higher among disadvantaged and poor socioeconomic groups where the experience of oral disease restricts activities in daily living, affects self-esteem, and contributes to stress and depression.

2.3. Oral Health Statistics in Orange County

Oral health very closely imitates the overall health of a given community. Dental disease is largely preventable but remains a common chronic disease throughout an individual’s lifetime. In terms of the United States as a whole, over 108 million children and adults have no dental insurance, which is over 2.5 times the amount of medical insurance. Orange County, California has a population of approximately 3 million and of that population 57% are children (17 and under) and seniors (65 and older). It is important to focus on those two age groups as they are more vulnerable in terms of oral health.

The older population is more susceptible to oral disease while children face the chronic disease. With that said, one of the most common chronic diseases for children is a milder form of tooth decay, and the statistics in terms of Orange County are quite high. In 2005, children who were a part of the California program First 5 were provided free dental screenings over a two-year grant period. Of the 14,049 children screened, about 25% were identified as having an immediate need for dental care with moderate to severe problems in 5-8 areas of the mouth.

3. Choosing the Right Surgeon

Take your time looking for a dental surgeon. The best oral surgeons have a lot of experience, usually more than 5 years in the field, expertise, and of course good qualifications and credentials such as Diplomat from the American Board of Oral and Maxillofacial Surgeons (ABOMS) or Fellow in the College of Dental Surgeons. He or she will also be happy to answer all of the questions that you ask and will make you feel comfortable and secure to have him or her doing the surgery.

A good surgeon will not hesitate to give you all of the information that you need and have good communication skills. He or she will tell you about the procedures, preparations, what to expect, and the risks or complications in a way that you could understand. He or she will also give you clear information about the expected outcome and explore your options including the possibility of not having the surgery, other surgical options, and the benefits and risks of each option.

Remember, always have more than one option. Not all oral and maxillofacial surgeons provide the same quality of services and insight. Taking more than one option will, in the end, get you the best surgeon that will suit your needs. Always look for their websites or other information to find out about their qualifications and credentials, expertise and experience, any testimonials or stories from their previous patients, and compare it with the information from the other surgeons.

And if you still have doubts, don’t hesitate to have another consultation with the other surgeons. By choosing the right surgeon, you will feel more secure and at ease by knowing that you are in good hands. And do not be discouraged with the search and consideration of time that you take to find the right surgeon. Because the best decision usually takes time.

3.1. Qualifications and Credentials

It is essential for individuals to search out a surgeon who has the right qualifications and credentials. There are oral surgeons who hold a dental degree and have only completed an oral and maxillofacial surgery residency (which consists of 4 to 6 years of intense surgical and anesthesia training). A candidate in this particular circumstance may not be board certified by the American Board of Oral and Maxillofacial Surgery.

Instead, the individual may be board certified by another board (i.e. plastic surgery, general dentistry, etc.). Now while this instance does not necessarily mean that he or she is not a competent surgeon in his or her field, it speaks to the fact that it can be confusing to identify the surgeon who is most qualified to address a patient’s specific needs. One of the most critical aspects to consider in regards to a surgeon’s credentials is whether or not the individual has completed an OMS program and is a diplomate of the American Board of Oral and Maxillofacial Surgery.

This ensures that the surgeon is proficient, has demonstrated a high level of knowledge and experience in the OMS specialty, and is committed to providing excellent patient care. Achieving diplomate status is in essence the difference between a surgeon being at the pinnacle of his or her profession, having been tested on his or her expertise in the field, versus a surgeon who has simply completed the minimum requirements to practice oral surgery.

3.2. Experience and Expertise

The type and amount of relevant experience and expertise can vary greatly by surgeon, and likewise, so do the results produced. Generally speaking, the more experience and expertise a surgeon has with a surgery, the better they will be able to adapt to and handle any complications that arise. Experience enables surgeons to have the knowledge and ability to innovate, while learning from past mistakes and successes. As a rule, the ideal surgeon for a given surgery will have many years of experience with that procedure, with a proven success record.

To find out a surgeon’s experience with a given surgery, the best and most direct way is to ask the surgeon themselves. Many surgeons will be honest in the event that they have little experience with a specific procedure, and many will even be able to direct you to another surgeon who has more experience with your particular needs. Once you have found a surgeon with the right amount of experience, it is also beneficial to review their expertise with the surgical procedure. Many surgeons who have a significant amount of experience with a surgery will perform it in a slightly different manner, and many procedures themselves have a range of techniques available.

Specifically, you will want to find a surgeon who is very comfortable with the specific technique that you are going to have performed, or a surgeon who has notable expertise with the use of certain equipment for your procedure. High levels of expertise with a given procedure can also lead to better results, and it may allow a surgeon to recommend alternative procedures or techniques that could be more beneficial for your specific needs.

3.3. Patient Reviews and Testimonials

Patient reviews and testimonials provide valuable insight into a provider’s competency, skill, and expertise and can give potential patients a good idea of what they can expect. Often times, patients with positive experiences are more than happy to refer a surgeon and share their experience with others and can play an important role in helping others make the right decision when choosing a provider. On the other hand, negative experiences can be a warning sign for potential patients and can help them avoid making a decision that they may later regret.

When reviewing testimonials, it’s important to keep in mind that not all experiences are the same, and in some cases, a negative testimonial may be the result of dissatisfying results for a procedure that has an inherent risk or the experience of a patient with unrealistic expectations. When evaluating testimonials, look for detailed accounts that relay a personal experience, as opposed to general statements that do not offer specific information.

General statements such as “good experience” or “I would recommend him” do not offer substantial information and can often be ambiguous, as they do not specify the reason for the patient’s satisfaction. Positive accounts that detail a surgeon’s compassion, understanding, and ability to inform and reassure patients regarding their elective procedures are an indication of good patient rapport and are attributes to look for in a competent provider.

4. Oral Surgery Procedures

Surgeons that specialize in oral and maxillofacial surgery are the most qualified providers to remove your wisdom teeth. An oral and maxillofacial surgeon has at least four to six years of additional training after dental school and all of this training is hospital-based. This training involves the administration of anesthesia and the diagnosis and surgical treatment of oral and maxillofacial pathologic conditions. During this training, the oral surgeon gains experience in understanding the interaction of the wisdom teeth and the bacteria in the adjacent gums, which often leads to painful and acute infection.

This understanding comes from many years of clinical and emergency room experience in diagnosing and treating various oral infections. Oral and maxillofacial surgeons are also very experienced with removing wisdom teeth in a manner that maximizes safety and minimizes complications. Often, a referral to an oral surgeon occurs after your general dentist has discussed with you the possibility of removing your wisdom teeth.

In many cases, your general dentist is the one who will refer you to an oral surgeon because he/she believes the extraction is beyond his/her comfort level due to the predicted difficulty of the extractions or the patient’s desires in being sedated for the procedure. With their advanced training and high level of competency, the wisdom teeth removal procedure is quite routine for an oral and maxillofacial surgeon. In general, the removal of wisdom teeth in young healthy adults is recommended in order to prevent future problems and to ensure optimal healing.

The rationale behind this recommendation is based on the idea that the roots of the teeth have not fully developed and the bone surrounding the teeth is less dense. These factors make the extraction process easier with less risk of complications. A study of the positioning and the anticipated course of the extractions can be easily obtained with a panoramic x-ray. This x-ray, which is a full view x-ray of the teeth and jaws, is a very common way to determine the health and position of the wisdom teeth and to potentially identify any underlying pathology.

4.1. Wisdom Teeth Extraction

Wisdom teeth are third molars that usually appear between the ages of 16 and 25 at the back of the mouth. It is generally considered essential to remove wisdom teeth when they first appear, even if there is no apparent problem. This is done in order to prevent a more painful or complicated extraction that might have to be done a few years later. The best solution to this problem is to extract the teeth when someone is young rather than wait until the roots are firmly embedded in the jawbone.

To have impacted wisdom teeth extracted, it is necessary to open the overlying bone and remove the teeth beneath it. Extracting a number of teeth at once takes between 20-60 minutes. Usually after these types of extractions, there is swelling of the face with bruising, the swelling being at its worst in 2 or 3 days after the surgery. Let the worst of the swelling go away, and there should be no problems. A surgical extraction of an impacted molar or wisdom tooth is a standard minor surgical procedure.

The dentist will open the gum that covers the tooth, then remove any bone that is covering the tooth. He will separate the tooth from any others in the jaw, and finally remove the tooth. The dentist may need to put in stitches to help the gum heal. In order to prevent unnecessary pain and decrease the chance of tooth loss, many people agree to have early removal of their lower wisdom teeth.

Because the extraction of the wisdom teeth is easier in a young person, they often weigh up the cost of the surgery against the future pain and risk. Although the prospect of having teeth removed is often grim, it is usually more emotionally traumatic for people who have to have their wisdom teeth extracted later on in life, usually when it is more difficult and painful due to complications with the impaction.

4.2. Dental Implants

Dental implant surgery is a procedure that replaces damaged or missing teeth with artificial teeth that look and function much like real ones. Dental implant surgery can offer a welcome alternative to ill-fitting dentures or bridgework. There are several advantages to having dental implants. Implants act much like natural teeth and are strong enough to allow the patient to chew and bite food with relative ease. Implants have a high success rate and are a good option for almost anyone who needs a tooth replaced.

Dental implants can also greatly improve a person’s smile. This can lead to an increase in self-esteem and confidence for many patients. As well, with good oral hygiene, dental implants can last a lifetime. The implants are made of titanium, a metal that is well tolerated by bone, and serve as artificial tooth roots. The surgeon will embed the implant into a small space made in the jaw. As the jaw heals over the next two to six months, the implant will bond with the bone and attach to the gum.

During this time, a temporary crown can be made. This will fill the space and make it easier to chew, smile, and talk. During the last phase of the procedure, the surgeon will attach an abutment to the implant. This is a small metal post that serves as a medium for the crown. The crown is then made to match the size, shape, and color of the natural teeth and attached to the abutment. At this point, the implant will be fully functional and virtually indistinguishable from natural teeth.

4.3. Corrective Jaw Surgery

At the completion of your surgery, you will be placed in a repositioning splint to assist the repositioning of your jaw. In most cases, braces are maintained during the surgery and may be changed following your recovery. Expect 2-4 weeks of intermaxillary fixation following your surgery. Full-time elastics will begin once your jaws are released from intermaxillary fixation. Your orthodontist will continue to fine-tune your bite in the months following surgery. Remember, the goal of orthognathic surgery is to provide a healthy, functional bite. Your treatment plan will also include post-surgical visits to monitor your progress. When your treatment is complete, you will no doubt have a positive change in the functional and esthetic aspects of your dental-facial structures.

In the majority of cases, the jaws can be repositioned and the chin realigned by orthognathic surgery, moving them in harmony with their surrounding structures. If you are a candidate for corrective jaw surgery, your surgeon will work closely with your dentist and orthodontist during your treatment. The actual surgery can move your teeth and jaws into a new position that results in a more attractive, functional, and healthy dental-facial relationship.

Corrective jaw surgery, commonly known as orthognathic surgery, is performed by an oral and maxillofacial surgeon to correct a wide range of minor and major skeletal and dental irregularities, including the misalignment of jaws and teeth. Surgery can improve chewing, speaking, and breathing. While the patient’s appearance may be dramatically enhanced as a result of their surgery, orthognathic surgery is performed to correct functional problems.

4.4. Oral Pathology

Oral pathology refers to the study and treatment of diseases that affect the mouth and its related structures. It is a recognized specialty in both dentistry and pathology. Diagnosing the patient’s condition involves using clinical, radiographic, microscopic, biochemical, or other examinations. Oral pathologists provide biopsy services for dentists and offer diagnosis and treatment of a wide range of diseases. These may include mucosal diseases such as lichen planus, pemphigus vulgaris, and mucous membrane pemphigoid, as well as hard tissue pathologies such as osteonecrosis or neuralgia-inducing cavitational osteonecrosis (NICO).

The information provided by the oral pathologist can often be crucial in deciding the most appropriate treatment regimen for the patient, and in some cases, it is necessary for the oral pathologist to be involved in the treatment process. With relation to this, there are several oral diseases that are only diagnosed through laboratory tests. An example of this is systemic lupus erythematosus. In many cases, the patient’s general medical doctor needs to be informed of the results of the oral pathology tests, especially if the disease is systemic in nature.

5. Preparing for Oral Surgery

Upon deciding to undergo oral surgery, we must first look at the consultation and evaluation with the surgeon. In doing so, the surgeon must be informed of any medical conditions or use of medication. It is important for the surgeon to be informed of any medical conditions such as hypertension, thyroid problems, diabetes, etc., as well as any use of medication, whether prescription, over-the-counter, or herbal supplements.

In doing so, the patient and surgeon can be made aware of the medication that may influence the surgery and can make a decision on whether the surgery should be performed in the office or at the hospital. Additionally, any x-rays taken within the past year should be brought to the office at the time of consultation. The x-rays will help the surgeon to better understand the anatomy of the mouth, better formulate a diagnosis, and help determine what treatment can be done.

It is also helpful to have a copy of the x-ray for the surgeon to keep as a reference. Finally, the consultation is a good time for the patient to ask any final questions they have about the surgery. A list of possible questions has been included with this information. This patient is discussing his medical history with his surgeon. Once the decision for the surgery has been made, the surgeon will provide the patient with preoperative instructions.

This can be described as a plan of what to do for the surgery. Making preparations for surgery will better ensure a safe and more comfortable recovery. This may include obtaining a prescription for an antibacterial mouth rinse and antibiotics to use before and after surgery. Specific instructions may also be given regarding food and drink. It is often recommended to have a good meal prior to surgery and avoid heavy foods and liquids for 8 hours before the surgery. Knowing what to expect before going into surgery is a good way for the patient to mentally and physically prepare.

5.1. Consultation and Evaluation

After this assessment, your surgeon will review the findings and x-rays and consider the optimal surgery plan for your condition and overall health. He will also determine whether surgery should be performed in the office with local anesthesia, nitrous oxide sedation, or in the hospital by an oral and maxillofacial surgeon with intravenous sedation or general anesthesia.

This will be discussed with you as the best treatment plan. He will then give a thorough explanation of the chosen treatment plan, including the type of anesthesia, where the surgery will be performed, incision information, expected surgery length, and approximate expected recovery time. Finally, the surgeon will answer any questions and address any concerns you may have regarding the treatment plan.

During the consultation, there are several details you should provide the surgeon to avoid having your surgery postponed. A list of the names and dosages of all medications you are taking, medical or surgical consultation reports pertaining to your medical conditions, a card or letter from your physician describing your medical condition and clearance for the planned surgery, and copies of EKG’s and results of appropriate lab work done within the last six months. This information will help the surgeon properly assess your surgery and will prevent postponement.

Before surgery, you will have a consultation with your surgeon. During the consultation, your surgeon will perform an examination of your teeth, possibly take x-rays, and ask about your past medical history.

5.2. Preoperative Instructions

Your help in following these guidelines will assist us in providing you with optimal care and allow your surgical procedure to be as pleasant as possible. Taking medications with even a small sip of water on the day of surgery can lead to cancellation of your surgery. Patients who arrive with a cold, sore throat or any other sign of illness may also have to be rescheduled for another day. These decisions are made for your safety and to reduce the risk of any complications during or after surgery.

General guidelines for preoperative care are as follows: 1. Do not eat or drink anything (including water) for six hours prior to the scheduled time of your surgery. This will prevent stomach upset and vomiting. 2. No smoking for at least 12 hours before surgery. Ideally, cut down or stop smoking as soon as possible prior to the day of surgery, as this will reduce postoperative complications and enhance your recovery. 3. A responsible adult must accompany the patient to the office, remain in the office during the procedure, and drive the patient home.

If the patient is to receive IV sedation or general anesthesia, the escort must be prepared to stay with the patient at least two hours after surgery. 4. Please wear loose fitting, short sleeved comfortable clothing and flat shoes. Do not wear contact lenses, jewelry, or dentures. These can be removed at the time of surgery. A sweater or jacket is recommended since our office tends to be rather cool.

Written and oral instructions are key to good preoperative care. Several days before surgery, you will receive a call from the surgical assistant. He will provide you with specific instructions for the day of surgery, a review of your health history, and an opportunity to ask questions.

5.3. Anesthesia Options

Nitrous Oxide Nitrous oxide, known as “laughing gas,” is a safe and effective anxiolytic agent. It is mixed with oxygen and inhaled through a small mask that fits over your nose to help you relax. It is indicated for patients of all ages. The dose is adjusted as needed and it reduces anxiety and gagging. The patient will return to normal body function and feel like themselves within just minutes of stopping the gas. This is the only form of sedation where you may be able to drive yourself home after the procedure.

Local Anesthesia Local anesthesia is the numbing of just the surgical site. The surgery staff will discuss with you a specific local to use. Some local anesthetics last longer than others (3-4 hours to 12 or more hours). You must remember that when your lip and/or tongue are numb, you can bite them and not feel the injury. It is best to avoid eating until the anesthetic has worn off to prevent injury to your soft tissues.

Anesthesia options depend on the nature of the surgery, your medical history, and your level of apprehension. Our nursing staff will review your specific needs for anesthesia during your consultation appointment. It is our hope that the following information will provide some information in advance of that appointment to prepare you for a discussion of your anesthesia needs.

6. The Surgical Process

First, the dental surgeon will schedule a comprehensive consultation to explain the diagnosis and treatment options. The patient will usually request an appointment with the surgeon after they have seen their general dentist or specialist. This is often due to a referral indicating that a surgical opinion is required. Computer images and x-rays will be reviewed during the consultation. Often, a preoperative assessment is required, including a history of the patient’s past and present medical and dental status as well as a full clinical examination. A treatment plan is formulated given the patient’s desires and medical and dental status.

Informed consent is an important aspect of this process. The informed consent process ensures that the patient is fully aware of their diagnosis and treatment, and the risks involved. This process often requires a separate appointment and is important that both the patient and surgeon understand what treatment is agreed upon.

Surgical dental procedures can be opted for a number of reasons. Commonly, surgical procedures are designed to save teeth damaged by decay. Teeth are extracted when diseased, non-restorable, or to create space. Some teeth, such as impacted wisdom teeth or canines, require an exposure before they can be guided into place with braces. Often, a tooth or teeth should be removed and replaced with a bridge or dental implant. Lastly, the removal of tumors or cysts in the jaw may also require a surgical procedure.

6.1. Surgical Techniques

Many oral surgeries require intricate and specialized techniques to effectively address certain oral diseases. Without skilled application of surgical techniques, many procedures would only partially address problems and oral diseases could be left untreated. The chapter provides an introduction to surgical techniques, and the applied anatomy of the maxillary and mandibular regions. These give a concise overview of what is to be expected in future chapters about surgical procedures. Ennen et al. found that surgeons tend to use more force than necessary in attempting to extract teeth.

This can be related to inadequate application of basic principles of surgery and the use of inappropriate instruments. With better understanding of force application and proper use of instruments, surgical procedures can be accomplished more efficiently and effectively. This can be a significant advantage in reducing patient morbidity during surgery and the healing phase that follows. Understanding of the anatomy to enable the least traumatic procedure is key to successful surgical treatment. Anatomy can differ from patient to patient, with the same procedure being more difficult for some than others.

The superior and inferior alveolar nerve blocks are commonly used when attempting to anesthetize the mandibular teeth, however various other techniques have been suggested such as intraligamentary injections and nerve block anesthesia at the foramen. This can increase patient comfort during the procedure and also reduce morbidity. Overall, an improvement in the use of surgical techniques can give rise to a better prognosis for the patient and reduce patient complications. An example is how successful removal of wisdom teeth prevents many problems that are associated with impacted molars; these can include but are not limited to mucocoeles, cystic lesions, pain, and limited jaw opening.

6.2. Postoperative Care

The major aspect of postoperative care is determining whether a hospital stay is required for the patient’s condition. If hospitalization occurs, we will need to determine whether the patient will be admitted to a medical or surgical floor. Furthermore, what level of care is required for postoperative care? This can range from simply changing a dressing and monitoring the wound to very intensive nursing care, including wound care, as well as physical and occupational therapy.

This also must be individualized based on the type of surgery, wound location, patient goals, and preoperative level of function. Another important aspect of postoperative care is wound management. The surgical wound should be monitored closely, and any increase in redness, pain, swelling, warmth, odorous drainage, or fever should be reported immediately to your surgeon. It is often helpful to take a photograph of the wound every day to monitor for any changes. High-risk wounds, such as with cosmetic or implant removal surgeries, should be monitored closely by the surgeon and possibly with the help of a wound care nurse.

6.3. Potential Risks and Complications

The most frightening topic on the patient’s mind when making the decision to undergo surgery surrounds the potential complications faced during and after the procedure. This is a profound and reflective topic as the welfare and wellbeing of the patient weighs heavily. It is important to address these complications and risk and it must be discussed between the surgeon and patient in great detail. It is an ethic of professionals within the medical industry to provide the best possible care whilst retaining the safety and wellbeing of the patient. It is important that the surgeon has been completely honest and realistic about what the patient will experience during and after the surgery. This is with particular reference to the postoperative complications or those related to the general anesthesia.

7. Recovery and Aftercare

It is also for the person who is undertaking the treatment’s family and friends, to help them better understand what the recovery process involves. The main objectives of the surgery are to reduce pain, increase the range of movement in the temporomandibular joint, improve the occlusion by repositioning the jaws or correcting irregularities or deformities, replace joint parts, extract teeth, remove cysts or tumors, as well as other possible objectives. This surgery is performed with the intent to leave the patient with the least amount of scarring as possible. Recovery time varies between procedures and can take weeks or months for the patient to feel fully recovered. This will be discussed in greater detail.

Oral and maxillofacial surgery is a surgical treatment of the hard and soft tissues of the mouth, face, upper jaw, lower jaw bone, and the temporomandibular joint. It is usually carried out by an oral and maxillofacial surgeon. This type of surgery is often confused with dental surgery. We recommend this essay aims to inform the average adult who is undergoing this surgery, as well as people who are considering this type of treatment, by discussing what the surgery involves and the different types of procedures that come under oral and maxillofacial surgery.

7.1. Managing Pain and Discomfort

It should be noted that all acute pain following surgery is only temporary and will subside with time. The objective is to keep this to a minimum. Measures to reduce acute pain at a surgical site include rest, ice, compression, and elevation of the affected limb, known by the acronym RICE. Using the above measures along with good medication management will go a long way in helping patient discomfort after surgery.

Opioid medications are more effective in managing acute nerve pain. However, due to the addictive potential of these medications, their use should be restricted to a short period and strictly regulated by the surgeon. If a patient is already on opioid medications for chronic pain management, surgery may worsen their pain if they then suffer acute on chronic pain.

The cause of pain following a surgical procedure is either inflammatory, due to surgically induced trauma on muscle, bone, or connective tissue, or nerve pain. Nerve pain can be acute with a sharp shooting quality or chronic and cause numbness and tingling. Different pains require different methods of management. Non-inflammatory pain and pain due to muscle trauma are usually well managed with NSAIDs, paracetamol, or weak opioid medications such as codeine. It is important with these medications to adhere to the recommended daily dose as stated by a doctor or pharmacist and to not exceed the total daily dose of paracetamol as this can cause liver damage.

Communication between patient and surgeon is crucial in eliminating or reducing pain following an operation. This exchange of information can identify patients “at risk” of a more painful recovery and allows the surgeon to find alternative methods or medication to help reduce pain. It can also give the patient a realistic idea of what to expect after their operation.

Patient anxiety can play a significant role in the way they experience pain. If a patient is anxious about what might happen after a surgical procedure, this may actually cause them to feel more pain. Similarly, if an individual is primarily concerned with the pain at a surgical site, this can distract them from other tasks that need to be performed to aid recovery.

Pain is a sensory and emotional experience that is only truly understood by the person experiencing it. Many procedures can be carried out to remove the cause of the pain, yet they can cause acute post-surgical pain and discomfort. Usually, however, the better someone can understand and anticipate any discomfort, pain, or anxiety, the more able they are to help manage and control it. This involves the pre-planning of what may happen during the post-operative period and what can be done to help alleviate or manage any of the symptoms.

7.2. Dietary Guidelines

This is similar to the Red Cross Blood Donor Diet, and one of the reasons for this diet is that the Dental Implant Surgery leaves an open wound in the mouth. This means that anything that you would not give to a child with a fresh mouth would not be good for the adult during their recovery. The adult mouth is no different from a child’s, so we put our best effort into creating a list of food that the adult would be happy with eating.

This starts with plenty of water. For the first few days, water might be the only thing that you can drink, but in the duration of the entire diet, water is the best thing to drink for your health. Next, the diet suggests you consume protein shakes or smoothies and a number of juices for a meal or a snack. These can actually be quite nutritious and fulfilling. The smoothies are recommended to be made with yogurt and any fruits except berries. The yogurt is good because it is packed with protein, and berries are forbidden because of the small seeds. Step three involves making well-cooked canned vegetables. In the case of these vegetables, less is more.

This means it is important to cook them to a point where they are soft and easy to chew. Overcooked is not the way to go; however, nutrients can be lost if foods are overcooked, and it is also tasteless. Your mission is to cook the vegetables to chew them without needing to break out the old dentures. Finally, the diet suggests eggs and egg-based foods. Eggs are a good source of protein and are just what you need, scrambled, boiled, or poached.

This will cover the duration of the diet. Eggs are perfect because with a bit of seasoning, there is plenty of variety to how eggs can be made, and this prevents food boredom. Don’t be yolked to the computer, print off the diet! A food log is also an excellent way to keep track of what you’ve been eating so that you don’t stray from the diet. Output in a waiting room, tack it to the fridge: The Dietary Guidelines for Dental and Oral Surgery is sure to keep you on track.

This diet is often seen as too hard, and many people who it is recommended for default back to their regular diet habits. You might read over the diet and think “Eh, what’s the worst that can happen? I’ll just have this…” Well, the worst that can happen is eating something that violates the food restrictions and causes an infection in the surgical area.

This would require additional treatment, and drive-thru at the dentists’ office is never fun. An infection can lead to an array of complications and yield a longer recovery time. Failure to comply with the diet can also lead to an increase in swelling and more pain. Remember the Red Cross diet and your children with it for your oral surgery specific path. You will be nourishing your body and promoting quicker healing. Let the kids have that ice cream.

7.3. Follow-up Appointments

You should come back to the office in 7-10 days to check the surgical site and we will ensure that you are healing uneventfully. Sutures are often removed at this visit. Any other postoperative instructions will be given at the time of your surgery. If you were sedated during your surgical procedure, you will need a responsible adult to drive you to and from your appointment. All patients are required to have an empty stomach if they will be taking prescription pain medication, in order to prevent nausea and vomiting.

Those patients who are in the early stages of dental implant reconstruction will need to coordinate postoperative visits with their restorative dentist. This is often an excellent time for the surgeon and restorative dentist to discuss your individual case and ensure that both providers are clear about the treatment plan. In certain cases, telephone follow up may be necessary.

This is often the case for long distance patients who have returned home and are having an uneventful recovery. And finally, we encourage all postoperative patients to continue with routine dental cleanings every 3-6 months. This is an excellent way to prevent future oral health issues by catching them early when they are easily treatable.

8. Maintaining Oral Health

This section is about how to maintain your oral health. The three main ways are your oral hygiene, regular dental check-ups, and how your personal lifestyle can affect your mouth’s health. Your oral hygiene is the most important way you can maintain oral health. This involves cleaning your mouth in a way that prevents gum disease and tooth decay. The two main dental diseases that poor oral hygiene can cause are gingivitis and periodontal disease.

It is recommended that you brush your teeth at least twice a day. Ideally, it would be after every meal or snack to prevent plaque build-up and bacteria. If you were to only brush once a day, plaque would not be totally removed as it takes about 24 hours to form on the teeth again. Using dental floss is another way to remove plaque after meals. Gingivitis is more easily prevented than periodontal disease. By removing plaque every day, your gums will remain pink and healthy. Otherwise, the gums will become inflamed and bleeding occurs.

If gingivitis is not treated, it can turn into periodontal disease where the inner layer of the gum and bone will pull away from the teeth and form infected pockets. If not treated, the teeth can become loose and fall out. The most effective prevention for these diseases is brushing and flossing. Massage of the gums and cleaning the tongue are also included in oral hygiene practices, as well as drinking water and using mouth rinse to wash away food. The type of toothbrush and brushing technique are also important factors.

A toothbrush with soft, rounded bristles is less likely to cause wear on the teeth and damage to the gums. The handle should also be the right size for your hand and the head should be the right size for your mouth. The brushing technique should not be scrubbing back and forth as this can cause damage to the gums and erode the gum line. Small circular movements with the brush at a 45-degree angle towards the gum are the best way to effectively clean the teeth and gums.

8.1. Oral Hygiene Practices

Patients should be encouraged to brush and floss in the morning and at night. Using a soft or ultra-soft bristled brush, whichever is more comfortable, to prevent any damage to the enamel on the teeth, while being abrasive enough to remove the plaque. An electric brush can be just as effective as a regular brush if used properly; however, make sure it is not damaging to the enamel. The practice of brushing and flossing in the morning and at night is said to prevent gum disease and future dental procedures in 80-85% of adult patients.

This is the basic formula to maintaining proper oral hygiene and should not be forgotten even if periodontal disease begins to progress (gum disease). If 80-85% of patients can prevent future oral disease with proper tooth brushing and flossing, it should be the foremost attempt in preventive care therapy to stop disease. Using antimicrobial mouth rinses has been proven to reduce plaque and bacteria activity. However, if the patient is using the rinse to mask the problem of brushing, then it will not be effective in preventing any oral disease. Only if it is used in combination with proper brushing and flossing.

8.2. Regular Dental Check-ups

Finances can be a major deterrent when it comes to dental care. The costs associated with dentistry have caused a rift among socioeconomic classes regarding oral health. Dental care has been deemed a luxury for some, and it is often the first thing to be excluded from one’s budget. It is important to remember that neglecting oral health can greatly increase the cost of future treatment. Preventative treatment is far less costly than the treatment of problems that have been neglected or ignored for years. High costs can also be offset by the purchase of dental insurance. This will cover check-ups and cleanings, as well as assistance in the cost of a lot of other dental procedures. In the long run, the small cost of insurance will pay off.

Pregnancy and menopause bring about changes in the body, including the mouth. Pregnancy gingivitis is most often attributed to the hormonal changes in the body. An increase in hormones can increase the flow of blood to the gums, causing them to be more sensitive, irritable, and easier to bleed. Menopause can cause oral changes due to the aging process and also lack of estrogen. Receding gums are often attributed to this lack of estrogen. It is important to address these oral health concerns during these times in one’s life.

Many people do not see their dentist on a regular basis. They only go when they have a problem. This is known as “crisis treatment” as opposed to “preventive treatment.” Regular visits to the dentist will prevent problems from occurring in the first place. It is important to remember that the cost of dentistry is high. However, the cost of neglecting your oral health could be higher. Brushing removes plaque from the surfaces of the teeth. Once plaque is removed, it cannot harm the enamel on your teeth. Plaque generates acid that can cause cavities.

If plaque is not removed, it can harden into something called “tartar” within 24 hours. Regular professional cleaning is the only way to remove tartar, and it prevents the development of a variety of other problems. During a dental check-up, your dentist will also be able to detect problems early on in their development. A small filling is far less expensive than a root canal or crown. Small problems can also be addressed before they become larger issues. Issues such as blood pressure or overall health problems can be detected in their early stages in the mouth.

8.3. Lifestyle Factors Affecting Oral Health

Factors such as diet, alcohol, and tobacco use can have a major impact on oral health. Diet can dictate oral health due to the quantity and frequency of sugar intake. High-sugar foods and drinks provide an abundant supply of substrate for acid-producing bacteria, which will lead to decay. It is important to note that sugar is present in many food and drink items. Fruit, although a healthy food product, contains high levels of sugar.

It is recommended that fruit be consumed as part of a meal and not as a between-meal snack. That way, the other foods consumed will help neutralize the acid produced when eating fruit and will help to remineralize the tooth. Sugar frequency is a major factor in the cause of dental decay, and it is recommended that if one is to have sugary foods or drinks, they are consumed at meal times. Acids and drinks can also cause erosion, especially when followed up with toothbrushing.

The toothbrush is an abrasive and will remove some of the softened tooth surface. It is recommended that in order to prevent tooth erosion from excessive consumption of fruit and drinks, a softer bristle toothbrush is used and less force is applied when brushing. Sugar-free drinks and chewing gum are other products that can help reduce tooth decay. Mainly, the detrimental effects of smoking and tobacco use are common knowledge to the general public.

What they may not be aware of is that smokers are more likely to have gum disease compared to non-smokers. This is due to the effect that smoking has on the amount of bone in the jaw and the buildup of tartar on the teeth. Smokers will also have a reduced rate of success with any periodontal treatment. It has also been shown that smoking has an effect on the success of dental implants. It is wise that any patients who have had a tooth extracted or are seeking a tooth extraction should quit smoking.

9. Oral Health Resources in Orange County

There are a wide range of resources that are designed to fulfill the oral health needs of a diverse population in Orange County. This section will focus on the systems, which are in place and the changes which are needed, to ensure that the dental health needs of all Orange County residents can be met. Similar to intro – maybe too similar? The first step to improving a population’s oral health is to put in place comprehensive dental services that are accessible to all members of the community, especially those who have been identified as being at high risk for oral disease.

Currently, there are limited resources for the uninsured, those reliant on Denti-Cal and children. Denti-Cal is the state’s Medicaid program which provides oral health services to individuals who are entitled to public assistance. Unfortunately, there are only a few private dentists and no private oral surgeons in Orange County that accept Denti-Cal. This means that a large proportion of oral surgery needs are being directed to the USC Medical Centre and LA County Hospital because they are the closest facilities with oral surgeons that accept Denti-Cal.

This not only inconveniences the patients but is not a cost-effective way to manage the oral surgery needs of Orange County residents. Low-income adults can access basic dental services through the Medi-Cal program; however, there are no oral surgeons in Orange County that accept Medi-Cal, and the dental services offered to adults via both Denti-Cal and Medi-Cal are very limited. In Orange County, there is only one program specifically designed to provide free dental care to the low-income population. The Hurtt Family Health Clinic is a non-profit organization run primarily…

9.1. Dental Clinics and Surgeons

The comprehensive oral health infrastructure in Orange County reflects the credence of oral health as an essential component of overall health. Orange County offers a wealth of qualified and experienced dental surgeons and specialists. These surgeons work at a variety of dental clinics countywide, and some have private practices. In addition to private practices, community-based dental clinics focusing on the underserved populations are found in Orange County, and these are places where those who have Medi-Cal, low income, or are developmentally disabled can go to seek treatment.

The majority of dental clinics take a multitude of insurances including Medi-Cal, and some even take the Denti-Cal insurance which is specifically for dental services. Those who are enrolled in Denti-Cal often have difficulty finding a surgeon or specialist who will accept their insurance, and the Department of Health Care Services has efforts underway to improve this. With over 3000 licensed dentists in Orange County, an individual seeking dental care or surgery has a valuable index of qualified professionals from whom to seek services.

9.2. Insurance and Payment Options

The essay provides an overview of available oral health resources in Orange County for underserved populations. The essay is an adaptation of the most current Orange County Oral Health Resource guide, which provides updated public resources for low-income populations. This includes Medicare recipients, MediCal recipients, County Medical Services program recipients, the California Children’s Services program, and the Healthy Families program, and the access to resources available for each group.

The essay profiles public dental health programs and resources throughout Orange County. These resources include the Orange County Dental Society, Orange County Dental Foundation, and various non-profit organizations. The essay provides valuable information regarding services provided and where to access them. The Orange County Dental Society website and phone number are provided for the ability to contact and receive more information.

The essay lists available services including information and referral services, discounted dental services, and community and school-based prevention programs offered by the Orange County Dental Foundation. There are various other non-profit organizations such as the Healthy Smiles for Kids of Orange County that provide vital dental services for children. This information will help guide parents of children to low-cost programs that are designed for children. Overall, the essay provides a valuable outline of available providers and steps to accessing dental services in Orange County.

9.3. Oral Health Education Programs

Oral health education programs are a critical part of any plan to improve the oral health of a community. Unfortunately, there are few dedicated programs in Orange County. The Orange County Dental Society provides a number of presentations and lectures to the community, but the commitment to these programs is sporadic and their effect is unmeasured. Local dental hygienist programs have participated in educational programs directed at increasing the oral health knowledge of certain segments of the population in Orange County. These programs have targeted the elderly, adolescents, and pregnant women.

The Pacific Center for Special Care at the University of the Pacific School of Dentistry runs the only other significant educational program in Orange County. The program aims to increase oral health access for various underserved communities. The program is based on building inter-professional teams of healthcare providers and training them to provide care to their target communities. The program has had a number of successes, including a recently established program for developmentally disabled children in conjunction with the Orange County Regional Center.

Overall, the sparsity of oral health educational programs in Orange County is indicative of the low priority oral health has in the public health field. This needs to change. An effective education program should increase public understanding of the importance of oral health and the connection between oral and overall health. It should target specific at-risk groups and it should be continuous and measurable. The goal is for oral health to become a valued and understood aspect of overall health in all segments of the population in Orange County.

10. Conclusion

After reading the article, the writer thinks that it will be easier to be fixed within an issue, but there is a relevant connection to the health issue. In the context of some point in patients who need surgical treatment, it is important to keep the motivation to fix health issues with oneself, family, and another environment. So, knowing the surgeon conditions are helpful as a parameter in choosing the best surgery. From the method of this article, it is expected the article can help to fix the health issue for the patients in Orange County by using the surgeon services. This is an interesting start toward how the health issues in some areas can be fixed properly.

This format makes understandable tableaus of the health issue through Orange County’s potential surgeons rated through the magazine. It is clear from the article that it reveals surgeons with high ratings and the true winner is known who blew the writer’s mind. This format explains to the reader the importance of the Orange County health agencies by expanding surgeon information. In the future, the article hints that this will help the reader’s decision to make a personal choice of which specific surgeon they are aiming for. The best part of this article is how it makes simplifying these tableaus easy for readers’ comprehension. 

References:

Martin, S. R. and Kain, Z. N. “The intersection of pediatric anesthesiology and social determinants of health.” Current Opinion in Anesthesiology, 2024. HTML

Mahure, Siddharth A., et al. “Learning curve for active robotic total knee arthroplasty.” Knee Surgery, Sports Traumatology, Arthroscopy 30.8 (2022): 2666-2676. HTML

Vyas, Raj M., et al. “Using virtual augmented reality to remotely proctor overseas surgical outreach: building long-term international capacity and sustainability.” Plastic and Reconstructive Surgery 146.5 (2020): 622e-629e. gsmile.org

Roseland, Molly E., et al. “Neoadjuvant chemotherapy for high-grade serous ovarian cancer: radiologic–pathologic correlation of response assessment and predictors of progression.” Abdominal Radiology (2024): 1-9. HTML

Chen, Jonlin, et al. “The zoom boom: how video calling impacts attitudes towards aesthetic surgery in the COVID-19 era.” Aesthetic surgery journal 41.12 (2021): NP2086-NP2093. HTML

Chmielewska, Malgorzata, et al. “Motivation factors affecting the job attitude of medical doctors and the organizational performance of public hospitals in Warsaw, Poland.” BMC Health Services Research 20 (2020): 1-12. springer.com

Jung, Richard G., et al. “Methodological quality of COVID-19 clinical research.” Nature communications 12.1 (2021): 943. nature.com

Tran, D. B., Owyang, A., Hwang, J., and Potvin, R. “Visual acuity, quality of vision, and patient-reported outcomes after bilateral implantation with a trifocal or extended depth of focus intraocular lens.” Clinical Ophthalmology, 2021. tandfonline.com

Zhong, Zhaoming, et al. “Transcriptome analysis reveals the link between lncRNA-mRNA co-expression network and tumor immune microenvironment and overall survival in head and neck squamous cell carcinoma.” BMC Medical Genomics 13 (2020): 1-11. springer.com

Valentine, K. D., et al. “Development and evaluation of the shared decision making process scale: a short patient-reported measure.” Medical Decision Making 41.2 (2021): 108-119. sagepub.com