Oral surgery deals with the surgical treatment or correction of diseases, defects, or injuries of the oral cavity, teeth, and adjacent tissues. A sound knowledge of surgical assisting procedures is essential if you are to be an effective oral surgery assistant.
Oral surgery provides surgical treatment or correction of diseases, defects, or injuries of the oral cavity and facial structures. A wide variety of surgical procedures takes place in the oral-maxillofacial surgery area. Exodontics is the term used to describe the extraction of teeth in oral surgery. General dentists are trained in surgical procedures; however, they may choose to refer the patient with a more complicated case to an oral surgeon who has specialized training in the area. A maxillofacial surgeon is an oral surgeon who specializes in the reduction of bone fractures and reconstruction of the maxilla or mandible, and performs reconstructive surgery.
Before a surgical procedure can be done, the oral surgeon will evaluate each patient's record for indications and contraindications to treatment. Some indications for oral surgery include:
Carious teeth unrestorable by restorative procedures.
Nonvital teeth when endodontic treatment is not indicated or has little chance of success.
Removal of teeth to provide space in the arch for orthodontic treatment.
Teeth without sufficient bone support.
Supernumerary or impacted teeth interfering with normal dentition.
Malpositioned teeth that cannot be aligned.
Root fragments from prior extractions or surgery.
Removal of soft-tissue.
Removal of exostosis (overgrowth of bone), such as torus mandibularis and torus plantinus.
Accidental fracture or reconstruction of the mandible or maxilla.
The oral surgeon will also evaluate the patient for possible contraindications to surgical treatment. Extractions should be avoided when an active infection is present because local anesthesia is difficult to achieve and the infection can spread to other parts of the body. Patients suffering from any potentially serious disease, such as heart disease, diabetes, and blood disorders, should first be evaluated by a physician to determine if they can withstand the prescribed treatment. Patients in the early stages of pregnancy should have the surgery postponed until they are in the second trimester.
Examination and informed consent are essential to determine what treatment is required, and provide all relevant information to the patient to make an informed decision regarding proposed treatment.
The oral surgeon examines the patient to confirm the findings of the referring dentist and gather any other additional information to make treatment recommendations. Oral surgeons should order radiographs of the teeth, mandible, maxilla, or other facial areas to verify the treatment recommendations if not already taken. The radiographs may include periapical, extraoral of the skull or facial aspects, panoramic, temporomandibular, and occlusal. A comprehensive medical history review is essential for the surgical patient because of the strain surgery places on the body. If there are any questions regarding the patient's health or ability to withstand surgery, the surgeon should consult with the patient's physician before surgery. During the examination, the oral surgeon also discusses appropriate pain-control methods for the surgical treatment recommended, and informed consent with the patient or legal guardian.
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