Expert and comfortable surgical care for your complex dental needs.

The word “surgery” can be intimidating, but at Elite Smile, we have redefined oral surgery as a precise, comfortable, and compassionate experience. Our surgical services are performed by highly trained professionals using modern anesthesia, sedation options, and minimally invasive techniques. Whether you need a simple tooth extraction or complex jaw reconstruction, our goal is the same: resolve your problem efficiently while keeping you pain-free and informed.

What Is Oral and Maxillofacial Surgery?

Oral and maxillofacial surgery (OMS) is the specialty of dentistry that diagnoses and treats diseases, injuries, and defects of the mouth, teeth, jaws, face, and neck. It is a surgical specialty that requires an additional 4–6 years of hospital-based residency training after dental school. At Elite Smile, our surgeons are equipped to handle everything from routine extractions to advanced reconstructive procedures.

Surgical Services We Provide

1. Tooth Extractions (Simple and Surgical)

• Simple extraction: Performed on visible teeth above the gum line. Uses elevator and forceps. Local anesthesia only. Recovery: 1–3 days.

• Surgical extraction: Required for teeth that are broken, impacted, or below the gum line. Involves incisions, bone removal, or tooth sectioning. Recovery: 5–7 days.

Indications for extraction:

• Severe decay beyond restoration

• Advanced periodontal disease (tooth mobility)

• Impacted wisdom teeth

• Overcrowding (orthodontic reasons)

• Fractured teeth below the gum line

• Primary (baby) teeth that won’t fall out

2. Impacted Wisdom Teeth Removal

Wisdom teeth (third molars) are the most commonly extracted teeth. They typically erupt between ages 17–25. Impaction occurs when there is insufficient space or improper angulation.

Types of impaction and surgical difficulty:

Why remove them? Even asymptomatic impacted wisdom teeth can cause:

• Pericoronitis (infection of the gum flap)

• Damage to adjacent molars (root resorption, decay)

• Cysts (dentigerous cyst destroys jawbone)

• Sinus problems (upper wisdom teeth)

• Crowding (controversial but possible)

Statistics: 85% of people will develop at least one impacted wisdom tooth. Approximately 10 million wisdom teeth are extracted annually in the U.S.

3. Dental Implant Surgery

Dental implant placement is a surgical procedure where a titanium post is inserted into the jawbone to serve as an artificial tooth root. This is typically done in two phases:

• Phase 1 (implant placement): Under local anesthesia or sedation, a small incision is made in the gum, a hole is drilled into the bone, and the implant is placed. The gum is sutured over or around the implant.

• Osseointegration period: 3–6 months for bone to fuse to the titanium surface (success rate 95–98%).

• Phase 2 (abutment placement): A small connector is attached to the implant.

• Phase 3 (crown placement): The artificial tooth is cemented or screwed onto the abutment.

Bone grafting: If there is insufficient bone height or width, a bone graft (from your own bone, donor bone, or synthetic material) is placed first, followed by 4–9 months of healing before implant placement.

4. Bone Grafting and Sinus Lifts

• Socket preservation: Graft placed immediately after extraction to preserve bone volume for future implants.

• Ridge augmentation: Horizontal or vertical bone grafting to rebuild deficient ridges.

• Sinus lift (sinus augmentation): Lifting the sinus membrane in the upper jaw to add bone for implants in the molar/premolar area.

5. Apicoectomy (Root-End Surgery)

When a root canal fails or infection persists at the root tip, an apicoectomy removes the tip of the root and seals the canal from the end. This saves the tooth when conventional retreatment is impossible.

6. Biopsy and Oral Pathology

Any suspicious lesion (red patch, white patch, ulcer lasting >2 weeks, lump) may require a biopsy. Our surgeons perform:

• Incisional biopsy: Removal of a small piece of abnormal tissue.

• Excisional biopsy: Complete removal of a small lesion.

• Punch biopsy: Using a circular blade for small, deep lesions.

7. Pre-Prosthetic Surgery

Procedures that prepare the mouth for dentures:

• Alveoloplasty (smoothing of jawbone ridges)

• Removal of bony spicules or tori (bony growths)

• Frenectomy (removal of a restrictive frenum, e.g., tongue-tie or lip-tie)

8. Treatment of Facial Trauma

Fractures of the mandible (lower jaw), maxilla (upper jaw), cheekbone (zygoma), or eye socket (orbit) require surgical fixation using plates and screws. We coordinate with emergency departments and oral surgery specialists.

9. Temporomandibular Joint (TMJ) Surgery

For severe TMJ disorders that do not respond to conservative treatment (splints, physical therapy, medications), surgical options include:

• Arthrocentesis (joint lavage)

• Arthroscopy (minimally invasive with camera)

• Open joint surgery (repair or replacement of the joint disc)

Anesthesia and Sedation Options at Elite Smile

We believe surgical comfort is non-negotiable. Our patients choose from:

Safety: All sedation is monitored with pulse oximetry, blood pressure, and EKG. Our team is certified in Advanced Cardiac Life Support (ACLS).

Post-Operative Care and Recovery

After extraction or implant surgery:

• First 24 hours: Bite on gauze; no spitting, straws, or smoking (risk of dry socket); ice packs for swelling.

• Days 2–3: Soft foods; warm salt water rinses (no swishing); pain managed with NSAIDs (ibuprofen) or prescribed medication.

• Days 4–7: Gradual return to normal diet; avoid chewing directly on surgical site.

• Day 7–10: Suture removal if non-dissolvable stitches were used.

Dry socket (alveolar osteitis): Occurs in 2–5% of extractions (15% for lower wisdom teeth). Symptoms: severe pain 2–4 days after extraction, bad taste, exposed bone. Treatment: medicated dressing placed by dentist. Smokers have 3–4x higher risk.

Signs of complication (seek immediate care):

• Fever >101°F (38.3°C)

• Excessive bleeding (soaking through gauze after 4 hours)

• Severe swelling that worsens after 48 hours

• Difficulty breathing or swallowing

• Pus or foul discharge

Statistics and Evidence

• Wisdom teeth removal: The risk of permanent nerve injury (inferior alveolar nerve) is 0.5–2% for lower wisdom teeth; higher in patients over 25.

• Implant success: 95–98% in healthy patients; 90–95% in smokers and diabetics.

• Bone graft success: 90–95% when using guided bone regeneration techniques.

• Apicoectomy success: 85–90% when performed by an experienced surgeon.

• Patient satisfaction with IV sedation: 98% of patients report they would choose the same sedation method again.

Who Is a Candidate for Oral Surgery?

Most patients are candidates, but certain conditions require special consideration:

• Uncontrolled diabetes: Higher infection risk; optimize blood sugar first.

• Bisphosphonate medications (e.g., Fosamax, Actonel, Boniva, Reclast): Risk of osteonecrosis of the jaw (ONJ) after extraction or implant surgery. Requires medication holiday or alternative treatment.

• Radiation therapy to the head/neck: Risk of osteoradionecrosis. Hyperbaric oxygen therapy may be needed before surgery.

• Bleeding disorders (hemophilia, von Willebrand disease, or on blood thinners like warfarin, Eliquis, Xarelto): Coordination with hematologist; may need bridging therapy.

• Pregnancy: Elective surgery postponed; urgent surgery safe in second trimester.

Why Choose Elite Smile for Surgery?

• Expertise: Our oral surgeons are residency-trained in hospital settings.

• Technology: 3D CBCT imaging for precise implant and wisdom tooth planning.

• Comfort-first: Multiple sedation options; warm blankets; headphones.

• Same-day emergency surgery: We reserve slots for acute infections and fractures.

• Transparent pricing: We provide written estimates before any surgical procedure.

References

• AAOMS. “Parameters of Care for Oral and Maxillofacial Surgery.” 2020.

• Dodson, T.B. “The management of impacted wisdom teeth.” J Oral Maxillofac Surg, 2014.

• Moraschini, V., et al. “Success rates of dental implants.” J Oral Maxillofac Surg, 2015.

• Bouloux, G.F., et al. “Complications of third molar surgery.” Oral Maxillofac Surg Clin N Am, 2015.