Oral Surgery in Valencia, CA

Oral surgery includes tooth extractions and dental bone grafts: Cleveland Clinic classes both as oral surgery procedures, and describes a tooth extraction as a dentist removing your tooth from its socket and a dental bone graft as adding bone grafting material to areas of the jaw where bone has been lost or is thinning.

At the specialist end, AAOMS lists what oral and maxillofacial surgeons are trained in: tooth extractions, dental implants, anesthesia, oral pathology, corrective jaw surgery, facial trauma, TMJ and facial pain, obstructive sleep apnea, facial cosmetic surgery, and cleft lip and palate surgery. Corrective jaw surgery and facial fracture repair sit in that list.

Either can remove a tooth. Cleveland Clinic says dentists and some dental specialists, including oral and maxillofacial surgeons and periodontists, do tooth extractions, that general dentists do plenty of them, and that more complex cases are usually referred out to specialists.

Mayo Clinic gives the same picture for wisdom teeth: your dentist may do the procedure in the office, but if the tooth is deeply impacted or removing it is tougher than usual, your dentist may suggest that you see an oral surgeon. AAOMS says oral and maxillofacial surgeons are the only dental specialists recognized by the American Dental Association who are surgically trained in a hospital-based residency program for a minimum of four years, with training that focuses on the bone, skin and muscle of the face, mouth and jaws and on anesthesia.

Our team is a general dentist, a periodontist and an endodontist, not an oral and maxillofacial surgery practice. Dr. Robert P. Hedvat, a general dentist practicing since 2011 and leading Smile Care Valencia since 2018, places dental implants, titanium and metal-free zirconia, and does the bone grafting that implant treatment can need. Dr. Raffie Garabedian is our periodontist, the specialist in the gums and the bone that supports the teeth, and Dr. Benjamin Levi is our endodontist.

Dental surgery here also covers tooth extractions and wisdom teeth extractions. For selected gum and soft-tissue procedures we also offer laser dentistry, which in appropriate cases may reduce bleeding, minimize discomfort and make recovery easier.

Cleveland Clinic lists the sequence: local anesthesia to numb the tooth and surrounding gum, with sedation medication if you chose it; the tooth is gently loosened and removed from its socket, with incisions in the gum when the tooth is badly decayed or has broken off at the gum line, or the tooth divided into sections; the socket is cleaned and disinfected; a bone graft may be placed in the empty socket to help prevent bone loss in the jaw; and stitches may be placed, though you might not need them.

Cleveland Clinic says removing one tooth usually takes between 30 and 60 minutes, and that providers prefer to save natural teeth whenever possible, recommending extraction when fillings or crowns are not enough. Its list of reasons is a fractured tooth, advanced gum disease, an impacted tooth, crowded teeth and severe tooth decay. The risks it names are delayed healing, dry socket, infection, maxillary sinus damage and nerve injury.

Wisdom teeth need to be removed when they cause problems, and AAOMS lists the signs: dental pain, poor oral hygiene, infection, periodontal (gum) disease, cavities, cysts, tumors or other pathology, and damage to neighboring teeth. AAOMS says wisdom teeth may not need to be extracted if they grow in completely and are functional, free of pain, cavity-free, disease-free and surrounded by healthy gum tissue, but that they then require regular professional cleaning, annual check-ups and periodic X-rays to monitor for changes.

The ADA says third molars usually appear between the ages of 17 and 21; AAOMS puts the range at 17 to 25. A tooth that cannot break completely through the gums because there is not enough room is impacted, and AAOMS says nine out of ten people have at least one impacted wisdom tooth. Mayo Clinic notes that dental specialists disagree about removing impacted wisdom teeth that are not causing problems, and the ADA says that before any decision your dentist will examine your mouth and take an X-ray.

A dental bone graft rebuilds jawbone so that an implant has enough bone to hold it. Cleveland Clinic describes the graft material as a scaffold on which your own bone tissue can grow and regenerate, and lists four kinds: allograft (human donor bone from a licensed bank), alloplast (lab-made substitute), autogenous (your own bone from another part of your body) and xenograft (animal-derived bone from a licensed bank). It can fill a socket after an extraction, lift the maxillary sinuses, provide a foundation for implants, or rebuild the jaw before dentures.

Cleveland Clinic says initial recovery takes about a week, the graft itself needs at least three months to heal, and a large graft may take nine to 12 months. Once it has healed, it is best to get the implant within six to 12 months, because the new bone otherwise starts to shrink and lose density. At our office Dr. Hedvat does the bone grafting, and the in-office cone-beam CT scan is used to plan implant treatment with greater precision.

Mayo Clinic describes three levels for wisdom tooth removal: local anesthesia, where you are awake and feel pressure and movement but should not feel pain; sedation through an IV line, where you feel calm, less anxious and sleepy; and general anesthesia for complex procedures. Which one you get depends on how hard the removal is expected to be and your comfort level, and Mayo says most wisdom tooth removals occur with sedation where you feel sleepy but breathe on your own.

At Smile Care Valencia the sedation options are nitrous oxide, which is gentle and fast-acting with the patient awake and responsive and effects that wear off quickly; twilight sedation where appropriate, after reviewing your health and the planned procedure; and IV sedation, with deeper relaxation, the medication adjusted throughout and the patient carefully monitored under the care of a Dental Anesthesiologist. Cleveland Clinic says your dentist will talk with you about sedation options during the consultation.

Most people return to routine activities within 48 to 72 hours of a tooth extraction, according to Cleveland Clinic, while the jawbone takes several weeks to heal completely. It says day three is usually the worst day of pain, and that if you plan to replace the tooth with an implant you will probably wait a few months while the socket heals. Mayo Clinic says swelling of the cheeks after wisdom tooth removal usually gets better in two or three days.

Cleveland Clinic's do's are to eat soft foods, keep the extraction site clean and take all medications as directed. Its don'ts are strenuous activity or lifting over 10 pounds, poking at the site, smoking or vaping, spitting or rinsing vigorously, and using straws. Mayo Clinic adds not smoking for at least 72 hours and no straws for at least a week.

Call the office at (661) 255-1211 if you have any of the signs Cleveland Clinic and Mayo Clinic list: a fever of 100.4 degrees Fahrenheit or higher after an extraction, or 101 after a bone graft; pus or drainage around the site; severe pain that does not improve with medication; swelling that worsens after two or three days; lasting numbness; or a hard time swallowing or breathing.