Oral Surgery
It’s our number one priority at Puri Dentistry to provide our patients with the best oral surgery options in California. Our team of experienced oral surgeons can offer numerous advanced oral surgery procedures, including bond grafting, wisdom teeth removal, tooth extraction, and many other dental surgery procedures.
You may be a good candidate for one of our dental oral surgery procedures if you are suffering from receding gums, wisdom tooth pain, tooth infections, or other oral health issues that require surgery. Many of our offices are conveniently open every day, so you can count on us to provide high-quality oral surgery any day of the year. wisdom tooth pain, receding gums, and other oral health problems that require surgical intervention.
Restore Your Health With Bone Grafting
If, due to tooth loss or trauma you have experienced a loss of bone, it may be necessary to build up this bone material in order to place a dental implant or other restorative device. At Puri Dentistry, we provide convenient, expert care that can restore your bone loss with extremely high success rates, as well as short recovery periods.
What is dental bone grafting?
Bone grafting is a common procedure. The additional bone material is often taken from the patient themselves, harvested from other areas of the mouth where drilling may have taken place and those bone fragments are suctioned from the mouth and used for the graft. In some cases, cadaver bones fragments are used. These fragments have been harvested by bone banks and are perfectly safe to use.
Why is bone grafting needed for dental implants or dentures?
If you have ever lost a tooth and did not replace it, your jawbone may have deteriorated over time. This loss of bone mass makes it difficult, and sometimes impossible, to get dental implants or dentures without first having corrective procedures to restore the bone loss.
Where does the bone come from for a dental bone graft?
There are a few different types of bone grafts, including:
- Autograft, in which bone is sourced from the patient’s jaw, hip, or another area.
- Allograft, which involves bone sourced from a cadaver donor.
- Xenoplast, which is made of animal bone.
- Alloplast, made from synthetic calcium, phosphorous, and hydroxylapatite.
Dentists determine the most suitable type of grafting material based on their experience with given sources and on the patient’s needs.
What kinds of bone grafting are used at Puri Dentistry?
The following different bone grafting procedures are commonly needed to correct bone loss before a patient is able to get dental implants or dentures:
Ridge Augmentation
Using a process called ridge augmentation, the deteriorated bone structure can be restored. Ridge Augmentation is the process of lifting the gum and exposing the deficient bone area. Then, a bone-like substance is used in the area to improve the appearance of the mouth and to help improve chances for restorative services. With ridge augmentation, dental implants can be applied, last for years and will feel like your own natural teeth.
Sinus Augmentation / Sinus Lift Bone Graft
Replacing your upper back teeth with dental implants may require your sinus floor to be repositioned in order to create enough space for the implants.
During a simple procedure called sinus augmentation, various dental bone graft materials are used to encourage bone growth and eventually allow enough stability for the dental implant.
In some cases, it may be possible to gently “push up” the bone under the sinus floor resulting in lifting the floor of the “dropped” sinus. And place bone replacement materials beneath the lifted bone. This bone material is replaced as your body introduces new bone into the area.
What happens after a dental bone graft?
After the donor's bone is inserted, the body is stimulated to make new bone around it. It can take several months for sufficient bone growth to have occurred to support dental implants. Once the jawbone has healed, the dentist can move forward with the placement of small titanium posts.
Is a synthetic bone graft safe?
Synthetic bone graft material is safe and effective. The material made of calcium and other minerals mimics bone and is highly capable of stimulating new bone growth. When synthetic grafts are used, there is no risk of disease or infection transfer and the dentist obtains the necessary amount of material every time. Only a single process is needed for a synthetic graft, no bone is taken from another part of the body.
Are dental bone grafts painful?
Dental bone grafting is performed using a local anesthetic, which numbs the nerve endings in the jaw. In some cases, patients also include sedation in their procedure to increase physical and emotional comfort. Also, in some cases, bone is obtained from a tissue bank, eliminating the need for two surgical sites.
After bone grafting, patients can expect to feel slight discomfort. Initially, prescription pain medication may be necessary to manage this. Within about a week, it is usually possible to switch from prescription drugs to over-the-counter pain medication. We typically expect comfort to improve significantly within the first 1 to 2 weeks after bone grafting.
Can a dental bone graft get infected?
Dentists take precautions to reduce the risk of infection, such as sterilizing dental instruments before procedures. While the bone graft material can be the source of infection, this risk is very low. The most significant factor associated with graft infection is poor postoperative care. Patients are advised to stay vigilant in following the postoperative oral care instructions provided by their dentist.
What can I eat after a dental bone graft?
Through the first week of recovery after a bone graft, a soft diet is recommended. Foods that are high in calcium and vitamin D are optimal as they assist with the formation of new bone. Patients may consider options such as smoothies made with fortified milk and greek yogurt, soups, eggs, and pudding. By the end of the first week of recovery, denser foods such as cheese and soft sandwiches may be well-tolerated. Patients should listen to their body and maintain a diet in which chewing is comfortable.
Are you put to sleep for a dental bone graft?
Bone graft treatment is conducted with a local anesthetic that numbs the nerves of the mouth. Additionally, patients may also elect to have sedation administered to make them as comfortable as possible. This may include nitrous oxide, which is inhaled throughout treatment, or oral sedation, which is taken about an hour before the appointment. Both nitrous oxide and oral sedation work on the central nervous system to calm responses to stimulation. Patients are not in deep sleep during their procedure. They can breathe and swallow on their own and can communicate with the dentist if so desired. However, they are in a deeply relaxed state.
Can a dental bone graft fall out?
The bone graft is made up of several small particles of material. Patients may feel particles in their mouth for the first several days after treatment. This is normal and does not indicate that the bone graft itself has fallen out. The bone graft material is often protected by a temporary covering. The covering may fall out sometime during the first week after treatment.
How long does it take to recover from a dental bone graft?
The initial recovery from bone grafting involves tissue healing. This may occur over 1 to 2 weeks. After this initial phase, swelling and comfort are significantly better, but bone is still transforming beneath the gums. This phase of healing can take several months depending on several factors, including whether or not a patient smokes and their state of general health. Most of the time, bone grafting is done at the same time as a tooth extraction or implant procedure to reduce the number of surgical visits and the level of postoperative discomfort for the patient. Periodic follow-up visits are scheduled to follow the progress of healing.
Prevent Oral Health Issues with Wisdom Tooth Removal
When wisdom teeth come in, they can cause numerous oral health issues, ranging from periodontal disease to overcrowded teeth. The expert team at Puri Dentistry offers wisdom tooth removal at their California practices to help you avoid problems before they occur. If you are experiencing painful symptoms, or you have questions about removing your wisdom teeth, reach out to us today to set up an appointment.
What is dental bone grafting?
Bone grafting is a common procedure. The additional bone material is often taken from the patient themselves, harvested from other areas of the mouth where drilling may have taken place and those bone fragments are suctioned from the mouth and used for the graft. In some cases, cadaver bone fragments are used. These fragments have been harvested by bone banks and are perfectly safe to use.
What are wisdom teeth?
Wisdom teeth get their name from their delayed growth. Rather than emerging with the rest of your teeth in early childhood, this third set of molars typically does not come in until you are in your mid-to-late-adolescence.
Why is wisdom teeth removal necessary?
Wisdom teeth are not needed for a healthy mouth or function. In fact, they can often cause complications when they are left intact. In most cases, removing your wisdom teeth can improve oral health and prevent future issues. Specific reasons for extracting your wisdom teeth may include:
Impacted Teeth
In some cases, the wisdom teeth may fail to erupt or become impacted. This can damage surrounding teeth and bone tissue. Cysts can often develop around the impacted tooth, causing further complications and making impacted wisdom teeth removal necessary.
Infection
If a wisdom tooth only partially erupts, a flap of tissue usually grows over it. This flap can trap food, bacteria, and other contaminants, which may lead to periodontal disease.
Overcrowding
If your jaw cannot accommodate a third set of molars, wisdom teeth can force other teeth out of alignment, resulting in many other oral health issues.
While it is possible for wisdom teeth to erupt without issue, this is rare enough that we may recommend that you have them removed as a preventative measure.
What does wisdom tooth extraction involve?
Due to the extensive nature of wisdom teeth surgery, we will typically administer an anesthetic to ensure your comfort. You may only need a local anesthetic, but more complex procedures typically require heavier sedation.
Once the anesthetic is administered, we will open the gum tissue over your wisdom tooth. If bone is blocking access to the tooth root, it will be removed so that we can separate the root from the jawbone. We sometimes separate the wisdom tooth into sections to make it easier to remove.
Once the tooth and tissue have been completely removed, the treatment site will be thoroughly cleaned to ensure no debris remains. We then suture the surgical site closed and place a cotton gauze pad to control bleeding.
What can I expect after wisdom tooth removal?
Much of your aftercare will involve taking care of the treatment site. You will need to replace the gauze regularly. Strenuous activity or even lying flat can prolong bleeding, so it is recommended that you prop your head up with pillows when you rest. If the treatment site bleeds for more than 24 hours, you should contact us immediately.
During recovery, you must be careful to avoid developing what is known as dry sockets, or the loss of blood clots at the treatment sites. You will receive specific instructions for preventing dry sockets, including eating only soft foods and avoiding the use of a straw when drinking beverages.
Pain management plays an important role in recovery, as well. Over-the-counter or prescription pain medication can help minimize discomfort. We will outline specific instructions on how to manage your pain.
Swelling and bruising will typically last for several days after the surgery, but ice packs can help decrease this inflammation. Both side effects usually go away within several days, though bruising may last a little longer.
Soft Tissue Grafting
What is a Soft Tissue Graft?
A soft tissue graft may also be referred to as gum grafting. This procedure can be performed to improve the appearance of the gum line. Often, it is performed to cover roots that have been exposed as a result of gum recession or gum disease.
Is a Gum Graft Painful?
Gum grafting procedures are performed with a local anesthetic that numbs the area being treated. Patients may feel a tiny poke from the anesthesia needle. However, the medication takes only moments to diminish sensation in the mouth.
After gum grafting, patients may experience soreness or tenderness around the affected tooth and, if applicable, where donor tissue has been taken. Comfort improves gradually over a few days and can be managed with prescription or over-the-counter pain-relieving medication.
What Treatment Options Are Available for Receding Gums?
Gum recession may occur for several reasons. Depending on the reason, there are various ways to address the problem. For example, if gums are receding as a result of brushing habits, the toothbrush can be changed to one with soft bristles. Patients may also switch from a manual toothbrush to an electric or sonic toothbrush that encourages them to be gentler with their brushing motions.
It is important to identify the reason for gum recession by undergoing a thorough dental exam. Your dentist can help you understand why your gums are pulling away from your teeth and what you can do to halt the progress of recession.
Can Receding Gums Grow Back?
Gum tissue does not grow back. This is why gum recession is a problem that we prefer to address right away. If you notice the signs of receding gums, such as a tooth looking longer than normal, contact an office near you to arrange a checkup.
What is the Recovery from Gum Graft Surgery?
Patients who undergo gum graft surgery are provided with detailed care guidelines that help the gums heal as quickly as possible. It is important to follow these guidelines strictly to minimize the risk of infection and maximize comfort as the tissue heals. Some of the strategies that may be recommended include:
- Limit physical activity and exercise until swelling has gone down.
- Use prescribed medication as directed.
- Avoid brushing and flossing the gum graft until it has healed.
- Use prescribed or recommended mouthwash as directed.
- Eat soft foods for one to two weeks after gum graft treatment. Keep it healthy, such as steamed vegetables, eggs, oatmeal, soups, and yogurt.
- Call the dentist if bleeding persists or if pain or swelling is worse than expected.
Can Receding Gums Heal? How Long Does it Take?
Gum recession may be caused by infection. In this instance, the gums absolutely need to heal. The only way for this to happen is to treat the infection that has developed. Infection in the gums is what we call gum disease. This condition progresses in stages. When treatment such as deep cleaning (scaling and root planing) is conducted early, recession may slow or stop altogether. If gum disease becomes severe, gum grafting and even bone grafting may become necessary.
A gum graft typically heals completely within one to two weeks. Patients are advised to strictly follow post-treatment oral care instructions regarding cleaning the mouth, eating soft foods, and avoiding tobacco.
Tooth Extraction
What is dental tooth extraction?
Whenever possible, our expert dentists at Puri Dentistry do everything in our power to save a tooth through conservative treatment options. However, in some cases, a tooth cannot be saved. When this happens–usually due to a traumatic injury, a tooth infection, tooth damage, or tooth decay over time – tooth extraction is performed in the most gentle way possible. Our skilled oral surgeons across California have the ability to extract a tooth gently and with precision.
What does tooth extraction involve?
Wisdom tooth extraction or another tooth removal involves gently removing a damaged or infected tooth in the event that no other conservative restoration dental options are possible to save the tooth. To extract or pull a tooth, your dentist will carefully numb the area and remove the tooth. After tooth extraction, the area is prepared for a dental bridge or dental implant to take the place of the pulled tooth. Getting a tooth pulled may be a good option to restore function to your bite, increase the quality of your oral health, or to improve the look of your smile, and tooth extraction healing usually takes little time.
When does a tooth need to be extracted?
You may be a candidate for the gentle tooth extraction procedure at Puri Dentistry if you are suffering from any of the below reasons for tooth extraction:
- Crowded teeth
- Decayed teeth
- Damaged teeth
- Abscessed tooth
- Injury or trauma to teeth
- Gum disease
- Having wisdom teeth
What is the difference between simple tooth extraction and surgical tooth extraction?
There are two types of tooth extractions, simple extractions, and surgical extractions:
Simple Tooth Extraction
A simple extraction is performed on teeth that are visible in the mouth. These can be performed by a general dentist, using local anesthesia.
Surgical Tooth Extraction
A surgical extraction is more complex and involves the removal of a tooth that cannot easily be seen or reached, either because it has not fully erupted or it has broken off at the gum line.
Does tooth extraction hurt?
Surgical tooth extraction requires a dentist who has undergone training specifically in safe and gentle tooth removal procedures. At Dental365, our tooth extraction dentists do everything in our ability to ensure our patients are as comfortable as possible during the tooth extraction procedure. Speak with one of our knowledgeable staff members to learn about sedation dentistry, which may be an option during your tooth-pulling procedure to further reduce tooth extraction pain.
What happens during a tooth extraction?
The tooth-pulling procedure may be performed at one of our Puri Dentistry locations by either one of our general dentists or an oral surgeon, depending on your specific needs and the type of tooth extraction you will be undergoing.
During your surgical tooth extraction, our dentists make a small incision in your gums. Then, the tooth is gently removed one section at a time.
After the tooth extraction, we may provide you with prescription pain medication, depending on your level of discomfort. We recommend that patients apply a warm compress to the tooth removal area to reduce pain after your tooth extraction. You should also avoid chewing food near that tooth-pulling location after your oral surgery to avoid tooth extraction complications.
What is the recovery process for a tooth extraction?
Many patients wonder what happens after a tooth extraction, what is the tooth extraction healing process and what kind of recovery from a tooth extraction is necessary. If you’ve had a tooth extracted, you know that the days following the procedure will require some extra care and attention to the area.
Your dentist may recommend pain medication to help with any discomfort, using a small gauze pad to cover the area, and applying ice to the area to reduce swelling in the area. For more details on how you can ensure you’ll have a speedy and successful recovery from a tooth extraction, speak to your dentist at Dental365. We are happy to answer your questions!
Are there any possible complications to tooth extraction?
It is possible that a patient may encounter tooth-pulling complications after the oral surgery, including dry socket. The best way to reduce the chances of getting dry socket following tooth extraction, includes:
- Avoiding tough foods and sticking with softer foods
- Drinking out of a cup without using a straw
- Using warm salt water to rinse your mouth
Make sure you contact a staff member at Puri Dentistry right away if you notice severe pain or symptoms of dry socket following your procedure.
Can I replace my tooth after extraction?
Once a tooth has been extracted, there are a number of restoration options, including:
Dental Bridge
A dental bridge replaces one tooth or a row of teeth, as long as there are healthy teeth on either side of the extraction site. Bridges consist of a prosthetic tooth (or teeth) attached to crowns on either side. We permanently attach the crowns to healthy teeth to hold the bridge in place.
Partial Dentures
Dentures feature a full arch of prosthetic teeth, attached to a gum-colored base that fits snugly against the gums. Partial dentures are used when at least one healthy tooth remains, while full dentures replace all of the teeth in an arch. Partial and full dentures can be removable, or supported by dental implants.
Dental Implants
Implants are small titanium posts, surgically implanted into the jawbone. The posts fuse with bone and support a crown, bridge, partial, or full dentures. Implant crowns and bridges are permanent, while partial and full dentures may be removable or permanent.
Sedation Dentistry
If you are uncomfortable going to the dentist, we provide numerous sedation dentistry options, to ensure that you are relaxed during your office visit. We understand that many patients can experience high levels of fear and anxiety when they think about going to the dentist, and that fear can keep them from seeing the dentist as regularly as they should. This can create the need for major dental work, which can be timely and costly. To learn more about our sedation dentistry options, contact one of our New York, New Jersey, Connecticut, Massachusetts, and Rhode Island office locations to schedule your appointment.
What is sedation dentistry?
There are numerous sedation dentistry options that ensure your relaxation during your dental procedures. Some patients experience high levels of fear and anxiety when they think about going to the dentist. Sedatives reduce the brain’s recognition of pain and discomfort, while easing feelings of fear and stress. At Puri Dentistry, we offer sedatives to our patients with dental anxiety to help them relax during procedures.
Why is sedation dentistry used?
Patients who have a very low tolerance for pain or sensitive gag reflexes may be good candidates for oral sedation. Sedation dentistry is also a good option for patients who have difficulty controlling their movements or cannot comfortably sit still for long periods of time.
What are the benefits of using sedation dentistry at Puri Dentistry?
Benefits of using sedation dentistry at one of our dental offices may include the following:
- Allows a great deal of dental work can be completed while sedated
- Provides comfort for patients for hours at a time
- Reduces or eliminates pain and discomfort during the procedure
- Reduces anxiety and fear associated with the dentist
- Improves oral health for patients who are less hesitant to visit the dentist knowing sedation is available
How does dental sedation work?
Many forms of dental sedation affect the central nervous system. The medications that are classified as sedatives diminish the activity of the nervous system so, when external stimulation occurs, the response is much less intense than it would be otherwise. For dental sedation, medications are prescribed accurately so patients do not experience the sensations that are common with dental anxiety.
Can you be put to sleep for dental work?
Yes. Oral Surgery procedures are performed under IV anesthesia. This method of sedation is deeper than those that are commonly used (nitrous oxide and oral conscious sedation). While necessary in select cases, deep sedation that achieves deep sleep is typically not administered for routine procedures like root canals or dental implants.
Types of dental sedation
During a consultation with your dentist, the various sedation methods will be explained to you and your dentist will help you decide the best sedation dentistry type for your needs. Depending on the type of sedation used, your experience will range from simply feeling more relaxed to experiencing a sleep-like state, during which little is felt or remembered. Below are the different types of sedation that can be used during dental procedures:
Nitrous Oxide
Often referred to as laughing gas because of the euphoric feelings it induces, nitrous oxide is inhaled through a mask, leaving you to feel calm and relaxed. The effects of the sedative diminish as soon as the mask is removed, and you will be free to resume normal activities right away, and will be able to drive yourself home.
Oral Sedatives
Oral sedatives come in pill form and are usually taken about one hour before dental treatment. They work fairly quickly and wear off gradually, so you will need a friend or family member to drive you to and from your appointment. Under dental sedatives, you will be in a state of relaxation, and will retain the ability to talk to the doctor, but will be unaware of many of the details of your procedure. Most patients can resume normal activities by that same evening, or the following morning.
Dental Anesthesia
A local anesthetic may also be administered during your procedure, depending on your procedure type, since oral sedatives and nitrous oxide do not provide pain relief.
How long does dental anesthesia last?
Dental anesthesia is the term we use to describe the local anesthetic that is administered to the gums. This anesthetic eliminates pain sensations so patients can receive care in the most comfortable manner. The numbing sensation wears off over 2 to 4 hours.
What to expect during sedation
Sedation dentistry allows patients to experience a more comfortable experience at the dentist’s office, especially if they suffer from dental anxiety, by using medication. The forms of dental sedation that we use are mild. Patients can breathe and swallow on their own. They can communicate with us during their treatment if needed. Depending on the type of sedation chosen, a patient may feel deeply relaxed. Their body may feel heavy or very light, almost like floating. Some people experience a warming sensation in their body under sedation. Some doze off. Across the board, though, most feel no sense of the anxiety that had previously kept them from seeing the dentist.
How long does it take for conscious sedation to wear off?
Dental sedation can take anywhere from a few minutes to several hours to wear off. Nitrous oxide is nearly immediately effective after the gas is inhaled. Once administration stops, the effects of this sedative begin to lift. Patients feel alert within a few minutes and can safely drive themselves home to resume normal activities. Oral conscious sedation tends to last several hours. Patients may feel somewhat groggy for the remainder of the day. A friend or loved one must drive the patient home after their appointment.
Is dental sedation needed for tooth extraction?
There are few instances in which patients need to be “put to sleep” for tooth extraction. While this is possible, most patients can undergo this procedure very comfortably with conscious sedation techniques like nitrous oxide or an oral sedative.
Will I feel any pain with dental sedation?
Dental sedation is used alongside dental anesthesia that numbs the nerves in the mouth. The local anesthetic desensitizes the nerves themselves. Sedation compounds the pain-relieving effects by depressing the reactivity of the central nervous system. Therefore, dental sedation works to enhance the effects of local numbing medication.
How else can I manage dental anxiety?
Several strategies can be used to help reduce dental anxiety. These include:
- Choose a dentist that creates a sense of trust and comfort.
- Choose a dentist that offers sedation services.
- Bring earphones to dental appointments to listen to calming music or music that uplifts the mood.
- Talk to the dentist about feelings of anxiety. They can assist with comfort-improving techniques.
- Don’t wait until a toothache has developed to see the dentist. Routine exams and cleanings are much less stressful than appointments to address pain.