Treatments

Approximately 3-5% of the population have impacted teeth other than wisdom teeth. This means that they stay buried and unerupted or partially erupted. The commonest tooth to be affected is the upper canine or eye tooth. Sometimes both upper canines are impacted. Lower canines can also be affected. Upper or lower second premolar impactions are also seen but less frequently. In fact any of the other teeth can be impacted and this is seen less frequently again. The abnormal position of these teeth is usually discovered on routine examination or during an orthodontic assessment. Based on various factors, such as the position of the tooth, the orientation of the tooth and the available space, these teeth can be surgically exposed as part of an orthodontic treatment plan. The tooth is then bonded with an orthodontic bracket and then can pulled in and aligned over a period of usually 3-9 months. Occasionally it is not feasible to expose and align a tooth. This decision lies with the patient and the orthodontist, but the oral surgeon can advise also on this. These teeth can be surgically removed or occasionally just left in situ if they are not interfering with other teeth. Exposure of a tooth is generally a fairly simple surgical procedure and is nothing to worry about. We carry out these procedures on a daily basis. They can be done under local anaesthetic only or more commonly with IV sedation. A consultation including X-ray assessment and occasionally a 3D scan takes place before the procedure. 

Cysts of the jaws are quite a rare finding but do of course occur and are assessed carefully with X-rays and 3D scans. The usual treatment is enucleation (removal) of the cyst with close follow up to make sure that the cyst does not re-occur. The tissue recovered is sent to the laboratory for analysis and the type of cyst is determined. Treatment is carried out under local anaesthetic, local anaesthetic and IV sedation or occasionally under general anaesthetic. 

Various lumps and bumps do occur in the mouth. The vast majority of these are benign and harmless although they do need to be removed in most cases. Biopsies are carried out under local anaesthetic and generally have a mild post operative course but do require a day off work. Specimens recovered are usually sent to the laboratory for a report so that the nature of the lump/bump is determined. Results are then communicated by phone or at a follow up appointment.

Some teeth have large roots in solid bone and can be extensively broken down and decayed. They may have been root canal treated which can make the roots more brittle and difficult to remove. These teeth need to be removed surgically and this is normally done under local anaesthetic, but can also be done under local anaesthetic and intra-venous sedation, particularly if more than one tooth has to be removed or if an individual is very anxious about dental procedures. Here at The Harmony Institute these procedures are routine with excellent outcomes and there is nothing to worry about, even if it all sound a little daunting. You will feel no pain during the procedure, but you will have to take it easy for a few days afterwards. Please refer to the full post op instructions for full details of what you need to do and a few days off work and sports may be required.

Implants have revolutionised dentistry in the last thirty years. A missing tooth can now be replaced by a titanium implant. This is a surgical procedure which involves raising a small gum flap, carefully drilling a precise hole in the bone called an osteotomy, and tapping or screwing the implant into position. The implant is then covered up by the gum flap and left alone for three months to heal and integrate into the bone of the jaw. This process is called osseo-integration and is the biological miracle which makes implants possible. After the healing and integration phase, the implant is uncovered and a special attachment is connected to it called a healing abutment. The implant is now ready for phase two of the process which is to make a crown that fits onto the implant. Impressions are sent to the laboratory and a crown is made up. This crown is then attached to the implant which completes the process. Implants have a very high success rate of 95%. Occasionally osseo-integration fails to take place but this is a rare outcome. The key to success in implant therapy is a consultation and detailed assessment. This involves clinical examination, X-rays and usually also 3D scans. Occasionally grafting of an implant site is required to increase the volume of tissue to optimise the successful placement of an implant. It is common for a patient to be referred for an implant to the surgeon who will then refer the patient back for crown placement. All of the above is only the briefest description of implantology with many variations possible. Your own custom made treatment plan will be carefully worked out for your before any treatment takes place here in The Harmony Institute.