Phillip Geoffrey Cary, DDS

Braces are generally placed prior to surgery, with treatment initially dedicated to aligning and leveling the upper and lower teeth independently. Jaw surgery is then done to align the jaws. There is almost always another course of orthodontic treatment to fine tune things after jaw surgery. Every case is unique, but this is a general pattern we follow. Make certain you see an Oral and Maxillofacial surgeon before you begin orthodontic treatment if jaw surgery is being planned so that the surgeon and orthodontist can plan the case properly.

P. Cary

An "overbite," in common usage, is generally what is called overjet in professional terms. An overjet problem is where there is excess horizontal space excess between the edges of the upper and lower anterior teeth when all teeth are in contact. Overbite is built into all of our "bites," and can be excessive when the upper teeth overlap the lower teeth such that less than 60% of the lower anterior teeth are exposed when all teeth are in contact. Excessive overjet can be due to tooth position problems, or can be from insufficient horizontal projection of the lower jaw or excessive projection of the upper jaw. Orthognathic surgery, corrective jaw surgery, is generally recommended to normalize the relationships of the upper and lower jaws in conjunction with orthodontic treatment to align and level the teeth. Jaw surgery can provide both improved facial aesthetics and correct malocclusion in cases where the upper and lower jaws are not in harmony with one another or the face in general. A specific answer to this question would require a direct evaluation by an Oral and Maxillofacial surgeon to determine what options a patient has, and what these options mean in terms of treatment time, treatment expense, possible complications, anticipated final results, and long-term stability.


Phillip Cary, DDS

Any time after about 19 years of age. Some underbites can be addressed with orthodontics alone. Some are due to abnormal growth of the lower jaw. In that case, treatment done too early may result in a return to an undesirable instability of the correction as the lower jaw may continue to grow with return of the underbite. One needs to take into account that a large percentage of "underbites" are due to insufficient horizontal/forward growth of the upper jaw with normal lower jaw harmony with facial form. In that case, earlier surgical intervention is generally stable. Regardless, at age 23, you can be treated with the expectation of a stable correction, but the diagnosis and cause of the malocclusion needs to be clearly identified. You should see an Oral and Maxillofacial surgeon for an evaluation prior to treatment.

Phillip Cary, DDS

Jaw surgery is recommended when the alignment of the upper and lower jaws is not proper for correction of malocclusion. A severe "overbite" is often due to underdevelopment of the horizontal projection of the lower jaw. A recessive chin is a feature of this problem. Jaw surgery will allow for correction of the malocclusion and improvement in the facial form and facial profile. Less severe overbites can be corrected with braces without surgery. If in doubt, always consult with an Oral and Maxillofacial surgeon prior to beginning any treatment.

Phillip Cary, DDS

Pain isolated to the chin is a rare matter, particularly if it crosses the middle of your chin. As for the medication, I believe you are referring to CBD (cannabidiol), a non-psychoactive phytocannabinoid from the cannabis plant. There is certainly many people who are using these products for pain relief, although the products are not regulated by the FDA and as such purity and potency, as well as general safety, are really unknown from one product to the next. I always like to come to a diagnosis before recommending any treatment, surgical or medical. I suggest you keep looking for a diagnosis, and you may find it will take seeing additional doctors (other oral surgeons, dentists, perhaps a neurologist) to do so.

We recommend sleeping in a reclining position for the first 2-4 days depending on the case. Sometimes removing wisdom teeth will result in minimal pain and swelling, and other times these outcomes cannot be avoided. Ice on the jaw for 24-48 hours is always beneficial. Good luck, make certain your daughter has her surgery done by an oral and maxillofacial surgeon.

Canker sores (aphthous ulcers) are not treated surgically in almost all cases. There may be benefit in early onset lesions in the use of laser in diminishing pain and hastening the healing process. Generally we use medications that are put on the lesions (topical application).

Dysphagia, pain on swallowing, is a symptom that may have a number of causes ranging from simple pharyngitis (bacterial or viral) to throat or esophageal cancer. I recommend you see an Oral and Maxillofacial surgeon or an Otolaryngologist (ENT) surgeon.

A surgical tooth extraction is a procedure where a tooth is removed requiring some or all of the following: incision of the gum tissue, elevation of the adjacent gum tissue, sectioning of the tooth, removal of adjacent bone, placement of stitches or a combination of some or all of these things. Multirooted teeth, fractured teeth, extensively restored teeth, root canal treated teeth, and teeth in very dense bone are generally those that require surgical extraction. I recommend seeing an Oral and Maxillofacial surgeon for such procedures.

First control bleeding with pressure applied to the extraction site with gauze packs. Warm salt water rinses after the first two days helps with the healing process. Use care, but maintain strict oral hygiene. You should always receive detailed instruction from your surgeon for postoperative care.

Yes.

Difficult to say. In some cases the symptoms of pain, joint clicking and locking, limited jaw motion will resolve without treatment. Only a small percentage of patients require surgery, but treatment of TMJ disorders needs to be directed and monitored by someone with a good deal of knowledge and experience. I recommend seeing an Oral and Maxillofacial surgeon for evaluation

The procedure: Depends on what is being grafted (location, size of graft, graft type, graft harvest location). Anywhere between 30 and 60 minutes for an average case. The graft should last a lifetime as long as initial healing goes well.

Moist heat, muscle massage, meditation, biofeedback. Sometimes muscle relaxants are used. Botox is sometimes injected into the tight muscles.

Anywhere from one to all of them, depending on the case. Hard to answer this without first evaluation of the patient, their specific dental problems and any medical conditions that may influence the judgement.

A blood clot forms in the tooth socket and acts as a bandage for the bone and a scaffold for the ingrowth of cells that will heal the bone and gum tissue. If a blood clot does not form well, or is lost prematurely one may develop a condition known as "dry socket", which should be evaluated and treatment provided to alleviate the associated pain.

Absolutely. One of the most common procedures for an Oral and Maxillofacial surgery. I recommend seeing an Oral and Maxillofacial surgeon for evaluation and treatment.

Variable, depending on the procedure, the conditions present at the time of tooth extraction, the level of trauma associated with the surgery, and individual patient health and psychological variables that may come to play.

Yes, primarily a concern in the back of the lower jaw where a large nerve is positioned in the bone and in close proximity with the roots of teeth.

Sometimes a patient experiences such symptoms simply due to the injections required to numb the jaw, specifically in extraction of lower teeth. I recommend you contact the doctor who performed the procedure for evaluation (probably not X-rays) if this is a condition that lasts more than just a few days.