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Orthognathic surgery is surgery to correct a wide variety of abnormalities of our patients' jaw and teeth. The surgery is often done in conjunction with orthodontic treatment. While the patient’s appearance may be significantly improved as a result, the primary purpose of the surgery is to correct functional problems including but not limited to:

• Unbalanced facial appearance
• Protruding jaw
• Open bite (upper and lower teeth don’t overlap properly
• Excessive wearing down of the teeth
• Difficulty with chewing or biting
• Chronic mouth breathing
• Sleeping problems such as sleep apnea
• TMJ pain (jaw joint pain)
• Restoring facial injuries

Knowing when to start the orthodontic treatment in preparation for orthognathic surgery can also be tricky if our team at Oral and Maxillofacial Surgery of Coastal Georgia is treating a teenager. It is important to know when to get started. If orthodontic treatment is initiated too soon and the teenager is still growing, the patient will either need to hold in braces until his or her growth is complete and they are ready for surgery or the braces will have to be removed and then placed again when growth is complete. Neither of these options is attractive since it requires longer time in treatment, which is something all our patients want to avoid. Our team at Oral and Maxillofacial Surgery of Coastal Georgia strives to get all patients finished with treatment as quickly as possible because it is healthier for the teeth and gums and gives them a beautiful smile to enjoy for a lifetime.

If you are considering orthognathic surgery or you have been told that you need jaw surgery, give us a call to schedule your initial consultation today. Dr. Theodotou and our team at Oral and Maxillofacial Surgery of Coastal Georgia will explain our treatment plan in a way you will understand and we will keep you informed every step of the way.

Happily, a root canal is usually all that you need to treat an infection in your inner tooth. But when inflammation or infection returns at the tip of the root, or in the bone surrounding the tip, your dentist may recommend that you see an oral and maxillofacial surgeon like Dr. Theodotou for further diagnosis and treatment.

And often when pain, inflammation, or infection recur after a root canal, we may suggest an apicoectomy—a procedure that can save your natural tooth and prevent further infection or damage to the neighboring bone and teeth.

• Just what is an apicoectomy?

The tip of a root is also called its “apex.” An apicoectomy means the surgical removal (“ectomy”) of the apex (“apico”) of a tooth’s root.

• How does the procedure work?

Often local anesthesia is all that is needed. (But if you have concerns, talk to us about your anesthesia and sedation options. We are expert in all forms of anesthesia.)

After the area is numb, an incision is made in the gum tissue to allow access to the root and any affected bone tissue.

Dr. Theodotou will carefully remove the tip of the root and any damaged or infected tissue from the bone surrounding it. The root end will then be cleaned and sealed.

Stitches or sutures will be used to close the incision, which will either dissolve on their own or which will be removed on a follow-up visit. We will let you know just how to take care of the site after surgery.

In general, any pain or sensitivity after the procedure can be treated with over-the-counter anti-inflammatory pain relief such as ibuprofen. Patients should follow post-op instructions carefully to reduce any swelling, and be sure to follow any dietary suggestions and restrictions.

• Why choose an oral and maxillofacial surgeon for your apicoectomy?

An oral and maxillofacial surgeon has the training and skill to perform this specialized procedure. After dental school, oral surgeons pursue four to six years of additional advanced medical studies at a residency-based hospital.

They train with medical residents in the fields of anesthesiology, general surgery, internal medicine, and other surgical areas, concentrating on the bone, skin, and muscle of the face and jaw. They are uniquely qualified to diagnose and treat oral conditions that require a surgical solution, and routinely perform procedures such as apicoectomies.

Happily, a root canal is usually all that you need to treat an infection in your inner tooth. But if you have recurring or new pain or infection after a root canal, and if you want to preserve your natural tooth, an apicoectomy at our Pooler office is an option well worth investigating.

A famous mouthwash company chose the marketing slogan, “Better than flossing.” As a consumer, would you believe a high-end commercial that essentially tells you to stop flossing? Just use this brand of mouthwash and the risk of gingivitis, cavities, etc., is gone. What a wonderful idea! Now for the reality: This is simply not true.

The company that made these claims received some negative feedback for making this false claim. Does this mean that all mouthwashes are ineffective? Absolutely not. It takes a little bit of research to know which mouthwashes are most effective and best suited for you. Here are some key points to remember when choosing a mouthwash.

First, think about why you want to use a mouthwash. If you are at high risk for cavities, you would benefit from a fluoride mouthwash. Check the labels to see which ones contain fluoride.

If you have active gingivitis, a mouthwash with some antibacterial properties would be preferable. Read the labels carefully. You do not want a mouthwash containing alcohol. If you have active periodontal disease, an antibacterial mouthwash is appropriate, though you may want to discuss which kind would be best for your individual needs.

Prescription mouthwashes are also an option. You should pay close attention to the directions, such as how much and how long to use them. There is one brand in particular whose effectiveness can steadily diminish if you use it continually. There can also be side effects you should discuss with our office and/or your pharmacist.

Some great mouthwashes for kids change the color of plaque on their teeth to help them see how they are doing with their brushing. This is a great learning tool for the child and the parent! Why not pick up a bottle for yourself next time you’re at the store and evaluate your own performance?

Beware of claims that a mouthwash can loosen plaque. This is not accurate. Beware of any mouthwash that has alcohol. This is worth mentioning twice. Take care of your taste buds. If you are using a strong mouthwash, it can reduce your sense of taste.

These tips should help you choose the right mouthwash for your needs. Please contact Dr. Theodotou at our Pooler office with any specific questions!

You’ve chosen Dr. Theodotou for your extraction because oral surgeons are experts in this surgical procedure. When an extraction is necessary, whether because of impaction, injury, or infection, for orthodontic purposes, or for any other reason, we have the skill and experience to ensure that patients have the best possible surgical outcome.

And you want the best possible outcome for your recovery as well. What are some basic steps you can follow at home to speed the healing process? Here are the ABC’s of aftercare to help make your post-extraction recovery a speedy and healthy one.

• Antibiotics

Antibiotics aren’t generally necessary after oral surgery, but, if they are prescribed to prevent infection, be sure to take them as directed. Always finish the entire prescription to ensure that the antibiotics work properly. And, if you have any allergies to medications, always tell us in advance.

• Brush carefully

Don’t brush or floss in the area of your surgical site until you get our approval. You don’t want to damage delicate tissue or sutures. Be sure to brush and floss the rest of your teeth normally, because you want your mouth its cleanest while you heal, but no swishing or spitting! After the extraction, a clot will form to protect the socket, and you’ll need to be careful to avoid dislodging it. Otherwise, a painful condition called “dry socket” can result.

• Clean the extraction site as directed

The directions we will give you for cleaning the extraction site will depend on your specific surgery, but gentle rinsing is usually the recommended way to keep the area clean after oral surgery.

After 24-48 hours, depending on our instructions, you might be asked to use a salt water solution or a prescription rinse to gently cleanse the extraction area. Just remember, the “no forceful swishing or spitting” rule still applies! Rinse after eating and snacking to keep the extraction area clean and free from food particles. A good general rule is to avoid over-the-counter mouthwash for now, because the alcohol it contains can be irritating.

Even with careful attention, sometimes the wound site can become infected. If you notice any signs of infection, including severe pain, redness, prolonged swelling, pus or other discharge around the extraction, or fever or chills, call our Pooler office immediately. Other symptoms such as nausea, heart pain, or shortness of breath should also be reported at once.

• Diet

Eating a nutritious diet after oral surgery can help speed wound healing. Foods rich in proteins, vitamins A and C, and Zinc have been found to assist healing, while alcohol and smoking have the opposite effect.

And while you’re eating for health, eat for comfort, too. The traditional diet choices after an extraction are still the best. Soft, creamy foods such as yogurt, applesauce, pudding, or soft-serve ice cream are gentle on your healing tissue. Drink plenty of fluids in the days after surgery, including clear broth and non-acidic and non-carbonated beverages.

Temporarily eliminate foods from your diet that are grainy, seedy, or crunchy to keep particles out of the extraction site. Avoid sticky and chewy foods, which can dislodge the clot. And while you’re at it, take acidic and spicy foods off the menu—they can irritate sensitive tissue.

Be sure that you protect the clot that protects your socket. Foods that are too hot can interfere with clot formation over the wound, and any use of a straw or other suction can dislodge the clot completely. Use a spoon for your milkshake, and, of course, don’t smoke.

• Every patient is different!

While all of the above suggestions are good generally guidelines, we will have information that has been specifically tailored to your needs. Which leads us to the most important recommendation of all . . .

• Follow our aftercare instructions

You will receive detailed instructions after surgery. Following this advice to the letter is the very best way to make sure your mouth is its cleanest and healthiest.

Taking care of yourself after an extraction isn’t quite as easy as ABC (DEF), but with guidance from Dr. Theodotou, careful attention to the extraction site, and patience as you allow the healing process to take place, you have all the basics you need for a healthy recovery.