Mark D. Breese, D.D.S.
Hector Caballero, D.D.S.
Their advanced training in anesthesia allows them to provide quality care with maximum patient comfort and safety in the office setting. While many patients decide to have their procedures done under a local anesthetic, other people feel that it is less stressful to be put to sleep during the procedure. As long as the patient can arrange for a ride home and has someone who can watch them for the evening, many patients report that they love waking up “when it's over."
Conditions & Symptoms
Oral and maxillofacial surgeons, the surgical specialists of the dental profession, complete four to six year surgical residencies that specifically train them to diagnose, treat and manage the conditions, defects, and injuries of the mouth, teeth, jaws and face. Among the conditions and symptoms treated by oral and maxillofacial surgeons are:
- Diagnosis and management of impacted teeth, tooth extraction and dentoalveolar surgery;
- Facial pain, including problems related to issues relating to temporomandibular joint disease;
- Diagnosis and treatment of oral cancers. Patients are encouraged to perform routine oral exams and to see their general dentist or an oral and maxillofacial surgeon annually for a professional examination.
- Pathologies in the maxillofacial region, including the performance of biopsies and other diagnostic tests and procedures required to diagnose the problem and develop an appropriate treatment plan
Treatments & Procedures
Office-based surgery is often the most efficient and cost effective way to perform many procedures while maintaining maximum patient comfort and safety. Oral and maxillofacial surgeons are trained to perform the following treatments and procedures:
- Reconstructive surgery to address hard and soft tissue injuries in the upper and/or lower jaws resulting from injury or trauma, tumor surgery or long-term denture wear.
- Dental implant placement to replace a single tooth, several teeth or an entire mouthful of teeth. Dental implants offer a long-lasting, comfortable and functional alternative to conventional dentures.
- Diagnosis and treatment of infections in the maxillofacial region, which can develop into life-threatening emergencies if not treated promptly and effectively.
- Treatment and repair of injuries to the face, jaws, mouth and teeth caused by trauma. Oral and maxillofacial surgeons are experts in treating trauma, including fractures of the upper and lower jaws and orbits, and the cosmetic management of facial lacerations.
- Surgical correction of oral and facial deformities caused by differences in skeletal growth between the upper and lower jaws and congenital deformities like cleft lip and palate, which occur when all or a portion of the oral-nasal cavity does not grow together during fetal development.
- Their surgical and dental background and their ability to reconstruct facial structures damaged through trauma enable oral and maxillofacial surgeons to perform facial cosmetic procedures on an outpatient basis in the oral and maxillofacial surgeon's office under local anesthesia, IV sedation, or general anesthesia.
Corrective Jaw Surgery
Corrective jaw, or orthognathic, surgery is performed by Oral and Maxillofacial Surgeons to correct a wide range of minor and major skeletal and dental irregularities, including the misalignment of jaws and teeth, which, in turn, can improve chewing, speaking and breathing. While the patient's appearance may be dramatically enhanced as a result of their surgery, orthognathic surgery is performed to correct functional problems.
Who Needs Corrective Jaw Surgery?
People who may benefit from corrective jaw surgery include those with an improper bite resulting from misaligned teeth and/or jaws. In some cases, the upper and lower jaws may grow at different rates. Injuries and birth defects may also affect jaw alignment. While orthodontics can usually correct bite, or "occlusion," problems when only the teeth are misaligned, corrective jaw surgery may be necessary to correct misalignment of the jaws.
Evaluating Your Need for Corrective Jaw Surgery
Your dentist, orthodontist and Oral and Maxillofacial Surgeon will work together to determine whether you are a candidate for corrective jaw, or orthognathic, surgery. The Oral and Maxillofacial Surgeon determines which corrective jaw surgical procedure is appropriate and performs the actual surgery. It is important to understand that your treatment, which will probably include orthodontics before and after surgery, may take several years to complete. Your Oral and Maxillofacial Surgeon and orthodontist understand that this is a long-term commitment for you and your family. They will try to realistically estimate the time required for your treatment.
Corrective jaw surgery may reposition all or part of the upper jaw, lower jaw and chin. When you are fully informed about your case and your treatment options, you and your dental team will determine the course of treatment that is best for you.
Extensive Training and Experience in the Control of Pain and Anxiety
The ability to provide patients with safe, effective outpatient anesthesia has distinguished the specialty of oral and maxillofacial surgery since its earliest days. As the surgical specialists of the dental profession, Oral and Maxillofacial Surgeons are trained in all aspects of anesthesia administration. Following dental school, Oral and Maxillofacial Surgeons complete at least four years of training in a hospital-based surgical residency program alongside medical residents in general surgery, anesthesia and other specialties. During this time, OMS residents must complete a rotation on the medical anesthesiology service, during which they become competent in evaluating patients for anesthesia, delivering the anesthetic and monitoring post-anesthetic patients.
As a result of this extensive training, Oral and Maxillofacial Surgeons are well-prepared to identify, diagnose and assess the source of pain and anxiety within the scope of their discipline, and to appropriately administer local anesthesia, all forms of sedation and general anesthesia. Further, they are experienced in airway management, endotracheal intubation, establishing and maintaining intravenous lines, and managing complications and emergencies that may arise during the administration of anesthesia.
Putting Your Mind at Ease
The best way to reduce anxiety is to make certain you know what to expect during and after surgery. As with most anxiety-producing situations, the more you know, the less you have to be anxious about. Prior to surgery, your Oral and Maxillofacial Surgeon will review with you the type of anesthetic to be used, as well as the way you're likely to feel during and after the operation. This is the time to discuss any concerns you may have about any facet of the operation.
During surgery, one or more of the following may be used to control your pain and anxiety: local anesthesia, nitrous oxide-oxygen, intravenous sedation and general anesthesia. Commonly, patients describe their feelings during surgery as comfortable and surprisingly pleasant.