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Troy Lawhorn - Oral and Maxillofaical Surgery
Insider Article By Dr. Troy Lawhorn
Troy Lowhorn - Oral & Maxillofacial Surgery

Q:  If someone has a severe dentist phobia, when they have a consultation with you for removal of wisdom teeth, can you sedate them before beginning the procedure?

A: 

The answer is yes!  At your preoperative consultation appointment we will discuss all aspects of your surgical visit (everything from arrival to discharge).  Most people with any types of anxiety, or phobia, can be given some form of medication to take prior to arriving for their surgery appointment to help them relax.  Also, the majority of oral surgery procedures are performed with the patient under IV Sedation (or twilight sleep).  We strive to make everyone's experience the best we possibly can.


Q:  Is it too late for a dental implant if my bone has already deteriorated?

A: 

Thank you for your question.  Dental implants continue to be one of the best ways, in most cases, to replace a missing tooth (or teeth).  Dental implants do require a sufficient amount bone volume in order to be placed predictably.  Your general dentist and oral surgeon typically treatment plansbone grafting and dental implant procedures together as a team.  If someone has lost bone in a particular area there are a number of different bone grafting procedures which can be used to reconstruct the bony area prior to, or sometimes in conjunction with, the placement of a dental implant. 


Q:  Do you conduct chin augmentation procedures? How long does a procedure like this last?

A:  Thank you for your question.  The type of chin augmentation procedure (Genioplasty) that I perform is called a sliding osteotomy.  This surgery actually advances the portion of the lower jaw which is referred to as the symphysis (or chin).  The bone is then fixated at its new position and allowed to heal.  The procedure is performed under general anesthesia, is an outpatient type of surgery, and takes approximately 1 hour.  The results should be very long lasting since the actual chin bone position is being modified.


Q:  Does everyone need their wisdom teeth removed?

A:  Wisdom teeth are the last teeth to erupt within the mouth. When they align properly and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen. They may grow sideways, partially emerge from the gum, and even remain trapped beneath the gum and bone. These poorly positioned impacted teeth can cause many problems (pain, swelling, infection, pressure, possible shifting of teeth, damage to adjacent teeth, cysts, tumors, etc.). Removal of the offending impacted teeth usually the treatment of choice. Early removal is also recommended to avoid future problems and to decrease the surgical risk involved with the procedure.


Q:  I have had a tooth retreated twice for a root canal and it still hurts to bite down. It has been over 8 months. Can you treat it again? Does insurance usually cover a procedure like this?

A:  Thank you for your question.  If you are having trouble with a tooth that has been retreated with a root canal twice, then you have several options.  The tooth may need a minor oral surgery procedure which cleans out any remaining infection from around the root tip of the tooth (apicoectomy), or it may be time to start considering removal of the problematic tooth and future replacement with a dental implant.  Either procedure will require joint communication between your general dentist and oral surgeon.  As far as insurance coverage goes, each person's specific policy can vary with regards to what procedures are covered.  This information is usually found out during your initial consultation visit.   


Q:  What types of anesthesia are used for surgery?

A:  The type of anesthesia I use for surgery depends on several factors.  The specific surgical procedure and its complexity, the patient's desire and anxiety level, and the patient's overall health are all important considerations.  Simple procedures can usually be accomplished with local anesthesia.  Oral sedation and nitrous oxide can be utilized to help alleviate mild levels of anxiety regarding a surgical procedure.  Intravenous sedation is the most common, effective, and safest form of anesthesia to ensure a painless and pleasant experience during an office surgical procedure.  For more complex and longer procedures, I utilize the operating rooms at East Georgia Regional Medical Center where anesthesiologists will administer general anesthesia. 


Q:  What is the best way to replace a missing tooth?

A: In the majority of situations, the ideal way to replace a missing tooth is with a dental implant.  Dental implants require a team approach between your oral surgeon and general dentist.  The implant itself is a tiny titanium post which is placed into the jawbone.  The implant acts as a tooth root substitute.  After your jaw bone bonds with the dental implant, your general dentist will fabricate the replacement tooth and attach it to the implant.  The replacement tooth looks, feels, and functions like a natural teeth.


Q:  I had a root canal over 6 months ago. What can I do about the extreme sensitivity?

A: Thank you for the question.  My practice is limited to Oral and Maxillofacial Surgery only, but I may still be able to give you a little advice.  If you are still having trouble with a root canal treated tooth there are several options.  Your Dentist will be able to determine which one may be indicated.  The bite may need to be adjusted on the tooth, the root canal may need to be "retreated" or redone, or a minor surgical procedure may be required which cleans out any remaining infection around the root tip of the tooth (apicoectomy).  Again, thank you for your question.