Short answer: Oral surgery is the field of dentistry that covers procedures such as tooth extractions, impacted tooth operations, implant placement, bone procedures such as bone grafting and sinus lifting, root-end surgery, treatment of jaw cysts and biopsies of lesions inside the mouth. Most procedures are performed under local anesthesia; in suitable cases, sedation or general anesthesia may be preferred.
Although the word "surgery" makes many people anxious, a significant portion of the surgical procedures performed in dentistry are planned and controlled procedures carried out under local anesthesia in a dental office setting. Oral surgery is a broad field that covers surgical procedures involving the teeth, jawbones and soft tissues of the mouth. Many procedures fall under this heading, from a simple tooth extraction to an impacted wisdom tooth operation, and from implant placement to the treatment of jaw cysts. In this article, we introduce the scope of oral surgery, commonly performed procedures and anesthesia options.
What is oral surgery?
Oral surgery is the field of dentistry concerned with the diagnosis and treatment of diseases, injuries and developmental problems that require surgical intervention in the hard and soft tissues of the mouth and its surroundings. In Türkiye, dentists specialized in this field are called "oral, dental and maxillofacial surgery specialists." More complex cases, such as extensive jaw operations or large tumors, are treated in a hospital setting under general anesthesia.
The main procedures covered by oral surgery are:
- Simple and surgical tooth extractions,
- Removal of impacted or partially impacted teeth,
- Implant placement and bone augmentation procedures,
- Root-end surgery (apical resection),
- Treatment of jaw cysts and benign tumors,
- Biopsies of lesions inside the mouth,
- Tongue and lip tie (frenulum) procedures,
- Bone and soft tissue adjustments before dentures,
- Treatment of dental and jaw injuries.
Most of these procedures are planned in cooperation with other fields of dentistry, especially orthodontics, prosthodontics and periodontology.
How are extractions and impacted teeth treated?
Tooth extractions are the most commonly performed procedure in oral surgery and are carried out as simple or surgical extractions depending on the position of the tooth. Extracting a tooth that is fully visible in the mouth and has straight roots is generally a simple extraction. For teeth that are broken, have curved roots or remain inside the bone, however, it may be necessary to open the gum, remove part of the bone if needed and take the tooth out in pieces; this is called a surgical extraction.
Impacted teeth are teeth that have not been able to erupt into the mouth even though their normal eruption time has passed. They are most often seen in wisdom teeth and upper canines. Two different approaches may apply to impacted teeth:
- Extraction: The impacted tooth is removed in cases of problems such as recurrent inflammation, damage to the neighboring tooth or cyst formation, or when the treatment plan requires it.
- Exposure and orthodontic eruption: Especially for teeth that are important for the smile and the bite, such as impacted canines, the tooth is surgically exposed and brought into place with orthodontic forces. This procedure is carried out through joint planning by the oral surgeon and the orthodontist.
For recovery after an extraction to go smoothly, it is important to follow the care instructions recommended by the dentist, stay away from smoking and avoid behavior that would disturb the extraction site in the first days.
What do implant and bone procedures involve?
Implant surgery is the placement of a titanium or zirconia screw into the jawbone to replace the root of a lost tooth; when the bone is insufficient, bone augmentation procedures are performed before or together with the implant. It is one of the most commonly practiced areas of oral surgery today.
The main surgical procedures related to implants are:
- Implant placement: The implant is placed into the bone under local anesthesia; a healing period of usually a few months is allowed for the implant to integrate with the bone.
- Bone grafting: When the bone is insufficient in width or height, bone volume is increased using the person's own bone or various graft materials.
- Sinus lift: Raising the floor of the sinus in the back area of the upper jaw and placing a bone graft underneath it.
- Guided bone regeneration: Supporting the regeneration of bone in the desired area by using special membranes.
- Socket preservation: Limiting bone loss by placing a graft into the extraction socket after a tooth is extracted.
At the planning stage, the amount of bone and the position of important structures such as nerves and sinuses are evaluated with three-dimensional computed tomography. In some cases, the position of the implant is determined in advance using surgical guides prepared with digital planning.
How are cysts and tumors treated?
Jaw cysts and benign tumors inside the mouth are most often removed surgically, and the removed tissue is sent for pathological examination for a definitive diagnosis. Some of the cysts seen in the jawbones originate from the teeth; for example, they can develop at the root tip of a tooth that has been inflamed for a long time or around an impacted tooth.
Cysts usually grow slowly and may not cause symptoms for a long time; they are often noticed by chance on routine X-rays. As they grow, they can cause swelling in the jaw, shifting or loosening of teeth and, rarely, changes in sensation. Depending on the size and type of the cyst, treatment can be planned as complete removal of the cyst or, for large cysts, first draining it to make it smaller.
Sores in the mouth that do not heal for more than two weeks, white or red patches, hardened areas and unexplained swellings should always be evaluated. If deemed necessary, a biopsy is taken from these areas for tissue examination. Early diagnosis is decisive for treatment success, especially in serious diseases such as oral cancer. That is why regular dental check-ups are important not only for the teeth but also for the health of the tissues inside the mouth.
What are the anesthesia and sedation options?
The vast majority of procedures in oral surgery are performed under local anesthesia; for patients with high anxiety levels, in long and extensive procedures or in certain medical conditions, sedation or general anesthesia options may be considered.
- Local anesthesia: The area to be treated is numbed; the patient is awake but does not feel pain. Pressure and vibration may be felt. Extractions, implants and many minor surgical procedures are performed with this method.
- Conscious sedation: The patient is relaxed and their anxiety is reduced with suitable medications; they are awake and can respond to questions. It is used together with local anesthesia. It requires appropriate equipment, monitoring and a trained team.
- General anesthesia: The patient is put fully to sleep. It is preferred for extensive jaw operations, situations where many procedures need to be done in a single session, or for some patients who cannot cooperate with treatment in the chair; it is performed with an anesthesiologist present and in a suitable healthcare facility.
Which method is suitable is determined by evaluating the scope of the procedure, the patient's general health, the medications they use and their anxiety level. Before the procedure, conditions such as heart disease, use of blood thinners, diabetes, bone medications and pregnancy must be reported to the doctor; this information directly affects both anesthesia and surgical planning. For other topics you are curious about, you can take a look at our frequently asked questions page.
What should you pay attention to after a surgical procedure?
Smooth recovery after oral surgery depends largely on following the doctor's recommendations. Biting on a gauze pad in the first hours helps control bleeding. On the first day, applying cold to the cheek at intervals can reduce swelling. It is recommended to stay away from smoking and alcohol, not to disturb the treated area with your tongue or fingers, and to choose lukewarm and soft foods in the first days. Medications prescribed by the doctor should be used as directed. In case of increasing pain, swelling, fever or bleeding that does not stop, you should see your doctor without delay.
When should you seek an oral surgery evaluation in Ankara?
In situations such as recurrent toothache, a suspected impacted tooth, swelling in the jaw, a sore in the mouth that will not heal or implant planning, the problem first needs to be correctly identified with a comprehensive examination and imaging. At our polyclinic in Park Oran Ofis in Çankaya, after the examination, which procedure is necessary, the suitable anesthesia option and the treatment process are discussed with you in detail.
Frequently asked questions
Do oral surgery procedures require general anesthesia?
The vast majority of procedures, such as tooth extractions, impacted tooth operations and implant placement, are performed under local anesthesia. Sedation or general anesthesia may be preferred for extensive operations, high anxiety levels or certain medical conditions. The decision is made based on the doctor's evaluation.
How long does impacted tooth removal take?
The duration varies according to the tooth's position, depth and root structure. Some impacted teeth are removed in a short time, while the procedure may take longer for teeth that are deep and angled. The doctor can share an estimated duration after evaluating the X-rays.
Is a jaw cyst dangerous?
Most jaw cysts are benign, but as they grow they can cause bone loss, shifting of teeth and swelling. For this reason, they are usually treated surgically, and the removed tissue is sent for pathological examination for a definitive diagnosis.
Can I have a tooth extracted if I take blood thinners?
In most cases, a tooth can be extracted with appropriate precautions. However, you must tell your dentist about the medication you use and must not stop the medication on your own. If deemed necessary, an evaluation is made together with the doctor who prescribed the medication.
