Oral Surgery

Extractions:

In certain cases it becomes necessary to remove a tooth. The following list  contains some good examples of those situations.

• Impacted wisdom teeth as shown in the diagram below. If the wisdom teeth are not removed, infection, damage to the tooth in front of the impaction, and bone damaging cysts can all occur.
• Teeth that are so badly broken, decayed, or infected that they can no longer be restored to function and need to be removed. In many of these cases, an implant can be a good choice as a replacement.
• When the tooth, such as a baby tooth, fails to come into it's normal place and interferes with the eruption of the permanant tooth.
• Somtimes when the teeth are very crowded it is necessary to remove a tooth to gain space for aligning the teeth for orthodontic treatment.

Dr. Melnick believes in and practices extraction in his own unique way based on his years of experience. Teeth are extracted with as little trauma as possible. Rather than apply heavy forces and create a series of complication and delayed healing, Dr. Melnick prefers to use "Finess not Force". By disconnecting the tooth from the fibers that attach it to the bone around it, most teeth come out easily. It is a rare exception when forcepts are needed. Drs. objective is to make the tooth so loose that it can be lifted out with fingers.

Dr. Melnick has researched and developed his own  unique procedure to minimize post-operative problems. A material that improves blood clotting is placed in the empty socket. Next, a wide spectrum antibiotic is also placed in the socket.  From years of experience, Dr. Melnick has found this process greatly reduces the chances of problems after the extraction.

At times, Dr. Melnick refers complex extractions and general anesthesia case to several carefully selected specialists. The best interests of the patient is always the top priority. All of the patients options are carefully explained.

There are several important steps that must be followed in any surgical case. First, a medical history needs to be taken. Next an x-ray should be taken to determine the position of the tooth and if there are any possible complications or unusual situations present. If an infection is present an antibiotic will be prescribed for several days prior to the procedure to eliminate the possibility of spreading the infection. Frequently a sedative, antibiotic, or an anti-inflamatory medication will be prescribed prior to the visit.

After the procedure the patient and their family members will be informed on the necessary care following an extraction. This will include both verbal and written instructions. Supplies will be given so they are available if needed. Follow up visits are always recommended to check healing.

Below you can see impacted wisdom teeth. To the left is a horizontal impaction what can severly damage the tooth infront of it. In the center is a vertical impaction. Because of thick bone above it the tooth can never erupt into a normal position. Infections and pain are often associated with these situations.

The diagram to the right shows the tissue that connects the bone to the tooth. This was referred to above in the discription of Dr. Melnicks "trauma-less" technique.

Horizontal Impaction

Vertical Impaction

Extraction Situation

Connective Tissue

Biopsy:

When Dr. Melnick observes an area in the tissues of the mouth that appears abnormal, he can remove a small sample for further examination. The sample is preserved and sent to a pathology lab for microscopic examination. With that information a treatment decision can be made. The vast majority in our encino dental office of biopsys are negative. Dr. melnick is very caution in his approach to abnormalities and does many more biopsys than other Encino dental offices. He feels it is far better to do many rather than to miss one. The procedure is quite simple and done with local anesthesia. A small bit of tissue is removed and a stich closes the area. There are few post operative problems.