Oral and Maxillofacial Surgery (Including Wisdom Teeth)
Information on oral surgery procedures including impacted wisdom tooth removal, cyst operations, root-tip surgery and surgical preparation before dental implants.
What Is Oral and Maxillofacial Surgery?
Oral and maxillofacial surgery is the field of dentistry that treats conditions of the teeth, jawbones and the soft tissues of the mouth using surgical techniques. It covers a wide range of procedures, from routine extractions and impacted wisdom tooth operations to cyst removal, root-tip surgery and bone preparation before dental implants.
The field is not limited to extractions. It also includes the treatment of lesions inside the jawbone, the surgical cleaning of persistent infections at the root tip, adjustments of bone and soft tissue before dentures, and the correction of lip and tongue ties. Thanks to imaging methods such as panoramic X-rays and three-dimensional tomography, surgical procedures can now be planned with a high degree of predictability.
At ADEN Dental in Çukurambar, Ankara, surgical procedures are carried out under sterile conditions and in line with current dental protocols. Because every patient presents a different clinical picture, the treatment plan is always determined through a clinical examination by the dentist.
Why Do Wisdom Teeth Cause Problems?
Wisdom teeth are the third molars, which usually erupt between the ages of 17 and 25 and are the last teeth to take their place in the mouth. When the jaw does not offer enough space, they may remain fully or partially impacted within the bone or gum tissue.
Impacted or poorly positioned wisdom teeth can lead to pain, recurring gum inflammation, decay in the neighbouring molar and a feeling of pressure caused by crowding. Impacted teeth that cause no symptoms and do not harm the surrounding tissues, however, can often simply be monitored at regular check-ups; not every wisdom tooth needs to be removed.
You can find more detailed information on how wisdom teeth develop, which symptoms they may cause and when monitoring is sufficient in our blog article on wisdom teeth.
Types of impaction
Impacted wisdom teeth are classified according to their position within the jaw, and this position directly influences the scope and duration of the operation:
- Vertical impaction: the tooth is upright but remains under bone or gum tissue
- Angular impaction: the tooth is tilted towards or away from the neighbouring molar
- Horizontal impaction: the tooth lies completely sideways within the jawbone
- Soft-tissue impaction: the tooth has cleared the bone but remains covered by gum
Which Conditions Are Treated Surgically?
The procedures most frequently performed within oral surgery include:
Which procedure is appropriate is decided after a clinical examination and radiographic imaging, such as a panoramic X-ray and, where necessary, three-dimensional tomography. Imaging clearly shows the relationship of the tooth to structures such as nerves and the sinuses.
When the jaw does not offer enough bone volume for implants, preparatory procedures such as bone grafting or a sinus lift may be planned. This preparatory stage plays an important role in the long-term success of dental implant treatment; for patients who have lost all their teeth, fixed solutions such as the All-on-Four concept are assessed together with the surgical plan.
- Removal of fully or partially impacted wisdom teeth
- Complicated extractions of broken, severely damaged or curved-rooted teeth
- Removal of cysts and similar lesions within the jawbone
- Apical resection (root-tip surgery) for persistent infections at the root end
- Bone grafting and sinus lifting to prepare the jaw for dental implants
- Correction of lip and tongue ties (frenectomy)
Who Is a Candidate for Oral Surgery?
The decision in favour of surgery is based on the nature of the complaint, the position of the tooth, the radiographic findings and the patient's general health. Patients with recurring episodes of gum inflammation around a wisdom tooth, decay or root resorption starting in the neighbouring molar, an orthodontic treatment plan that requires space, or a need for bone adjustments before dentures are evaluated for surgical treatment.
Well-controlled systemic diseases are not an obstacle to oral surgery, but the planning is adapted to the patient's medication and medical history. Impacted tooth operations performed at a younger age, before the roots have fully developed, are technically often easier; for teeth that are being monitored, the timing of removal is therefore determined by the dentist.
How Is an Impacted Wisdom Tooth Removed?
The area is first numbed with local anaesthesia, so no pain is expected during the operation itself; only a sensation of pressure may be felt. A small opening is made in the gum and, if required, the thin layer of bone covering the tooth is removed.
Depending on its position, the tooth is taken out in one piece or divided and removed in sections. The duration varies with the position of the tooth and the shape of its roots, but most operations are completed within 20 to 60 minutes. The site is then closed with sutures, which are removed after about a week or dissolve on their own.
The operation step by step
A typical impacted tooth operation proceeds through the following stages:
- Planning with a clinical examination and X-rays, supplemented by 3D imaging where necessary
- Numbing the area with local anaesthesia and confirming that it has taken full effect
- Creating a small opening in the gum and removing a thin layer of bone if required
- Removing the tooth in one piece or in sections
- Rinsing and cleaning the site and closing it with sutures
- Placing a gauze pad and explaining the aftercare instructions
How Does the Treatment Process Work at ADEN Dental?
The process begins with a detailed oral examination and imaging. The dentist assesses the position of the tooth, its relationship to nearby anatomical structures such as nerves and the sinuses, and reviews the patient's general health history and current medication. Where necessary, three-dimensional tomography is used to examine the position of the tooth within the bone in detail.
During the planning stage, the scope of the procedure, the type of anaesthesia and possible risks are explained openly, and the patient's questions are answered before treatment goes ahead. For anxious patients, each step is described in advance and short breaks are taken whenever needed.
Once the procedure is completed, written and verbal aftercare instructions are provided. A follow-up appointment is scheduled to assess healing and remove sutures if needed, and the follow-up period is extended when the dentist considers it necessary.
How Does Recovery Progress After Surgery?
The gauze pad placed on the surgical site should be held in place with gentle biting pressure for about 30 to 40 minutes. Spitting and rinsing should be avoided for the first 24 hours, and applying a cold compress from the outside at intervals on the first day helps limit swelling and protect the blood clot in the wound.
Soft, lukewarm foods are recommended for the first few days; hot, hard and grainy foods should be avoided. Smoking and alcohol can delay healing and should be avoided for at least 48 to 72 hours, and drinking through a straw is discouraged because it can dislodge the clot.
Early loss of the blood clot in the extraction socket can lead to a painful condition known as dry socket (alveolitis), which typically announces itself with increasing pain a few days after the extraction. Avoiding smoking, straws and vigorous rinsing during the first days considerably reduces this risk; if symptoms occur, the clinic should be contacted for a check-up.
Prescribed medication should be taken exactly as directed. Increasing pain, bleeding that does not stop or fever are reasons to contact the clinic. Soft-tissue healing is largely complete within one to two weeks, while full healing of the bone can take several months.
The first 24 hours at a glance
The first day after the operation is the most critical period for healing:
- Hold the gauze pad in place with gentle biting pressure for 30 to 40 minutes
- Avoid spitting, rinsing and drinking through a straw
- Apply a cold compress from the outside at intervals
- Stay away from hot food and drinks as well as strenuous exercise
- Do not smoke or drink alcohol
What Should Be Considered Before Oral Surgery?
Uncontrolled diabetes, blood-thinning medication, a history of chemotherapy or radiotherapy and drugs used to treat osteoporosis (bisphosphonates) directly influence surgical planning. It is therefore important to share your full medical history and a complete list of your medication during the examination.
During pregnancy, non-urgent surgical procedures are postponed until after the birth where possible; when treatment cannot wait, the dentist coordinates the most suitable timing together with the patient's obstetrician.
Feeling anxious before oral surgery is very common. Having each step explained in advance, agreeing on a stop signal with the dentist and taking short breaks during treatment make the procedure noticeably easier for many patients. Our article on coping with dental anxiety offers further practical suggestions.
What Supports Long-Term Oral Health After Surgery?
Alongside uneventful healing of the surgical site, protecting oral health in the long term is just as important. Regular brushing, cleaning between the teeth and dental check-ups every six months allow both the operated area and the neighbouring teeth to be monitored.
Smoking, uncontrolled diabetes and neglected gum disease are the main factors that can impair wound healing. Keeping to the follow-up intervals recommended by the dentist after surgery helps detect possible problems at an early stage.
Because the procedure is performed under local anaesthesia, no pain is expected during the extraction itself; only pressure may be felt. Mild to moderate discomfort after the anaesthesia wears off can usually be managed with the pain relief recommended by the dentist.
The duration depends on the position of the tooth, its root anatomy and its relationship to the bone. Simple extractions may take only a few minutes, while impacted tooth operations usually take 20 to 60 minutes.
Swelling and tenderness usually peak within the first two to three days and subside noticeably within a week. Soft-tissue healing is mostly complete within one to two weeks, while full bone healing can take several months.
No. Impacted teeth that cause no symptoms and do not damage neighbouring teeth or surrounding tissues can be monitored at regular check-ups. The decision to extract is made by the dentist based on the clinical examination and X-ray findings.
Patients with uncontrolled systemic diseases, those taking blood thinners or osteoporosis medication, and pregnant patients require a detailed assessment before the procedure; when necessary, the dentist consults the other physicians involved in their care.
For the first 24 hours, hot, hard, grainy and heavily spiced foods should be avoided in favour of soft, lukewarm meals. Using a straw and smoking are discouraged, as they can dislodge the blood clot protecting the wound.
Most patients return to their daily activities on the same day after simple extractions and within one to two days after impacted tooth operations. Strenuous physical activity should be avoided during the first days; the exact timing depends on the extent of the procedure.
Non-dissolving sutures are usually removed at the follow-up appointment about a week after the procedure. If dissolving sutures were used, no removal is needed; the dentist explains which type was used at the end of the operation.
In suitable cases an implant can be placed in the same session as the extraction; in most situations, however, a healing period of a few months is recommended before implant placement. The timing is determined through a clinical examination, based on bone volume and the condition of the site.
Dry socket is a condition caused by early loss of the blood clot in the extraction site and typically presents with increasing pain a few days after the extraction. Avoiding smoking, straws and rinsing during the first 24 hours helps reduce the risk; if symptoms occur, the clinic should be contacted.