Oral Surgery Procedures in Midtown Manhattan

When oral surgery may be needed

Surgery usually comes into play when a problem can't be fixed with a filling, crown or root canal. Common reasons include:

• a tooth broken or cracked below the gum line, or too decayed to rebuild
• a tooth loosened by advanced gum disease
• an infection or abscess around a tooth
• a missing tooth you want to replace with an implant
• a tooth that needs to come out to make room during orthodontic treatment
• an injury that has damaged a tooth beyond repair
• a wisdom tooth causing pain, infection or damage to the tooth next to it

Dr. Avner believes in conservative, preventive dentistry, so we first look at whether a tooth can be saved. Sometimes a root canal and a crown can keep a tooth that might otherwise be removed.

If you have swelling, severe pain or a broken tooth, call the office. Emergency pain management is one of Dr. Avner's areas of focus, and we treat urgent problems such as toothaches, abscesses and broken teeth during office hours; see emergency dental care. If swelling makes it hard to breathe or swallow, or you have any medical emergency, call 911.

What oral surgery at our office includes

Oral surgery covers procedures on the teeth, gums and jawbone. The main procedures at our office are:

• Tooth extractions. Many teeth can be removed with a simple extraction once the area is numb. A tooth that is broken at the gum line, has unusual roots or hasn't fully come in may need a surgical extraction, and how complex it is determines whether it's done here or by an oral and maxillofacial surgeon. Our tooth extraction page has more detail.
• Dental implant placement. An implant is placed in the jawbone to replace a missing tooth, from a single tooth to a full arch with All-on-4 or All-on-6. Our dental implants page covers the full process.

Some procedures are typically handled by an oral and maxillofacial surgeon, a dental specialist with several years of hospital-based surgical training. These include corrective jaw surgery, treatment of facial fractures and the removal of deeply impacted wisdom teeth or teeth lying close to major nerves. If your case calls for a specialist, we'll tell you and explain why.

Benefits and what to expect

When surgery is the right choice, it can relieve pain and clear infection when a tooth can't be saved, protect neighboring teeth, gums and bone from further damage, and prepare your mouth for a replacement tooth such as an implant, bridge or denture.

Before the procedure, tell us about every medicine you take, especially blood thinners and medicines that affect bone, as well as any allergies or health conditions. We use anesthesia so the area is numb. You may still feel pressure; if you feel anything sharp, tell us so we can give more anesthetic.

After an extraction or implant placement:

• bite gently on gauze to control bleeding; light oozing during the first day is normal
• expect swelling and soreness that often peak around the second or third day, then ease
• use a cold compress on your cheek during the first day to limit swelling
• eat soft foods and chew on the other side
• for the first few days, avoid smoking, drinking through a straw and vigorous rinsing, which can dislodge the blood clot

Call the office during office hours if bleeding doesn't slow with firm pressure, swelling keeps growing after the third day, or you notice fever, pus, a bad taste or pain that gets worse instead of better. Recovery varies from person to person and with the procedure.

How it works, step by step

1. Examination and X-rays. We find the cause of the problem and look at the tooth's roots, the surrounding bone and nearby nerves and sinuses.
2. Talking through your options. We explain whether the tooth can be saved, what removal or implant placement involves, the risks and how the gap could be filled later.
3. Preparing for the procedure. We review your health history and medications and give you instructions for the day of the procedure.
4. The procedure. Once the area is numb, the tooth is removed or the implant is placed. Stitches are used when needed.
5. Aftercare. Before you leave, we go over how to control bleeding and swelling, what to eat and what to avoid.
6. Follow-up and next steps. We check how you're healing and, if a tooth was removed, plan its replacement when the time is right.