Craig Wm Wong, DMD
Steven D. Hokett, DDS, MCR
Diplomate, American Board of Periodontology

Oral Surgery

Wisdom Teeth

The third molars or wisdom teeth are the last teeth to erupt; usually appearing in the late teens or early twenties. It is not necessary to extract wisdom teeth when they align properly in the mouth and the gum tissue is healthy. However, generally, this does not happen. Wisdom teeth may erupt sideways, partially surface or remain trapped below the gum and bone. As they attempt to grow properly, impacted wisdom teeth can erupt in many positions in the bone.

When any wisdom tooth lacks the space to come through or simply develops in the wrong place of the jaw and becomes impacted, problems can arise. The tooth must be extracted. When a tooth is partially erupted, bacteria develop due to the opening around the teeth. The growth of bacteria often leads to infection and causes stiffness, swelling pain, and illness (often very severe). Pressure from erupting wisdom teeth may cause other teeth to shift, thus disrupting proper teeth alignment. The formation of tumors and cysts around impacted teeth damage healthy teeth and the jaw bone. Extraction usually resolves these complications. Early removal prevents such problems from arising and decreases the risks of surgery associated with the procedure.

Following an oral examination and X-ray analysis, Dr. Wong can determine if wisdom teeth are erupting properly. Studies indicate that early evaluation and treatment yields optimum results. Generally, a dentist, orthodontist or oral surgeon evaluates the position of wisdom teeth during the teenage years.

Dr. Wong and staff have the licensing, knowledge and expertise to properly administer several types of anesthesia to ensure patients are comfortable and that the procedure is efficient. Procedures are performed in a safe environment, equipped with state-of-the-art monitoring systems, and staff who are knowledgeable of anesthesia methods.

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Orthognathic Surgery

Corrective Jaw Surgery

At Salmon Creek Oral Surgery and Periodontics, Dr. Wong has completed advanced training in head and neck surgery. In order to provide our patients with the most advanced and comprehensive oral health care available, Dr. Wong works in close conjunction with orthodontists to better treat developmental and congenital disorders of the teeth, jaws and maxillofacial and craniofacial regions.

Orthognathic surgery is also referred to as “corrective jaw surgery.” It is used to treat a number of facial and jaw abnormalities. If not corrected, these abnormalities can cause difficulties with chewing, speech, jaw function, and in many cases, facial appearance can be affected. Orthognathic surgery, in conjunction with orthodontics, can correct these jaw and facial deformities. As soon as the jaw is corrected, the teeth will come together properly.

Before surgery, patients will go through an extensive preparation process. We will work with each patient individually, in conjunction with an orthodontist, to determine the best course of treatment needed to achieve the desired result. In addition, photographs and radiographs will be taken to assist us with our computerized treatment planning. This will also help us keep the patient thoroughly educated about both the functional and esthetic benefits of the procedure.

The two most commonly performed procedures are the sagittal split osteotomy of the lower jaw and the Le Fort I osteotomy of the upper jaw. Patients usually undergo 6-12 months of pre-surgical orthodontics prior to surgery. Following the surgery and a recovery period, the patient again undergoes a period of post-operative orthodontics that generally lasts between 3-12 months.

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Sagittal split osteotomy (lower jaw)

The sagittal split osteotomy of the lower jaw is performed through incisions placed inside the mouth close to the back part of the cheek where it is attached to the lower jaw. The jaw bone is then divided where the jaw angles. This will allow the tooth-bearing area of the lower jaw to slide backwards or forwards, depending on the patient’s specific case.

In the past, thin wires were used following surgery to support the bones in their new position for 6-12 months. Thanks to new technologies, this uncomfortable method has been replaced with a more effective and healthier process. Now, small titanium screws are used to hold the jaw segments together during the recovery process. The jaws will also be rubber-banded together for only about a week.

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Le Fort 1 osteotomy (upper jaw)

The Le Fort I osteotomy of the upper jaw is performed through incisions that are placed inside the upper lip in the mouth. A horizontal transection is performed where the upper jaws attach to the base of the nose and sinuses. This will allow the jaw to be moved into the necessary direction for correction of the bite and facial problem.

Small titanium screws are used to hold the jaws together during the recovery process and rubberbands will be used to hold the jaws together for about a week. Patients will be placed on a soft diet for about five weeks.

To learn more about orthognathic (corrective jaw) surgery, please visit www.aaoms.org/pamphlets.cfm.

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Head and Neck Oncological (Cancer) Surgery

Dr. Wong proudly offers his patients the most advanced and comprehensive, specialized care to treat benign and malignant tumors located between the brain and clavicle, anterior to the spine. This also includes tumors of the mouth, jaw, tongue, face, throat, voice box and thyroid gland.

We specialize in head and neck oncology, as well as reconstructive surgery. When necessary, they work closely with orthopedic microvascular surgeons, neurosurgeons, ophthalmologists, general dentists and oncologists to ensure our patients receive the highest level of care possible.

Patients who have evidence of a tumor, whether through a biopsy or X-ray, will follow a two-step process for treatment. The first phase of treatment will involve a thorough evaluation by a head and neck surgeon. In addition, diagnostic procedures, including open biopsies, CT scans and MRIs, will be performed allowing us to be fully prepared to treat your specific case. We believe in the importance of patient education and promise to keep you thoroughly informed of the specific nature of your condition. We will work with each patient individually to create a personalized treatment plan that bests fits your needs and that will provide optimum results for your specific case.

After all the necessary data is collected, the second phase of treatment begins, which may include surgery or radiation alone, a combination of surgery and radiation, or in some cases, chemotherapy.

We specialize in complex anatomical and functional problems and utilize the latest treatments and technologies available in reconstructive rehabilitation to ensure our patients achieve optimum results. We work in close conjunction with other oral health specialists to optimize dental rehabilitation and closely coordinate with the referring physician throughout your post-operative care.

We understand that the diagnosis of a benign or malignant tumor can be emotionally traumatizing. Here at Salmon Creek Oral Surgery and Periodontics, our physicians and staff are specially trained to deal with our oncology patients in a supportive, informative and caring manner. We strive to not only build up their confidence, but to give them hope as well.

To learn more about head and neck cancer visit, please visit
http://www.cancer.gov/cancerinfo/types/head-and-neck/.

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