Expert Interview: Oral Surgery

This week’s Expert Interview focuses on oral surgery but touches on other exciting areas as well. DentalFind sat down with dentist Dr. Roger Densley, DDS, who practices in Las Vegas, NV.

For adult-age patients, should the number of wisdom teeth being pulled determine whether you use general anesthesia, or is it a patient choice?

It’s a combination. If the teeth are difficult extractions, especially the lowers – if they’re horizontally impacted they are going to be much more difficult to take out, and general anesthesia would be advisable. Also if the patient is extremely apprehensive, obviously, they should be put under. Most of the time, though, patients’ fears are unfounded. Extractions are usually quick and easy and painless.

What’s the best way to ensure my wisdom teeth aren’t slowly pushing my other teeth together?

Teeth move naturally. They have a tendency to blame the wisdom teeth coming and pushing them, but to the best of my knowledge I have never heard of study that proves that point.

Should both the fragment of a chipped tooth as well as a complete knocked-out tooth be placed in milk between the time of accident and medical attention?

Just the whole teeth. You should have the root. If the root is split it’s worthless.

"Most people get more radiation taking an airplane trip."

Do you have a general rule about when to extract versus doing a root canal?

If the tooth doesn’t have good support or if the top of the tooth doesn’t have enough support, it’s best to extract the tooth. Especially with the advent of implants, they can be replaced. The odds of saving the tooth go down if there’s gum disease or if the crown of the tooth, the top of the tooth, isn’t in good shape.

Can headaches, including migraines, be related to tooth problems, such as wisdom teeth?

Migraines wouldn’t be related to wisdom teeth; however, often times they are related to joint problems. The TMJ. You can get, obviously, earaches based on a dental infection, whether it’s a wisdom tooth or any other tooth.

Can reduced salivation, because of, say, prior head and neck radiation, limit what dental procedure one can or should have?

Dental extractions should be performed by an oral surgeon if radiation to the head and neck has occurred, because of possibility of bone infection.

Do you think, in general, x-ray and imaging in dentistry are overused, and should patients question their dentists more about their use?

There is no reason to fear dental radiation. Most people get more radiation taking an airplane trip.

Do you manage differently patients who have a present or prior use of bisphosphonates?

Definitely extractions need to be seriously considered because of the possibility of bone infection. Extractions only if necessary.




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