Modern anesthesia technology now makes it possible for Dr. Smith to perform even complex surgery at the office with little or no discomfort. During surgery, one or more of the following is used to control pain and anxiety: local anesthesia that numbs the surgical area; nitrous oxide-oxygen ( sometimes called "laughing gas") for light relaxation; intravenous sedation for deep relaxation; and general anesthesia, which puts you to sleep.

If your preference is to have sedation or general anesthesia, Dr. Smith will even use laughing gas while starting your IV (intravenous line) to aide in your comfort. While you are sleeping, Dr. Smith will give you injections of a special local anesthetic, which will keep you numb and comfortable for several hours following your procedure. This will allow you time to get home and to start taking your pain medications before any discomfort arises. During your consultation Dr. Smith will fully explain the different types of anesthesia, and which type is most appropriate for your needs.

Before the procedure is started, a complete and thorough health and medical history will be taken. Particular attention is paid to allergies, medications or health problems, which may affect the surgery and/or administration of anesthesia. Dr. Smith will discuss with you the type of anesthesia which is appropriate for you depending on the procedure and your medical history.

In the past 20 years, there has been a huge increase in patients seeking cosmetic surgery. Many health care specialist such as, dermatology; oral and maxillofacial surgery; ophthalmology; ear, nose, and throat; and plastic surgery, are trained and qualified to perform facial cosmetic procedures.

These procedures, no matter how minimally invasive, hurt. Fortunately, oral surgeons, unlike other health care colleagues, can use laughing gas, sedation, and even general anesthesia in their private offices or surgical suites to make these procedures painless. This environment makes the surgical experience easier, less expensive, and more personal, with increased anonymity. Finally, technological increases in anesthesia, equipment, and procedures have made it easier and safer than ever to have cosmetic surgery.

The last 5 years have brought about an extreme interest in minimally invasive rejuvenation techniques. These procedures can range from being temporary/reversible, to permanent.

The reversible or temporary procedures would include the injection of filler substances and/ or Botox . These are the most common procedures in cosmetic surgery. The ease and popularity of Botox (Allergen, Inc., Irvine, CA), and collagen fillers has popularized and expanded the use of rejuvenate injections. This, coupled with the introduction of multiple new products, has increased the number of treatment options for cosmetic patients. Multiple substances are available to inject into facial wrinkles, folds, lips, traumatic defects, depressed scars, and to augment facial form.

The extraction of teeth, whether simple or a complex bony impaction, is a surgical operation involving the teeth, bone, and soft tissues of the oral cavity.

With modern anesthesia technology, it is now possible to perform these procedures in the dental office safely while you sleep, so there is little or no discomfort to you.

Teeth may need to be extracted for a variety of reasons, whether as a result of infection, crowding, periodontal disease, dental caries, or trauma. Most teeth can be removed in an office setting, painlessly and with a short recovery period.

Wisdom tooth are the last tooth behind the upper and lower second molars, and usually appear during a person’s late teens or early twenties.

When a wisdom tooth is blocked from erupting or coming into the mouth in its normally position, it is termed “impacted”.

Serious problems may develop from impacted teeth, such as pain, infection, crowding of, or damage to adjacent teeth. Sometimes more serious problems can occur if the sac that surrounds the impacted tooth fills with fluid and enlarges to form a cyst. This enlargement can hollow out the jaw and result in permanent damage to the adjacent teeth, jawbone and nerves. If the cyst is not treated, a tumor may develop from the walls of the cyst and a more involved surgical procedure may be required for removal. Many problems with wisdom teeth may occur with few or no symptoms, so there may be damage without you knowing it.

Treatment of impacted wisdom teeth involves their removal using special surgical techniques and instruments appropriate for each individual case.

Dr. Smith is a dentist who has specialized training in the removal of wisdom teeth and is an Board Certified Oral and Maxillofacial Surgeon.

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The temporomandibular joint, or TMJ, is a small joint located in front of the ear where the skull and the lower jaw meet. This joint allows the lower jaw (mandible) to move and function, and is the most constantly used joint in the body. The TMJ is a “ball and Socket” joint, and in this joint is a disc made of cartilage that acts as a cushion to absorb stress and allows the lower jaw to easily move when the mouth opens and closes.

At the back of the join, the disc attaches to tissue that contains nerves and blood vessels and can be quite sensitive. Ligaments hold the disc and lower jaw in place. Muscles surrounding the TMJ also help stabilize the joint as well as move the lower jaw during chewing, speaking and other functions.

The teeth themselves are also important for proper TMJ function, because if they don’t fit together properly, stresses can be generated that can affect the joint and damage the disc, ligaments and muscles. Trauma can also damage the TMJ and inhibit proper function.

TMJ disorders can be relatively minor, or they can be extremely painful and potentially debilitating. TMJ suffers can display a variety of symptoms, and certain signs may indicate the potential for TMJ disorders to develop. The following are signs and symptoms that are possible in patients with TMJ problems:

Painful clicks or pops in the joint when opening or closing the mouth

A habit of tooth grinding or clenching

Sore jaw muscles when awakening

Difficulty in opening the mouth fully

Frequent headaches or neck aches

Pain in TMJ area

Locking of the jaw

Presence of some of these signs and symptoms could also indicate a specific type of disorder known as myofascial pain dysfunction syndrome or MPD. This disorder is accompanied by muscle pain and tenderness, limitation in range of jaw motion, and local pain usually limited to one side of the face. This can be diagnosed during your consultation, and evaluate your need for possible TMJ treatment.

Differential diagnosis of pathology in the maxillofacial region is an important part of the practice of oral and maxillofacial surgery. Pathology may range for growths, cysts, tumors, vascular lesions, and even cancer. If indicated, biopsies and/or other tests can be performed to arrive at a definitive diagnosis and appropriate treatment plan. Early detection and treatment of oral lesions or cancer greatly improve the patient’s prognosis. Lesions may be managed medically and/or surgically.

Jaw growth is a slow and gradual process, and occasionally the over development or underdevelopment of either jaw may occur as a result of disease, trauma, or genetics. This developmental defect of the jaws, requires corrective jaw or orthographic surgery to correct this problem.

One or both jaws may grow too much or too little. The resulting abnormality may interfere with proper teeth alignment, speaking and chewing. The tongue and lips may be forced to move awkwardly during speech and swallowing, in an attempt to compensate for the jaw mal relationship. There may even be a speech defect or excessive mouth breathing.

An improper bite may threaten the long-term health of gums and teeth. The jaw joint or temprormandibular joint (TMJ) can also be adversely affected by jaw mal relationship. In addition, jaws of different sizes which don’t match, can grossly affect your facial appearance.

A large proportion of individuals with jaw mal relationships manifest temporomandibular joint (TMJ) dysfunction, which includes a variety of problems ranging from painless clicking in the temporomandibular joints to severe intolerable pain in the joints and muscles. A balanced bio mechanical relationship between the masticator (chewing) muscles, jaws, temporomandibular joints, and teeth is necessary to achieve normal function after surgical repositioning of the jaws. To reach these objectives, orthographic surgery techniques combining upper and lower jaw, and chin surgery with efficient orthodontic treatment and systematic neuromuscular rehabilitation have been developed.

There is a clinical, functional, and biological foundation for surgical repositioning of the jaws in many adult and adolescent patients. Restoration of normal jaw function or improved function, optimal facial esthetics, and long-term dental and skeletal stability are the objectives of a successful surgery. To achieve these objectives we analyze the facial proportions, and in many instances team up with your orthodontist (to apply braces or other appliances) to align the teeth properly.

Corrective jaw or orthographic surgery involves moving all or part of the upper and/or lower jaw into a more favorable position. For example, the entire jaw can be moved backward if it’s too large. The total procedure is usually done inside the mouth so there is no surgical scar on the face

Because of Dr. Smith's expanded dental/medical background and hospital-based training as an oral and maxillofacial surgeon, he is uniquely qualified to deal with injuries to the face, jaws, mouth and teeth. Oral and Maxillofacial surgeons have extensive training in repairing traumatic injuries, including fractures of the mandible (lower jaw), maxilla (upper jaw) and orbits (bones surrounding the eye) as well as closure of skin lacerations or cuts. In dealing with complex facial fractures (multiple broken bones), the dental occlusion is the most important piece of the puzzle in placing the bones in their proper position.

Childhood injuries resulting from various sports or activities, often involve dental or maxillofacial trauma. Younger children often sustain damage to teeth or supporting structures from falls. These injuries can usually be treated at the office, safely and effectively using various sedation techniques.