Our Services

Surgical Procedures

Anesthesia

During your initial consultation, Dr. Alto will take a comprehensive history designed to help recommend the safest and most effective anesthesia/deep sedation for your operation. Your anesthesia plan will involve a combination of agents that target pain both during and after the operation. General anesthesia may be administered intravenously. Conscious sedation may be delivered intravenously or in a gas form such as nitrous oxide or “laughing gas.” Local anesthesia is injected into the site to provide pain relief both during and following the procedure. Local anesthesia is often not completely effective for more complicated procedures in which sedation may be recommended. Oral medications provide post-operative pain control and can be self-administered in the days following the procedure.

It is important to understand what anesthesia is planned for your procedure and to follow pre-operative instructions precisely. Many types of anesthesia require that you do not eat or drink anything for at least six hours prior to surgery. In addition, patients are required to arrange an escort to assist with transportation following the procedure.

Wisdom Teeth

Wisdom teeth, or third molars, are the last teeth to develop and appear in your mouth. They usually appear during the late teens and are positioned behind the upper and lower second or twelve-year molars. A person’s jaw is often not large enough to accommodate wisdom teeth and as a result can create complications if they are not removed. A result can be pain or infection, crowding of teeth or damage to the surrounding teeth.

Removal of wisdom teeth is usually performed in our office under IV sedation with local anesthesia. The surgery usually lasts about 45 minutes. Once the teeth have been removed, Dr. Alto provides each patient with detailed post-op instructions. Patients will need a few days to recuperate and may have some swelling and discomfort. Patients will be given a prescription for pain management and possibly an antibiotic. It is essential to maintain good oral hygiene throughout the recovery process.

The removal of Wisdom teeth is a common procedure with minimal side effects. Although rare, Dr. Alto will provide a comprehensive explanation of any risks and complications associated with the procedure; the most common are infection, dry socket, numbness and sinus complications.

Pediatric Maxillofacial Surgery

Dr. Alto treats children using general and local anesthesia in the office, including the full range of pediatric care including extractions, pathology, and corrective surgery.

Maxillofacial Trauma

There are numerous causes of facial trauma which can range from injuries of teeth to extremely severe injuries of the skin and bones of the face. Trauma to the face is usually classified as soft tissue injuries (skin and gums), bony injuries (fractures), or injuries to special regions (such as the eyes, facial nerves or the salivary glands).

When soft tissue injuries occur, they are repaired by suturing. In addition to repair any damage for cosmetic purposes, care is taken to inspect for and treat, injuries such as facial nerves, salivary glands and salivary ducts.

Fractures of the bones of the face are treated in a manner similar to the fractures in other parts of the body. The specific form of treatment is determined by various factors, which include the location of the fracture, the severity of the fracture, and the age and general health of the patient.

Dental Implants

Dental implants are permanent fixtures of very durable, tiny titanium posts which are inserted into the jawbone where teeth are missing. The metal anchors act as tooth root substitutes. They are surgically placed into the jawbone; the bone then bonds with the titanium, creating a strong foundation for artificial teeth. Small posts are then attached to the implant, which protrude through the gums. These posts provide stable anchors for artificial replacement teeth.

People often consider implants because a sliding lower denture makes chewing and talking difficult. Implants require the same maintenance as real teeth, including brushing, flossing and regular dental check-ups. Dental implants can help restore almost anyone's smile even if natural teeth have been lost. The success rate for implants is impressive with a 98 percent for lower implants and 95 percent for upper implants!

TMJ Disorder

TMJ (temporomandibular joint) disorders related to the jaw joint. TMJ disorders develop for many reasons and may result in a misaligned bite, pain, clicking or grating noises when you open your mouth, or trouble opening your mouth wide. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.

There are various treatment options that Dr. Alto can utilize to improve the function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Dr. Alto will determine the proper course of treatment.

Orthognathic (Corrective Jaw) Surgery

Orthognathic surgery is a corrective and reconstructive surgery designed to establish proper jaw and facial alignment. Candidates for orthognathic surgery often have discrepancies in the facial skeleton, the treatment for which requires the teeth to be straightened with orthodontics followed by corrective jaw surgery to re-align the jaw.

Not treating the problem may prevent you from being able to bite and chew your food, close your lips together, and to speak clearly. The health of the teeth, gums and particularly the jaw joint (TMJ) may be in jeopardy if surgery is not done. While not often a primary reason for orthognathic surgery, the appearance of your face may be made to look more balanced or normal.

Most orthognathic surgeries are performed in the hospital and the surgery can last from two to three hours, depending on the severity of your condition.

Oral Pathology

The inside of the mouth is normally lined with a special type of skin (mucosa) that is smooth and coral pink in color. Any alteration in this appearance could be a warning sign for a pathological process. The most serious of these is oral cancer. The following can be signs at the beginning of a pathologic process or cancerous growth:

These changes can be detected on the lips, cheeks, palate, and gum tissue around the teeth, tongue, face, and/or neck. Pain does not always occur with pathology and is not often associated with oral cancer. However, any patient with facial and/or oral pain without an obvious cause or reason may also be at risk for oral cancer.