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Oral Surgery/Full Upper Extraction & Partial Lower Extraction.

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Question
Hello,

I'm a 23 year old Australian who's in the last few months had to have complete upper extraction of the teeth, and all but 6 lower teeth extracted too (as well as 2 lower wisdom teeth).

Within the last 2-3 months, the recovery period I was advised would be 'enough time' before the process of the dentures being created would begin - I've had quite a lot of problems and my dentist seems to just shrug them off.

My gums aren't healing over the jawbone in a few places, and I was told to 'come back in 2 months' and 'hopefully' the gums would have healed properly over the bone, and the 'roughness' of my jawbone would decrease. I'm in that period of time now (1 month to go roughly).

She told me that if the 'roughness' didn't decrease, I may need to go in for more surgery to fix..well..whatever it is that's specifically wrong.. My dentist doesn't ever really go into much detail with me, and I'm never sure what to ask.

My problem with this situation (..actually, there are a couple) is that I'm already fully aware Myself, what will most likely have to be done - skin grafts to cover the exposed jawbone. My gums are very much healed now, and it's very *very* clear to me that they will Not heal over the jawbone that is still exposed. There's just too much bone for it to possibly cover.
I also have weight problems, mostly problems with gaining weight - so this process has been very rough on me so far - and the idea of it continuing on for several more months before they even begin the process of creating my dentures really worries me. I'm borderline anorexic after the last bout of 'recovery time' & I really can't afford to lose any more weight.

It's very difficult for me, because I'm reliant solely on our countries' healthcare to get these problems fixed, and I'm on a disability pension.

My question(s) is/are, what would you recommend I do in this scenario, or what do you think would be the best course of action ?
Do you think I should see another dentist instead ?

Answer
Matthew, Thank you for your question. The process of the tissue healing over the bone may take a while and really depends a bit on your medical conditions. It is always advisable to get a second opinion. There are many different approaches to providing care in the dental field and you should always seek a second opinion, especially if the recommendations your are getting do not make sense to you. Good Luck.

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James M. Ryan. DDS, MS; Board Certified Oral and Maxillofacial Surgeon

Expertise

Dr. Ryan's expertise is in the field of Oral and Maxillofacial Surgery. Specifically, Dr. Ryan is an expert in Orthognathic Surgery. He holds uniques experience as the former Assistant Program Director of the Oral and Maxillofacial Surgery Residency Training Program at Washington Hospital Center where he trained residents to perform these complicated surgical procedures. Additionally, Dr. Ryan also has a tremendous amount of experience in reconstruction of the maxillofacial skeleton related to trauma and tooth loss. Dr. Ryan is an expert in 3 dimensional treatment planning for Orthognathic Surgery, Dental Implant Surgery and Wisdom Teeth removal. To learn more about Dr. Ryan, his full profile can be seen at www.eosdds.com

Experience

Diplomate of the American Board of Oral and Maxillofacial Surgery with current hospital affiliations at: Washington Hospital Center Holy Cross Germantown Hospital National Institute of Health/NIDCR

Organizations
American Dental Association. American Association of Oral and Maxillofacial Surgeons. District of Columbia Society of Oral and Maxillofacial Surgeons. District of Columbia Dental Society. American Board of Oral and Maxillofacial Surgeons. Health Volunteers Overseas.

Publications
Journal of Oral and Maxillofacial Surgery Journal of The American Dental Association

Education/Credentials
S.U.N.Y @ Stony Brook- B.S. in Biochemistry, Stony Brook, NY. Northeastern University- M.S. in Perfusion Technology, Boston, MA. D.D.S.- New York University College of Dentistry, New York, NY. Certificate and Chief Resident- Washington Hospital Center, Washington, DC. Clinical Fellow- The Johns Hopkins Hospital, Baltimore, MD.

Awards and Honors
Dr. Ryan has received numerous awards including: 2006 American Association of Oral and Maxillofacial Surgeons Dental Student Award, Washington Hospital Center 2008 Nurses' Choice Physician Collaboration Award, 2009 Resident Research Summit Scholarship Award, and the 2011 Outstanding Surgical Attending in the Department of Oral & Maxillofacial Surgery at Washington Hospital Center. He has also authored/coauthored and published several journal articles and held several teaching positions,including assistant professor, while at NYUCD.

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