Our Services
Tooth Extraction
Extraction of diseased teeth is a major part of our daily practice at North Coast Oral & Maxillofacial Surgery. Although your general dentist may feel comfortable performing some simple extractions, the removal of more complicated teeth, such as teeth that are broken at the gumline, is often best left to the specialist. From extraction of a single tooth to removal of all remaining teeth, Drs. Clemow and Bartholomew have the expertise to get it done safely and efficiently. Nervous about the procedure? We can talk to you about a variety of sedation options to help make the experience comfortable.
Wisdom Teeth
Wisdom teeth, also known as 3rd molars, are the last teeth to develop in the mouth, usually between the age of 15 and 24. There is often insufficient space in the mouth to allow for the healthy eruption of these teeth into the mouth. A tooth that isn’t able to fully erupt into the mouth is called “impacted.” Impacted teeth can cause infections, gum disease, cavities on adjacent teeth, and pain. Less commonly, impacted wisdom teeth can also lead to development of cysts, tumors, and increased risk for jaw fracture. Occasionally there is enough space for wisdom teeth to erupt, although they are at increased risk for development of cavities and gum disease because of the hygiene challenges associated with their position so far back in the mouth.
The ideal time to remove wisdom teeth is before they have completed their development, often in the mid/late teens. At North Coast Oral & Maxillofacial Surgery we remove impacted teeth on a daily basis, and our specific training and expertise will ensure that you receive the absolute best care possible.
What to expect:
Your appointment will start with a consultation, which will include a review of your symptoms and medical history, a clinical examination, and an evaluation of your panoramic radiograph. Most wisdom tooth extractions take place in our office setting. An IV is placed and sedation is administered through the IV. The areas will be numbed with local anesthesia so you should have no pain during the procedure, or for several hours afterwards. The wisdom teeth will be removed while you are sedated, and if sutures are required, they will be dissolvable. After the procedure you will be transferred to our recovery room and post-op instructions will be given verbally and in writing to you and your escort (the adult who will drive you home).
Orthodontic Exposure
Occasionally your general dentist or orthodontist may identify a tooth that isn’t erupting as expected (other than the wisdom teeth or third molars). This anomaly most commonly affects the canine teeth in the upper jaw, although others may be affected as well. Once you have braces in place and your orthodontist has created enough space for the tooth, treatment requires surgical exposure of the tooth and bonding an orthodontic bracket and chain to the tooth. Your orthodontist will attach the chain to your braces and use this to guide the tooth into the mouth over several months.
Bone Grafting
Dr. Justin Clemow and Dr. Timothy Bartholomew have extensive training and experience with all types of bone grafting, including socket preservation, ridge augmentation, and sinus lifts. These procedures are generally done in preparation for dental implant placement, which will also be expertly performed at North Coast Oral & Maxillofacial Surgery either in conjunction with bone grafting or several months afterwards.
Socket Preservation: This is bone grafting that is performed at the time of tooth extraction. Sometimes bone removal is required to extract a tooth, and always after a tooth is lost or removed, the bone of the socket will resorb or shrink. If an implant is planned to replace the missing tooth, then socket grafting is performed at the time of tooth removal to counteract the bone resorption that occurs. An implant is then placed about 4 months later.
Ridge Augmentation / Guided Bone Regeneration: Occasionally patients don’t consider implants until after they have been missing teeth for a while. If a 3D CT scan of the site(s) shows that there isn’t enough bone height or width for implant placement, then ridge augmentation is required. At North Coast Oral & Maxillofacial Surgery we can discuss a variety of techniques to achieve ridge augmentation, and offer the option that best fits your specific situation.
Sinus lift: When implants are desired in upper molar location, sometimes the position of the sinus cavity is a factor. When there is not enough bone height to allow for implant placement, a sinus lift is required. This procedure may be done in conjunction with implant placement, or months before, depending on how much bone you have to begin with. Sinus lift grafting involves making a window in the sinus wall, carefully lifting up the sinus membrane, and placing a bone graft along the sinus floor elevate it.
Oral Pathology
Have you or your dentist noticed a growth or lesion on your gums, your tongue, your palate, your lips, your cheeks, or the floor of your mouth? You may need an evaluation for a biopsy by Dr. Justin Clemow and Dr. Timothy Bartholomew. Even for benign lesions, excision can provide relief of discomfort, prevention of irritation, and peace of mind. However, sometimes a biopsy returns bad news, like cancer. Early diagnosis of oral cancer can significantly improve long term outcomes. Since oral cancer often has minimal symptoms in the early stages, regular oral health exams play an important role in identifying signs of disease as soon as possible.
Dental Implants
Whether you are already missing teeth, or you need to have a tooth removed, you may benefit from dental implant treatment. Dental implants are becoming the gold standard for replacement of missing teeth because they heal by fusing to the jaw bone, a process called “oseointegration,” and they are therefore an excellent long-term solution to tooth loss. Implants can be used to replace single teeth, multiple adjacent teeth, or an entire arch of teeth.
Your evaluation will begin with a clinical examination and review of available imaging. A Conebeam CT will be obtained to provide a detailed 3D evaluation of your jaw bone, including bone quality, bone quantity, and position of important anatomy like the maxillary sinus, adjacent teeth, and the inferior alveolar nerve. In some cases, this imaging may reveal that bone grafting is required prior to, or during, implant placement.
Dr. Timothy Bartholomew and Dr. Justin Clemow have extensive training and experience in dental implant placement and they can comprehensively handle all of your dental implant needs. When implant placement is performed by our board-certified surgeons, it is very well tolerated with less discomfort than a normal tooth extraction. Many patients are able to return to work the same day! We routinely offer advanced options like flapless implant surgery (no incisions), immediate implant placement (implant placed at the time of tooth extraction), and single-stage implant placement (no second-stage surgery required to expose the implant). Contact us today to schedule your consultation.
Sleep Apnea
Facial Trauma
Orthognathic Surgery
Jaw Cyst/Tumor Removal
Sleep Apnea
Obstructive sleep apnea (OSA) is a serious condition which can lead to a number of health consequences and affect your quality of life. Untreated OSA can lead to high blood pressure, heart attack, heart disease, impaired memory, cognitive problems, stroke, and decreased libido. An estimated 20 million Americans are afflicted by obstructive sleep apnea, and many of these are undiagnosed.
Obstructive sleep apnea is a condition in which the upper airway collapses during sleep, leading to loud snoring, decreased oxygen levels, and sleep arousals. Sleep apnea is diagnosed by a sleep study (polysomnogram), and first line treatment is usually an oral appliance or air pressure device. For those who can’t tolerate CPAP treatment, there are a variety of surgical solutions that can be used to treat OSA.
Sleep apnea surgery is a specific area of expertise for Dr. Justin Clemow. His first step is to diagnose the type of collapse and the anatomic area of collapse so that he can select the appropriate surgical solution to address the problem. These surgeries will be performed in a hospital setting with an overnight stay.
Facial Trauma
At North Coast Oral & Maxillofacial Surgery, we can treat any type of facial trauma. We have extensive experience in the treatment of fractures of the forehead bone, eye socket, cheekbone, nose, upper jaw, and lower jaw. Our knowledge of how the jaws come together (dental occlusion) is critical when repairing complex facial fractures. Dr. Justin Clemow also has expertise in repair of facial lacerations, and post-traumatic scar revision and reconstruction.
Orthognathic Surgery
Do you have trouble with how your teeth come together? Have an underbite, or an overbite, or an excessively gummy smile? Then you may benefit from corrective jaw surgery. Patients will generally be referred by an orthodontist who suspects that the issue with their bite is related to abnormal growth of the jaws, rather than just imperfect tooth position. Surgery is effective at addressing irregularities of the facial skeleton, including misalignment of the jaws and the teeth. While we expect significant cosmetic enhancement by restoring facial harmony, corrective jaw surgery is performed to correct functional problems.
The upper and/or lower jaw is surgically repositioned into proper anatomic alignment, and fixated in place with screws and plates. Incisions are all inside the mouth, so there is no external scarring, and the result is not only improved oral function/chewing, but also a more harmonious facial profile.
Jaw Cyst/Tumor Removal
Many jaw cysts/tumors are asymptomatic and may be diagnosed on a routine radiograph. At North Coast Oral & Maxillofacial Surgery we have experience treating all types of jaw cysts. Many of these procedures can be safely performed in the office by simply enucleating (shelling out) the lesion, but some require more aggressive surgery that may require a treatment in a hospital setting. Dr. Justin Clemow can surgically remove the cyst/tumor and perform any required bone grafting for reconstruction at the same time.
Intravenous Sedation
At North Coast Oral & Maxillofacial Surgery we offer a variety of anesthesia options for your comfort and safety. A major part of the residency training in Oral & Maxillofacial Surgery focusses on the administration of IV sedation and general anesthesia. Our surgeons hold General Anesthesia permits, our staff are certified as Dental Anesthesia Assistants, and we are equipped with all of the necessary monitoring equipment recommended by the American Society of Anesthesiology. We can safely provide the following anesthesia options.
Local Anesthesia: Many procedures can be comfortably completed with local anesthesia nerve block or infiltration. This option will make you “numb” and block any pain from the procedure. For this option, you DO NOT need a driver, you DO NOT need to fast.
Oral Sedation: To calm your nerves, a relaxation pill can be prescribed beforehand to “take the edge off.” For this option, you DO need a driver, you DO NOT need to fast.
Nitrous Oxide (Laughing Gas): This option provides some relaxation similar to the effect of oral sedation. You will have a small mask over your nose that delivers nitrous oxide and oxygen. For this option, you DO NOT need a driver, you DO NOT need to fast.
IV sedation: Depending on a number of factors, including your overall health and the invasiveness of the procedure, light IV (twilight) sedation or deep IV sedation may be offered. In either case an IV is started, the patient is attached to a number of safety monitors, and medications are administered through the IV until the patient falls asleep. The depth of the sleep is adjusted as needed for your safety and comfort. Our experienced anesthesia team has your safety as our primary objective throughout the sedation process, and you will have no awareness of the surgery or even the injections to numb the surgery site! For this option, you DO need a driver, you DO need to fast for 8 hours, including water.
2D And 3D Imaging
Radiographic imaging is generally required for the adequate diagnosis and treatment of most oral surgery procedures. If your referring dentist has taken an xray that is good diagnostic quality, we may likely be able to use that image if you bring it with you. If not, we are fully equipped with digital imaging equipment to take state of the art digital imaging quickly and comfortably, with minimal radiation exposure. Depending on the condition being evaluated, we may take a 2-dimensional panoramic radiograph (panorex), or a 3-dimensional conebeam CT (CBCT) for greater anatomic detail.
CONTACT INFORMATION
Phone: (419) 627-8131
Fax: (419) 621-1773
Email: ncoms@bex.net
Address: 2500 Strub Rd., Sandusky, Ohio 44870
BUSINESS HOURS
- Mon - Thu
- -
- Friday
- -
- Sat - Sun
- Closed