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Richmond Oral and Cosmetic Surgeons

Dr Thomas Padgett, DMD

Procedures

To learn more about the oral surgery procedures that we provide, please select a procedure from the menu below:

  • Facial Trauma
  • Oral Pathology
  • TMJ Disorders
  • Orthognathic Surgery
  • Wisdom Teeth
  • Dental Implants
  • All-on-4® Treatment
  • Bone Grafting

Maxillofacial Trauma

Oral and Maxillofacial Surgeons are trained, skilled and uniquely qualified to manage and treat Facial Trauma.

Dr. Padgett is on staff at the local hospital and provides emergency room coverage for facial injuries including:

  • Facial lacerations
  • Intra-oral lacerations
  • Avulsed (knocked out) teeth
  • Fractured facial bones (cheek, nose, or eye socket)
  • Fractured jaws (upper and lower jaw)

Injuries to the face , by their very nature, impart a high degree of emotional, as well as physical trauma to patients. The science and art of treating these injuries requires special training involving a “hands on” experience and an understanding of how the treatment provided will influence the patient’s long term function and appearance.

The Nature of Maxillofacial Trauma

There are a number of possible causes of facial trauma. Motor vehicle accidents, accidental falls, sports injuries, interpersonal violence and work related injuries account for many. Types of facial injuries can range from injuries of teeth to extremely severe injuries of the skin and bones of the face. Typically, facial injuries are classified as either soft tissue injuries (skin and gums), bony injuries (fractures), or injuries to special regions (such as the eyes, facial nerves or the salivary glands).

Soft Tissue Injuries of the Maxillofacial Region

When soft tissue injuries such as lacerations occur on the face, they are repaired by “suturing”. In addition to the obvious concern of providing a repair which yields the best cosmetic result possible, care is taken to inspect for and treat, injuries to structures such as facial nerves, salivary glands and salivary ducts (or outflow channels). Dr. Padgett is a well-trained oral and maxillofacial surgeons and is proficient at diagnosing and treating all types of facial lacerations.

Bone Injuries of the Maxillofacial Region

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. When an arm or a leg is fractured, a “cast” is often applied to stabilize the bone and allow for proper healing. Since a cast cannot be placed on the face, other means have been developed to stabilize facial fractures.

One of these options involves wiring the jaws together for certain fractures of the upper and/or lower jaw. However, certain other types of fractures of the jaw are best treated and stabilized by the surgical placement of small “plates and screws” at the involved site. This technique of treatment can often allow for healing and obviates the necessity of having the jaws wired together. This technique is called “rigid fixation” of a fracture. The relatively recent development and use of “rigid fixation” has profoundly improved the recovery period for many patients by allowing them to return to normal function more quickly.

The treatment of facial fractures should be accomplished in a thorough and predictable manner. Importantly, the patient’s facial appearance should be minimally affected. An attempt at accessing the facial bones through the fewest incisions necessary is always made. At the same time, the incisions that become necessary are designed to be small and, whenever possible, are placed so that the resultant scar is “hidden”.

Injuries to the Teeth and Surrounding Dental Structures

Isolated injuries to teeth are quite common and may require the expertise of various dental specialists. Oral surgeons usually are involved in treating fractures in the supporting bone or in replanting teeth which have been displaced or “knocked out”. These types of injuries are treated by one of a number of forms of “splinting” (stabilizing by wiring or bonding teeth together). If a tooth is “knocked out”, it should be placed in salt water or milk. The sooner the tooth is re-inserted into the dental socket, the better for the survival of the tooth. Therefore, the patient should see a dentist or oral surgeon as soon as possible.

Never attempt to “wipe the tooth off”, since remnants of the ligament which hold the tooth in the jaw are attached and are vital to the success of replanting the tooth. Other dental specialists may be called upon such as endodontists, who may be asked to perform root canal therapy, and/or restorative dentists who may need to repair or rebuild fractured teeth. In the event that injured teeth cannot be saved or repaired, dental implants are often now utilized as replacements for missing teeth.

The proper treatment of facial injuries is now the realm of specialists, well versed in the emergency care, acute treatment and long term reconstruction and rehabilitation of the patient.

Initial Consultation

At this visit, your doctor will assess you needs and desires and discuss various treatment options. He will also review your expectations and the probable outcome of treatment. You may be shown several before and after photographs, but remember, results vary with individuals. Your doctor will provide literature for you to review at home and request you return at a later date to finalize the type of procedure you desire and schedule the surgery. At this time, before and after photographs may be taken of the area to document your results. For smaller procedures, a surgery date may be made at the initial visit.


Please assist us by providing the following information at the time of your consultation:

  • Your surgical referral slip and any x-rays if applicable.
  • A list of medications you are presently taking.
  • If you have medical insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.

IMPORTANT: A parent or guardian must accompany all patients under 18 at the consultation visit.


A pre-operative consultation is mandatory for patients undergoing IV anesthesia for surgery. Please have nothing to eat or drink 6 hours prior to your surgery. You will also need an adult to drive you home.


Please alert the office if you have a medical condition that may be of concern prior to surgery (i.e. diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are on any medication (i.e. heart medications, aspirin, anticoagulant therapy, etc.)


X-Ray

If your physician or dentist has taken X-Rays, you may request that they forward them to our office. If there is not enough time, please pick them up and bring them to our office. If additional films are necessary, they can be taken at our facility.

Copyright 2019, Richmond Oral and Cosmetic Surgeons

Specialists in Dental Implants, Wisdom Teeth, and Sedation