Many oral surgeries give you the opportunity to make a life changing difference for your patients. Oral tumor removal, palate defect repairs, oro-nasal fistula repairs, jaw fracture repairs, maxillofacial reconstruction and extensive extractions can be involved procedures with extended post-operative nursing care, but these can also be some of the most satisfying and rewarding cases. Recent advances in dental materials utilized in oral surgery have made non-invasive fracture repair and bone regeneration a possibility for some cases that might otherwise have been considered salvage procedures. Fundamental principles for oral surgery include maintenance of blood supply to healing tissues, reduction of tension across gingival mucosal closures, closure of fresh cut mucosa to fresh cut mucosa surfaces, careful handling of oral tissues, placement of two layers of protection over defects where needed, and placement of suture lines over connective tissue rather than defects. Adherence to these principles will help increase the likelihood of successful outcomes. One further measure we like to implement is the placement of adjunctive feeding routes such as esophagostomy or gastrostomy tubes to help supplement nutrition during the healing period while by-passing the oral cavity, in effect reducing the stress placed on the healing tissues and reducing the potential for contamination. These feeding tubes also assist in the administration of oral medications and in many instances make giving medications easier than trying to force them orally. The ability to provide adequate nutrition to the patient during the healing period cannot be over emphasized. Healing patients need more nutrition than healthy patients, and a patient that is in a negative metabolic nutritional state is not as able to heal as those that are given good nutrition. Complete oral examination and treatment planning, even if it is in stages, can also help the client and patient better cope with these often debilitating conditions and result in a successful outcome.
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