Oral Surgery

When a dental problem requires surgery, patients naturally have questions. Is the procedure really necessary? Will it hurt? How complicated is the recovery? Can the tooth be saved instead? Will bone grafting be necessary? What happens if an extraction eventually needs to be followed by a dental implant? These are important questions, and at Kary Dental, we believe patients deserve clear answers before treatment begins.

Our approach to oral surgery is based on careful diagnosis, appropriate treatment, and honest recommendations. Dr. Andrew L. Kary completed an internship in Oral and Maxillofacial Surgery at Madigan Army Medical Center and spent six years in the Army Dental Corps. He served as the primary wisdom tooth provider at Okubo Dental Clinic and as a surgical extraction and bone grafting preceptor for other Army general dentists. That surgical background allows us to perform a broad range of procedures within our Bethesda dental office rather than automatically referring every surgical case elsewhere.

For patients searching for an oral surgeon in Bethesda or researching Bethesda oral surgery options, it is important to understand that the right treatment begins long before the actual procedure. Evaluation, imaging, medical history, diagnosis, treatment planning, anesthesia considerations, preservation of healthy tissue, and postoperative care all influence the experience and outcome. At Kary Dental, we bring those pieces together so patients can make informed decisions about their oral health.

Comprehensive Oral Surgery With a Patient-Specific Approach

Oral surgery covers much more than simply removing teeth. Surgical dental treatment may become necessary because a tooth cannot be predictably restored, wisdom teeth are impacted, an infection is present, bone needs to be preserved for a future implant, soft tissue requires treatment, or an abnormal area needs further evaluation.

The first question we ask is not simply how to perform a procedure. It is whether that procedure is the appropriate treatment for the individual patient.

This distinction matters. A wisdom tooth that is fully erupted, healthy, functional, and easy to clean may not need to be removed. A damaged tooth may sometimes be saved with restorative or root canal treatment instead of extraction. Conversely, delaying treatment for a severely infected or structurally compromised tooth can allow pain, infection, bone loss, or damage to surrounding structures to progress.

Our role is to evaluate the complete clinical picture and explain the available options. When surgery is appropriate, we plan treatment carefully. When another treatment provides a better opportunity to preserve the tooth, we discuss that as well. When a case requires expertise outside our scope, we help coordinate care with a trusted specialist.

Oral Surgery Services Available at Kary Dental

Our Bethesda practice offers a range of surgical procedures so that many patients can receive evaluation, treatment, and follow-up care in one familiar dental office. According to the needs of each patient, our oral surgery services include:

• Tooth extractions and surgical extractions
• Wisdom teeth removal, including complete bony impactions
• Bone grafting, including socket preservation, ridge augmentation, and sinus lifts
• Soft tissue grafting
• Laser frenectomy and frenotomy involving labial and lingual frenums
• Management of oral infections
• Dental trauma management
• Oral biopsies

Having these capabilities within a comprehensive dental practice can be particularly valuable when surgery is one part of a larger treatment plan. An extraction, for example, should not be viewed only as the removal of a tooth. We also need to consider what happens to the resulting space, how the surrounding bone may change, whether replacement is planned, and how today's procedure may affect future restorative choices.

Tooth Extractions in Bethesda

We believe natural teeth should be preserved when doing so is predictable and beneficial. There are circumstances, however, when removing a tooth becomes the healthier option.

Severe decay can leave too little healthy tooth structure for a dependable restoration. A fracture may extend below the gumline or into the root. Advanced infection can compromise the tooth and surrounding tissues. Periodontal disease can cause extensive loss of supporting bone. In other cases, a tooth may need to be removed because of trauma or as part of a broader restorative plan.

Before recommending an extraction, we evaluate why the tooth is failing and what options remain. This is especially important because removing a tooth creates additional considerations. Neighboring teeth can shift over time, chewing patterns may change, and the jawbone in the area begins to remodel after the tooth is gone.

When replacement with a dental implant is being considered, planning ahead becomes particularly important. Bone preservation performed at the time of extraction may reduce the amount of reconstruction required later.

Wisdom Teeth Removal

Wisdom teeth, or third molars, are among the most common reasons patients seek Bethesda oral surgery. These teeth typically develop at the back of the mouth and may not have enough room to erupt into a healthy, functional position.

Some wisdom teeth remain partially or completely trapped beneath gum tissue or bone. Others emerge at an angle that makes them difficult to clean. These conditions can contribute to recurrent inflammation, infection, decay, food trapping, discomfort, or damage to adjacent teeth.

At Kary Dental, we do not believe every wisdom tooth should automatically be removed. If a wisdom tooth is fully erupted, functional, healthy, and maintainable, removal may not provide a meaningful benefit.

When removal is indicated, Dr. Kary's surgical background is especially relevant. His experience includes serving as the primary wisdom tooth provider at Okubo Dental Clinic, and our office performs wisdom tooth removal including complete bony impactions.

The complexity of wisdom tooth removal depends on factors such as the tooth's position, root development, surrounding bone, relationship to nearby anatomical structures, and whether the tooth has erupted. Careful evaluation helps us determine the appropriate surgical and sedation plan before treatment begins.

Bone Grafting and Preserving Future Treatment Options

Bone is living tissue that responds to function. When a natural tooth is present, forces transmitted through the tooth help maintain the surrounding jawbone. After a tooth is removed, that stimulation changes and the ridge begins to remodel.

This is why an extraction site that looks adequate immediately after tooth removal may have considerably less bone later.

Socket preservation involves placing graft material into an extraction site to help maintain the dimensions of the ridge as healing occurs. It can be especially useful when a dental implant may be placed in the future.

Ridge augmentation addresses areas where bone volume is already insufficient. Sinus lift procedures may be recommended when replacing upper back teeth and there is not enough vertical bone between the mouth and the sinus to support an implant. At Kary Dental, sinus lift planning is performed using cone-beam CT imaging so that we can evaluate the anatomy in three dimensions.

Bone grafting is not necessary after every extraction. We recommend it based on the location of the tooth, existing anatomy, condition of the socket, and long-term restorative plan. The purpose is not simply to add another procedure. It is to preserve or rebuild the foundation when doing so provides a meaningful clinical advantage.

Advanced Imaging and Technology for Surgical Planning

Modern oral surgery depends heavily on what can be understood before an incision or extraction is ever made. At Kary Dental, technology is integrated into treatment planning rather than being used simply for its own sake.

Our office incorporates cone-beam CT imaging, intraoral scanning, on-site milling, 3D printing, and dental laser technology as part of our broader dental capabilities.

Cone-beam CT imaging can be particularly valuable in surgical dentistry because it provides three-dimensional information about teeth, bone, and surrounding anatomy. This can help us evaluate impacted teeth, available bone, implant sites, sinus anatomy, and other structures that may influence treatment.

Better information allows for more deliberate planning. Patients also benefit because we can explain what we see and why a particular procedure is or is not being recommended.

Sedation Options for Oral Surgery

Anxiety about oral surgery is common. Some patients are comfortable with local anesthesia, while others strongly prefer additional sedation, particularly for wisdom teeth, multiple extractions, or longer surgical procedures.

At Kary Dental, sedation is discussed before the procedure is scheduled so patients know what to expect. Available options range from local anesthetic and nitrous oxide to oral sedation and general anesthesia administered in our office by a board-certified anesthesiologist.

The appropriate option depends on the procedure, medical history, level of anxiety, and individual preferences. Sedation and pain control are related but different considerations. Local anesthesia is used to numb the treatment area, while sedation can help manage awareness, anxiety, and the overall experience.

Our goal is to choose the level of care appropriate for the patient rather than treating every surgical case identically.

Managing Dental Infections

Dental infections should not be ignored simply because symptoms temporarily improve. An infection generally develops because bacteria have gained access to tissues where the body's defenses cannot completely eliminate the source.

Symptoms can include persistent throbbing pain, swelling of the gum, face, or jaw, sensitivity to pressure, an unpleasant taste, or fever.

Treatment depends on the source and severity of the problem. Some infected teeth may be treatable with root canal therapy. Others may have a prognosis that makes extraction more appropriate. The important point is to diagnose the source rather than relying solely on temporary symptom relief.

Our office also reserves time for urgent and emergency dental visits involving pain, swelling, infection, broken teeth, and dental trauma. This is particularly important because infections and traumatic injuries do not always occur at convenient times.

Soft Tissue Grafting and Laser Frenectomy

Oral surgery can also involve the soft tissues of the mouth. Kary Dental provides soft tissue grafting as well as frenectomy and frenotomy procedures involving labial and lingual frenums.

A frenum is a small band of tissue connecting structures in the mouth, such as the tongue to the floor of the mouth or the lip to the gum. When this tissue is unusually restrictive or positioned in a way that creates functional concerns, releasing it may be recommended.

At our practice, these procedures are performed using a dental laser. Laser treatment can minimize bleeding and swelling and may eliminate the need for sutures in many cases.

As with every procedure we provide, treatment is recommended based on an identifiable clinical need rather than simply because the technology is available.

Dental Trauma and Oral Biopsies

Dental injuries can range from relatively minor enamel damage to fractures, displaced teeth, soft tissue injuries, or damage involving the supporting structures of the mouth. Prompt evaluation allows us to determine what has been affected and whether immediate treatment is necessary.

Our oral surgery services include management of minor dental trauma as well as oral biopsies. An oral biopsy may be recommended when an area of tissue has an appearance, texture, or pattern that warrants closer evaluation.

Many oral abnormalities are benign, but persistent or unexplained changes should not simply be ignored. Appropriate evaluation provides information needed to determine whether additional care is necessary.

What to Expect Before Oral Surgery

A successful surgical experience starts with planning. Before treatment, we review the reason surgery is being considered, relevant imaging, medical history, medications, anesthesia or sedation preferences, and expected recovery.

Patients should understand what procedure is being performed and why. We also discuss what will happen afterward. If a tooth is being removed, for example, we may need to discuss whether replacement is recommended and whether bone preservation should be performed at the same appointment.

Patients receiving sedation may have additional preparation requirements, including instructions related to eating, drinking, transportation, and medications. These details are reviewed ahead of time because preparation is an important part of safe care.

Recovery After Oral Surgery

Recovery varies significantly depending on the procedure. A straightforward extraction is different from removing a complete bony impaction, and both differ from bone grafting or more extensive surgery.

Swelling and soreness are common after an extraction, particularly during the first few days. Ice and prescribed or recommended medication may be used to manage discomfort. Many patients can return to normal activities relatively quickly after uncomplicated procedures, while surgical extractions and impacted wisdom teeth generally require more recovery time.

Protecting the blood clot that forms in an extraction site is an important part of early healing. Patients receive postoperative instructions explaining how to care for the area, what to eat, how to maintain oral hygiene, what activities to avoid, and which symptoms warrant contacting our office.

We also provide patients with a number to call if something does not seem right during recovery. Surgical care should not end when the patient leaves the treatment room. Monitoring healing and knowing when to ask questions are part of the process.

Oral Surgery for the Bethesda Community

Bethesda is a community where access, quality, and efficiency matter. Patients often balance dental appointments with professional responsibilities, family schedules, school calendars, commuting, and other demands throughout Montgomery County and the greater Washington, D.C. area. When a dental problem requires surgery, being sent from one office to another can add appointments and make an already stressful situation more complicated.

Our office at 7700 Wisconsin Avenue in Bethesda allows patients to receive a broad range of dental services in one practice. For a patient who requires an extraction followed by bone grafting and eventual implant restoration, continuity can be especially useful. Instead of viewing each stage as an isolated procedure, we can plan treatment with the final objective in mind.

This matters in a community like Bethesda because comprehensive care is not simply about convenience. It can improve coordination. The dentist evaluating the failing tooth can understand the potential replacement plan. Surgical decisions can account for future restorative needs. Imaging can be incorporated across stages of care. Follow-up occurs within the same practice.

For local families, adults, teens, and professionals looking for a dentist in Bethesda who can manage both routine and more complex needs, this breadth of care can reduce fragmentation. It also means that establishing a relationship with our practice is not limited to one surgical procedure. Once the immediate problem has been addressed, we can continue helping patients maintain their oral health through preventive, restorative, implant, periodontal, orthodontic, cosmetic, and other services available at Kary Dental.

Why Experience Matters in Oral Surgery

Surgical dentistry requires technical ability, but technical ability is only part of good care. Clinical judgment is equally important.

Knowing when not to remove a tooth matters. Understanding when bone preservation will benefit a future implant matters. Recognizing when a case should be referred matters. Being able to manage complications and understand the relationship between surgery and restorative dentistry matters.

Dr. Kary's background includes an Oral and Maxillofacial Surgery internship at Madigan Army Medical Center, six years in the Army Dental Corps, experience as a primary wisdom tooth provider, and work as a surgical extraction and bone grafting preceptor for other Army general dentists.

For patients searching online for an oral surgeon in Bethesda, those details provide useful context about the level of surgical experience available within our general dental practice. At the same time, we are straightforward about the limits of in-office care. When a patient would be better served by a specialist, we refer and help coordinate that care.

That balance is important to us. The goal is not to perform every possible procedure. The goal is to help each patient receive the right treatment.

Comprehensive Dental Services Beyond Oral Surgery

One advantage of receiving Bethesda oral surgery within a comprehensive dental practice is that surgery can be coordinated with the rest of your oral healthcare.

Kary Dental offers preventive and routine care, same-day restorations, dental implants, oral surgery, sedation dentistry, root canal therapy, dental sleep medicine, clear aligner orthodontics, traditional braces, cosmetic dentistry, TMJ treatment and neuromodulators, periodontal therapy, full-mouth rehabilitation, emergency dentistry, dentures and removable prosthetics, dental bridges, dental sealants, sports mouthguards, and children's and teen dentistry within the parameters described by our practice.

This broader scope becomes especially useful when a surgical problem overlaps with restorative needs. A tooth causing pain, for example, may need to be evaluated for root canal treatment versus extraction. A missing tooth may require implant planning. Significant tooth loss may call for a more comprehensive rehabilitation plan rather than treating each missing or damaged tooth independently.

Our ability to look beyond the immediate procedure allows us to plan care around long-term function, comfort, oral health, and maintainability.

Choosing Kary Dental for Oral Surgery in Bethesda, MD

Choosing a dental practice for surgery involves more than finding someone who performs the procedure. Patients should feel comfortable asking why treatment is necessary, what alternatives exist, how the procedure will be performed, what recovery involves, and what happens afterward.

At Kary Dental, we want our patients to understand those answers.

We combine Dr. Kary's surgical training and experience with advanced dental technology, comprehensive restorative capabilities, and multiple sedation options. We perform many procedures in-house while maintaining a clear standard for referral when specialist care is more appropriate.

For patients in Bethesda and surrounding Montgomery County communities, our objective is straightforward: provide thoughtful dentistry that solves the immediate problem without losing sight of long-term oral health.

If you are experiencing dental pain, have been told that you may need an extraction, are concerned about wisdom teeth, need bone grafting, or have another condition that may require oral surgery, an evaluation is the appropriate place to begin. At Kary Dental, we will assess your needs, explain what we find, discuss your treatment options, and help you determine the next step. Our Bethesda office provides comprehensive dental and surgical care with an emphasis on clinical judgment, careful planning, and treatment that is appropriate for the individual patient.