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This article is aimed at discussing the concept of operative dentistry, which is that branch of dentistry that deals with operative procedures like extractions, surgical treatment for dental caries, teeth preservation and management. What is Operative Dentistry? The term "operative dentistry" refers to any dental treatment requiring manipulation or alteration (ia. surgical extraction), because it originated from the Latin word "operari" meaning "to work." This includes any procedure involving operation on dental tissues, including extracapitaion (extraction) of impacted wisdom teeth; root canal therapy; replacement therapy for missing teeth; osseointegration implants for edentulous patients, etc. Operative dentistry is the most common form of dental treatment, as it provides more than 75% of all dental interventions. It is considered as an alternative to conventional dentistry, which focuses only on the restoration and management of teeth and periodontal disease. The fundamentals of operative dentistry are: 1. The patient with a tooth out-of-place with a need for a surgical treatment is referred to a specialist who has the necessary skills and knowledge. 2. A detailed evaluation is carried out by the dentist with regard to the type of treatment required, health status of the patient, stage of caries and other factors that may affect prognosis and success rates. 3. The dentist prepares the patient for the treatment with regard to anesthesia and gives appropriate information about the procedure, post operative care and possible complications. 4. The surgeons collects all relevant information about the tooth and even takes x-rays of the tooth and surrounding structures. Sometimes it may be considered necessary for them to perform a biopsy of gum tissue around the tooth. 5. The surgeon makes an incision through which they access the root canal, if any, or perform soft tissue opening of gum so that an impacted wisdom tooth can be removed sucessfully, if required. If there is decay, they prepare cavities in such a way that no further damage is caused to healthy tissues or vital structures like nerves, etc. 6. The surgeon places the affected tooth in the correct position and applies a splint to hold it in place. 6. The patient is made to rest in a semi-reclining position to allow for easier breathing and prevent straining of the muscles. 7. Intravenous sedatives such as xylocaine or propofol may be given to keep patient calm and relaxed before surgery begins. 8. Patients are usually asked to take ant-inflammatory drugs in order to reduce swelling and pain, in addition to taking antibiotics post-operatively so as to prevent infection and sepsis in the gum tissue and surrounding area. 9. The surgeon and dental assistant (if used) may use local anesthesia such as Novocaine or bupivacaine around the tooth and gum tissues to help reduce post operative pain. Each procedure that requires surgery involves different stages of anesthesia, depending on the type of surgery and the age of the patient. A simple extraction, for example, is done very briefly, at a few minutes after the patient arrives at the surgery center. On the other hand, complex operations like gingivoperiosteoplasty & palatoplasty are performed under general anesthesia. The main reason for this difference is that complex surgeries require higher skill level by specialists who have undergone many years of training. cfa1e77820