East End Oral Surgery

Tooth loss as a result of periodontal (gum) disease, facial trauma or tooth extractions can cause the jaw bone to atrophy, as it no longer has something to support. As if bone deterioration isn’t bad enough, tooth replacement requires a solid foundation, meaning that patients with jawbone degeneration aren’t candidates for dental implants. Fortunately, our state-of-the-art restorative techniques allow us to augment areas with inadequate bone structure so we can restore your smile! We have the answers to all your bone grafting questions below, so keep reading!

What is bone grafting?
During a bone grafting procedure, the jawbone is restored so it can support a dental implant. An incision is made in the gum and the bone graft material is transplanted into the jawbone. There are four types of bone grafts:

1. Autogenous: bone grafts are harvested from other parts of your body, such as the chin or hip. They are the most effective because using your own living cells promotes natural bone growth.
2. Allogenic: bone grafts are donor grafts collected from tissue banks.
3. Xenogenic: bone grafts are harvested from other species, typically bovine donors.
4. Synthetic: bone grafts are artificial bone material composed of calcium phosphates

When is bone grafting necessary?
Bone grafting procedures are routinely performed in preparation for dental implants. This is due to the fact that the implants are unable to anchor themselves into a stable foundation unless the jawbone is adequate.

How long after bone grafting can I get dental implants?
Minor bone grafting can be done the same day as dental implants, but major bone grafting requires downtime between procedures. Dental implants will be placed 4-9 months after your bone grafting procedure once the major bone grafts have had time to fuse with your natural jawbone. We will decide the best time to place your dental implants based on your recovery.

Give us a call if you think bone grafting can get you on track to replace missing teeth for natural, lasting, functional results!

Loss of permanent teeth is more common than you’d think. The average adult age 20-34 is missing 1 permanent tooth, the average adult age 35-49 is missing 3 permanent teeth, and the average adult over the age of 50 is missing 6 permanent teeth! There are a variety of different tooth replacement options, but we believe that dental implants offer the most success, with the best aesthetics and functionality. Take a look at just a few of the many benefits of dental implants!

1. Long-lasting. Dental implants are designed to be the permanent solution for missing teeth. Dental bridges last 5-10 years and crowns last 10-15 years, but dental implants can last 20 years, even a lifetime with proper dental care, making them a cost-efficient alternative to other modes of tooth replacement.
2. No cavities. Because they are made of titanium, dental implants are not subject to decay. They also don’t put stress on other teeth, which helps avoid tooth erosion.
3. Like natural teeth. Dental implants are natural-looking and fully functional. Unlike dentures, which are bulky and removable, cause sores and require the application of adhesive, dental implants are comfortable, permanent fixtures that don’t interfere with eating or speaking. And, because pressure is applied to the jaw bone when you bite down on dental implants, chewing with dental implants doesn’t feel any different from chewing with your natural teeth.
4. Preserve jaw bone. Without a tooth to support, the jaw bone begins to atrophy, and this bone degradation makes the replacement of missing teeth nearly impossible without the help of jaw regenerative procedures such as bone grafting.
5. Appearance. Your teeth play an important role in supporting your facial structure. Missing teeth can cause your features to sag and your face to lose shape, which tends to have an aging effect. Replacing missing teeth works wonders for improving your appearance and helping you look younger.
6. Tooth stability. When you’re missing a tooth, your surrounding teeth are no longer stabilized and they start to shift out of position. Dental implants secure teeth in place and, as a result, prevent severe problems such as periodontal disease and further tooth loss.

Schedule a consultation with us if you’re ready to transform your smile!

These days, we all know someone who has a dental implant, and you have probably heard us champion these teeth substitutes, as they become more and more the common cure for missing teeth!

But why?

We think that’s a valid question and it deserves a good answer!

Bone Loss
Any oral health professional will tell you that living with a missing tooth can have negative consequences that go well below the gum line. The problem doesn’t stop at the single tooth that goes missing. The jawbone also suffers. When there is not a tooth set in the jawbone offering regular stimulation, you lose bone mass in that area. That loss of jawbone contributes to a decline in facial aesthetics as the jaw shrinks away. The loss of jawbone also means that when you do have an implant later in life, you will likely require extensive bone grafting prior to the implant procedure. Traditional tooth “replacement” methods such as dentures and bridges do not solve the problem of bone loss.

In contrast, dental implants eliminate these problems and encourage a healthy, strong and adequate jaw by integrating with it (also known as: osseointegration). The implant then provides regular stimulation (as you chew food), and keeps the jawbone in proper health.

Lifestyle and Diet
Most people with dentures report that in addition to living in fear of their dentures falling out in social settings, they also must live with a restricted diet, unable to enjoy the foods that they previously ate. This same restricted diet goes for those with wobbly bridges and crowns as well. More often than not, those restricted foods are some of the healthiest ones, such as crunchy, fibrous fruits and vegetables.

Dental implants look and feel nearly identical to your regular teeth, and are second only to your natural teeth when it comes to form and function. Dental implants allow you to eat and live freely with a healthy diet and without fear. In addition to that, dental implants have a 98% success rate and can often last you for a lifetime!

Our patients often wonder why we recommend wisdom tooth extractions, or what the purpose of wisdom teeth even is. We are eager to help you better understand the benefits of removal and the extraction process! Read on for the answers to some frequently asked questions about those tricky third molars.

Why do we have wisdom teeth?
Human ancestors used their wisdom teeth to grind up food that was hard to digest. They had large jaws and powerful teeth with plenty of room for a third set of molars.

Modern humans, however, eat cooked foods and have a more effective digestive system, so we have evolved smaller jaws and teeth. This means less room in our mouths for wisdom teeth.

Why do I need to have my wisdom teeth removed? 
There are several reasons why you may benefit from having your wisdom teeth extracted, as wisdom teeth can cause a variety of short-term and long-term complications.

• Impaction: If there is not enough room for your wisdom teeth to erupt, they can become impacted, causing them to grow in at an angle. You may experience pain or discomfort while eating due to impaction.
• Damage to other teeth: Impacted wisdom teeth can push against your second molars, potentially damaging them and making them more susceptible to tooth decay.
• Disease: Narrowed spaces between molars due to impaction also allows for bacteria to form more easily, putting you at risk of inflammation, cysts, and periodontal (gum) disease.

When should I get my wisdom teeth out? 
Wisdom teeth usually erupt between the ages of 17 and 25, which means that many people get their wisdom teeth extracted before they graduate high school. The longer you wait, the more complications may arise. The roots of your wisdom teeth continue growing as you get older and may eventually come in contact with a nerve. At this point, nerve damage is a possible outcome of wisdom tooth extraction.

When are wisdom teeth okay to keep?
Sometimes, wisdom teeth have room to erupt healthily and do not need to be extracted. If this is the case, your dentist may recommend you keep your third molars.

Make sure you are coming in for regular check ups so our team can keep an eye on your wisdom teeth. Consult with our practice about the right course of action for your wisdom teeth, because everyone’s teeth are different.

You tripped, you fell and now you have found yourself with a part of your tooth broken and the root exposed. A complicated crown/root fracture is common in trip and fall injuries. In this form of fracture, the crown is fractured with the fracture extending below the gum line, involving the root of the tooth. This is the kind of fracture we typically see portrayed in movies.   This is a dental emergency and you should see us right away. Since this injury is traumatic, we thought it be best if you had a general overview of what to expect during the investigation and treatment stages.

Complicated crown/root fracture is the most challenging type of fracture to treat. As traumatic injury responders our priority is you, your health and your safety. We will do our very best to ensure your comfort during a stressful injury such as this.

We will work quickly in order to assess the vitality of the tooth. We will first assess for pulpal necrosis, vestibule swelling, periapical lesions and/or dramatic color change of the crown. There are instances in crown/root fractures where a gingiovectomy may be necessary in order to ensure that the tooth can be properly restored. During a gingiovectomy, we remove gum tissue that is no longer vital and reshape it to accommodate the tooth accordingly. Using the most current technology and techniques, we will treat your injury as the unique situation it truly is, tailoring a treatment plan and follow-up schedule specifically for you.

Remember: chipping your tooth mildly may not always be a dental emergency but you should call or see us right away so we may help you determine this.

While we cannot all necessarily prevent cancer from happening, with most cancers, including oral, head and neck cancers, there are things that you can do (or not do!) to reduce your risk.

• Quit Smoking: After five years of quitting smoking, your risk of oral cancer is cut down to just half of that of a smoker.
• Limit Alcohol: Excessive alcohol use is the second largest risk factor for oral cancer. Limit drinks to one per day for women and two per day for men.
• HPV Vaccine: HPV is the leading cause of oropharyngeal cancer (the back of the mouth and throat). HPV is also responsible for a small number of oral cavity cancers (the mouth).
• Self-Exams: Be an advocate for your own health by regularly examining your mouth with a mirror and flashlight. Don’t forget to look under the tongue! Watch for unusual bumps, patches, different coloring, and report any to us that don’t heal within 14 days. Feel your lips, cheeks, throat and neck for unusual bumps and masses. There are a number of online guides for performing a thorough at home oral cancer self-exam.
• Have Regular Checkups: Oral health professionals such as dentists and oral surgeons are the second line of defense (after you) in terms of screening for oral cancers. Be sure to ask us any questions that come up during your exam.
• Eat Well: A healthy diet includes plentiful vegetables and fruits, is low in sugar and saturated fats, and includes lean sources of protein and whole grains. Incorporate new foods into your diet slowly for long lasting results.
• Exercise: Aim for 30 minutes of moderate exercise a day or more!
• Get Adequate Sleep and Minimize Stress: A lack of sleep and stress both contribute to inflammation which has long been recognized as a player in the cancer game.

Tooth trauma can happen at any time. It could happen during a sports game, a car accident or as a result of something as simple and unexpected as a fall. The more information you have about correctly handling these situations the better. This knowledge could very well mean the difference between life and death for the tooth. The goal in treating a tooth trauma case is always to maintain or regain pulpal vitality in the affected tooth/teeth. In the previous tooth trauma entry we covered: avulsion (when a tooth is out of the socket). In this entry we will investigate a different kind of tooth trauma: an uncomplicated crown fracture. In this tooth fracture, the damage is limited to the crown of the tooth. There will be dentin exposed, but no pulp exposure.

In the instance of an uncomplicated crown fracture the first step an individual should try to accomplish is finding the piece of broken tooth. If a saline solution or distilled water is readily available, place the broken piece of tooth in this solution. Once you reach the dental professional, the rehydrated piece of tooth will be easier to bond, as the hydration increases its bonding strength.

What to expect during your visit, following an uncomplicated crown fracture:

• X-Rays will be taken
• Mouth will be checked for soft tissue lacerations and the presence of any other foreign bodies
• A sensitivity analysis will be performed
• The doctor or staff member will collect the tooth segment from you if you were able to find and preserve it
• We will assess the prognosis for the tooth

If the tooth is still vital, the process of reattaching the segment of tooth and the subsequent bonding will occur. Filling the dentin wound and applying calcium hydroxide to the vicinity of the pulp is the second to last step. Finally, smoothing and fluoridating small enamel defects.

Stay tuned in the upcoming months for the conclusion of the “What Now?” blog series!

Facial lacerations can be a scary situation for anyone. That is why it’s best to visit experts, like us, who have experience in treating and repairing facial injuries and trauma. However, we know that your recovery doesn’t end the moment you leave our doors. We want you to have the best outcome following surgery, which is why we’re writing this to answer some of your most common questions and to give you our best tips for treating your wound as it heals.

• Know the general timetable of healing. Within 2 days the cut should seal, and by 5 to 10 days it should be strong. In the first 3 months you may notice the skin around the scar may thicken and have a red or purple tint. By 4 to 6 months this process should reverse and the scar will flatten and the discoloration will fade. Usually by 6 months the scar will be completely healed, but there can be continued improvement for up to a year.
• There are many factors that impact your healing. How deep your cut is, its location, your age, and the way your skin heals all determine how visible a final scar will be. Younger skin actually produces thicker scarring.
• Apply ointment frequently to keep the wound moist. This can increase the speed of healing considerably and reduce scabbing, which actually increases the build up of scar tissue.
• Apply antibiotic ointment to prevent infection. An infected wound will make a bigger scar. Be sure to continue to apply antibiotic ointment or cream as directed by our team to keep the wound moist and fight off any infection.
• Make sure you know the signs of infection. Antibiotics will often be prescribed to prevent infection, especially if the wound is a result of injury. Contact us immediately if you see any signs of an infection including:
  • A large amount of pus coming from the wound
  • Increased redness or swelling
  • Fever
• Massage the wound gently to increase blood flow. Sutures are usually removed between 5 and 8 days. Massage the wound after sutures have been removed using a moisturizing lotion with Vitamin E or Aloe. Gently massage the skin around the wound twice daily for the first two weeks, and then once a day for a month. This will increase the blood flow in the area and prevent scar tissue build up.
• Be gentle and avoid scrubbing your wound. It is usually okay to allow clean shower water to wash over the wound as long as you don’t scrub it. If crusts of blood accumulate, lightly dabbing with clean gauze moistened with hydrogen peroxide is best.
• Avoid sun exposure. It is extremely important that you do your best to avoid sun exposure. The scar may tan a much darker color than the skin around it, and this may become permanent. Cover the area as much as possible or use sun block of SPF 50 or greater.

Whether you have had elective surgery or surgery to repair a facial injury we hope that these tips help answer your questions. If you or your loved one ever requires a trip to the emergency room involving a facial injury or laceration, be sure to seek our consultation as soon as possible and please contact us with any additional questions that you may have.

Oral cancer has a bad reputation for being more deadly than some other forms of cancer that you hear of more commonly. We are here to tell you that it doesn’t have to be that way. Oral cancer goes unnoticed, not because it is difficult to see or feel, but because the idea of regular oral cancer screenings (either at home or in our office) is rather new. It simply has not been on the public health radar until now.

That is why we want to get the word out, and we need your help! Examining the neck, throat and oral cavity is a relatively simple task when compared to other parts of the body such as internal organs. Early diagnosis leads to better prognosis!

We recommend that once a month, you give yourself the following exam. It should only take 2-3 minutes and could save your life, or the life of a loved one!

First, a word about the ever-changing mouth: We know that many patients avoid self-exams because the mouth is one area of the body that has constant change going on. For example, you may have a recent burn, bite or cold sore and probably don’t want to bother us every time you notice these things! That is why we offer this rule of thumb: any suspicious area that is not better after 14 days should be brought to our attention.

How to perform an Oral Cancer Self Exam:

1. Use a mirror and a bright light.
2. Remove dentures.
3. Look and feel lips and front of gums. Grasp lips with your thumb and forefinger and feel for lumps.
4. Tilt your head back and inspect the roof of your mouth
5. Pull your cheek out to see the inside surface and gums in the rear.
6. Pull out your tongue and look at all surfaces.
7. Feel your neck and under the lower jaw for enlarged lymph nodes, swelling or lumps.

What are you looking for?

1. White patches
2. Red Patches
3. Combination of red and white patches
4. Sores
5. Abnormal lumps or thickening
6. Chronic sore throat/hoarseness
7. Difficulty chewing/swallowing
8. Masses or lumps in the neck

You may have heard, BOTOX® is not just for women. Men have also discovered the wonders of this industry-changing cosmetic injectable, and what it can do for a person’s confidence! That’s why we are seeing more and more professional men in our office now than ever. In fact, over the past 15 years, BOTOX® use among men has increased by over 200%. These numbers aren’t surprising. What is interesting to note, however, is that the average man is using BOTOX® a bit differently than the average woman.

Here are some of the ways that men are using BOTOX® to enhance their personal and professional lives.

First of all, most of the men that we see actually prefer to leave some of the wrinkles as is. In fact, most men are leaving all wrinkles there at least partially. The trend is to look distinguished and experienced, which wrinkles can help with, just not too old.

Another difference between men and women seems to be that men are less likely to share their use of BOTOX® with other men. Whether it is because they are doing it more for professional reasons or not isn’t clear, but what we do know is that plenty of men are coming to us for this treatment nowadays.

So, if you are a man with wrinkles that you would like diminished, you may think you are alone, but you certainly are not! Give us a call to find out what we can do for you!