Capital Oral & Facial Surgery

Ah, wisdom teeth removal! It’s a dental surgery that most teens face with dread (except for the thought of a few days off from school and copious amounts of ice cream). Some people, including parents, are so worried about having wisdom teeth removed that they take a “wait and see” attitude. Unfortunately, keeping your fingers crossed and hoping your wisdom teeth won’t cause you problems later isn’t the best option. The older you are when wisdom teeth are removed, the greater the likelihood of complications. There are several reasons you should consider having your wisdom teeth removed now rather than later.

Faster Healing

The older you are, the slower you heal. Having your wisdom teeth removed when you are in your teens or twenties allows you to bounce back quickly. Most young adults can return to work or school a few days after their wisdom teeth are removed. The older you are, the longer the recovery time. If you are over 20, you may experience pain, bruising, and swelling for a week or more.

As we age, we develop other health problems that can interfere with healing. Our bodies do not produce as many stem cells, growth factors, or hormones associated with healing. Diabetes, heart disease, periodontal disease, and other health issues all contribute to slower recovery.

Easier Extraction

Wisdom teeth are the last teeth to develop. If you remove them while you’re young, the procedure is simpler because the teeth are not fully developed and have relatively short roots. As you grow older, the roots of wisdom teeth continue to grow and may impinge on nerve bundles in the base of the jawbone. Longer roots close to nerves require greater care during extraction and usually result in more extensive surgery.

Fewer Complications

Some patients don’t have their wisdom teeth removed until they start to erupt, causing problems. Once a wisdom tooth tries to emerge, it may become impacted (trapped in the jawbone). When this happens, it is difficult to keep the teeth clean, adjacent teeth are pushed out of alignment, and severe pain or infection can develop. Removing wisdom teeth after they are impacted is more complicated, particularly when an infection is involved.

As mentioned earlier, the roots of your wisdom teeth continue to grow as you age. If the roots become entangled in nerve bundles, extraction can damage the nerves, leading to numbness or tingling in the face. The earlier your wisdom teeth are removed, the shorter the roots. The result is an easier extraction procedure with less risk of nerve damage

When it comes to wisdom teeth removal, NOW is almost always better than later! Wisdom teeth removal when you are young and healthy minimizes the risk of complications and promotes rapid healing. Waiting until they become a problem when you are older is an invitation to additional issues that can lead to serious problems.

To schedule an appointment to discuss Wisdom Teeth Removal for you or your teen, please contact one of our offices:

> Read more about Wisdom Teeth and Impacted Wisdom Teeth.

What are dental implants? Dental implants are replacement tooth roots that provide a foundation for both fixed and removable replacement teeth. Like roots, dental implants are secured within the jawbone and not visible once surgically placed. Teeth replacement is not new to dental technology. Early civilizations practiced teeth replacements; archaeologists have discovered skulls where teeth have been replaced by cast iron and sea shells. Despite their primitive methods, some of these implants were fused with bone like modern dental implants! However, unlike the ancient cast iron or sea shell implants, modern implants are composed of titanium. Titanium is lightweight, strong, and biocompatible.

According to the American Academy of Implant Dentistry (AAID), dental implants have the highest success rate of any implanted surgical device — 98%. Dental implants are available in several designs that meet individual needs: single tooth replacement, multiple tooth replacement, implant supported prosthesis (removable), and an implant stabilized denture. Aside from meeting individual needs, there are a few other advantages to having dental implants:

1. Improved appearance. Dental implants are designed to fuse with bone, and look and feel like your natural teeth.
2. Improved comfort. Because dental implants become an extension of your natural mouth, implants remove the discomfort associated with removable dentures.
3. Easier eating. Dental implants act as your natural teeth, allowing you to eat without the pain and discomfort that often accompany slipping of dentures.
4. Improved self-esteem. Dental implants give your best natural smiling, helping build self-confidence!
5. Improved oral health. Dental implants are the only proven way to prevent bone loss after the loss of natural teeth. The jawbone needs consistent chewing action to stimulate continual bone growth. Tooth/teeth replacement with dental implants offers a solution to prevent bone loss.
6. With proper care, consistent brushing, flossing and routine dental visits, dental implants can last 40-years to life.

If you are interested in dental implants, or have any questions regarding the procedure, call the office today!

As doctors, we always weigh the risks and benefits of any procedure or medication therapy. One of the most significant procedures that we perform in our office is orthognathic surgery, more commonly known as “jaw surgery”.

Orthognathic surgery has the ability to enhance a patient’s life, giving him or her the comfort needed to eat properly and, often, the freedom from pain. Because the decision to have jaw surgery is such a serious one, we would like to take a moment to look at the positive side of the procedure in this blog, focusing on the benefits of orthognathic surgery:

• Pain Relief – There are several reasons that a person may experience jaw pain bad enough to warrant orthognathic surgery. They may have unnecessarily been causing excessive wear and tear in the joints over many years and living with constant inflammation. Correcting the alignment of the jaws through surgery is sometimes the only way to set the jaw back on the correct path, reducing strain and therefore pain. Another common scenario occurs with injury to the jaw, often from trauma caused by car and sports accidents. If the jaw is knocked too far out of place or suffers significant trauma, it may not heal on its own and may require resetting through a surgical procedure. These two situations represent occasions where the benefits of orthognathic surgery far outweigh the risks.
• Regular Eating Patterns – A misaligned jaw can make it difficult to chew and swallow, particularly if your teeth do not line up correctly. Often, braces are not enough to correct the alignment issues with the teeth and the jaw itself must be altered. Sometimes, patients don’t even know that they are working too hard to chew because they are used to it always having been that way. Once their bite is corrected through surgery, they are pleasantly surprised to find a significant enhancement in their quality of life.
• Better Overall Health – The health of your body starts in your mouth. Proper nutrition is key to everything from longevity to happiness. Whether your jaws are misaligned from injury or genetics – if your bite is significantly affected, your nutritional habits may be as well, and orthognathic surgery may be the best option for getting your health back on track.

Bones, grafting, or any combination of the two are rarely the subject of casual conversation. Most of us, regardless of our profession, are happier discussing recent football scores, the price of gasoline, or the abnormally high number of Dunkin Doughnut franchise locations. Perhaps for it is for this very reason, however, that we should bring up this important topic–to raise awareness, maximize modern technology, and inform the public about the options offered in terms of dental implant surgery.

Bone grafting for dental implants is the process by which bone tissue is placed (grafted) into the mouth to act as a placeholder for tissue that has been lost. In the modern medical landscape this is a safe, painless, and routine process: indeed, more than two million bone-grafting operations occur worldwide each year, making bone the second most transplanted organ (after blood!).

As well as natural bone tissue, synthetic tissue is an alternative for patients seeking the best results. Structured as a ‘biodegradable scaffold’ that can be implanted within the body and trigger bone regeneration, this strong, flexible material has been compared to tire rubber! Dr. Karin Hing, author of the study and reader in Biomedical Materials at Queen Mary’s University of London Institute of Bioengineering stated that the challenge being tackled currently is the development of a graft that is as clever as bone. By mechanically evaluating the way bone adapts to its environment and reacts to chemical and physical components, progress is taking place in leaps and bounds.

What does this mean for the average person who just wants to be happy with their mouth? Comfortable outpatient procedures complete with local anesthesia or intravenous sedation make bone grafting a sensible and worry-free choice. Browse our procedures page for more information on maximizing your resources!

Wisdom tooth removal has become somewhat of a rite of passage – puffy-cheeked post-extraction photos, a diet of Jell-O and mashed potatoes. But not everyone gets their wisdom teeth taken out. In fact, not everyone has wisdom teeth at all! Have you ever wondered why some people have four wisdom teeth while others have fewer or even none? We’ve got the facts behind how many wisdom teeth people have and why!

Why do we have wisdom teeth?

Third molars, or wisdom teeth, were once very useful to our ancestors. Because prehistoric man’s diet of hard-to-chew plants and uncooked meat required powerful chewing muscles, our ancestors’ jaws were large enough to fit 32 teeth, not just 28. Now that humans have evolved a better means of chewing and digesting our food, we no longer have large jaws, so we simply have no need or no room for wisdom teeth. Many scientists believe humans are currently evolving third molar hypodontia, or the lack of wisdom teeth, due to their inability to develop in the first place.

How many people have wisdom teeth?

About 20-25% of the human population is born with 1 to 3 wisdom teeth, and 35% is born without any wisdom teeth at all.

Why do some people have wisdom teeth and some don’t?

There are a few reasons why scientists believe that not everyone develops wisdom teeth:

1. Genetics: Some evidence suggests that a genetic mutation occurred hundreds of thousands of years ago, causing some people to be born without wisdom teeth.
2. Environment: Percentages of people who develop wisdom teeth varies from culture to culture. Certain ethnic groups are known for low percentages of wisdom teeth development, while others are known for high percentages. Environmental factors during dental development are also a possible explanation.

Will wisdom teeth become obsolete?

With the number of people lacking wisdom teeth steadily growing, it’s possible that we could someday completely evolve to not develop wisdom teeth at all. Scientists have experimented with chemically preventing the development of wisdom teeth. Researchers have found that children ages 2-6 that are given local anesthesia for dental work have a higher chance of not developing wisdom teeth later on. Maybe in the future, simple injections at a young age will keep all of us from having to go through wisdom tooth extraction!

Orthognathic surgery, commonly referred to as “jaw surgery,” is used to correct a wide range of both minor and major skeletal and dental irregularities, often the misalignment of the jaws and teeth. Patients looking at undergoing orthognathic surgery are often faced with an extensive recovery period, as well as a restricted diet in the beginning of their recovery process. Post-surgery patients are discouraged from chewing to allow the bone to heal and stabilize. Due to the fact that adequate healing can take up to 8-12 weeks, patients will initially be on the “swallowing diet” for a number of weeks.

When it comes to the “swallowing diet,” the name of the game is high calorie, high protein, and low volume. Facing a large volume of liquid each meal that meets both the necessary caloric and protein needs can be overwhelming. Consuming enough calories, as well as enough protein is a necessity to heal in a timely manner. In order to get adequate volume of fluid and nutrition daily, it may require you to eat smaller meals 5-6 times per day, rather than the usual 3 times per day.

Patients who are well prepared for their surgery often have a smoother recovery. Here is an example of smoothie recipe a patient can consume following orthognathic surgery:

Peanut Butter Banana Smoothie

• 2 chilled bananas, broken into chunks
• 2 cups milk
• 1/2 cup peanut butter
• 2 cups ice cubs
• 2 tablespoons honey, or to taste

Place bananas, milk, peanut butter, honey, and ice cubes in a blender; blend until smooth, about 30 seconds.

Though patients are faced with a restricted diet post-surgery, it is important to remember to try and maintain a balanced diet. In particular, foods rich in vitamins A and C. According to the Academy of General Dentistry (AGD), plenty of vitamin C is one way post-surgery patients ensure a timely recovery!

Oral cancer screenings are performed regularly at dental exams, but that doesn’t mean you shouldn’t be paying attention to your dental hygiene between appointments. Taking matters into your own hands is the best way to maintain your oral health. Not sure how to screen for oral cancer? We’ll show you!

What is oral pathology?
This branch of dentistry involves the evaluation and treatment of diseases of the mouth. The most dangerous, but not always the most obvious, of these diseases is oral cancer.
What should I look for?
Keep an eye out for these oral cancer symptoms during your self-screenings:

• Red or white patches in the mouth
• Lumps on the tongue or lining of the mouth
• Mouth sores that won’t heal
• Unexplained bleeding
• Chronic throat soreness
• Difficulty chewing or swallowing
• Mouth numbness

How do I perform an oral cancer self-exam?

1. When performing your oral cancer self-screening, be sure to check all areas of the mouth, including the roof, floor, tongue, lips, cheeks and the back of your throat.
2. Examine your face in the mirror for abnormal asymmetry and irregularities.
3. Feel your neck and the back of your head with your fingers to look for any bumps or changes in texture.
4. Examine your throat by placing your fingers around your thyroid cartilage (Adam’s apple) and swallowing.

How often should I perform a self-exam?
Self-exams should be performed at least once a month. Changes to your oral health can occur rapidly, so it’s important to stay on top of things. Treatment is most effective if we detect symptoms early.
Ask us about performing an oral cancer screening when you visit – we’re here to ease your mind and give you the tools you need to maintain your health!

Has there ever been a moment in your life where you felt that you should be a part of something bigger than yourself? An organization, a charity, or a non-profit perhaps? Humans are born with the innate desire to help others, so it’s no wonder that we may feel the need to give back to the world in one way or another. And sometimes, it’s the simple acts that yield the most difference. This month you have the opportunity to get involved with a sweeping issue that goes unnoticed too often, and you may help save a life by doing it.

April is Oral Cancer Awareness Month and we need to stir up some conversation.
Oral cancer awareness in the American public is extremely low, with very little acknowledgment of its devastating realities. According to the AAOMS, oral and pharyngeal cancer (cancer of the upper throat and mouth) collectively kills nearly one person of every hour of everyday of the year. Approximately 48,250 people in the US will be newly diagnosed with oral cancer this year. While smoking and tobacco use are still major risk factors, the fastest growing segment of oral cancer patients is healthy, young, nonsmoking individuals. We know this sounds scary, but the truth of the matter is that it is scary, and we need to confront the concern head on.

Awareness is so much more than just knowing about an issue, it’s also about collective, meaningful action.
Share this information with your family, friends, and coworkers. Help educate those around you about the importance of regular self-exams and screenings. Oral cancer is not a new phenomenon, but with advancing technologies and the ability to rapidly share information, we can have a new approach. It is possible for fatalities to be avoided! As reported by the AAOMS, the death rate associated with oral and pharyngeal cancers remains particularly high due to the cancer being routinely discovered late in its development. This means our voice can carry the power to make a difference in the world of oral cancers.

April 10-16th is Oral, Head and Neck Cancer Week (OHANCAW).
A message from President Louis K. Rafetto, DMD, mentions that the AAOMS is joining a number of dental organizations in support of the Oral Cancer Foundation’s 17th annual observance this April. This designated week will support free oral cancer screenings and encourage practitioners, patients and other interested individuals (like YOU) to promote head and neck cancer awareness through the use of public service announcements, news releases, talks at middle and high schools, walk-a-thons, and other community-based activities.

As an Oral and Maxillofacial surgical care practice, we have the unique ability to diagnose and treat these conditions. Call us to discuss the steps that you and those within your community can take to help detect early signs of oral cancer.

Being that we are entering April, now is the time to be proactive and get yourself checked for oral cancer. According to the American Cancer Society, about 48,330 people will be diagnosed with oral cancer, and an estimated 9,570 people will die from oral cancer in 2016. In the spirit of April’s Oral Cancer Awareness, we urge you to receive regular oral cancer examinations. Remember—early detection saves lives!

Are you at risk?
The sad truth is that oral cancers are more than twice as common in men as in women, and the fastest growing group of oral cancer patients are young, healthy, nonsmoking individuals. It is more important than ever for young adults, as well as older men and women, to get regular screenings whether they think they’re at risk or not.

Knowing the risks can help you make educated decisions about your health. There are several risks that increase your chances of developing oral cancer:
• Smoking and using tobacco products have been a known long-term historic causes of oral cancer.
• Heavy alcohol usage also makes you more susceptible to develop oral cancer.
• The HPV virus, a sexually-transmitted disease, is the leading cause of oropharyngeal (the back part of the mouth) cancer.

What are the signs and symptoms?
The mouth is one of the body’s most crucial early warning signs in the fight against oral cancer. In between regular dental visits, it’s important to be aware of the mouth’s signs and symptoms. Remember, if you see any of these signs or symptoms, schedule an appointment at the office if you don’t see improvement within two-three weeks:
• Hoarseness, chronic sore throat, or change in voice.
• The development of white, red, or speckled (white and red) patches in the mouth.
• Lumps, thickening tissues, rough spots, crusty or eroded areas.
• Difficulty chewing or swallowing, speaking, or moving the jaw or tongue.
• A change in the way your teeth or dentures fit together when you close your mouth.
• Dramatic weight loss.
• Unexplained numbness, loss of feeling, or pain/tenderness in any area of the face, mouth, or neck.
• Unexplained bleeding in the mouth.

Don’t wait any longer. In the spirit of Oral Cancer Awareness Month, be proactive about your oral health, and get checked today!

There’s nothing like oral surgery to make you appreciate the solid foods and acidic drinks you can’t have right away. Sandwiches, chips, and orange juice should all be avoided after oral surgery such as wisdom tooth removal, dental implant surgery, and orthognathic surgery. Too much chewing can re-open the sensitive areas of your mouth, and can cause bleeding or infection. But don’t worry–we have a few healthy food and beverage recommendations you can use while your mouth is delicate.

First 24 Hours: For the first 24 hours after your surgery, your teeth/jaw will need some time off. Therefore, smoothies, low-fat jello/puddings, and warm (not hot!) soups will be the most beneficial for your healing process. Soft foods are your friends! It is extremely important to refrain from using a straw, as the sucking causes excess strain, which can delay the healing process.

Here are a few recommendations for the first 24 hours:

Banana Shake: A healthy, filling way to start the day after your surgery. Don’t use a straw! Also, bananas help replace electrolytes and maintain fluid balance within your body. Other milkshakes and smoothies work great too, as long as they don’t have seeds in them that can get stuck in wounds.

Applesauce: You can’t eat apples, but this is the next best thing!

Soup: Soup with soft ingredients is a great way to go. Don’t include chunks of food that need lots of chewing. Make sure that it’s the right temperature for your sensitive mouth.

Mashed Potatoes: The softest food around. Mashed potatoes require very little effort from your mouth and have great calories and nutrition. Try different toppings to make things interesting.

Next Few Weeks

Over the next few weeks, you will start easing into enjoying solid foods again. Here are some tasty transitional foods (some can even help the healing process!)

Gnocci: Gnocci is one of the softest pastas there is. Try it with tomato sauce, powdered parmesan cheese and a hearty meat filling.

Hamburger Stroganoff: Minced or finely sliced meat is a good place to start, and cooked mushrooms should be soft enough not to bother you. Added sour cream will give the dish a smooth consistency.

We hope that these recommendations help! We genuinely want you to heal as quickly as possibly while maintaining a healthy lifestyle. Feel free to call us with any questions about the post oral surgery process.