Yearly Archives: 2015

Jawbone Grafting: Minor vs. Major Oral Surgery Procedures

Jawbone grafting is commonly required for dental implant patients, but it’s certainly nothing to fear!

Many dental restorations, especially permanent implants, require an adequate volume of Jawbone Graftingbone tissue in the jaw to provide the necessary support. Unfortunately, aging, tooth loss and gum disease are just some of the factors that can contribute to bone loss.

Fortunately, transplanting bone tissue into the jaw from other parts of the body or from a tissue bank provides a solid foundation for dental implants.

Major Jawbone Grafting

When a traumatic injury, congenital defect or tumor surgery leaves a patient with a defect in the jaw, a major bone graft may be necessary. Larger and more extensive than minor procedures, major grafts are routinely performed in a surgery center or regular operating room under general anesthesia, and may warrant a brief hospital stay.

In most cases, bone tissue for these grafts is harvested from the patient’s body, often from the skull, hip or knee.

Sinus Lift and Ridge Expansion Procedures

The maxillary sinuses are located above the upper teeth behind the cheeks. When upper teeth are removed, only a thin wall of bone remains. This sometimes isn’t enough to hold the dental implants securely in place, so jawbone grafting may be necessary.

With a sinus lift procedure, the sinus membrane is brought upward to allow the insertion of bone tissue. After a few months of healing, the graft is stable enough to facilitate the secure placement of implants.

If the bony ridge of the jaw is too thin to support dental implants, a graft is performed to restore bone dimension. With a ridge expansion procedure, bone tissue is implanted to increase the height and/or width of the jaw ridge and to create a solid foundation for the replacement teeth.

Nerve Repositioning

When patients require dental implants in the lower jaw, the surgeon may find it necessary to move the inferior alveolar nerve to make room for the permanent restorations.

Nerve repositioning may be indicated if implants are to replace the back molars or the second premolars. This procedure is considered to be aggressive, as post-operative numbness may persist over time. Consequently, your oral surgeon may consider other options first, such as the placement of blade implants.

We typically perform minor bone grafting procedures, including sinus lift, ridge expansion and nerve repositioning, in an outpatient surgical center. These procedures require IV sedation or general anesthesia, but patients can go home the day of surgery in most cases.

The dental professionals at Oral and Maxillofacial Surgery of Utah are both trained and experienced in all the latest jawbone grafting techniques used to ensure the stability and longevity of dental implants. Contact our office today to schedule a consultation to discuss jawbone grafting and permanent implants.

Oral Surgery for Prosthesis Preparation

In many cases, oral surgery may be required to prepare your mouth for dental implants, dentures or another type of prosthetic device.Oral Surgery for Prosthesis

Some patients require minor procedures to ensure the stability and comfort of a dental prosthesis, as well as a pleasing visual outcome. Pre-prosthetic surgery takes care of any problems in your mouth and provides a supportive foundation for replacement teeth and dental restorations.

Bone Smoothing and Ridge Reduction

When teeth are extracted or missing, the alveolar ridge (jawbone ridge) may have irregularities that result in an abnormal shape.

Undercuts or bone spicules in the jaw must be removed using an oral surgery procedure called an alveoplasty. During this procedure, the surgeon smooths or re-contours the jawbone.

Any benign outgrowths from the bone, called tori, also need to be removed before dental prosthesis placement.

The mylohyoid ridge is the bony area on the interior of the lower jaw that runs at an angle from the roots of the last molar to the floor of the mouth.

If this ridge is too sharp or too large, it can affect how a prosthetic device sits. Ridge reduction oral surgery is done to reduce the size of the mylohyoid ridge to allow your prosthesis to fit properly.

Excess Gum Removal

If you have excess gum tissue that affects prosthetic device placement, oral surgery may also be necessary.

Through a gingivectomy, overgrown tissue is removed, exposing the full length of the tooth and shaping the gums to properly fit a prosthesis. This procedure also may be necessary if you have a severe gum infection (periodontitis) that cannot be handled with other methods such as root planing and scaling.

The oral surgeon will remove diseased gum tissue and reshape any loose tissue so that no pockets remain between the gums and teeth.

Exposure of Impacted Teeth

An impacted tooth is one that cannot fully erupt from the bone. While impacted wisdom teeth are often extracted, impacted canines or other teeth may be exposed instead.

During this procedure, the surgeon removes bone and gum tissue covering the impacted tooth and preventing it from erupting. In some cases, the surgeon will attach a bracketing device that helps the tooth erupt and gradually moves it into its proper position.

If your doctor recommends any one or more of the above procedures, rest assured that this will provide the best fit for your prosthetic device. To learn more about dental prostheses procedures, contact Oral and Maxillofacial Surgery of Utah for a consultation.

Our experienced surgeons can evaluate you and make any necessary recommendations for prostheses or oral surgery.

Oral Cancer Facts

Oral and oropharyngeal cancer strike 45,000 people annually in the United States, according to the National Cancer Institute (NCI). That figure jumps to more than 450,000 when you Oral Cancerconsider new diagnoses worldwide.

Also called oral cavity cancer, oral cancer starts in the mouth; if the disease starts in the throat instead, it is referred to as oropharyngeal cancer.

Read on to learn more about this pervasive and potentially deadly disease.

Prevalence

Anyone can develop oral or oropharyngeal cancer, but research from the American Cancer Society (ACS) indicates that these cancers are more than twice as common in men as they are in women.

The average age at diagnosis is 62, but about 20 percent of cases occur in people who are younger than 55. In most cases, cancerous tissue is found in the tongue, tonsils, gums or the floor of the mouth.

Less often, it may be found in the lips or the minor salivary glands in the roof of the mouth. Data from the NCI has shown that approximately 1.1 percent of men and women will be diagnosed with one of these cancers during their lifetimes.

Risk Factors

It may come as little surprise, but one of the biggest risk factors for developing oral cavity or oropharyngeal cancer is tobacco use.

Use of cigarettes, cigars, pipes, chewing tobacco or snuff have all been linked to these types of cancer. In fact, according to the ACS, most people who develop these cancers use tobacco. The risk of developing any type of pathology increases with long-term use.

Drinking alcohol may also contribute to oral cancer.

The ACS says that roughly 70 percent of people diagnosed with oral cavity or oropharyngeal cancer are heavy drinkers. Drinkers who also use tobacco have an even higher risk of getting these diseases — as much as 100 times greater than that of people who don’t use alcohol or tobacco.

Prognosis

Patients diagnosed with oral cavity or oropharyngeal cancer have a 63.2 percent chance of surviving if they live with the disease at least five years, according to NCI research. Prognoses will vary, however, depending upon the stage of diagnosis.

Localized cancers, in which the cancerous tissue is confined to a primary site, have the greatest five-year survival rate at 83 percent. Regional cancers that have spread to the lymph nodes and distant cancers that have spread to other areas of the body have survival rates between 37.7 and 61.5 percent, depending upon factors such as the age and health of the patient and how effective treatment is.

Screening tests can be used to check for oral cavity and oropharyngeal cancer, but conducting your own self-checks can lead to earlier detection and a greater chance for recovery.

Call Oral and Maxillofacial Surgery of Utah today to schedule your oral cancer screening, and to learn how to do self-checks.

Do Children’s Eye Teeth Fall Out?

Children’s eye teeth, sometimes called canines, are so-named due to their direct positioning beneath the eyes. Dental professionals refer to these teeth, easily recognizable by their pointedChildren's Eye Teeth shape and length, as the cuspids.

The upper and lower canines typically erupt in children between ages of 16 and 23 months. More than any others, these teeth often cause confusion for parents about when — or if — they should fall out.

When Children’s Eye Teeth Fall Out

Primary teeth (also known as first teeth or baby teeth) generally begin falling out around the age of 6 or 7. The first to go are the central and lateral incisors, which you may know as the four front teeth — the middle two on the top and bottom. The canines are some of the last teeth to go — they start falling out between the ages 10 and 12 in most children.

What if the Canines Don’t Fall Out?

If your child’s canine teeth have not fallen out on their own by the time they are 13, a problem may be brewing. The adult (second) teeth grow below the gum line and they push out the primary set one by one. If the baby canines are not shed, your child may have one of several issues.

The first possibility is that the adult cuspids could be impacted, which can happen for several reasons. Some children have extra teeth, inhibiting the natural eruption of the second teeth. In other cases, kids may be missing some adult teeth — about 1 in 20 children has one or more missing teeth.

Overcrowding also may be an issue. Poor alignment can make the canines compete for space in the mouth with the nearby incisors and molars. Rarely, an unusual growth in the soft tissue of the gums can hamper the progress of cuspid development as well.

A dental examination and X-rays can quickly and easily reveal whether canines are impacted .

Impaction issues may be prevented or easily treated if diagnosed early enough. Consequently, it’s important to have an oral health professional monitor your child’s mouth during this time.

Treatment for Impacted Canines

The wisdom teeth, or third molars, become impacted most frequently. When that happens, a dentist or oral surgeon removes them. The cuspids, however, serve an important function in the mouth, are critical to the bite and therefore are not typically removed.

These are the teeth that touch first when the jaw closes, guiding the other teeth into place. They are essential to the correct alignment of the jaw and other teeth.

If extraction is warranted, the missing tooth should be replaced promptly with a dental implant in order to maintain a correctly aligned bite. An implant also will help restore an aesthetic appearance and prevent bone loss.

In some cases, a combined surgical and orthodontic treatment plan is the best approach. The oral surgeon can expose the impacted cuspid, which can then be shifted into the correct position, thus achieving both function and a beautiful smile.

If you have concerns about the progress of your child’s teeth, schedule a consultation with Oral and Maxillofacial Surgery of Utah, serving Salt Lake City and the surrounding communities. Our doctors can provide a comprehensive evaluation and recommend any beneficial treatments for preserving your children’s eye teeth and improving dental health.

HPV and Oral Cancer: What You Need to Know

For millions of Americans, HPV and oral cancer are a life-threatening combination. With almost 200 different strains of HPV (most of which will not harm your body), 9 are known to cause HPV and Oral Cancercancer. One strain, known as HPV 16, is associated with oral cancer. You may not ever know you have the virus, as it doesn’t produce noticeable symptoms. This can be especially dangerous with oral cancers, because unlike oral cancer caused by tobacco, HPV-related oral cancer symptoms are unnoticeable and painless. Protect yourself by learning more about the link between the two.

What Cancers are Related to HPV?

HPV is the leading cause for oropharyngeal cancers, which are found in the very back of the mouth and the part of your throat closest to your mouth. A smaller percentage of HPV and oral cancer cases are found in the front of the mouth and oral cavities. For oropharyngeal cancers, the most likely locations are the base of the tongue, the back of the throat, tonsils and tonsillar crypts, and tonsillar pillars.

What are HPV-Related Oral Cancer Symptoms?

Although oral cancer caused by the HPV infection makes up a small percentage of diagnosed cases, knowing the signs and symptoms can help you stay healthy and protected. Some symptoms mimic the common cold or upper respiratory infection:

  • Constant coughing
  • Difficulty swallowing
  • A persistent sore throat
  • Hoarseness that doesn’t go away
  • An earache on one side that doesn’t go away after two days

Other signs include pain while you’re chewing food, swelling in your mouth, a mouth ulcer or sore that doesn’t heal within two weeks, or a numb feeling in the mouth or lips. There are no visible oral signs of an HPV infection.

Who is at Risk for Oral Cancer From HPV?

Males and females are both affected by HPV oral cancer diagnoses. White non-smoking males between 35 and 55 are most at risk. A growing population for oral and oropharyngeal cancer is healthy, non-smoking adults between ages 25 and 50. As far as HPV is concerned, about 26 million Americans each day have an oral HPV infection, and more than 2600 are HPV16, the HPV strain most often responsible for oral cancer.

How Can I Prevent HPV-Related Oral Cancer?

The best prevention is to avoid contracting the virus in the first place. The virus infects mucosa areas of the body such as the mouth interior, throat, tongue, tonsils, vagina, cervix, vulva, penis urethra and anus. Sexual contact, including oral, is a leading source of transmission. Practicing safe sex and using protection is one way to minimize risk of contracting the virus.

The HPV vaccine, Gardasil, protects against four strains of the human papillomavirus virus (6, 11, 16, and 18); as HPV 16 is the one associated with oral cancer, receiving the vaccine may help prevent oral cancer caused by HPV. The vaccine is recommended for boys and girls ages 9 through 26, regardless of whether they are sexually active.

Contact Oral & Maxillofacial Surgery of Utah if you’re concerned about unusual changes in your mouth, gums or throat. We offer oral pathology and monitoring for symptoms of HPV and oral cancer.

Should I Use the Oral Surgeon Recommended by My Dentist?

If your dentist has recommended an oral surgeon for a procedure you need, do you have to use that surgeon? The obvious upside to using the recommended oral surgeon is that your dentistOral Surgeon Recommendation knows him or her and is confident in the surgeon’s capabilities and expertise. But what if the oral surgeon is out of network, is far away, or isn’t accepting new patients?

Just because you receive a referral for a specific oral surgeon, you don’t have to accept the first suggestion. Like shopping around for a dental office that fits your lifestyle, you have the ability to shop around for the right oral surgeon for you. Here are a few factors to help you determine if you should visit the recommended oral surgeon or find someone on your own.

Cost and Insurance

Oral surgery can sometimes fall in the gray area between medical and dental insurance. To complicate this, recommended oral surgeons may or may not be “in network” depending on your insurance plan. Others still may have higher copay costs or higher prices on the procedure, which could mean more out-of-pocket costs for you. Make sure to get a cost estimate from your recommended oral surgeon, and call your insurance company to find out what your portion will be.

Location

Depending on the procedure, you may be put under anesthesia – or at the very least, may not feel like traveling a long distance back home. For this reason, location is an important part of the selection process. Research the office location and map the distance it will take you to get there and home.

Oral Surgery Specialty

Oral surgeons are specialists just like other surgeons in their field, and may have interest or experience in certain types of conditions. For instance, one oral surgeon may have extensive experience and training in birth defects, while another specializes in dental implants; just like one orthopedic surgeon might specialize in hip surgery, while another focuses only on treating spinal disorders.

Your dentist may have recommended an oral surgeon because he or she is the best in the area for your specific condition.

Personal Relationship

You should feel comfortable with your dentist and oral surgeon. If you have a preference for a specific oral surgeon, perhaps a surgeon you’ve had surgery with previously, you may consider going back to him or her for a consultation regarding your current diagnosis. Personal relationship and trust are two factors that are intangible, but very important when it comes to health care.

Oral & Maxillofacial Surgery of Utah provides the highest quality care in three convenient locations in Utah. If your dentist has recommended an oral surgeon from our practice, contact us today for a free consultation.

Does Insurance Cover Oral Surgery?

For an insurance to cover oral surgery, there are several factors involved. Like other types of surgical procedures, the surgeon, location, type of procedure, and how much is involved in the Oral Surgery Insuranceprocedure will influence how much it costs. Here are a few tips for determining if your insurance covers oral surgery

Which Plan Covers Oral Surgery: Medical or Dental?

Oral surgery can be tricky to cover because it involves both types of care, which are often covered with different policies. Medical and dental companies have strict guidelines on what insurance covers in oral surgery, and one may not pay for what the other does not cover, which can lead to expensive out of pocket costs if you go ahead without knowing what your plans provide.

Some insurance companies use different reimbursement rates for medical and dental insurance plan patients; therefore, there’s no easy answer as to if medical or dental insurance covers oral surgery. The most practical solution is to call both of your insurance providers for their individual information.

What Does Insurance Cover for Oral Surgery?

All health insurance plans are different, but as a general rule, insurance covers oral surgery for oral medical conditions, but not for dental services or enhancements.

  • Some conditions insurance covers for oral surgery include tooth infections, abscesses of the mouth that are not of dental origin; new or unusual growth in the jaw, cheek or other hard or soft tissue in your mouth; or any cysts in your mouth that your oral surgeon or dentist suspects to be cancerous.
  • Some conditions insurance may not cover for oral surgery include tooth extractions, treatment of periodontal disease, cysts that interfere with your child’s teeth coming through; treatment to prepare your mouth for dentures; dental reconstruction, prosthesis, or dental implants.

Your plan may be different, or may reimburse these procedures at different rates, so it’s always best to talk to your insurance company and find out if insurance covers the oral surgery procedures you’re anticipating.

Ask for an estimate from your oral surgeon with details on the type of procedure you’re expecting, which will help your insurance company determine if it is covered.

Keep in mind that you may have several different bills from different organizations, including anesthesia charges or surgical center fees.

How do I Get Reimbursed when Insurance Covers Oral Surgery?

The financial staff at your oral surgeon’s office is specially trained to make reimbursement for insurance claims fast and easy as possible. Although patients are normally responsible for the fees regardless of insurance coverage, most oral surgery clinics work with patients to develop a payment plan to help the patient pay for out of pocket charges.

Patients at Oral & Maxillofacial Surgery or Utah can expect the best care and the most cost-effective financial solutions. Our team of professionals walks patients through insurance reimbursements, as well as helps create an affordable monthly payment plan.

How Long is Recovery for Oral Surgery?

Like any surgery, recovery from oral surgery depends on the procedure and the person. Oral surgery procedures can be anything from a dental implant, to jaw surgery, to fixing a birth Oral Surgery Recoverydefect like cleft lip.

However, there are some general guidelines for recovery for oral surgery tested time and again on millions of patients worldwide. Learn more about recovery from your oral surgery.

Anesthesia During Oral Surgery

Recovery for oral surgery depends first on the type of anesthesia the oral surgeon uses during the procedure. Typically, you will recover faster from procedures that use smaller amounts of anesthetic medications.

With local anesthetic, you remain awake the whole time, but a certain part of your mouth, gum, or jaw is numbed using a local anesthetic like lidocaine. Nitrous oxide mixed with oxygen is a step up from local anesthesia. These types of anesthetics are used in minor procedures or tooth removal. Recovery for oral surgery with this type of anesthetic is relatively quick, as long as there aren’t any complications after surgery.

With IV and general anesthesia, you will fall asleep completely. These types are used in more complicated or long surgeries, so by the nature of the surgery, you’ll need more time for recovery. Additionally, you’ll need immediate recovery time to “wake up” and become conscious again in addition to recovering from incisions.

Recovery for Oral Surgery After Discharge

Recovery not only depends on the anesthesia used, but the complexity of your surgery. The more time the surgery takes and how complicated the surgery is, the longer your recovery time will be.

Teeth removal procedures have the fastest recovery time. You can expect to have some pain immediately after the removal, but should be able to resume your normal activities the next day – although most oral surgeons will recommend a soft-food diet for a few days after.

Recovery for procedures like wisdom teeth removal averages four days, but depending on how impacted the wisdom teeth are, could be slightly longer. You’ll experience swelling, pain, and discomfort for at least two to three days, and will continue to have mild discomfort and bruising for another two to four days after that.

Dental implants recovery may be more complex and therefore take much longer than other more common procedures. Dental implants are sometimes done in stages, and with each stage, you should expect a recovery time of between 10 to 14 days. If your oral surgeon has stitches that aren’t self-dissolving, they will be removed in about 10 days. You may have several days of gum swelling, minor bleeding, bruising, and pain, which should be gone within two weeks.

Oral & Maxillofacial Surgery of Utah will work to get you back to your normal lifestyle after a oral surgery. Learn more about the innovative procedures available in the office to minimize recovery for oral surgery.

Is Tooth Extraction Over Winter Break a Good Idea?

Oral surgeons recommend extractions for teeth that have been damaged due to trauma or decay, and for teeth that are crowding the mouth or causing other serious problems.Tooth Extraction

Extractions can be arduous, particularly if multiple teeth are being pulled or if the teeth are impacted, so some recovery time is necessary for the patient. Consequently, scheduling the surgery requires planning, especially for students.

For many teens and young adults, the winter break can be a good time for tooth extraction. Here’s what you need to know to decide if winter break is the right time for your procedure.

What to Expect from an Extraction

Before removing a tooth, your dentist will inject a local anesthetic to numb your mouth and gums near the extraction site. When multiple teeth are being pulled, which is often the case with wisdom tooth removal, the dentist or oral surgeon may use a stronger general anesthetic that will allow the patient to sleep through the procedure.

During the extraction, any gum or bone tissue that covers the tooth will be cut away and forceps will be used to remove the tooth. If a tooth cannot be loosened and pulled away from the jawbone, it may be necessary to break it and remove it in pieces.

Recovery from an Extraction

Immediately following extraction, a blood clot will begin to form in the socket of the removed tooth. In some cases, the dentist may place a few self-dissolving stitches to aid in healing. You may need to bite down on a piece of gauze to stop the blood flow, changing gauze pads as necessary.

Pain medication is often prescribed, and ice may be used to decrease swelling. Patients are typically advised to keep their activity to a minimum, resting and relaxing for a day or two.

Healing Over Winter Break

While many people can resume their normal activities within a couple of days of tooth extraction, some have longer recovery periods.

When more than one tooth is pulled, it can take several days or more to be completely free of pain. Winter break or any other period away from school or college can be a good time for extractions for this reason.

The side effects of anesthesia render the patient unable to drive on the day of the procedure, so it’s important for a parent or guardian to be available. Scheduling a procedure during this time can make this easier, since parents are often able to be home from work during the holidays.

Having the procedure performed during a break also ensures that you have enough time to heal, and gives you the extra time you may need for recovery if you should happen to suffer any complications, such as infection or dry socket.

Here at Oral and Maxillofacial Surgery of Utah, we understand that scheduling a major procedure can be challenging for many families. The holidays are a busy time for us, so if your child needs any type of dental procedures, oral surgery or tooth extraction over the winter break, don’t delay ― schedule it today.

TMJ Surgery: Here’s Why You Shouldn’t Avoid It

TMJ surgery can relieve the pain, tenderness and headaches associated with temporomandibular joint and muscle disorder, but some patients balk at the idea.TMJ Surgery

In many cases, surgery is not advised because the problems can be addressed in a less invasive manner. For patients with persistent pain and other symptoms in the jaw area, however, surgical treatment may be necessary.

Treatment for TMJ Disorders

According to the National Institute of Dental and Craniofacial Research (NIDCR), a part of the National Institutes of Health, a less invasive approach should be attempted before surgery. This is because, for many patients, discomfort and other symptoms can be mild and temporary.

The NIDCR suggests ice packs and nonsteroidal anti-inflammatory pain relievers to alleviate pain and swelling, if your doctor OKs it.

Your doctor or dentist will likely recommend that you avoid overworking the jaw by eating soft foods and that you avoid yawning. The doctor may recommend jaw exercises or physical therapy, and may prescribe a specialized bite guard to wear during sleep.

Some patients may also find relief through trigger point management or alternative medical treatments.

Unfortunately, these preliminary attempts to remedy the problem are ineffective for many patients who suffer from a more advanced case of TMJ.

When Surgery Is Recommended

Most doctors and medical experts, including those at the NIDCR, believe that jaw surgery should be considered when other treatments fail to correct TMJ-related problems, if the patient is experiencing chronic pain and dysfunction in the jaw. Surgery also may be advised if the jaw joint has severe structural problems, such as issues with bone alignment, degeneration or scar tissue in the joint.

Having TMJ Surgery

Through surgery, patients are able to find relief from pain in the joint and see normal jaw function restored. For many, arthroscopic procedures are used, in which a tiny camera and tools are inserted through a tube into the joint. The joint area may be cleared of debris and tissue blocking or impeding joint movement.

If the jaw problem cannot be viewed through arthroscopy, or if the damaged area cannot be easily accessed, an open joint arthroplasty may be performed. In rare cases, a total joint replacement may be considered.

Though surgery may not be the first treatment option for TMJ disorders, it is sometimes the only treatment that works to provide symptomatic relief for some patients. If you are experiencing popping, grinding or pain in your jaw, contact our office today for more information on potential treatments and the benefits of TMJ surgery.