Oral Surgery

  • By Website Team Technicians
  • 09 Dec, 2016

Q At a recent dental exam, my general dentist noticed an area on my gums which concerned him. He has recommended that I see an oral and maxillofacial surgeon for evaluation and possible treatment. Why?
A   Oral and maxillofacial surgeons are well trained in the identification and treatment of pathologies of the oral and perioral hard and soft tissues. After taking your history and a careful clinical exam, they can advise you on the need for further tests or observation or the need for a biopsy to determine the exact diagnosis and need for treatment of the lesion. Their training and expertise can provide evaluation, management and possible surgical care for all the pathologies which present in the oral cavity and perioral tissues.

Q Does the oral surgeon always use sutures when removing impacted wisdom teeth (3rd molars)?
A   The use of sutures depends on the type of tooth impaction. Sutures are used to hold the tissue in place until initial healing occurs (usually around 7 days). Most impacted teeth require some suturing. These sutures are commonly resorbable(dissolve in the mouth) and do not need removal in the office. Your oral surgeon will explain if sutures were used in the surgery, and how to manage them in the healing period.

Q I have osteoporosis and I take a bisphosphonate drug to help strengthen my bone structure. Recently I heard these drugs can interfere with bone healing in some people. Is that true?
A   Bisphosphonate drugs have been used intravenously to help cancer patients and orally for patients with osteoporosis. These drugs have improved the quality of life forpatients with metastatic cancer that involves the skeletal system. They have also been extremely effective in the prevention of bone fractures in patients with osteoporosis. Unfortunately,there have been reports of an increasing number of cases of osteonecrosis of the jaw. This condition is characterized by an area of nonhealing, exposed jaw bone which can lead to severe loss or destruction of the jaw bone. The majority of these cases have been related to the injectable form of bisphosphonate however there has been a small percentage related to the oral form. Most cases of osteonecrosis have been diagnosed after dental procedures such as tooth extraction however the condition can occur spontaneously. Patients who have been taking bisphosphonates and are considering elective dental surgery should speak with their prescribing medical specialist, family dentist, or oral and maxillofacial surgeon about the risks and benefits of continuing treatment.

Q My dentist recommended that I have my wisdom teeth extracted. Will I have to stay home from school?
A   Usually the postoperative course is influenced by the complexity of the extractions. In most situations the patient is advised to stay home for a couple of days following the removal of the wisdom teeth. This is due to the occurrence of post op discomfort and swelling which often tends to reach its peak within forty-eight to seventy-two hours after surgery. Ultimately the recuperative period will depend on the individual's ability to heal.

Q I lost a tooth sometime ago and now worry that I do not have enough bone to allow dental implant placement. Do I have options if bone is missing?
A   Your Oral Surgeon can advise you if there is sufficient bone to allow dental implant placement by examining you and reviewing your x-rays. Bone grafting is an option to make you an implant candidate. Various bone grafting materials can be used including your bone, bank bone, bovine bone mineral or other bioactive substance that promotes bone growth. Bone grafting for dental implants has become common and quite successful, enabling you to move ahead with dental implants versus conventional restorations such as a bridge.

Q I have been told that my jaws do not “match” one another affecting my bite and profile. What are my options for treatment?
A   Discrepancies between the upper and lower jaws can be significant and may require surgery in conjunction with orthodontic care. Such surgery is termed “orthognathic” and can be used to correct many skeletal(bony) abnormalities of the jaws. It is usually covered by medical insurance. A few examples include: retrusive or small lower jaw; protrusive or large lower jaw; gummy smile or long upper jaw. Crooked or asymmetric aws can also be fixed. See your oral surgeon and orthodontist to discuss proper diagnosis and treatment.

Q My child has a bump on their lower lip. It periodically swells, then "pops" and decreases in size. What is this?
A   A bump on the lips or within the oral cavity should be evaluated by your dentist. An area that swells periodically and then decreases in size is most typically a mucocele. It forms due to blockage of minor salivary glands. This creates a swelling filled with mucous from the gland. Treatment of a mucocele requires removal of the soft tissue enlargement and underlying minor salivary gland tissue. An oral and maxillofacial surgeon would evaluate the area and perform removal in their clinic.

Q My child was seen by his orthodontist and he recommended having teeth removed to facilitate his growth and dental development. Our general dentist referred us to an oral and maxillofacial surgeon for their removal because my child is extremely fearful and apprehensive. Why?
A   You were referred to an oral and maxillofacial surgeon because of their training and expertise in anesthesia and their ability to safely and comfortably manage the surgical experience for your child. As part of their residency, they have full training in anesthesia and can provide care from local anesthesia to conscious sedation and outpatient general anesthesia. All of these anesthesia modalities are provided in an office setting and will allow your child to have a safe and comfortable surgical experience without the need and cost of hospital care. There are many anesthesia options which you and your surgeon can discuss to provide an optimal experience for your child.

Q My child has a baby tooth that has been loose for some time but it hasn't come out yet. I can see the permanent tooth coming in behind it. Do I need to do anything?
A   You should see your dentist or paediatric dentist to evaluate your child's teeth if a loose tooth does not come out on its own or if the permanent teeth proceed to erupt when the primary teeth is still in place. They will examine the area and make radiographs. They may recommend removal of the primary tooth to facilitate the eruption of the permanent tooth in a timely fashion.

Q My seventeen year old daughter told me that she wants to get her tongue pierced. I don't feel comfortable with this. What do you suggest?
A   Common symptoms after oral piercing include pain, swelling, and occasionally infection. It may also induce a slight change in speech and periodically contribute to chipped or cracked teeth. The oral cavity is very vascular, especially the tongue. If a blood vessel is penetrated during the piercing severe bleeding can occur which may be difficult to control. As mentioned earlier, swelling of the tongue can be a common side effect. In extreme cases the swelling can become so severe that it can compromise the airway and prevent breathing. I would advise against it. She may think it's fashionable now but many young people are not aware of the potential complications that can occur.

Q I need to have a tooth removed and my dentist suggested a dental implant. What is a dental implant?
A   Dental implants are a titanium implant that is placed into the bone of the upper or lower jaw. It replaces the root of the missing tooth. The bone integrates, or heals directly to the surface of the implant, which gives it longevity. Once this healing has occurred, your dentist makes a crown, or tooth, to go on top of the implant.

Q What is an oral and maxillofacial surgeon?
A   An oral and maxillofacial surgeon has received extensive training and experience in the diagnosis and management of impacted teeth, misaligned jaws, and dental related infections of the head and neck. They also treat accident victims suffering facial injuries, perform jaw reconstruction with bone grafts, care for patients with tumors and cysts of the jaws, and provide dental implant surgery for patients who are missing teeth.
Another significant aspect of their training is the acquisition of knowledge and skill in advanced and complex pain control methods, including intravenous sedation and ambulatory general anesthesia. Thus, the oral and maxillofacial surgeon is able to provide quality care with maximum patient comfort and safety in the office setting.

Q Should my wisdom teeth be removed if they haven’t caused any problems yet?
A   Wisdom teeth, also known as third molars, are the last teeth to erupt in your mouth. Third molars however frequently become impacted due to a lack of space in the dental arch and their growth and eruption may be prevented by overlying gum, bone, or another tooth. Impacted third molars can be painful and lead to infection. However, not all problems related to third molars are painful or visible. These teeth may eventually crowd or damage adjacent teeth or roots. Sometimes they may even be associated with the growth of certain cysts or tumors. As wisdom teeth grow, their roots become longer and therefore more difficult to remove. This is why it is often recommended to remove impacted third molars when the roots are one-third to twothirds formed, usually between the ages of seventeen and twenty.

By Tonya Davis 29 Jun, 2017
In general, the typical shade of healthy teeth is an off-white hue with slight undertones of brown, yellow or grey. However, many people find that their teeth are much darker than off-white. If you're one of these people, you may be wondering why your teeth aren't as bright as everyone else's and what you can do about it.

Browning and yellowing teeth have a variety of possible causes. One of the most well-known is aging, but what about discolouration that happens before you reach your senior years? If you're an adult with stained teeth, there are two broad categories of tooth discolouration you should look to: extrinsic and intrinsic.

Both can be remedied in different ways, but the right solution will depend on which of these discolouration types is affecting you.
By Tonya Davis 28 Mar, 2017
By Tonya Davis 23 Jan, 2017
By Website Team Technicians 09 Dec, 2016

The time has come. You brush and floss your kids' teeth every day, but it's finally time for their first official dentist appointment. You know how important it is to attend regular dentist appointments. You want your kids to have good oral health for life and don't want them to develop a fear of the dentist or feel anxiety about dental visits.

To ensure your kids have a good experience on their foundational visit to the dentist, prepare them properly before the big day.

Schedule the First Visit Early

Most experts advise that children see a dentist sometime before their first birthday. The earlier you can get your kids in to the dentist, the better. If they start early, they'll be familiar with the process and know what to expect as they get older.

However, if you missed that first early visit, it's not too late to establish good oral health for your kids. Get them in to see a dentist as soon, and as young, as possible.

Go to a Family-Friendly Dentist

What kind of dentist you choose matters. Even if you love your own dentist, they may not be right for your kids.

Choose a dentist who regularly deals with children and families. Many dentists' offices have long experience dealing with children and will happily accept appointments for the whole family. Your kids will likely have a better time if their dentist knows how to appeal to children.

Remember it's not just the dentist who will deal with your kids. Everyone from the front-office staff to the oral hygienist will also interact with your children and contribute to their first dental experience. Choose an office that knows how to make a positive first impression.

Explain Why You Go to the Dentist

Before their first visit, explain to your kids why it's important to go to the dentist. Talk, in a kidfriendly way, about how the dentist uses special tools to make their teeth squeaky clean again.  

Use metaphors or imagery that are easy for kids to understand. Decide, based on your children's personalities, whether to tell them how little cavity bugs hide in their teeth and the dentist needs to clean them off, or whether to just say you need the dentist to keep teeth healthy and strong.

Tell your children what you personally like about going to the dentist. Maybe you like when the dentist polishes your teeth or takes an X-ray. Relay your own experience to give your kids a positive impression of what to expect.

Show Your Kids Positive Media

Familiarize your children with the environment and equipment they'll see at the dentist's office. Show them pictures and videos of kids at the dentist and images of the tools the dentist uses to clean their teeth. Find episodes of kid-friendly TV shows that address dental visits, and watch them with your children.

Expose your children to a variety of positive media about dental visits. If they know what things look like and what to expect before they get to the office, they'll be less intimidated by the dental environment.

Give Your Kids Something to Look Forward To

Offer your children a treat or special event for after their dentist visit. Maybe they'll get to spend a day at the zoo, or just go out for ice cream after their appointment. Give them a positive event to look forward to so they approach their first visit to the dentist with happy anticipation.

With the right preparation, you can help your kids establish a positive relationship to dentists and oral hygiene. Promote a good attitude before their first dental visit and build a healthy foundation for the rest of their lives.  

By Website Team Technicians 09 Dec, 2016

From the moment you wake up to the last few minutes before you go to sleep, you're constantly on the move. You have to rush to work. You must drive your kids to and from school and extracurricular activities. And you can't forget to shop for groceries, pick up the dry cleaning and stop by the bank.

When you're on the go, you don't have the chance to prepare and pack healthy foods. In between tasks, you may only have a few minutes to grab a granola bar or stop by a nearby coffee shop for a doughnut or two.

But these sweet treats and snacks can wreak havoc on your dental health, especially when you don't have time to brush afterward. The more sugary foods you eat, the greater your risk for cavities and decay.

If you're in a rush, try grabbing these simple snacks before you step foot out the door. They only take you a minute or so to prepare, and they can keep your teeth in great shape.

1. Cheese Cubes

Although cheese tends to last best when refrigerated, string cheese, cheese cubes and cheese curds all travel well if packaged appropriately. Simply throw a stick or package in your purse or backpack, and you have a flavourful way to feed yourself (or your kids) while on the go.

Cheese is one of the best foods you can eat when you want to maintain a healthy smile. Cheese supplies plenty of vitamin D and calcium for building strong bones, and it temporarily increases your mouth's pH levels to keep cavity-causing bacteria at bay.

To read more about the benefits of cheese for your oral health, feel free to check out   our previous blog .

2. Raw Almonds

Cashews, almonds, walnuts and pistachios make for the ultimate last-minute snack, as they don't require any refrigeration or preparation. You can eat them directly out of the box, bag or can, or you can set aside a reasonable portion in a travel-friendly plastic container.

Almonds offer lots of calcium for supporting teeth and nourishing healthy gum tissue. Additionally, almonds supply a hefty amount of vitamin E and can effectively regulate blood sugar levels. As a result, almonds can effectively reduce your risk for periodontal disease.

As you snack, eat nuts with care. If you try to chomp through a harder nut or de-shell the nut with your teeth, you may chip a tooth. If you worry about accidentally damaging your teeth, opt for de-shelled and chopped nuts rather than whole.

Don't Forget to Brush When You Can

These snacks are a tooth-friendly way to satisfy your hunger pangs when you're too busy to cook. But remember that even the healthiest foods still have the potential to damage teeth.

Ideally, you should brush within 30 to 60 minutes after snacking. But if you don't have the opportunity to brush, at least take a few moments to rinse your mouth with water. Water will clear away some of the lingering food particles and restore your mouth's pH balance.

And though you may be busy, don't forget to schedule an appointment with your dentist. A single appointment every six months could save you multiple dental surgeries in the future.

By Website Team Technicians 09 Dec, 2016

Chances are, you don't think about your teeth much except while practicing your daily oral hygiene routine. And even then, your mind will be busy planning your day or trying to remember last night's dream.

However, a toothache is a painful reminder of the fragility of your teeth, one which can cause disruption in your life. Even fairly mild localised pain can become distracting quickly. More major toothaches change the way you eat, speak and smile almost immediately.

Unfortunately, there're no guaranteed answers to most questions about your toothache. But in this blog, we guide you through common causes, telltale symptoms and sure signs you should see your dentist.

What Causes Toothaches?

Though your teeth have a strong outer layer of enamel, they connect to a network of sensitive oral nerves. These nerves exist inside each tooth as well as in the soft tissues of your mouth. Toothaches indicate irritation of or damage to these nerves.

Common causes of toothaches include the following:

Abscess or other oral infection

Bruxism, also called tooth grinding

Chipping or fracturing of a tooth

Lost or damaged filling, bridge or crown Untreated cavities and tooth decay

You are more likely to experience tooth-related discomfort if you have a temporomandibular joint disorder (TMD), frequent headaches and certain chronic diseases. Always discuss your medical history with your healthcare providers to rule out non-dental causes of tooth discomfort.

How Do Toothaches Manifest?

Toothaches can appear at any time, in patients of any age. Most patients describe a combination of one or more of the following symptoms:

Change in taste -If you have an infected tooth or section of gum tissue, you may notice a foul taste in your mouth that doesn't disappear when you eat or drink. The change usually results from wound discharge.

Headache -Your teeth, jaw and facial bones can easily be affected by each other. You may experience headaches before, during or after a toothache.

Tooth pain -Tooth pain can come in many forms, from sharp to achy and from throbbing to constant. Additionally, your tooth pain may only appear when you eat sugary or acidic foods, put pressure on your teeth or expose your teeth to heat or cold. All these pain types qualify as a toothache.

Because toothaches can result from a number of different causes, their symptoms vary. Some patients experience dull pain that comes and goes, while others report intense, focused pain over extended time periods. Take note of your symptoms before you have your appointment as these effects can help your dentist identify the cause.

When Should You See Your Dentist?

If you have brief, mild discomfort, you may get away without a trip to the dentist. However, most toothaches require professional evaluation and treatment for them to disappear.

You should see your dentist as soon as possible if you experience any of the following:

Difficulty opening your mouth, chewing or speaking

Discomfort lasting for two or more days

Earaches or localised discomfort around the ears

Extreme pain, even if you only feel it intermittently

Inability to properly care for your teeth due to the pain

Visible changes to your teeth, gums or oral tissues

If you develop fever, lightheadedness or other sudden and serious symptoms, seek medical attention from your general practitioner or from an emergency dentist. These symptoms may indicate infection or a different pain source, such as an advanced sinus infection.

If you have a history of tooth sensitivity, decay or aches, bring up your concerns during your next appointment at Dental Smile Clinic. Your dentist can develop a hygiene, appointment and procedure plan based on your specific circumstances. With some simple proactive measures, you should be able to avoid most future toothaches.

By Website Team Technicians 09 Dec, 2016

Most people have been advised many times to visit the dentist every six months. However, some people still don't visit the dentist regularly. Even if you practice excellent oral hygiene care at home, you should still see a dentist on a regular basis.

Missing only a couple of dental check-ups likely won't cause permanent damage to your teeth. However, if you frequently skip these oral exams, here are some reasons to break the habit.  Disease Prevention

Dental check-ups usually involve cleaning and polishing your teeth. Without this regular cleaning, bacteria and tartar may build up in your mouth. Over time, this tartar build-up can irritate gum tissue and result in gum disease.

When you visit the dentist, your dental hygienist will mostly likely use an ultrasonic dental instrument or hand scaler to remove tartar from your teeth. This process is one of the only ways to remove tartar. You simply cannot remove it by only flossing or brushing.

Examination

After the dental hygienist cleans your teeth, he or she will examine your gums and teeth for signs of potential complications. Many dental issues won't cause pain or become apparent until they enter advanced stages. This examination helps prevent health and dental complications because your dentist is trained to catch early signs of complications.

If you visit the dentist regularly, you can take care of potential dental and health issues before they become serious.

Some possible health complications that have possible oral symptoms include:

Heart disease.  Early signs of heart disease include loose teeth and inflamed gums. In addition, bacteria near your gums may spread to other parts of the body if you have gum disease. Once bacteria enter your body, they can form clots or plaque in your arteries.   Diabetes . Though poor oral health doesn't cause diabetes, this health condition causes issues in your mouth such as bleeding gums, gum disease, and loose teeth.

Osteoporosis.  Although this disease doesn't affect your teeth, it can alter the bones that support your teeth. Your dentist may identify osteoporosis by loose teeth and receded gum lines.

Eating disorder.   Dentists may notice signs of an eating disorder if a patient has a dry mouth and bleeding gums. Poor nutrition can also cause the insides of the front teeth to erode.

Gastroesophageal reflux disease (GERD).  When inside tooth enamel begins to erode, it can indicate GERD. GERD causes erosion throughout the oesophagus and may lead to oesophageal cancer. If your dentist detects early signs of GERD, notify your doctor as well.

If your dentist notices signs of these health issues, he or she may recommend a treatment plan or refer you to a specialist for further treatment.

Regular cleanings can sometimes be vital in preventing major health problems. For instance, people who regularly have their teeth cleaned are at a 24% lower risk to experience a heart attack and 13% lower risk of experiencing a stroke.

How Often Should You Visit the Dentist?

Most people only need to visit the dentist twice a year to maintain proper oral hygiene. Others may need to visit the dentist more frequently. For instance, people who have a high risk for developing periodontitis may need to visit the dentist every few months.

Never go longer than 18 months without visiting the dentist. Otherwise, you could develop more serious issues that may be more difficult and costly to treat. Talk with your dentist to determine a good schedule for you.

Your dental health is an important element of your overall health. Don't neglect the importance of regularly visiting your dentist. If you're due for a check-up, call your dentist to schedule your appointment today. When you regularly visit the dentist, you keep your teeth on the path for optimal health.

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