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Anesthesia
Why must I fast prior to surgery?
Anesthesia depresses the normal gag reflex that prevents solids and liquid matter from entering our lungs. The process of reflux of material from the stomach into the trachea and lungs is called aspiration. Fortunately, the incidence is quite low. Assuring that the stomach is as empty as possible prior to anesthesia is a mainstay in aspiration reduction. This has been routinely accomplished by nothing to eat or drink after midnight, the day of surgery.
What are some risks of anesthesia?
The rate of complications will vary with the health status of the patient and the magnitude of the procedure. The common side effects of general anesthesia include nausea, muscle aches and shivering postoperatively. The most severe complication, death is very rare.
How am I monitored?
The monitors we use under general anesthesia depend on both the type of operation and the patient's medical condition. The minimal monitors under general anesthesia include: blood pressure, EKG, heart rate, temperature, stethoscope and two monitors of breathing. The pulse oximeter(placed on the fingertips) measures the oxygen saturation of hemoglobin (oxygen carrier) in your blood. This monitor has markedly improved the safety of anesthesia.
What drugs do you use?
Anesthetic drugs are unique in that they are seldom used outside of the operating room setting. For induction of general anesthesia, the intravenous agent propofol is commonly used. It is shorter acting and associated with less nausea and vomiting compared with the many other choices. The general anesthetic state is maintained with a mixture of gases and intravenous agents. The trade names of the gases are forane, suprane and sevoflurane. They are administered from machines called vaporizers. Other classes of drugs are also used.
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Implants
What are dental implants?
Dental implants are basically sophisticated screws made of a medically pure metal, Titanium. These screws are then placed in the jaw bone and rest under the gum for 3 - 6 months. During this time they actually fuse to the jawbone and become osseo(bone)integrated. After the appropriate healing time, we uncover the implants and use them to replace one or more missing teeth by fabricating some sort of dental prosthesis.
Who is the ideal patient for dental implants?
Anyone in reasonable health who wants to replace missing teeth. You must have enough bone in the area of the missing teeth to provide for the anchorage of the implants. Almost everyone today is an excellent candidate for dental implants to replace small bridges, removable partial dentures and even just one missing single tooth.
What are implants made of?
Implants are made of commercially and medically pure Titanium. This is the same metal that has been successfully used in hip implants for many years. It is inert and is not known to cause any type of rejection phenomenon.
Can implants be rejected?
No! They are made of an inert metal which has no history of rejection by the body. They are not a living organ such as the lung or liver and therefore there is no rejection phenomenon. If failure should occur, and this is only a remote possibility, it is mechanical in nature and not due to rejection by the body. By the way, depending on the source you read, implants are anywhere from 85-95 percent successful depending upon certain factors such as implant location, amount and quality of bone etc. These factors will be evaluated before we place your implants. If you have any questions regarding this or any other aspect of the implant process, ask your dentist.
What about infection and complications?
During the surgery every attempt is made to maintain a totally sterile field. This tends to minimize any potential for postoperative infection. Once again, your dentist will prescribe the appropriate antibiotics as a precautionary measure. Once the implants have been engaged in your prosthesis, it is imperative for you to maintain scrupulous oral hygiene.
Will I be able to chew and function normally?
Yes. Once your implants have integrated, you will be able to function normally without any unusual sensations. Your chewing ability will really depend upon the type of prosthesis you have chosen.
How long is the entire implant process?
Dental implants take approximately 3-4 months in the lower jaw and 6 months in the upper to integrate. Once integrated, it takes several visits to several months to complete the restoration depending upon the complexity.
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TMJ
How is TMJ syndrome diagnosed?
TMJ syndrome is difficult to diagnose -- not only because of its potentially large number of disparate symptoms, but also because any of those symptoms can be associated with other conditions. Before arriving at a diagnosis of TMJ syndrome, the doctor must first eliminate other conditions that could be producing the symptoms. A professional diagnosis is necessary, and often the individual will have to see both a doctor and a dentist for an accurate diagnosis.
Why are ear symptoms associated with TMJ disorders?
Because of the close proximity of the ear tissues to the TM Joint. It is not uncommon to find on x-ray that the Condyle Head is improperly positioned in the Joint space such that it is in intimate contact with the Tympanic bone. The consequence often is ear pain in the absence of infection, a sense of fullness, or stuffiness, in one or both ears, and sometimes ringing in the ears. If you go to the "X-Ray Views" page, you can see these reasons graphically.
What is a "locking" episode?
A "locking" episode can occur during opening or closing movement. What happens is that the patient experiences an interruption of jaw movement - a "catch" or a "stop", and in order to complete the movement must jiggle, or somehow, self manipulate the jaw.
Who gets TMJ?
TMJ is diagnosed more frequently in certain demographic groups. The National Institute of Dental and Craniofacial Research (NIDCR) of the National Institutes of Health reports that there are over 10 million people in the US who have symptoms of TMJ problems at any given time. A large majority are females between the ages of puberty and menopause.
The greater prevalence of TMJ problems in women during child-bearing years suggests a need for research examining the influence of gender-specific hormones on temporomandibular joint structure and function.
How did I get TMJ?
Research has not yet determined all the possible causes of TMJ diseases. Many theories of causation have been proposed, but few have been scientifically validated. We do know that TMJ can be precipitated or aggravated by trauma, certain health care procedures, oral habits and postures, and other diseases such as osteoarthritis and fibromyalgia. However, TMJ symptoms are known to occur without an identifiable cause.
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Oral Pathology
What is Oral Pathology?
Oral pathology is a subspecialty of dentistry that focuses on the identification, treatment, origins and effects of oral and maxillofacial diseases. Oral pathologists are involved in all areas of disease management including research, diagnosis/examination and treatment.
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Orthognathic Surgery
Orthognathic surgery is needed when jaws don't meet correctly and/or teeth don't seem to "fit" with your jaws. In most cases, teeth are straightened with orthodontics, and then corrective jaw surgery repositions misaligned jaws. This not only improves facial appearance, but also ensures that teeth meet correctly and function properly. Orthognathic surgery allows for repositioning of teeth and facial bones to create a more balanced appearance with jaws that work together well.
Difficulty in the following areas should be evaluated:
- Protruding Jaw/Chin
- Elongated Chin
- Deficient Chin
- "Gummy" Smile
- Open Bite (space between upper and lower teeth)
- Difficulty In Chewing, Biting or Swallowing
- Chronic Jaw or TMJ Pain
- Speech Problems
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Trauma and Reconstructive Surgery
Our surgeons are trained to treat a range of facial traumas and provide emergency care for the following problems:
- Facial lacerations
- Lip lacerations
- Intra oral lacerations
- Fractured teeth
- Avulsed (knocked out) teeth
- Fractured facial bones (cheek or nose)
- Fractured jaws (upper and lower jaw)
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