Shimane Oral Surgery

Wisdom teeth, the late blooming elder teeth of your mouth, behave a little differently than your other teeth.

Know the facts:

• Wisdom teeth get their name from the time frame at which they finally show up in your mouth. They typically appear in a person’s late teens or early twenties, sometimes called “The Age of Wisdom,” though your parents may disagree.
• Wisdom teeth cause trouble because they often grow at odd angles. This makes it hard for them to break out of your gum, if at all.
• Another reason wisdom teeth often can’t get out of gums is because there is not enough room for them. The plus side is that this could be because you’ve kept your teeth nice and straight.
• Some people never grow wisdom teeth!
• Wisdom teeth, among other teeth, house valuable stem cells that can be saved to help you treat other conditions you may have down the road. A pearl of wisdom for you.
• Wisdom teeth removal, with proper sedation, is painless. The tough part is recovery, which can last a few days to several weeks. Following your physician’s instructions will help you through recovery as quickly as possible.
• In ancient times, when diets were harder on teeth, wisdom teeth made more sense. People couldn’t influence the way their teeth moved around so it was easier for wisdom teeth to find space to pop in. With today’s high-quality dental care, wisdom teeth aren’t necessary.
• Given that most people end up removing these teeth surgically, research is being done to find ways to prevent their growth altogether. This would save a trip to the surgeon!
• You may or may not ever notice that your wisdom teeth need to be removed. Some people notice some pain or irritation, some notice nothing at all. Making an appointment with our office is the only way to know for sure.
• Most people have four wisdom teeth. It’s possible to have fewer or more than four, though it’s very uncommon.

Wisdom teeth can be quirky and troublesome. To make sure you or your child’s wisdom teeth aren’t creating difficulties down the road, make an appointment with us today!

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!

Injuries to the face and mouth are emotionally upsetting as well as physically damaging. It’s extremely important to have medical and dental care by experts who know how to address the psychological, medical, and aesthetic elements of recovery. This blog will cover the most common causes of facial trauma and the types of injures that may occur. As with most injuries, prevention is the best medicine, so we will cover tips in avoiding facial trauma all together!

Most Common Causes of Facial Trauma: There are many ways in which the face can be damaged. Accidents, falls, automobile crashes, work related injuries, and interpersonal violence are among the most common causes for adults. For children, sports related injuries are the leading cause. Children who participate in contact sports, cheerleading, and gymnastics are especially at risk, especially for dental trauma. Dental trauma accounts for 17% of injuries to the body for children, according to the American Dental Association, compared to 5% across all ages. It is most frequently observed in males compared to females, and usually involves the front teeth.

Types of Injuries: Every year about 3 million people are treated for facial trauma according to the American Association of Oral and Maxillofacial Surgeons. Soft tissue trauma includes any cuts to the face or gums. Avulsed, or knocked out teeth are another type of injury, and must be dealt with immediately to increase the chances for reimplantation. Bone injuries, such as fractured jaws, cheekbones, and noses can also occur as well as damage to the nerves in the eyes, face and salivary glands. It is extremely important to have facial trauma assessed and treated by an expert in facial trauma. Besides the aesthetic reasons, serious health complications can occur, even from a small amount of damage. Depending on the location of the injury, speech, swallowing, and breathing can be affected. For dental injury, teeth that are loose in their sockets can make eating difficult and cause speech impediments. Chipped, broken, or misaligned teeth can cause TMJ and other functional problems, in addition to the loss of confidence in your appearance.

What You Can Do to Prevent Injuries: Using a mouthguard during sports or other high-risk activities is the most effective way to prevent injury. Studies in high-risk populations for facial trauma show relatively low compliance in using mouthguards. We can also recommend helmets, face shields, and protective eyewear that can further reduce your risks. The spring season seems to bring an increase of children to the emergency room as kids are eager to get on their bicycles, skateboards, and swing sets. As a parent, educate your child in safety measures and supervise their activity.

When facial trauma does happen, quick action is important. Please call us as soon as possible so we can best advise and support you in your recovery. Accidents happen, and when they do, we want to help!

When compared to the costs of other tooth replacement options, boy do dental implants seem expensive! Yet you may be surprised to learn that, in the long run, dental implants can be more affordable than their traditional counterparts. Understanding this procedure and the factors that determine the costs can help you decide if dental implants are a good investment for you!

What is a Dental Implant? A dental implant is a permanent replacement for lost teeth. It is made of an artificial tooth firmly held in place by a tooth root made of titanium (which is biocompatible) that is surgically placed into your jaw. Dental implants help stabilize the jaw and the bone around it to avoid future bone loss and maintain the shape of your jaw. They never have to be removed and feel more natural and comfortable than dentures. And unlike bridges or crowns, which are cemented in, the chances of slippage or shifting are eliminated. With implants, talking and eating become worry free.

Steps In a Dental Implant Procedure. We will first use extensive imaging to determine bone health, height, and thickness to assess your bone and teeth structure carefully. The surgery itself is done in our office in separate stages. First, the implant is surgically placed into your jawbone, completely hidden within your gum tissue. Once the implant has integrated into your bone, a healing process of about 4 to 6 months, the next stage is the placement of the abutment, or the post that penetrates the gum and will connect the replacement tooth to the implant. The final stage involves attaching your artificial tooth (made from impressions of your natural tooth) to the abutment. If more than one tooth is being replaced, a removable bridge is used, as it is more affordable than implanting each tooth separately. For a bridge, it takes only one implant on either side to span an area holding several teeth. The bridge snaps into place for a more permanent and natural fit than dentures.

Factors That Affect the Cost. While dental implant surgery is a safe and routine option, it is a complex procedure that takes time and expertise to be done effectively. There are many factors that will influence the final costs including what X-ray and CT scans are necessary to evaluate and assess the implant area and the brand and material of the post, abutment and artificial teeth. However, the biggest cost factor is the complexity of the surgery itself. For example, how many teeth are we replacing and what is the location? Will additional procedures, such as bone grafting or sinus elevation be required? We do our best to make sure that your estimate includes all of the possible costs of each of the steps of your procedure.

While dental implants may seem expensive, they are often more affordable in the long run than traditional restoration methods such as crowns and bridges, which are more vulnerable to damage and usually require repairs or replacement every few years.

Dental implants are known to have a 95% success rate when completed by professionals with the right experience and training, such as us! Because dental implants offer a permanent solution, are natural and comfortable, and require little maintenance, they are a cost effective choice for most of our patients.