Stonewalk Family Dentistry is a comprehensive dental practice that serves families in Alpharetta, GA, providing every form of care our patients may need, even complex oral surgery. With a highly-trained oral surgeon in-house, our experienced team can perform pain-free tooth extractions, dental implant placement, soft tissue grafting and more right here in our state-of-the-art dental facility.

While we’re proud of our advanced technology, we haven’t forgotten that the most important aspect of your visit is your comfort. Our anesthesiologist, Dr. Marcus Polk, is trained and certified to provide a variety of dental and general sedation methods that will keep you comfortable throughout your oral surgery. Plus, many of our general dentists are also certified to provide oral conscious and IV sedation.

If you’re in need of an oral surgery procedure and would like to see a highly-trained oral surgeon at our Alpharetta-area practice, call (770) 777-1911 or schedule an appointment online. We are located in Milton, GA and serve patients in the surrounding areas.

Visit an Alpharetta-Area Oral Surgeon

If you live in Alpharetta, GA and are looking for the services of a skilled oral surgeon, come visit the experts at Stonewalk Family Dentistry. We provide a number of oral surgery procedures, many of which can dramatically improve the condition of your smile in just one visit. To find out more about the procedures we offer, check out the information listed below.

A tooth extraction is a routine oral surgery procedure that is often performed when a patient has one or more teeth that could cause a variety of future dental issues, such as disease and infection. Teeth are often extracted when they begin to show signs of damage, decay or infection. Additionally, teeth may be extracted by an oral surgeon if a patient is not satisfied with the appearance of the tooth, at which point the surgeon can partner with a restorative dentist who will provide the patient with a dental implant to create a more attractive smile.

Not can only can tooth extractions save patients from potentially serious dental issues, they can also dramatically enhance a patient’s appearance when coupled with high-quality cosmetic dentistry. At Stonewalk Family Dentistry, our patients can receive both oral surgery and cosmetic procedures in-house, and each treatment can be performed with no discomfort to the patient, thanks to our many sedation dentistry options.

If you’re interested in learning more about the oral surgery procedures performed at our Alpharetta-area practice, call our office today at (770) 777-1911 or schedule a consultation with our team online. We are located in Milton, GA and provide comprehensive care to families in the surrounding areas.

Most teens and young adults will eventually need oral surgery to remove their wisdom teeth (also known as “third molars”). Because wisdom teeth are the last permanent teeth to erupt, there is often not enough room left in the mouth to accommodate them. The lack of space can cause wisdom teeth to come in sideways, only partially erupt or become impacted within the gums.

The disadvantages of keeping impacted, sideways or partially-erupted wisdom teeth include:

  • Shifting of permanent teeth
  • Jaw pain and headaches
  • Chronic sinus infections

Our in-house oral surgeon will evaluate the status of your wisdom teeth with a visual exam and panoramic X-ray. If it turns out that they’re not erupting properly, he will explain your options for removal (traditional extraction or removal via oral surgery) and thoroughly discuss the pros and cons of each method.

What is an Impacted Tooth?

When a tooth is unable to fully enter the mouth, it is said to be “impacted.” In general, impacted teeth are unable to break through the gums because there is not enough room, often resulting in the need for oral surgery. Nine out of ten people have had at least one impacted wisdom tooth.

If left in the mouth, impacted wisdom teeth may damage neighboring teeth, develop cysts, or become infected. Because the third molar area of the mouth is difficult to clean, it is a site that invites bacteria that lead to gum disease. Furthermore, oral bacteria may travel from your mouth through the bloodstream, where it may cause possible systemic infections and illnesses that affect the heart, kidneys and other organs. [1] [2] [3]

Research has shown that once periodontal disease is established in the third molar areas, the problem is persistent and progressive, but may greatly improve if an oral surgeon performs an extraction of the problematic teeth. [4] [5] [6]

Do My Wisdom Teeth Need to be Removed if I’m not Feeling Any Pain?

Many people believe that as long as they are not in pain, they do not have to worry about their wisdom teeth. However, wisdom teeth that come in normally may still be prone to disease, according to a study by the American Association of Oral and Maxillofacial Surgeons and the Oral and Maxillofacial Surgery Foundation. It is, therefore, important that your dentist monitors the health of your wisdom teeth during your annual dental check-ups.

What Happens During this Type of Oral Surgery?

If your dentist or healthcare professional recommends that your wisdom teeth be removed, you will most likely be referred to an oral surgeon for the procedure. Before surgery, your oral surgeon will discuss the procedure with you and tell you what to expect. This is a good time to bring up any questions or concerns you may have about the procedure.

There are several conditions that affect how easy it will be to remove a wisdom tooth, or that may cause the oral surgery to be more complicated. These conditions include how the tooth is positioned, the stage of root development, and if the wisdom teeth are impacted.

In most cases, third molars can be extracted with little or no pain, and in the office of your oral surgeon. Patients are given local anesthesia, intravenous sedation, general anesthesia or a combination of these numbing agents. During your initial consultation, you and your oral surgeon will decide upon the anesthetic option that is right for you.

What Can I Expect After Surgery?

Following your oral surgery, you may experience some swelling and mild discomfort, which are part of the normal healing process. Cold compresses may help decrease the swelling, and medication prescribed by your oral surgeon can help manage the discomfort. You also may be instructed to modify your diet following surgery, and progress from soft to more normal foods.

What if I Decide to Keep my Wisdom Teeth?

Wisdom teeth that are completely erupted, painless, cavity-free, disease-free and functioning in a hygienic environment with healthy gum tissue may not require extraction. They do, however, require regular, professional cleaning, annual check-ups and periodic radiographs to monitor for any changes. If, after discussing your situation with your dentist or oral surgeon, you decide to keep your wisdom teeth, be sure to take particular care in brushing and flossing your molars.

Wisdom teeth removal at Stonewalk Family Dentistry is an out-patient oral surgery procedure that can be completed in an hour or two. We offer many sedation dentistry options to make your time in our care as painless and stress-free as possible – call us at (770) 777-1911 or contact our team online today to schedule an appointment with an oral surgeon!

Oral and maxillofacial surgeons pioneered the placement of dental implants more than 25 years ago, and are still the leaders in providing the innovative techniques that offer patients long-lasting, natural-looking results that last a lifetime. Even “high-risk” patients suffering from chronic health conditions, gum disease or bone loss in the jaw area can receive a successful dental implant from a highly-trained oral surgeon.

A Solution for Missing Teeth

Statistics show that 69% of adults ages 35 to 44 have lost at least one permanent tooth to an accident, gum disease, a failed root canal or tooth decay. Furthermore, by age 74, 26% of adults have lost all of their permanent teeth.

With an overall success rate of about 95% and almost 50 years of clinical research to back them up, dental implants are frequently the best treatment option to replace missing teeth. The following are some of the oral surgery procedures provided to assure the best possible outcome:

  • Immediate loading: Thanks to advances in dental implant technology, your oral surgeon can extract teeth and place implants with crowns in one visit.
  • Bone grafting: Oral surgeons are the only dental specialists trained to obtain and place bone grafts in areas where little or no bone exists. Implant sites that lack the necessary bone can be enhanced with the use of bone grafts. For more information on bone grafts, please refer to the following section.
  • Sinus lift: A sinus lift is a bone grafting procedure that is sometimes performed when the amount of bone in a patient’s upper jaw is inadequate to accommodate a dental implant.

Dental Implants are a Team Effort

Dental implant placement combines the best of modern science and technology, incorporating a team approach that spans several disciplines. A successful implant requires that all parties involved – the patient, the restorative dentist who makes the crown for the implant, and the oral surgeon who surgically places the implant – follow a careful plan of treatment. All members of the implant team stay in close contact with each other to make sure the results meet the patient’s expectations.

Dental Implant Surgery

A dental implant designed to replace a single tooth is composed of three parts – the titanium implant that fuses with the jawbone, the abutment that fits over the portion of the implant that protrudes from the gum line and the crown that gives your implant a natural appearance in your smile.

Following an evaluation that includes a comprehensive examination, x-rays and a consultation, your oral surgeon will surgically place the posts, or implants, in your jaw.

Once the implants have stabilized in the jaw, a restorative dentist will prepare an impression of the upper and lower jaws. This impression is used to make the model from which the dentures or crowns are created.

Follow-up examinations with your oral surgeon and restorative dentist are critical, and your progress will be carefully charted to ensure you receive the highest level of care after your surgery.

Dental Implants vs. Conventional Dentures

Many patients who have selected dental implants describe a quality of life that is much more comfortable and secure than the lifestyle endured by those with fixed bridges or removable dentures. Dentures often make a person feel and look older than they are, cause embarrassment in social situations when they slip and click, and restrict the everyday pleasure of eating comfortably.

Further, conventional dentures may contribute to the loss of bone in the area where teeth are missing. As illustration (a) indicates, the presence of natural teeth preserves the jawbone. When a tooth is missing, as in illustration (b), the bone may erode and weaken until it may be necessary for your oral surgeon to graft bone to the area to strengthen it for placement of a dental implant. When a missing tooth is replaced by a dental implant, the fusion of the implant and bone provides stability, just as the natural tooth did.

If you are missing several teeth in the same area of your mouth, you may enjoy the confidence and lifestyle benefits that come with dental implants. Patients say their implants eliminate the day-to-day frustrations and discomfort of ill-fitting dentures, allowing them to enjoy a healthy and varied diet without restriction.

Are You a Candidate for Dental Implants?

Whether you are a young, middle-aged or an older adult; whether you need to replace one tooth, several teeth, or all your teeth, there is a dental implant solution for you. With the exception of growing children, dental implants are the solution of choice for people of all ages, even those with the following health concerns:

  • Existing Medical Conditions: If you can have routine dental treatment, you can generally have an implant placed. While precautions are advisable for certain conditions, patients with such chronic diseases as high blood pressure and diabetes are usually successful candidates for dental implant treatment.
  • Gum Disease or Problem Teeth: Almost all implants placed in patients who have lost their teeth to periodontal disease or decay have been successful.
  • Currently Wearing Partials or Dentures: Implants can replace removable bridges or dentures, or they can be used to stabilize and secure the denture, making it much more comfortable.
  • Smokers: Although smoking lowers the success rate of implants, it doesn’t eliminate the possibility of getting them.
  • Bone Loss: Bone loss is not uncommon for people who have lost teeth or had periodontal disease. Oral and maxillofacial surgeons are trained and experienced in grafting bone to safely and permanently secure the implant.

If you’re interested in receiving dental implants at our Alpharetta-area practice, please call us at (770) 777-1911 or schedule a dentist appointment online. We are located in Milton, GA and serve families in the surrounding areas!

The most common reason for a bone graft is to strengthen weakened bone in the jaw and prepare it for oral surgery. Patients who have been missing a tooth for some time, have had severe gum disease, or have had other congenital conditions, may need bone grafting to strengthen the jaw bone in the affected area. A jaw bone graft can replace missing bone and even stimulate new bone growth so your jaw will be able to support a dental implant.

Interested in learning more about oral surgery procedures like bone grafting? Call our Alpharetta-area practice at (770) 777-1911 or schedule an appointment online today. Our in-house oral surgeon will be happy to discuss the treatment that’s right for you!

Oral cyst or tumor removal is a common oral surgery procedure that may actually save a patient’s life. Oral cysts are small, fluid-filled bumps on the gums and soft tissues that are usually painless. Oral cysts have the potential to be cancerous; however, they usually are not. On the other hand, oral tumors, which are very similar to cysts in appearance, are more likely to be cancerous than cysts. An oral tumor may or may not be painful.

If you think you might have an oral cyst or tumor, please have it examined as soon as possible. If your dentist identifies a cyst or oral tumor, he or she will typically perform a biopsy to determine whether or not it is cancerous. Even if a cyst or tumor is non-cancerous, your dentist may recommend oral surgery to remove the cyst or tumor, as each has the potential to interfere with teeth and bone structures and even become cancerous in the future.

In certain cases, an expertly-trained oral surgeon can save a life – to learn more about oral cyst and tumor removal, call Stonewalk Family Dentistry at (770) 777-1911 or schedule an appointment with us online. Our practice is located in Milton, GA and serves families in Alpharetta and the surrounding areas.

More Oral Surgery Procedures and Information

Oral and maxillofacial surgeons are the surgical specialists of the dental profession. Their extensive education and training, oral surgery expertise and unparalleled understanding of aesthetics and function uniquely qualify them to treat the conditions, defects, injuries and cosmetic appearance of the mouth, teeth, jaws and face.

Dentoalveolar surgery encompasses the surgical management of diseases of the teeth and their supporting hard and soft tissues.

  • Tooth Extractions: Oral and maxillofacial surgeons have extensive surgical training and experience in diagnosing and extracting teeth. Whether the extraction is simple or complicated by impaction, disease or infection, their oral surgery skills make them very qualified to treat the patient in need.
  • Wisdom Teeth (Third Molars): A tooth that fails to emerge or fully break through the gum tissue is, by definition, “impacted.” While this is a common problem associated with third molars, or wisdom teeth, which are the last teeth to develop and erupt into the mouth, other teeth can also become impacted.
  • Orthodontic Surgery: Often a patient is referred to an oral surgeon for an extraction or another surgical procedure in preparation for orthodontic treatment, such as extraction of over-retained baby teeth or the exposure of un-erupted teeth.
  • Pre-prosthetic Surgery: Oral surgeons are experts at preparing the mouth for the placement of a partial or complete denture; ensuring a comfortable fit. Because dentures rest on a bone ridge, it is very important that the bone is the proper shape and size.

Through reconstructive oral surgery, a solid foundation can be provided for dental rehabilitation, which in turn aids nutrition and speech. For example, using bone grafts from either the patient’s own bone or bone substitutes can improve the quantity and quality of the hard tissue in the upper and/or lower jaw area. Also, skin grafts and soft tissue corrections can improve the architecture of the soft tissues in the oral and maxillofacial region. Once the tissues of the mouth have been restored, dental implants may be used to replace lost teeth and other structures. Implants can also be used to anchor oral and facial prostheses.

Infection, malocclusion, TMJ, tumors or nerve pathology may cause oro-facial pain. Your oral surgeon is trained to diagnose the full spectrum of conditions that may cause pain in the mouth or face and to provide the appropriate medical or surgical treatment.

Pain and swelling in the face, neck or jaws may indicate an infection, which can sometimes develop into a life-threatening emergency if not treated promptly and effectively. An oral surgeon can assist in diagnosing and treating this problem. Treatment, if needed, may include draining the infected area and eliminating the source of the infection through oral surgery.

Oral surgeons are trained to identify abnormal growths or tissue through a clinical examination of the mouth and the evaluation of X-rays. The surgeon can then either remove a representative sample (biopsy) for laboratory examination, or remove the entire pathology.

An oral surgeon is trained to perform biopsies of both benign and malignant lesions in the maxillofacial region, and are experts in the clinical and microscopic diagnosis of disorders involving the mouth and jaws. Oral lesions include benign tumors and cancers, growths of tooth origin and those that arise in the salivary glands, infections (both local and systemic) and manifestations of systemic disorders.

Oral cancer is no longer a disease experienced only by middle-aged patients with histories of smoking and alcohol consumption. Today, oral surgery experts are seeing a growing number of oral cancer patients in their 20s and 30s. A growing use of smokeless tobacco and a rise in Human Papillomavirus (HPV) are considered responsible for this situation. Early detection and treatment of oral lesions greatly improve the patient’s prognosis.

Differences in skeletal growth between the upper and lower jaws may lead to problems with chewing, swallowing, speech or TMJ performance. Patients may also experience psychological difficulties stemming from aesthetic and social concerns. In order to correct the appearance and functionality of the mouth and jaws in these situations, an oral surgeon may perform corrective jaw surgery, which you can read about in detail below.

Are you interested in seeing a highly-trained oral surgeon at Stonewalk Family Dentistry? Call our Alpharetta-area office at (770) 777-1911 or make an appointment online – we are located in Milton, GA and provide high-quality oral surgery to patients in the surrounding areas.

Corrective Jaw Surgery

Corrective jaw, or orthognathic, surgery is performed by an oral surgeon to correct a wide range of minor and major skeletal and dental irregularities, including the misalignment of jaws and teeth, which, in turn, can improve chewing, speaking and breathing. While the patient’s appearance may be dramatically enhanced as a result of their orthognathic surgery, this type of oral surgery is most importantly performed to correct functional problems.

People who may benefit from corrective jaw surgery include those with an improper bite resulting from misaligned teeth and/or jaws. In some cases, the upper and lower jaws may grow at different rates. Injuries and birth defects may also affect jaw alignment. While orthodontics can usually correct bite, or “occlusion,” problems when only the teeth are misaligned, corrective jaw surgery may be necessary to correct misalignment of the jaws.

Your dentist, orthodontist and oral surgeon will work together to determine whether you are a candidate for corrective jaw, or orthognathic, surgery. It is important to understand that your treatment, which will probably include orthodontics before and after your oral surgery, may take several years to complete.

Corrective jaw surgery may reposition all or part of the upper jaw, lower jaw and chin. When you are fully informed about your case and your treatment options, you and your dental team will determine the course of treatment that is best for you.

Correcting an Open Bite: An oral surgeon removes some of the bone in the upper tooth-bearing portion of the jaw. The upper jaw is then secured in position with plates and screws.

Correcting a Protruding Lower Jaw: The bone in the rear portion of the jaw is separated from the front portion and modified so that the tooth-bearing portion of the lower jaw can be moved back for proper alignment.

Correcting a Receding Lower Jaw or “Weak Chin:” The bone in the lower portion of the jaw is separated from its base and modified. The tooth-bearing portion of the lower jaw and a portion of the chin are repositioned forward.

Before your surgery, orthodontic braces move the teeth into a new position. Because your teeth are being moved into a position that will fit together after surgery, you may at first think your bite becomes worse, rather than better. After your oral surgery, the new position of your teeth will fit together properly.

As your pre-surgical orthodontic treatment nears completion, additional or updated records, including x-rays, pictures and models of your teeth, may be taken to help guide your surgery.

Depending on the procedure, corrective jaw surgery may be performed under general anesthesia in a hospital, an ambulatory surgical center or in the office of an oral surgeon. Surgery may take from one to several hours to complete.

Your oral surgeon will reposition the jawbones in accordance with your specific needs. In some cases, bone may be added, taken away or reshaped. Surgical plates, screws, wires and rubber bands may be used to hold your jaws in their new positions. Incisions are usually made inside the mouth to reduce visible scarring; however, some cases do require small incisions outside of the mouth. When this is necessary, care is taken to minimize their appearance.

After oral surgery, your surgeon will provide instructions for a modified diet, which may include solids and liquids, as well as a schedule for transitioning to a normal diet. Pain following corrective jaw surgery is easily controlled with medication and patients are generally able to return to work or school one to three weeks after surgery. While the initial healing phase is about six weeks, complete healing of the jaws takes between nine and 12 months.

The results of corrective jaw surgery performed by a highly-trained oral surgeon can have dramatic positive effects on many aspects of your life. Schedule an appointment with our team or call our office at (770) 777-1911 today to learn more about this type of oral surgery and how it could benefit you!

The Temporomandibular Joint

The temporomandibular joint (TMJ) is a common cause of facial pain and headache and sometimes requires oral surgery treatment. Located where the lower jaw and skull meet, the TMJ is a ball-and-socket joint that allows the lower jaw to move and function. Symptoms of TMJ disorders may include earaches, headaches and a limited range of jaw movement. Patients may also complain of clicking or grating sounds in the joint, or pain when opening or closing their mouths.

What Causes TMJ Disorders?

Determining the cause of a TMJ problem is important, because the cause will determine what form of your treatment your oral surgeon will suggest.

Painful TMJ symptoms may result from arthritis, an injury or from grinding the teeth at night. Another common cause involves displacement or dislocation of the disk located between the jawbone and the socket. A displaced disk may produce clicking or popping sounds, limit jaw movement and cause pain when opening and closing the mouth.

The disk can also develop a hole or perforation, which can produce a grating sound with joint movement. The TMJ may also fuse, preventing jaw movement altogether, due to conditions such as facial trauma or rheumatoid arthritis.

The Range of Possible Treatment

When symptoms of TMJ trouble appear, an oral surgeon should be consulted to correctly diagnose the problem. Special imaging studies of the joints may be ordered, and appropriate referral to other dental or medical specialists or a physical therapist may be made. Once TMJ disorders are correctly diagnosed, appropriate treatment can be provided.

TMJ treatment may range from conservative dental and medical care to complex oral surgery. Depending on the diagnosis, treatment may include short-term non-steroidal anti-inflammatory drugs for pain and muscle relaxation, bite plate or splint therapy, and even stress management counseling.

Generally, if non-surgical treatment is unsuccessful or if there is clear joint damage, surgery may be recommended. This form of oral surgery can involve either arthroscopy (the method identical to the orthopaedic procedures used to inspect and treat larger joints such as the knee) or repair of damaged tissue via a direct surgical approach.

Are you suffering from symptoms of TMJ disorder? The experts at Stonewalk Family Dentistry can help! Call our Alpharetta-area office at (770) 777-1911 or make an appointment today to speak with our in-house oral surgeon.

Oral Cancer

Because the mouth is a region where changes can be easily seen, oral cancer can be detected in its early stages. Performing a self-examination regularly will help in the early detection of oral cancer and increase the chance for cure.

Research has identified a number of factors that may contribute to the development of oral cancer. The most common is the use of tobacco – in fact, studies have shown the death rate of oral cancer is approximately four times higher for cigarette smokers. Other factors include alcohol use, poor oral hygiene, irritation caused by ill-fitting dentures and rough surfaces on teeth, poor nutrition, some chronic infections or a combination of these factors.

Those at an especially high risk of developing oral cancer are over 40 years of age, heavy drinkers and smokers, or users of smokeless tobacco, including snuff.

Oral surgery experts recommend that everyone perform an oral cancer self-exam each month. Using a bright light and a mirror, look for the following possible signs of oral cancer:

  • Red or white patches on the tongue and on the tissues of the mouth
  • Any lumps or bumps in the mouth, on the tongue or on the inside of cheeks

If you are at high risk for oral cancer – smokers, heavy consumers of alcohol, and users of smokeless tobacco – you should see your general dentist or oral surgeon for an annual exam.

See your oral and maxillofacial surgeon if you have any of these signs. If your oral surgeon agrees that something looks suspicious, a biopsy may be recommended. A biopsy is a routine form of oral surgery that removes a piece of the suspicious tissue, which is then sent to a pathology laboratory for a microscopic examination that will accurately diagnose the problem. The biopsy report not only helps establish a diagnosis, but also enables the doctor to develop a specific plan of treatment.

Oral cancer can be life-threatening, but the experts at Stonewalk Family Dentistry are here to help. If you fear you are experiencing symptoms, call our Alpharetta-area practice at (770) 777-1911 today to schedule a consultation with a highly-trained oral surgeon.

Treating and Preventing Facial Injury

Maxillofacial injuries, also referred to as facial trauma, encompass any injury to the mouth, face and jaw. Many maxillofacial injuries require oral surgery as a result of a sports mishap, motor vehicle accident, on-the-job accident, act of violence or an accident in the home. The use of safe and effective sedation techniques often allow certain traumatic injuries to be effectively treated in the office of an oral surgeon.

The most common and most serious injuries to the face involve fractures to the lower jaw, upper jaw, palate, cheekbones, eye sockets or a combination of these bones. These injuries can affect sight and the ability to breathe, speak and swallow.

The principles for treating facial fractures are the same as for a broken arm or leg. The parts of the bone must be lined up during oral surgery, and held in position long enough to permit them time to heal. This healing period may require six or more weeks depending on the patient’s age and the fracture’s complexity.

When maxillofacial fractures are complex or extensive, multiple incisions to expose the bones and a combination of wiring or plating techniques may be needed. The repositioning technique used by the oral surgeon depends upon the location and severity of the fracture. In the case of a break in the upper or lower jaw, for example, metal braces may be fastened to the teeth and rubber bands or wires used to hold the jaws together. Patients with few or no teeth may need dentures or specially-constructed splints to align and secure the fracture. Often, patients who sustain facial fractures have other medical problems as well. Therefore, an oral surgeon is trained to coordinate his or her treatment with that of other doctors.

After discharge from the hospital, the doctor gives the patient instructions on continued facial and oral care. During the healing period when jaws are wired shut, oral surgery patients are prescribed a nutritional liquid or pureed diet, which will help the healing process and keep them in good health.

While not all facial injuries are extensive, they are all complex since they affect an area of the body that is critical to breathing, eating, speaking and seeing. If a person is unconscious, disoriented, nauseated, dizzy or otherwise incapacitated, call 911 immediately. Do not attempt to move the individual yourself. If these symptoms are not present but the injury is severe or you are uncertain about its severity, take the person to the nearest hospital emergency room as quickly as possible.

Because avoiding injury is always best, every oral surgeon advocates the use of automobile seat belts, protective mouth guards, and appropriate masks and helmets for athletes at any level. If you play a sport, make the following safety gear part of your standard athletic equipment, so as to avoid facial injury and subsequent oral surgery:

Football: Helmets with face guards and mouth guards should be worn. Plastic faceguards should be replaced by carbon steel wire guards.

Baseball: A catcher should always wear a mask. Helmets with a clear, molded plastic faceguard should be worn while batting and may be worn while fielding.

Ice Hockey: Many ice hockey players are beginning to wear cage-like faceguards attached to their helmets. These are superior to the hard plastic facemasks worn by some goalies. For extra protection, both face and mouth guards, including external mouth guards made of hard plastic and secured with straps, can be worn.

Wrestling: More wrestlers are now required to wear head gear. A strap with a chin cup holds the gear in place and helps steady the jaw, while a mouth guard will protect the teeth.

Boxing: Mouth guards are mandatory in this sport. A new pacifier-like mouth guard for boxers has been designed with a thicker front, featuring air holes to aid breathing.

Lacrosse: Hard plastic helmets resembling baseball batting helmets with wire cage facemasks should be worn.

Field Hockey: All players should wear mouth guards, and goalies should receive extra protection by wearing lacrosse helmets.

Soccer: Soccer players should wear mouth guards for protection. Oral surgeons advise goalies to also wear helmets.

Biking: All riders should wear lightweight bike helmets.

Scooters and Skateboarders: Bike helmets are also recommended for those who ride two-wheeled scooters and skateboards.

Skiing and Snowboarding: The recent surge in accidents among skiers and snowboarders has encouraged many safety-conscious participants to wear lightweight helmets that protect the head in the event of a fall or crash.

Horseback Riding: Helmets and mouth guards are recommended for horseback riding, particularly if the rider is traveling cross-country or plans to jump the horse.

Basketball, Water Polo, Handball, Rugby, Karate, Judo, and Gymnastics: Participants in these sports should be fitted with mouth guards.

The team at Stonewalk Family Dentistry provides athletes with custom-fitted mouth guards that help prevent facial injury. If you’d like to schedule an appointment for a mouth guard fitting, or simply for a general dental visit, please call our office at (770) 777-1911 or contact us online today.

Facial Trauma

Before (a)
After (b)
Extensive maxillofacial fractures are often accompanied by other medical problems. The oral and maxillofacial surgeon coordinates treatment with other medical specialties to return the patient to their normal activities as soon as possible. The young woman pictured in fig. (a) prior to surgery and (b) following surgery to repair her injuries.

While disruptive snoring is usually only a social problem that may strain relationships for many men, women and children, loud habitual snoring may actually signal a potentially life-threatening disorder known as obstructive sleep apnea, or OSA.

Due to innovations in biomaterials, medical devices and surgical procedures, many of the cosmetic procedures performed now are simpler and less invasive than before. Surgeons can often operate in an office environment using intravenous and/or local anesthesia, although an outpatient facility, same-day surgical center or hospital may be required for more complex procedures.

Many people snore, so it is important to distinguish between simple snoring and obstructive sleep apnea (OSA). Approximately 30% to 50% of the U.S. population snore at one time or another, and while most cases are not indicative of OSA, they still may require treatment from your doctor or oral surgeon.

There are several options available to chronic snorers. Some non-medical treatments that may alleviate snoring include weight loss, changing sleeping positions, and avoiding alcohol, caffeine and sedatives. However, if you’re hoping for medical treatment options, you can research the following:

  • Radio Frequency (RF) of the Soft Palate, which uses radio waves to shrink the tissue in the throat or tongue, thereby increasing the space in the throat and making airway obstruction less likely.
  • Laser-Assisted Uvuloplasty (LAUP), which is an oral surgery procedure that removes the uvula and surrounding tissue to open the airway behind the palate.

Unlike simple snoring, obstructive sleep apnea (OSA) is a potentially life-threatening condition that requires attention from an oral surgeon or another medical professional. The risks of undiagnosed OSA include heart attack, stroke, irregular heartbeat, high blood pressure, heart disease and decreased libido. In addition, OSA causes daytime drowsiness that can result in accidents, loss of productivity and interpersonal relationship problems.

During sleep, the upper airway of an individual with OSA may be obstructed by excess tissue, large tonsils and/or a large tongue. Also contributing to the problem may be the nasal passages, the position of the jaw, and the airway muscles, which relax and collapse during sleep.

The cessation of breathing, or “apnea,” brought about by these factors initiates impulses from the brain to awaken the person just enough to restart the breathing process. This cycle repeats itself many times during the night – sleep apnea is generally defined as the presence of more than 30 apneas during seven hours of sleep. In severe cases, periods of not breathing may last for as long as 60 to 90 seconds and may recur up to 500 times a night. These cessations of breathing, as well as the serious side effects that often result, are why oral surgery may be required to treat OSA.

As many as one in five adults has at least mild sleep apnea, and one in 15 adults has at least moderate sleep apnea. If you exhibit several OSA symptoms, such as daytime drowsiness or high blood pressure, it’s important you visit your oral surgeon for a complete examination and an accurate diagnosis.

At your first visit, your doctor will check your medical history and perform a head and neck examination looking for problems that might contribute to sleep-related breathing problems. An interview with your bed partner or other household members about your sleeping and waking behavior may be recommended.

Obstructive sleep apnea can be effectively treated through either oral surgery or other less-invasive solutions. Depending on whether your OSA is mild, moderate or severe, your doctor or oral surgeon will select the treatment that is best for you.

  • Behavior Modification: If you are diagnosed with mild sleep apnea, your doctor may suggest you employ the non-medical treatments recommended to reduce snoring, such as a change of sleeping positions, weight loss, and avoiding alcohol, caffeine and heavy meals within two hours of bedtime.
  • C-PAP (Continuous Positive Airway Pressure) and Bi-PAP (Bi-Level): A C-PAP device is an effective treatment for patients with moderate OSA and the standard treatment for those diagnosed with severe sleep apnea. Through a specially-fitted mask that fits over the patient’s nose, the C-PAP’s constant, prescribed flow of pressured air prevents the airway or throat from collapsing. In some cases a Bi-PAP device, which blows air at two different pressures, may be used.
  • Oral Appliances: If you have mild to moderate sleep apnea, or are unable to use C-PAP, recent studies have shown that an oral appliance can be an effective therapy. A molded device will be placed in the mouth at night to hold the lower jaw and bring the tongue forward. The appliance elevates the soft palate, or retains the tongue to keep it from falling back in the airway. Patients using an oral appliance should have regular follow-up office visits with their oral surgeon to monitor compliance, to ensure the appliance is functioning correctly and to make sure their symptoms are not worsening.

While these devices help prevent snoring and interruptions in breathing, they only treat your condition and do not cure it. If you stop using your oral appliance, C-PAP or Bi-PAP, your symptoms will return. If you find you are unable to use these devices, do not discontinue their use without talking to your oral surgeon, who may be able to suggest other effective treatments.

Surgical intervention may be a viable alternative for some OSA patients; however, it is important to keep in mind that no oral surgery procedure is universally successful. Every patient has a different shaped nose and throat – before surgery is considered, your oral surgeon will measure the airway at several points and check for any abnormal flow of air from the nose to lungs. He or she may then follow through with one of the following oral surgery procedures:

  • Uvulopalatopharyngoplasty (UPPP): If the airway collapses at the soft palate, a UPPP may be helpful. UPPP is usually performed on patients who are unable to tolerate the C-PAP. The UPPP procedure shortens and stiffens the soft palate by partially removing the uvula and reducing the edge of the soft palate.
  • Hyoid Suspension: If collapse occurs at the tongue base, a hyoid suspension may be indicated. The hyoid bone is a U-shaped bone in the neck located above the level of the thyroid cartilage (“Adam’s apple”) that has attachments to the muscles of the tongue, as well as other muscles and soft tissues around the throat. The procedure secures the hyoid bone to the thyroid cartilage and helps to stabilize this region of the airway.
  • Genioglossus Advancement (GGA): GGA was developed specifically to treat obstructive sleep apnea, and is designed to open the upper breathing passage. The procedure tightens the front tongue tendon, thereby reducing the degree of tongue displacement into the throat. This operation is often performed in tandem with at least one other oral surgery procedure such as the UPPP or hyoid suspension.
  • Maxillomandibular Advancement (MMA): MMA is a procedure that surgically moves the upper and lower jaws forward. As the bones are surgically advanced, the soft tissues of the tongue and palate are also moved forward, again opening the upper airway. For some individuals, the MMA is the only technique that can create the necessary air passageway to resolve their OSA condition.

Sleep apnea is a serious condition, and individuals with OSA may not be aware they have a problem. If someone close to you has spoken of your loud snoring and has noticed that you often wake up abruptly, you should consult an oral surgeon at Stonewalk Family Dentistry. Call us today at (770) 777-1911 or schedule a dentist appointment with us online – we are located in Milton, GA and serve the surrounding areas.

Facial Cosmetic Surgery

Facial cosmetic surgery has long been the solution of choice for the correction of physical malformations resulting from disease, injury and birth defects. In recent years, however, a growing number of men and women of all ages are choosing facial cosmetic surgery to improve their appearance or reduce the signs of aging.

As a result of their surgical and dental background and their ability to reconstruct facial structures, oral surgeons are keenly aware of the importance of harmony between facial appearance and function. Thanks to the development of advanced medical devices and biomaterials, many of today’s facial cosmetic procedures are minimally invasive and can be performed in an office setting using local and/or intravenous anesthesia. Some procedures may require use of an outpatient or same-day surgery center, or hospital.

The following are some of the cosmetic procedures available:

  • Cheekbone Implants (Malar Augmentation) create the appearance of higher, more prominent cheekbones and better facial balance.
  • Chin Surgery (Genioplasty) increases or reduces the length and projection of the chin.
  • Ear Surgery (Otoplasty) is usually done to set prominent ears back closer to the head, or to change the shape or reduce the size of large ears.
  • Eyelid Surgery (Blepharoplasty) removes fat and excess skin from the upper and lower eyelids, and can be done alone or in conjunction with other facial surgery procedures such as a facelift or brow lift.
  • Facelift (Rhytidectomy) provides a more youthful appearance by tightening facial skin, muscles and removing excess skin. A mini-facelift is a minimally invasive technique involving only small incisions.
  • Facial and Neck Liposuction can help sculpt the face by removing excess fat. Neck liposuction is often performed in conjunction with such procedures as genioplasty and corrective jaw surgery.
  • Forehead/Brow Lift is often done in conjunction with blepharoplasty to improve brow positioning, minimize frown lines and reduce forehead wrinkles.
  • Lip Enhancement can reshape the upper and lower lip to give a more aesthetic or youthful appearance. Augmentation of the lips is accomplished using various materials that help “plump” the lips, creating fullness and decreasing vertical lines.
  • Nasal Reconstruction (Rhinoplasty) can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip.

Several techniques exist for treating skin that is wrinkled, scarred or otherwise damaged. The amount of improvement varies and depends upon the initial condition of the patient’s skin and the procedure.

  • Botox® Injections can reduce the signs of aging by reducing the muscle activity and wrinkles of the eyebrow and forehead. It is especially effective in reducing frown lines.
  • Chemical Peels involve the application of a solution that causes the wrinkled or damaged top layers of skin to peel, revealing new, healthier skin after healing. There are several types of chemical peels – a light peel to remove superficial wrinkles, a medium-depth peel, and a deep peel for more severe conditions.
  • Dermabrasion smoothes surface irregularities to produce a more uniform appearance.
  • Laser Treatments can remove the outer layers of damaged or wrinkled skin. The new skin appears healthier and smoother, giving a rejuvenated, more youthful appearance.
  • Injectable Fillers (Restylane®, Collagen, etc.) are synthetic or naturally-occurring materials that are placed with small needles to plump wrinkles, furrows or grooves in the skin. The results are instantaneous although the duration varies with the material chosen.

Facial cosmetic surgery may refine, enhance and/or rejuvenate existing features; however, it will not give you a new face or a new life. How much or how little change is realized depends on the individual and the extent of the surgical procedure. Your age, health, skin texture, bone structure, healing capacity and personal habits, such as smoking or alcohol consumption, are all factors that may affect the results of your surgery.

If you are interested in learning more about these procedures and determining whether you are a candidate for cosmetic surgery, please schedule a consultation today with our oral surgeon by calling (770) 777-1911.

Anesthesia

Oral surgeons are unique, in that they train with anesthesiologists and anesthesiology residents. No other dental or medical specialty requires this level of training and, as a result, your oral surgeon is part of a very small group of healthcare professionals that can administer all levels of sedation and anesthesia. The sedation dentistry options available during oral surgery range from conscious sedation to deep IV sedation and general anesthesia. The level of anesthesia used is carefully matched to the needs of the patient and the type of procedure performed.

An upcoming visit to an oral surgeon could produce anxiety in some patients. You may be wondering what kind of pain you may feel, if any, and how long the effects of the surgery may last. The good news is that today’s technology makes it possible to perform complex oral surgery in-office with little or no discomfort. So don’t worry – oral surgeons are highly-educated and expertly-trained in the administration of proper anesthesia for any given procedure.

The best way to reduce anxiety about your upcoming oral surgery is to make certain you know what to expect during and after the procedure. As with most anxiety-producing situations, the more you know, the less you’ll worry. Prior to surgery, your oral surgeon will discuss with you the type of anesthetic to be used, as well as the way you’re likely to feel during and after the operation. This is the time to discuss any concerns you may have about any facet of the operation.

During oral surgery, one or more of the following may be used to control your pain and anxiety: local anesthesia, nitrous oxide-oxygen, intravenous sedation and general anesthesia. Usually, patients describe their feelings during surgery as comfortable and surprisingly pleasant. Also, you may be prescribed a medication after surgery to make you as comfortable as possible when you get home.

To find out more about the many forms of sedation dentistry administered during oral surgery, or to schedule a consultation with an oral surgeon, call our office at (770) 777-1911 or make an appointment today through our website. Our family-oriented dental practice in Milton, GA serves patients in Alpharetta and the surrounding areas.

Nutrition

Nutrition, in its basic sense, refers to the intake of nourishment – specifically, the fluids and foods we need to survive. Following illness or surgical procedures, our nutritional needs increase, and proper care must be taken in order to facilitate healing. For oral surgery patients, nutritional upkeep may be particularly challenging, as the presence of surgical incisions in or around the mouth and postoperative swelling often make it more difficult to chew and swallow normally.

Post-Surgery Nutrition

Your oral surgeon may suggest a liquid or soft diet for a short time to make you more comfortable and to avoid inadvertently injuring your surgical site. In addition, following oral surgery, it is often recommended that you avoid activities that may physically disrupt clotting and healing. These activities may include consumption of carbonated beverages, drinking through a straw, vigorous tooth brushing and mouth rinsing. Questions regarding when you may resume these activities should be directed to your oral surgeon.

Nutrition After Jaw Surgery, Facial Fractures and Intermaxillary Fixation

In the past, patients undergoing jaw and fracture surgery had their jaws immobilized to promote healing. This was accomplished by wiring or using elastic rubber bands to hold the teeth together. This technique may still be necessary in some oral surgery cases, especially those involving jaw fractures. However, it is now more common to place small screws and fixation appliances to ensure accurate and predictable healing. These fixation appliances are small enough to be barely perceptible to patients and need not be removed following healing. On the other hand, their small size also means they are unable to withstand the forces of chewing until the surgical sites have had time to heal.

During this period of time, which may last several days, all nutrition may need to be consumed in liquid form. Particular care should be directed towards ensuring that you get your recommended six to eight glasses of water per day. To meet your caloric needs after oral surgery, your oral surgeon will likely suggest proprietary liquid nutritional supplements that contain a high amount of calories, as well as a proper balance of protein and vitamins. Brands such as Ensure®, Sustacal® and Boost® are available at any pharmacy for over-the-counter purchase. These supplements can also be accompanied by homemade shakes or smoothies containing fruit, protein powders or other additives. To prevent oral hygiene problems, these blended mixtures should be strained to remove particles and food fiber. Additionally, it may be helpful to keep a diet diary during this time to ensure your nutrient goals are being met.

Following this brief dependence on liquids, it is likely that a semi-solid, “non-chewing” diet will be recommended. Foods consumed during this phase should have a consistency that can be eaten without biting or chewing. These may include soft scrambled eggs, soft pancakes, well-cooked pasta, flaky fish, etc. This non-chewing diet should be maintained until your oral surgeon specifically approves a more solid diet, which may take place three to six weeks following your oral surgery.

If you’d like to learn more about how to meet nutritional needs after oral surgery, call our Alpharetta-area office at (770) 777-1911 or schedule a visit today – our in-house oral surgeon will be happy to give you as much information as possible! Stonewalk Family Dentistry is located in Milton, GA and serves families in the surrounding areas.

Sources

[1]Ash M. Costich ER, Hayward JR: A study of periodontal hazards of third molars. Journal of Periodontology 1962;33:209

[2]Elter JR, Coumo CJ, Offenbacher S, et.al. Third molars associated with periodontal pathology in NHANES III. Journal of Oral and Maxillofacial Surgery, 2004; 62:440

[3]Elter JR, Offenbacher S, White RP, et.al. Third molars associated with periodontal pathology in older Americans. Journal of Oral and Maxillofacial Surgery, 2005; 63:179

[4]Stewart PS, Costerton JW: Antibiotic resistance of bacteria in biofilms. Lancet 2001;358:135

[5]Stewart PS, Costerton JW: Antibiotic resistance of bacteria in biofilms. Lancet 2001;358:135

[6]Sedghizadeh pp, Kumar SKS, Gorur A, et.al. : Identification of microbial biofilms in osteonecrosis of the jaws

 

The American Association of Oral and Maxillofacial Surgeons (AAOMS), the professional organization representing more than 9,000 oral and maxillofacial surgeons in the United States, supports its members’ ability to practice their specialty through education, research and advocacy. AAOMS members comply with rigorous continuing education requirements and submit to periodic office examinations, ensuring the public that all office procedures and personnel meet stringent national standards.

© 2005-2012 American Association of Oral and Maxillofacial Surgeons (AAOMS). All rights reserved.

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