Face & Jaw Surgery Center

Dental implants have rapidly gained popular use over the past few decades as a technologically improved alternative to bridges and dentures. The various types of dental implants allow dental professionals and patients alike a broad range of options and possibilities when it comes to replacing missing teeth.

Determining the Best Possible Dental Implant

Each type of dental implant is designed and manufactured to execute a particular function. The majority of these implants are made of titanium, as this material has been shown to aid in the fusion of metal and bone. This process is called osseointegration, literally meaning “combining with the bone.” Depending on a patient’s specific situation, the oral surgeon will decide which of the following types of dental implants is the best possible choice:

• Root Form Implants
• Plate Form Implants
• Subperiosteal Implants

Root Form Implants

Of the three main types of dental implants, the root form implant most closely resembles the size and shape of the root found in a natural tooth. They are most often placed in wide areas of bone in order to offer stability and support for one or more teeth. First, after applying anesthetic to the area, the oral surgeon exposes the bone of the jaw into which the implant will be placed. The implant is then installed directly into a prepared area of bone. After this portion of the procedure, the gum area that has been opened may be stitched closed.

Over a period of approximately three to six months, the process of osseointegration ensues, allowing the living bone of the jaw to grow and harden around the implant. Often, the structural stability that is created here is even more secure than that of the natural tooth and root system that is replaced. When this healing process is complete, the root implant may need to be uncovered, if it was submerged, to allow attachment of an extension or abutment. The resulting unit is then prepared to support and hold the patient’s new tooth.

Plate Form Implants

This is a type of implant that is dated and not used anymore. This type of prosthesis is long and flat. The oral surgeon applies an anesthetic and carefully opens the gum tissue to expose the underlying jaw bone. This area of bone is then prepared to precisely accept the implant for a secure fit.

Subperiosteal Implants

This is also a dated technique that is not utilized anymore. These implants are manufactured to rest beneath the gums, but rest on top of the jaw bone rather than being incorporated into it. Subperiosteal implants are customized to suit the patient’s individual jaw and gum structure.

Face and Jaw Surgery Center serves all of North Dakota and North West Minnesota including Moorhead, MN and East Grand Forks, MN

Bismarck, ND office

Fargo, ND office

Grand Forks, ND office

Minot, ND office

What is Cleft Palate?

Cleft palate is one of the most common facial birth defects in children from all over the world and occurs in approximately one of every 700 births. During the first trimester of pregnancy, the fetus develops all major facial components. When the roof of the mouth fails to form completely, a gap is left where tissue should be. The condition may be mild to severe and may affect one or both sides of the mouth.

The Importance of Repairing a Cleft Palate in Young Children

The American Academy of Pediatrics states that every baby should be provided with an ample amount of breast milk or reconstituted infant formula for the first six months of life. Unfortunately, feeding a newborn with cleft palate is immensely difficult, especially when the condition is severe. In order to ensure that the affected child is able to eat an adequate amount during this period, it is important that the cleft in the palate be repaired as soon as is possible.

What Can Be Done to Correct a Cleft Palate?

A team of maxillofacial surgeons and other specialists work together to assess the extent of the condition before a plan for reconstructive surgery is developed. In addition to improving the appearance of the nose and mouth area, the primary goals of this complex form of surgery are to enhance the child’s ability to eat, speak, breathe and hear normally. Dental restoration may be necessary in the years following surgery to ensure that the formation of teeth is not affected by the original procedure.

The team of medical professionals that collaborate on the reconstructive procedures and rehabilitation include:

Oral and maxillofacial surgeon

• Cosmetic surgeon
• Pediatrician
• Speech therapist
• Orthodontist
• Auditory specialist
• Ear, nose and throat doctor
• Counselor or therapist to help with emotional issues

Treatment Before and After Reconstructive Surgery of a Cleft Palate

Prior to the surgical correction of the cleft, an orthodontist may recommend the use of a custom orthopedic device. The device usually resembles a retainer and is fitted into the roof of the child’s mouth. Its purpose is to gently and gradually bring the two sides of the palate closer together, which will enable the surgeon to perform the reconstruction more efficiently.

If a cleft lip is also present, this condition is generally repaired first. The entire procedure usually takes a few hours and is followed by a recovery period of about two days in the hospital. After the lip has healed sufficiently, the surgeons can begin work on the cleft in the palate. Follow-up procedures with an orthodontist, oral and maxillofacial surgeon and speech therapist may continue into late childhood, depending on the severity of the cleft. After a period of six months to two years, the child should enjoy a relatively normal pattern of speech and functionality of the entire mouth.

Face and Jaw Surgery Center serves all of North Dakota and North West Minnesota including Moorhead, MN and East Grand Forks, MN

Bismarck, ND office

Fargo, ND office

Grand Forks, ND office

Minot, ND office

Dentists use a variety of anesthesia products to help their patients feel as comfortable and relaxed as possible during dental procedures. Due to the incredible advances in dental technology, dentists are now able to provide medication for patients to lessen or completely eliminate pain and anxiety during treatment. Depending on the type of procedure you need, your dentist may be able to offer you more than one option for anesthesia.

What are the Different Types of Anesthesia?

The most common types of anesthesia used by dentists are:

• Analgesics
• Local anesthesia
• Sedation and general anesthesia

Analgesics

Analgesics (available in narcotic and non-narcotic forms) are the most commonly prescribed medications for pain during and following dental procedures. Non-narcotic analgesics include ibuprofen, acetaminophen and aspirin. The narcotic category can include drugs made with codeine, hydrocodone, or oxycodone; and are most frequently prescribed for severe pain.

Local Anesthesia

Local anesthetics can be divided into two categories: those that are applied topically and those that are injected directly into the tissue. In a topical form, the anesthetic numbs the tissue to which it is applied, preventing pain on the surface. Often, a topical anesthetic may be applied before an injected anesthetic is used to lessen the pinch of the needle. The injected anesthetic typically lasts much longer than the topical one and works by blocking the nerves that sense pain and allow pain messages to be sent to the brain. This type of anesthesia is frequently used during the filling of cavities, root canals, treatment of periodontal disease, or tooth extraction (tooth pull).

Sedation and General Anesthesia

These types of anesthesia are most commonly administered when a patient is especially anxious prior to the procedure. Sedatives can help a patient relax considerably, allowing the dentist to work with ease and efficiency. Nitrous oxide and other light sedation techniques simply help to place the patient into a deeply relaxed state, whereas more complex sedation methods can put a person completely “under,” or to sleep. This ability to induce temporary unconsciousness is especially useful in cases in which a child, for example, is so anxious that the dentist is unable to perform the procedure.

How to Talk to Your Dentist

One of your dentist’s primary concerns is your comfort and contentment while he or she treats your teeth and gums. If you routinely experience anxiety concerning dental procedures or anesthesia, talk to your dentist before you get started. State your concerns clearly and plainly, as this will help you both with developing a rapport and a course of treatment that works best for you.

After you’ve talked about anesthesia, work out a system of communication in which you can use your hands while you are unable to talk. Knowing that you will be able to tell your dentist when you are in discomfort or need a break can greatly reduce general anxiety during treatment.

Face and Jaw Surgery Center serves all of North Dakota and North West Minnesota including Moorhead, MN and East Grand Forks, MN.

Bismarck, ND office

Fargo, ND office

Grand Forks, ND office

Minot, ND office

Causes of Missing Teeth

There are a variety of reasons that teeth may be lost. Some of the most common include:

• Injury or trauma to the mouth or gums
• Certain hereditary disorders
• Tooth decay
• Gum disease
• Failed root canal treatment
• Chemotherapy and radiation therapy

Why Is It So Important to Replace Missing Teeth?

• General health – While missing teeth can certainly affect your sense of self-confidence, there are more pressing reasons to replace them. One of these reasons is related directly to your nutrition and overall health. Depending on the number and location of the missing teeth in your mouth, it may prove difficult to eat certain foods. The avoidance of specific foods can lead to malnutrition and recurrent illnesses. Thus, it is imperative to your general health to replace missing teeth with strong dental implants.
• Oral health – It is also important to replace teeth in order to avoid gum and jaw deterioration and shifting of the surrounding teeth. When a tooth is lost due to gum disease, the exposed jaw bone can begin to dissolve within a matter of months. This can cause intense pain and further spread of the disease throughout the mouth. When teeth begin to shift around the empty space left by a missing tooth, gaps and uneven spacing become more apparent over time.
• Off-bite problems – The gaps caused by missing teeth and the resulting shifting can lead to major problems with the way the jaws come together and close. This can lead to issues with chewing food, speech and further decay (due to food becoming lodged within the gaps).

What is the Best Way to Replace Missing Teeth?

When a patient presents with a dire need to replace missing teeth, options for resolving the issue are dependent upon that patient’s individual circumstances. Your dentist must evaluate your situation and determine the most effective treatment plan possible. However, a vast majority of patients today are finding that dental implants are the perfect solution for them.

Dental implants are largely preferable to bridges and dentures for many reasons. The advantages of having dental implants rather than other dental appliances include the following:

• Implants look like your natural teeth and are customized to match your other teeth
• Dentures can shift and irritate the gums, whereas implants are attached directly to the jaw
• Implants can be cared for in the same way as the rest of your natural teeth
• Implants are permanent and feel like natural teeth, whereas dentures must be removed

If you are missing one or more teeth, it is imperative to your general and oral health to have them replaced as soon as possible by your dental professional. The application of dental implants can transform your smile and your life.

Face and Jaw Surgery Center serves all of North Dakota and North West Minnesota including Moorhead, MN and East Grand Forks, MN.

Bismarck, ND office

Fargo, ND office

Grand Forks, ND office

Minot, ND office

After a tooth is extracted, the body’s natural defense system begins the process of forming a clot at the site in order to start healing. However, if this clot is dislodged before the wound has completely healed, the condition known as dry socket ensues, causing intense pain and sensitivity.

Dry socket is a painful dental complication that follows the extraction of a permanent tooth. The pain arises from the loss of a protective blood clot at the site of the extraction, which allows the bone and nerves there to be exposed to air, food and liquids. Pain is most frequently noticed within one to three days following the initial surgery.

Symptoms of Dry Socket

While it is normal to experience some tenderness and pain following an extraction, patients with the following symptoms are advised to consult their oral surgeons immediately to rule out potential complications:

• Intense pain at the extraction site within a few days of surgery
• Visibly exposed bone at the extraction site
• Visible loss of the blood clot at the  extraction site
• Unusually bad breath
• Foul taste in the mouth
• Swelling of the lymph nodes in the jaw and surrounding neck area

Causes and Risk Factors Associated with Dry Socket

The exact cause of this condition is still in a state of research, though the following have been shown to contribute to dry socket in a substantial number of cases:

• Trauma to bone and tissue surrounding the extraction site
• Minute fragments of tooth or bone that remain in the wound, preventing it from healing properly
• Contamination of the socket by bacteria or other external factors

Risk factors include the following:

• A previous case of dry socket
• Inadequate after-care at home
• Gingivitis or other gum infection
• Smoking cigarettes or chewing tobacco

Treatment of Dry Socket

The treatments of dry socket are primarily focused on reducing pain and the likelihood of contamination in the area so that the wound can continue to heal naturally. These treatments include:

• The dentist will flush out the socket to free it of any remaining debris and then pack it with medicated dressings. This process will assist in pain relief and prevent further infection.
• Because many cases of dry socket do not react to over-the-counter pain remedies, the dentist will often recommend prescription medication to alleviate pain while the wound heals.
• Self-care at home may include flushing of the socket with salt water or another prescription solution multiple times per day.

Prevention of Dry Socket

After an extraction, patients are given specific after-care instructions to prevent complications such as dry socket. These include:

• Getting plenty of rest following the surgery
• Drinking plenty of water to remain properly hydrated
• Avoiding hot, alcoholic or caffeinated beverages for the first 24 hours following extraction
• Abstaining from smoking or drinking from a straw, as this suction may interrupt clotting
• Eating only soft foods

The most effective way to prevent dry socket is to adhere exactly to the specific instructions given by a dentist or oral surgeon following an extraction.

Face and Jaw Surgery Center serves all of North Dakota and North West Minnesota including Moorhead, MN and East Grand Forks, MN.

Bismarck, ND office

Fargo, ND office

Grand Forks, ND office

Minot, ND office

See the video of our own Dr. Glosenger talking about dental implants on KXNews Noon Show.

What is Root Canal Failure?

A root canal fails when a tooth that has been previously treated with a root canal procedure becomes infected at the root. If this infection is allowed to continue to develop without proper treatment, the infection can potentially spread to other teeth in the area or cause illness in other parts of the body.

What Causes a Root Canal to Fail?

• Undetected canal branches: Depending on the circumstances and the patient, a root canal procedure can be an intricate process. Sometimes, a patient’s tooth (such as a lower incisor, for example) may have more canals within it than are expected. Molars that have three roots may have as many as four canals, some of them hidden behind others. If one of these canals is missed and not treated, an infection will ultimately develop and can potentially form a painful abscess.
• Obstruction: An obstruction (such as another tooth, filling material, etc.) may make it impossible for the dentist to reach and thoroughly clean the entirety of the canal affected.
• Cracks in the root: The root of the affected tooth may develop a fissure or fracture deep beneath the gum, making it impossible to fully seal the canal. This allows for the possibility of an infection that leads to increased sensitivity, pain and the need for retreatment.

What are the Treatment Options for Failed Root Canals?

There are a number of options available for dental patients affected by a failing root canal. These include:

• Retreatment
• Apicoectomy (or surgery at the apex of the tooth)
• Extraction of the affected tooth

Retreatment is the most common option and has the highest rate of success. It involves removing the original filling, disinfecting the canal and then resealing it to prevent further irritation and exposure to bacteria.

Apioectomy is the procedure most often chosen when a blockage of some sort prevents access to the canal or if the original procedure included a post and crown restoration. The process includes the creation of a small flap in the gum through which the root is accessed. The infected portion of the root may be completely or partially removed and a new seal is placed.

Extraction is the option chosen if retreatment is not effective or if the affected tooth cannot be successfully restored in any other way. If there exists sufficient bone at the site of the extraction, an implant may be used to fill the empty space.

Depending on the nature and the severity of the root canal failure, the dentist will consider all options available in order to make a decision regarding treatment and further surgery.

Face and Jaw Surgery Center serves all of North Dakota and North West Minnesota including Moorhead, MN and East Grand Forks, MN.

Bismarck, ND office

Fargo, ND office

Grand Forks, ND office

Minot, ND office

Though permanent teeth (when properly cleaned and maintained) are inherently strong enough to last for decades, certain situations arise in which one or more of these teeth must be removed.

Severe Tooth Damage

One of the most common reasons for extraction is based upon irreparable damage to a tooth. This may include one or more of the following circumstances:

• A tooth is affected by extensive decay
• The tooth is fractured so severely that it cannot be repaired
• A root canal is needed but is not possible or practical
• A crack or break in the tooth provides the dentist with reason to believe that the condition will worsen if the tooth is not extracted

Teeth Affected By Gum Disease

A tooth or group of teeth that have been affected by aggressive periodontitis or other periodontal diseases are often damaged to such an extent that they must be removed. As a result of the diminishing quality of the bone and gums surrounding the tooth, it may become loose and prone to shifting. In these cases, extraction is often the best option to avoid further damage and tooth loss.

Nonfunctional or Malpositioned Teeth

Nonfunctional teeth are defined as teeth that serve little to no purpose to the patient. In certain situations, these teeth may actually prove to be detrimental, as they may cause crowding of other teeth or pain and irritation to the dental patient. Under these circumstances, nonfunctional teeth may be removed. A lone wisdom tooth is often deemed nonfunctional.

Malpositioned teeth can also cause crowding and the eventual drifting of other teeth. Impacted teeth are an example of malpositioning, as these teeth are not in a position in which normal eruption through the gum is possible. Surgical extraction of these teeth often helps alleviate pressure and pain and can prevent overcrowding of teeth throughout the rest of the mouth.

Preparing the Mouth for Braces

Because the goal of orthodontic treatment is the ultimate alignment of the teeth, it is sometimes necessary to extract teeth in preparation for braces. If the mouth is overly crowded before orthodontic procedures begin, the ability of the braces to effectively straighten the teeth is often considerably diminished.

Risk of Infection

Because bacteria in the mouth can travel through the bloodstream, oral health affects the entire body. If a tooth is severely decayed and infected, an extraction may be necessary to prevent illness in other areas of the body. This is especially true in cases of pregnant women, individuals with compromised immune systems or cancer patients undergoing chemotherapy.

Following certain extractions, dental implants may be offered as an option for replacing missing teeth.

Face and Jaw Surgery Center serves all of North Dakota and North West Minnesota including Moorhead, MN and East Grand Forks, MN.

Bismarck, ND office

Fargo, ND office

Grand Forks, ND office

Minot, ND office