Face & Jaw Surgery Center

Having your impacted wisdom teeth removed is a serious surgical procedure, and post-operative care is extremely important! Read on for instructions on how to care for your sore mouth, and how to minimize unnecessary pain and complications.

Immediately Following Surgery

Keep a firm, yet gentle, bite on the gauze packs that have been placed in your mouth to keep them in place. You can remove them after an hour if the bleeding is controlled. If the surgical area continues to bleed, place new gauze for another 30 to 45 minutes.

Be careful!

Do not:
• Rinse vigorously
• Probe the area
• Smoke (hopefully you don’t!!)
• Participate in strenuous activities
You can:
• Brush gently (but not the area)
• Begin saltwater rinses 24 hours after surgery (mix 1 tbs of salt with 1 cup of water). Make sure to swish gently. These rinses should be done 2-3 times a day, especially after eating.

Enjoy some down-time!

Keep activity level to a minimum! Enjoy a day of couch or bed-rest, as being active could result in increased bleeding. Avoid exercise for 3-4 days, and when you do begin exercising again, keep in mind your caloric intake has been reduced so you may feel weaker.

Bleeding

As you’ve just had surgery, some bleeding will occur and it’s not uncommon to ooze blood for 24-48 hours after your procedure. REMEMBER-the blood you see is actually a little blood mixed with saliva, so don’t panic!
If excessive bleeding persists:
• Try repositioning the packs. They may not be putting enough pressure on the site.
• Sit upright and avoid physical activity.
• Use an ice pack and bite on gauze for one hour.
• You can also try biting on a moistened tea bag for 30 minutes (the tannic acid in tea promotes blood clotting).
• If bleeding persists, please call our office at 701-239-5969.

Pain

Unfortunately, some pain is to be expected after surgery. Try not to let the anesthetic wear off before taking your prescribed pain medication. Dr. Chahal, Dr. Deatherage, Dr. Gray, Dr. Gomez, Dr. Knoll or Dr. Miller will have discussed a plan to manage your pain, make sure you follow these instructions.

Diet

Eat nourishing food that takes little effort.
Avoid:
• Extremely hot foods
• Straws (for the first few days)
• Chewing (until tongue sensation has returned)
• Smaller foods that can become stuck in the socket area
• Skipping meals—while eating may seem like a lot of work, you need your nourishment to be able to heal and feel better!

Day 2 and 3 Following Surgery

Swelling

Swelling is a completely normal occurrence. Keep in mind, swelling will usually be at it’s worst in the 2-3 days after surgery. You can minimize swelling by applying a cold compress (covered with a towel) firmly to the cheek next to the surgical area. Apply the pack with 20 minutes on, and 20 minutes off for the first 24-48 hours. Also make sure to take the medication prescribed by Drs. Chahal, Deatherage, Gray, Gomez, Knoll or Miller. This helps with pain and swelling.

Keeping your mouth clean

Keeping your mouth clean is very important! Continue saltwater rinses as often as you’d like, but at least 2-3 times a day. Begin your normal oral hygiene (remember to brush softly and don’t do anything that hurts)!

Healing

Everyone heals differently, but your timeline should look similar to this:
• Day 1-2 will be the most uncomfortable and you will experience some swelling.
• Day 3 you should be more comfortable and while still swollen, you should be able to begin a more substantial diet.
• Day 4 and on you should see a gradual and steady improvement.

Other Normal Things

• Discoloration. Bruising is a normal post-operative occurrence you may notice 2-3 days after surgery.
• Stiff jaw muscles. You may find it difficult to open your mouth wide in the days following your surgery. This is normal and usually resolves itself within a week after surgery. Stretching these muscles may help to speed up recovery.
Since no two mouths are alike, do not take advice from friends (even well-intended advice could cause a healing set-back). The advice given to you from Drs. Chahal, Deatherage, Gray, Gomez, Knoll or Miller and the Face & Jaw Surgery Center team are tailored to fit your needs. Please call us at 701-239-5969 if you have any questions or concerns about your recovery. Happy healing!

Whether you are missing a tooth, or at risk of losing many, dental implants may be a great solution   for you. Dental implants are an increasingly popular fix for missing or dying teeth, and have many benefits.

What is a Dental Implant?

Dental implants are high tech teeth. The root of your current tooth is removed, and replaced with a screw attached to a ‘cap’ that looks identical to a natural tooth. Many people report higher confidence and comfort after receiving their new tooth.

What’s so Great About Them?

The cool thing about implants is that if taken care of, they can last for life. Usually all that needs to be replaced, if anything, is the cap. The other great thing about implants is that they can’t die like natural teeth. You still have to clean and maintain them like your other teeth, but no roots are any longer at risk of causing that tooth to fail. In addition to that, many implants can last a lifetime!

What is the Surgical Process Like?

The process is done either all at once, or in steps. This depends on the recommendations for your particular case. The first step is to remove the root of your natural tooth, and place the implant in its place. If there is not enough bone to place the implant, we may encourage you to have bone grafting first. The gum is then stitched closed and allowed to heal. This can take five to six months. The next step is to reopen the gum and place an abutment on the implant, along with a temporary crown so you can heal while the permanent crown is made for you. You then return to get your permanent crown attached in a few weeks. In other cases, all of these steps can be done in a single visit, but it depends on your specific case.

If you have any questions, please call our office for more information, we would be glad to help!

When it comes to getting your wisdom teeth pulled, you may be stressing about the long list of foods you can’t eat. Don’t worry – you won’t starve! We want your recovery to be as quick and painless as possible, so keep reading for an easy-to-follow guide to eating after your wisdom tooth removal!

DONT’S

• Remember not to drink from a straw during your recovery. Using a straw could rip out your stitches or blood clots, causing dry socket.
• The bubbles in carbonated drinks can also cause dry socket by loosening blood clots, so it’s best to avoid sodas.
• Don’t eat crunchy foods like nuts, chips, and popcorn because they are hard to chew and can easily get stuck in your extraction sites.
• Avoiding acidic foods and beverages can keep you from experiencing pain and stinging.

DO’S

• Any liquids are fair game, like soups and broths. Lukewarm beverages are best, because you may experience temperature sensitivity.
• Yogurt, pudding, applesauce and Jell-O are some go-to recovery foods: no chewing involved! Stick to these post-extraction staples for the first 24 hours after your surgery before moving on to soft foods that require chewing.
• Mashed potatoes are great for the first few days because you can flavor them with gravy, butter, garlic, sour cream, cheese, the list goes on. Soft, starchy and filling, you won’t feel like you’re missing out on solid foods with these!
• When you’re ready to move on to chewable foods, eggs are soft and can be eaten with just about anything.
• You can even eat pancakes! They’re light, fluffy, and easy on your extraction sites (Tip: you can make breads even easier to chew by letting them sit in your mouth for a few seconds and softening them with your saliva).
• Pasta is totally doable if you prepare it right. Macaroni and cheese is perfect because you can swallow the tiny noodles whole or chew them with your front teeth. You can also overcook your pasta noodles to make sure they are soft and easy to chew.

Your wisdom tooth extraction will be over with before you know it, and as long as you avoid difficult-to-chew foods you’ll be on your way to a speedy recovery!

Are missing teeth causing you difficulty, discomfort or embarrassment? Don’t worry – we have all the facts about tooth replacement treatments and the effectiveness of dental implants as a long-term solution for missing teeth.

What are dental implants?

Dental implants are replacement teeth made of titanium. They are composed of an artificial crown attached to a screw that is surgically implanted into the jaw for stability. Implants are an effective treatment for missing teeth because they maintain the strength of the jaw.

There are a few alternative treatment options, some more lasting than others:

Flippers are temporary, removable plastic teeth. They are attached to a retainer for easy removal. Flippers are one of the most cost efficient tooth replacement methods; however, they are the least durable alternatives to dental implants and are considered short-term solutions until a more lasting treatment can be performed.

Fixed bridges literally “bridge” gaps caused by one or more missing teeth. A dental bridge consists of a false tooth, called a pontic, and two abutment teeth, which are crowns that anchor the bridge to the teeth on either side of the gap. Abutment teeth can be secured to both natural teeth and dental implants; however, anchoring them to natural teeth can cause damage.

Dentures are a common treatment for individuals missing all their teeth in one or both of their jaws. They are made of a removable frame that holds an entire set of teeth.

Removable partial dentures are removable frames that hold a partial set of teeth rather than a full set of teeth. This option is often considered for individuals who are missing some but not all of their teeth in one or both jaws.

Why choose dental implants?

Implants are the longest lasting treatment for missing teeth. With proper care, dental implants can last up to ten years or longer. Because they are surgically anchored into the jawbone, they function like natural teeth.

What are dental implants? Dental implants are replacement tooth roots that provide a foundation for both fixed and removable replacement teeth. Like roots, dental implants are secured within the jawbone and not visible once surgically placed.

Teeth replacement is not new to dental technology. Early civilizations practiced teeth replacements; archaeologists have discovered skulls where teeth have been replaced by cast iron and sea shells. Despite their primitive methods, some of these implants were fused with bone like modern dental implants! However, unlike the ancient cast iron or sea shell implants, modern implants are composed of titanium. Titanium is lightweight, strong, and biocompatible.

According to the American Academy of Implant Dentistry (AAID), dental implants have the highest success rate of any implanted surgical device — 98%. Dental implants are available in several designs that meet individual needs: single tooth replacement, multiple tooth replacement, implant supported prosthesis (removable), and an implant stabilized denture. Aside from meeting individual needs, there are a few other advantages to having dental implants:

• Improved appearance. Dental implants are designed to fuse with bone, and look and feel like your natural teeth.
• Improved comfort. Because dental implants become an extension of your natural mouth, implants remove the discomfort associated with removable dentures.
• Easier eating. Dental implants act as your natural teeth, allowing you to eat without the pain and discomfort that often accompany slipping of dentures.
• Improved self-esteem. Dental implants give your best natural smiling, helping build self-confidence!
• Improved oral health. Dental implants are the only proven way to prevent bone loss after the loss of natural teeth. The jawbone needs consistent chewing action to stimulate continual bone growth. Tooth/teeth replacement with dental implants offers a solution to prevent bone loss.
• With proper care, consistent brushing, flossing and routine dental visits, dental implants can last 40-years to life.

If you are interested in dental implants, or have any questions regarding the procedure, call Face & Jaw Surgery Center today at 701-239-5969!

Wisdom tooth removal has become somewhat of a rite of passage – puffy-cheeked post-extraction photos, a diet of Jell-O and mashed potatoes. But not everyone gets their wisdom teeth taken out. In fact, not everyone has wisdom teeth at all! Have you ever wondered why some people have four wisdom teeth while others have fewer or even none? We’ve got the facts behind how many wisdom teeth people have and why!

Why do we have wisdom teeth?

Third molars, or wisdom teeth, were once very useful to our ancestors. Because prehistoric man’s diet of hard-to-chew plants and uncooked meat required powerful chewing muscles, our ancestors’ jaws were large enough to fit 32 teeth, not just 28. Now that humans have evolved a better means of chewing and digesting our food, we no longer have large jaws, so we simply have no need or no room for wisdom teeth. Many scientists believe humans are currently evolving third molar hypodontia, or the lack of wisdom teeth, due to their inability to develop in the first place.

How many people have wisdom teeth?

About 20-25% of the human population is born with 1 to 3 wisdom teeth, and 35% is born without any wisdom teeth at all.

Why do some people have wisdom teeth and some don’t?

There are a few reasons why scientists believe that not everyone develops wisdom teeth:

1. Genetics: Some evidence suggests that a genetic mutation occurred hundreds of thousands of years ago, causing some people to be born without wisdom teeth.
2. Environment: Percentages of people who develop wisdom teeth varies from culture to culture. Certain ethnic groups are known for low percentages of wisdom teeth development, while others are known for high percentages. Environmental factors during dental development are also a possible explanation.

Will wisdom teeth become obsolete?

With the number of people lacking wisdom teeth steadily growing, it’s possible that we could someday completely evolve to not develop wisdom teeth at all. Scientists have experimented with chemically preventing the development of wisdom teeth. Researchers have found that children ages 2-6 that are given local anesthesia for dental work have a higher chance of not developing wisdom teeth later on. Maybe in the future, simple injections at a young age will keep all of us from having to go through wisdom tooth extraction!

Orthognathic surgery, commonly referred to as “jaw surgery,” is used to correct a wide range of both minor and major skeletal and dental irregularities, often the misalignment of the jaws and teeth. Patients looking at undergoing orthognathic surgery are often faced with an extensive recovery period, as well as a restricted diet in the beginning of their recovery process. Post-surgery patients are discouraged from chewing hard foods to allow the bone to heal and stabilize. Due to the fact that adequate healing can take up to 8-12 weeks, patients will initially be on the “swallowing diet” for the first couple of weeks.

When it comes to the “swallowing diet,” the name of the game is high calorie, high protein, and low volume. Facing a large volume of liquid each meal that meets both the necessary caloric and protein needs can be overwhelming. Consuming enough calories, as well as enough protein is a necessity to heal in a timely manner. In order to get adequate volume of fluid and nutrition daily, it may require you to eat smaller meals 5-6 times per day, rather than the usual 3 times per day.

Patients who are well prepared for their surgery often have a smoother recovery. Here is an example of smoothie recipe a patient can consume following orthognathic surgery:

Peanut Butter Banana Smoothie

• 2 chilled bananas, broken into chunks
• 2 cups milk
• 1/2 cup peanut butter
• 2 cups ice cubs
• 2 tablespoons honey, or to taste

Place bananas, milk, peanut butter, honey, and ice cubes in a blender; blend until smooth, about 30 seconds.

Though patients are faced with a restricted diet post-surgery, it is important to remember to try and maintain a balanced diet. In particular, foods rich in vitamins A and C. According to the Academy of General Dentistry (AGD), plenty of vitamin C is one way post-surgery patients ensure a timely recovery!

As doctors, we always weigh the risks and benefits of any procedure or medication therapy. One of the most significant procedures that we perform in our office is orthognathic surgery, more commonly known as “jaw surgery.”

Orthognathic surgery has the ability to enhance a patient’s life, giving him or her the comfort needed to eat properly and, often, the freedom from pain. Because the decision to have jaw surgery is such a serious one, we would like to take a moment to look at the positive side of the procedure in this blog, focusing on the benefits of orthognathic surgery:

• Pain Relief – There are several reasons that a person may experience jaw pain bad enough to warrant orthognathic surgery. They may have unnecessarily been causing excessive wear and tear in the joints over many years and living with constant inflammation. Correcting the alignment of the jaws through surgery is sometimes the only way to set the jaw back on the correct path, reducing strain and therefore pain. Another common scenario occurs with injury to the jaw, often from trauma caused by car and sports accidents. If the jaw is knocked too far out of place or suffers significant trauma, it may not heal on its own and may require resetting through a surgical procedure. These two situations represent occasions where the benefits of orthognathic surgery far outweigh the risks.
• Regular Eating Patterns – A misaligned jaw can make it difficult to chew and swallow, particularly if your teeth do not line up correctly. Often, braces are not enough to correct the alignment issues with the teeth and the jaw itself must be altered. Sometimes, patients don’t even know that they are working too hard to chew because they are used to it always having been that way. Once their bite is corrected through surgery, they are pleasantly surprised to find a significant enhancement in their quality of life.
• Better Overall Health – The health of your body starts in your mouth. Proper nutrition is key to everything from longevity to happiness. Whether your jaws are misaligned from injury or genetics – if your bite is significantly affected, your nutritional habits may be as well, and orthognathic surgery may be the best option for getting your health back on track.

Oral cancer screenings are performed regularly at dental exams, but that doesn’t mean you shouldn’t be paying attention to your oral health between appointments. Taking matters into your own hands is the best way to maintain your oral health. Not sure how to screen for oral cancer? We’ll show you!

What is oral pathology?
This branch of dentistry involves the evaluation and treatment of diseases of the mouth. The most dangerous, but not always the most obvious, of these diseases is oral cancer.
What should I look for?
Keep an eye out for these oral cancer symptoms during your self-screenings:

• Red or white patches in the mouth
• Lumps on the tongue or lining of the mouth
• Mouth sores that won’t heal
• Unexplained bleeding
• Chronic throat soreness
• Difficulty chewing or swallowing
• Mouth numbness

How do I perform an oral cancer self-exam?

1. When performing your oral cancer self-screening, be sure to check all areas of the mouth, including the roof, floor, tongue, lips, cheeks and the back of your throat.
2. Examine your face in the mirror for abnormal asymmetry and irregularities.
3. Feel your neck and the back of your head with your fingers to look for any bumps or changes in texture.
4. Examine your throat by placing your fingers around your thyroid cartilage (Adam’s apple) and swallowing.

How often should I perform a self-exam?
Self-exams should be performed at least once a month. Changes to your oral health can occur rapidly, so it’s important to stay on top of things. Treatment is most effective if we detect symptoms early.

Being that we are entering April, now is the time to be proactive and get yourself checked for oral cancer. According to the American Cancer Society, about 48,330 people will be diagnosed with oral cancer, and an estimated 9,570 people will die from oral cancer in 2016. In the spirit of April’s Oral Cancer Awareness, we urge you to receive regular oral cancer examinations. Remember—early detection saves lives!

Are you at risk?
The sad truth is that oral cancers are more than twice as common in men as in women, and the fastest growing group of oral cancer patients are young, healthy, nonsmoking individuals. It is more important than ever for young adults, as well as older men and women, to get regular screenings whether they think they’re at risk or not.

Knowing the risks can help you make educated decisions about your health. There are several risks that increase your chances of developing oral cancer:

• Smoking and using tobacco products have been a known long-term historic causes of oral cancer.
• Heavy alcohol usage also makes you more susceptible to develop oral cancer.
• The HPV virus, a sexually-transmitted disease, is the leading cause of oropharyngeal (the back part of the mouth) cancer.

What are the signs and symptoms?
The mouth is one of the body’s most crucial early warning signs in the fight against oral cancer. In between regular dental visits, it’s important to be aware of the mouth’s signs and symptoms. Remember, if you see any of these signs or symptoms, schedule an appointment at the office if you don’t see improvement within two-three weeks:

• Hoarseness, chronic sore throat, or change in voice.
• The development of white, red, or speckled (white and red) patches in the mouth.
• Lumps, thickening tissues, rough spots, crusty or eroded areas.
• Difficulty chewing or swallowing, speaking, or moving the jaw or tongue.
• A change in the way your teeth or dentures fit together when you close your mouth.
• Dramatic weight loss.
• Unexplained numbness, loss of feeling, or pain/tenderness in any area of the face, mouth, or neck.
• Unexplained bleeding in the mouth.

Don’t wait any longer. In the spirit of Oral Cancer Awareness Month, be proactive about your oral health, and get checked today!