Face and Jaw Surgery Center

Dr. Brent Ludens

Dental implants are considered to be the treatment of choice when it comes to replacing one or more missing teeth. They offer many benefits over traditional tooth replacement methods such as dentures and fixed bridges, allowing patients to continue living their lives normally in comfort and in confidence. The materials with which they are made are manufactured to withstand the changeable pH environment of the mouth as well as daily use and necessary cleaning.

Though implants are typically placed and intended as a permanent solution to a lost tooth, there are a number of factors that play a role in how long they actually last.

Proper Oral Hygiene Following Placement

After an implant has been placed, the titanium post that serves as a new root will fuse with the bone of the jaw. The prosthetic tooth attached to this implanted post should be cared for in the same way that natural teeth are, from twice-daily brushing and flossing to being cleaned professionally at biannual visits to a qualified dental professional.

Health of Jaw Bone

A long-lasting dental implant is only as good as the bone to which it is fused. Excellent candidates for dental implants are individuals whose jaw presents a sufficient amount of strong, healthy bone in which to insert the titanium post.

Lifestyle and Habits

People who smoke are at an inherently higher risk of developing periodontal disease and generally suffer from poorer circulation than do nonsmokers. In order to ensure your implant’s longest life possible, it is highly encouraged that you refrain from smoking before and after placement.

Taking a Proactive Approach

The simple answer to the question “How long do dental implants last?” should ideally be “a lifetime.” If all variables — including patient care, implant location and health of the jaw bone — align properly, an implant can potentially endure throughout the entirety of the patient’s life. The very first dental implants, placed decades ago, are still functioning properly today.

One of the primary reasons that some dental implants do fail involves improper care of the gums and surrounding teeth. Periodontal disease is known to result in tooth loss in men and women of varying ages. The manner in which this condition causes tooth loss also leads to the loss of implants. As the gums recede and expose the roots of the teeth, the tissues that secure them within the bone of the jaw are gradually damaged.

Preventing conditions like gingivitis and advanced periodontal disease increases the chances that your implants will last a lifetime. Swollen gums and bleeding while brushing or flossing are symptoms of gum disease that may compromise the integrity of your dental implants.

Any patients experiencing pain, inflammation or other symptoms of periodontitis should visit a qualified oral surgeon immediately so as to ensure the longevity of their dental implants and natural teeth. With the right kind of care and regular dentist visits, it is possible to make implants, an invaluable part of your smile, last forever.

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

You Don’t Have to Brush All Your Teeth. Just the ones you want to keep. Feel free to pin and share!

If You Are Confident, You Are Beautiful. Feel free to pin and share!

Dental Implants: Bring Back Your Doggone Smile! Feel free to pin and share!

Beauty Is Ageless. Feel free to pin and share!

A frenectomy is a simple surgical procedure that involves the removal of one or both frena from the mouth. The frenum is a connective tissue membrane that attaches one surface within the mouth to another. The primary frena in the mouth are as follows:

• Lingual frenum – The vertical band of thin tissue that connects the tongue to the bottom of the mouth

• Labial frenum – The connective webbing that attaches the lips to the gum above the top two front teeth and below the bottom two front teeth

• Buccal frena – The thin strands of tissue that connect the gums to the insides of the cheeks

When is a Frenectomy Needed?

In infants, an elongated lingual frenum may make it difficult to nurse or to feed sufficiently from a bottle. A child with this condition is commonly referred to as being “tongue-tied.” If the abnormality is left uncorrected until the patient has reached the toddler years, parents and caregivers may notice that the child affected experiences a more difficult time of speaking than his peers. The condition is not always detected by a pediatrician or general dentist during routine checkups. In fact, it may be first noticed when the child enters pre-kindergarten or elementary school. A child with an elongated frenum may not be able to extend the tongue as would be considered normal. In extreme cases, the child may even experience difficulty and discomfort while swallowing. Fortunately, a typical frenectomy can usually be performed quickly and with minimal pain during the first few weeks of birth.

In the case of an extended maxillary labial frenum, the issue of concern is the potential for orthodontic problems. If the frenum here extends too far down near the gum line, it can interfere with proper growth and spacing of the upper two front teeth. This results in the development of a large gap between these two teeth. Though many parents may worry about this gap from an aesthetic perspective, believing it to signal the need for braces, it is generally recommended that orthodontic procedures be delayed until the child’s permanent teeth have emerged. If, after braces have been placed, the gap remains between two permanent teeth, the labial frenectomy should be considered as a solution to the abnormal spacing. In many cases, the emergence and growth of adult teeth result in a natural closure of the gap caused by the labial frenum’s length.

Performing the Procedure

If it is discovered that you or child are suffering the undesirable side effects of an elongated frenulum, a frenectomy may be recommended as a permanent solution. Your oral surgeon will assess the frenum or frena in question to determine whether or not the procedure is necessary. Generally, unless the existing frenum is causing a problem with feeding, such as breastfeeding in infants and toddlers, or is complicating speech, more natural and noninvasive approaches are considered first. If the surgery is deemed necessary, it is performed in the oral surgeon’s office. The entire procedure typically lasts only 10 to 15 minutes. Recovery is considered complete within a matter of two weeks, during which time the patient often receives pain relief medication to help with soreness at the surgical site. Proper aftercare procedures, including keeping the area clean and avoiding unnecessary movement of the tongue, are explained to the patient prior to leaving the oral surgery center.

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

The canines, or cuspids, are typically some of the last teeth to fully develop. They are crucial components of a healthy bite and should be monitored for normalcy throughout their development. One or more impacted canines can lead to a number of potentially complex issues and abnormalities in the dental arch, affecting all teeth adjacent to the unerupted tooth.

Canine impaction can be defined in more than one way and its specific definition varies from patient to patient. The tooth may be prevented from erupting by adjacent teeth that have grown too close together or may be embedded in the bone of the jaw. The tooth may simply fail to emerge after the root has formed completely. Approximately one to two percent of the general population suffers from impaction of one or more permanent canines.

Complications of Impacted Canines

In most cases of impacted canine teeth, the problem is first discovered during a routine visit to the dentist. Impaction of these vital teeth can be detected by a dentist or oral surgeon as early as the age of eight using a combination of physical and radiographic examination. If, however, the patient is not seen by a dental professional regularly and the impaction is not detected in a timely manner, there is an increased likelihood that the patient will experience some undesirable complications. These include:

• Pain and pressure in the gum at the expected eruption site
• Uneven spacing and malocclusion of adjacent teeth
• Gum recession and periodontal disease
• Dull ache or sharp pain in the teeth surrounding the affected area
• Decay of partially erupted or impacted tooth due to inability to clean properly
• Spread of decay from affected canine to healthy adjacent teeth
• Tumor or cyst formation potentially leading to alveolar bone and pathologic fracture

The age of the patient in question is an important factor to consider when evaluating an impacted canine. An older individual who has lived for many years with a simple impaction typically requires more specialized care than, for example, a child with a seemingly more complex impaction. This is due to the many consequences of utilizing an incomplete set of teeth for many years.

Canine Impaction Management for Orthodontic Therapy

Having Impacted Canine Surgery from AAOMS.org on Vimeo.

Proper management of impacted canines must involve the work and cooperation of both an oral surgeon and an orthodontist. Though each individual and each case will prove unique, treatment typically consists of the placement of orthodontic braces first and then a referral to the oral surgeon. The oral surgeon will make an incision along the gum above the empty cuspid’s space and lift a flap of tissue to reveal the impacted tooth beneath. When a primary tooth is present and impacted as well, it is removed to make room for the permanent tooth.

The oral surgeon then places an orthodontic bracket to the tooth, attaching the bonded and bracketed tooth with a small chain to the arch wire of the braces. In some cases, the gum tissue is repositioned over the impacted canine, leaving the chain visible. In others, the surgeon sutures the gum tissue higher up above the once hidden tooth. The oral surgeon and orthodontist will continue to work together as necessary throughout the full development and proper growth of the canine tooth or teeth treated. The ultimate result of this type of therapy is a complete set of teeth that function properly and are aesthetically pleasing.

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

Ankyloglossia, more commonly known as “tongue tie,” is a relatively common abnormality of the corded tissue structure beneath the tongue. This band of oral mucosa is called the lingual frenum or c and derives its name from the Latin “little bridle of the tongue.” The translation of the name is particularly apt in cases of ankyloglossia. When a patient is tongue tied, the lingual frenum actually does serve as a restricting bridle, preventing the tongue from extending as far out as it should.

Complications of Ankyloglossia

Tongue tie is typically initially detected within days or weeks of birth as the child first learns to nurse or drink from a bottle. When a tongue tied baby breastfeeds, the mother may find that the latch is incredibly painful and that her child is reluctant to feed. The baby will become increasingly fussy due to lack of food and may fail to gain weight as is expected of a newborn. A lactation consultant may be able to determine if ankyloglossia is the reason for this difficulty by observing how mother and child nurse.

While some infants and young children are capable of adapting to speech and feeding with a shortened frenum, many cases require surgical intervention at an early age. If the frenum’s length or width is interfering with the child’s ability to breastfeed, nurse from a bottle or speak normally, a frenectomy may be recommended. This simple procedure may also be performed when the frenum is causing the patient pain or discomfort while eating, speaking or moving the tongue about in the mouth.

Correcting Tongue Tie

Though most infants’ frena recede naturally over the course of their first year, up to two percent of babies experience ankyloglossia that affects their ability to develop normally in the areas of speech and feeding. In severe cases, the extended frenum may even contribute to the formation of a visible gap between the two bottom teeth.

To correct ankyloglossia in babies, the simple frenectomy is performed with or without anesthesia, depending on the severity of the tongue tie itself, the parents’ preferences and the informed recommendation of the attending doctor. Because there are very few nerve endings in the lingual frenum, pain is minimal and most children recover from the rapid snip very quickly. In fact, in the majority of cases, a baby can begin breastfeeding immediately after the procedure is completed. The tongue is free from its excessive attachment to the floor of the mouth and is capable of forming a proper latch, allowing the child to receive sufficient sustenance and preventing maternal discomfort.

Ankyloglossia in Older Children and Adults

In some cases, tongue tie does not cause problems with feeding or with speech and is therefore left uncorrected in infancy. Some older children and adults, however, find that their elongated or thickened frenum causes them trouble later in life and wish to have the issue remedied. In these cases, a more comprehensive surgery can be performed. This procedure, called a frenuplasty, is performed in an oral surgeon‘s office under local or general anesthesia.

The method of frenum release in a frenuplasty is loosely similar to that of a frenectomy. After the frenum is cut and the tongue is freed, the surgical site is thoroughly cleaned and sutured. Following this procedure, the oral surgeon may suggest specific tongue exercises to reduce the risk of post-surgical scars as well as to improve the tongue’s range of motion. Full recovery can be expected in approximately four weeks.

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

Over the past ten years, technological advances in the fields of oral surgery and orthodontics have made it possible for more patients than ever before to receive effective, minimally invasive dental treatment. In fact, the trained professionals in these fields have access to more progressive instruments and treatment methods today than they did even five years ago. One of the most monumental advancements in orthodontic therapy to surface during this period is the use of temporary anchorage devices, or TADs. The technology behind TADs makes it possible for orthodontic patients to attain a perfect smile without resorting to more outdated methods like unnecessary extraction and headgear.

The Importance of Proper Anchorage

Any orthodontic treatment, whether it consist of a full set of braces or a fixed retainer, requires the use of force to push and pull teeth into their proper positions over time. Prior to the advent of TADs, the ability to anchor one or more teeth to others was relatively limited. In some cases, the only tooth that could be used as an anchor failed to provide an ideal location and extra-oral appliances like headgear were often needed. TADs, however, offer the orthodontist the power to exert the necessary leverage in a wider range of locations, allowing gradual movement of teeth in virtually every direction.

How Does TADs Work?

Temporary Anchorage Devices from AAOMS.org on Vimeo.

Each temporary anchorage device consists of a sterile, titanium alloy screw or plate that is placed into the bone of the jaw at a predetermined location for connection to a bracketed tooth or system of bracketed teeth. TADs may be quickly and simply inserted into the bone that comprises a portion of the roof of the mouth or between teeth in the jaw bone.

The procedure often is performed using only a topical anesthetic and does not typically result in pain. Over the course of orthodontic treatment, the fixed TAD gently but firmly pulls the tooth or teeth in question into place, all without forcing potentially detrimental pressure onto surrounding teeth. The ultimate result is an optimized treatment plan that achieves only the level of movement in the teeth that is necessary.

Benefits of Using TADs

In addition to minimally invasive treatment, TADs offer a number of other advantages as compared to conventional orthodontic treatment options. Even highly substantial realignment cases can benefit from the use of TADs, including common issues such as anterior open bite, an overdeveloped jaw, tilted molars, impacted cuspids and occlusal cants. The various treatment methods typically utilized to correct these types of problems often caused unnecessary discomfort. Now, however, it is possible to restore a patient’s ideal smile with minimally invasive procedures through the use of TADs. Additional benefits of this form of orthodontic treatment include:

• Decreased duration of treatment
• Better comfort as compared to heavier, more obtrusive appliances
• Improved aesthetics during treatment
• Increased level of convenience
• Higher level of control in placement and treatment
• Removal often is as painless as insertion
• Rapid recovery time

Your board certified oral surgeon will evaluate your individual case and assess your needs before developing a customized treatment plan best suited for you. With the right technology and partnership with your surgeon, it is  possible to reclaim your smile.

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

FORT YATES, NORTH DAKOTA (October 17, 2013) — Standing Rock Pediatric Dental Days, a two-day endeavor to offer much-needed oral health services to children in the area, saw great success over the weekend with the collaboration of dozens of dental care professionals and volunteers.

Held at the Prairie Knights Resort in Fort Yates, the event kicked off early on Friday morning and lasted well into the afternoon on Saturday. A host of altruistic supporters and members of the dental community donated chairs, equipment and other necessary supplies.

To support the cause and offer their assistance in meeting the many dental needs of youth in the region, Face and Jaw Surgery Center sent two of its top oral surgeons to perform needed procedures at the event: Dr. Omar C. Chahal, D.D.S., M.D. and Dr. Jonathan R. Gray, D.D.S.

“We recognize the importance of keeping our community’s children healthy, particularly through providing adequate oral health care beginning at an early age,” says Dr. Chahal. “An event like this adds emphasis to that objective and, at the same time, allows these kids easy access to the services they really need now.”

Preliminary numbers for Standing Rock Pediatric Days include an estimated $150,000 worth of care donated to 367 children aged 0 to 18 in the area.

About Face and Jaw Surgery Center

Face and Jaw Surgery Center is comprised of a network of four full-service oral, maxillofacial and cosmetic surgery offices located throughout North Dakota. The licensed and board certified professionals at Face and Jaw Surgery Center are committed first to the patient’s well being and absolute comfort, offering a comprehensive menu of procedures and only the most advanced technology in the industry. For more information about centers, doctors and procedures, please visit www.faceandjawsurgery.com.

One of oral surgery’s newest and most successful implant procedures is the  All-on-4® concept for dental implant placement.

How Previous Methods Compare

Before the introduction of the revolutionary  All-on-4® implant procedure, patients with multiple missing teeth were often supplied relatively limited solutions. If they chose to use removable dentures, they would have to face the inherent hassle and inconvenience associated with this type of prosthetic device. With the advent of permanent dental implants came the ability to replace missing teeth with a secure, natural-looking prosthetic tooth that was rooted to the jaw itself. Even with the support of advanced oral surgery technology, the traditional implant procedure often required multiple visits over the course of many weeks or even months while the jaw tissue healed and implant materials were crafted.

Why One Day Implants?

For many patients who needed to have their teeth replaced, the procedure involved multiple steps forcing them to continue to wear a removable conventional denture while they waited. Some required additional procedures such as multiple bone grafts delaying the final restoration further.

The All-on-4® technique involves the placement of four primary implants made of titanium and a prosthetic bridge that helps the surgeon to use existing jaw bone when securing the replacement teeth. The four titanium posts are secured within the jaw and serve as pillars for the bridge of permanent teeth when they are placed. The entire procedure requires only one visit and patients are generally able to continue with their normal daily routine within two to three days.

Advantages of the Teeth in a Day Procedure

There are innumerable benefits associated with undergoing this procedure, though one of the most attractive elements revolves around convenience and comfort. The procedure itself may take as little as three to four hours, depending on the patient’s individual circumstances. Frequently cited advantages of the All-on-4® method include the following:

•  Replacement teeth look and feel like real, natural teeth
•  One day visit allows for treatment, even for patients with busy schedules
•  Many patients experienced less bruising and decreased discomfort following surgery
•  Ability to return to normal activities more quickly after the procedure

Taking Charge of Your Oral Health

Millions of patients suffer from missing teeth, whether due to disease, injury, age or poor oral hygiene. The full replacement of missing teeth in a single day allows men and women to regain a positive sense of self-image and improve oral health without sacrificing weeks and months to the cause. Now it is possible for you to reclaim your smile and your confidence with just one visit to your oral surgeon with the use of the advanced All-on-4® implant concept.

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

Bismarck, ND office

Fargo, ND office

Grand Forks, ND office

Minot, ND office