Coastal VA Oral and Maxillofacial Surgery

Orthognathic Surgery

'woman in dental chair'What is orthognathic surgery?

Also known as corrective jaw surgery, patients undergo this procedure in order to correct a wide range of major and minor dental and skeletal irregularities. Jaw surgery is used to correct the misalignment of a person’s jaw or teeth, which will eventually improve breathing, chewing, and speaking. While a patient’s physical appearance may be altered just a bit with surgery, orthognathic surgery is mostly meant to correct functional problems.

What are some conditions that require orthognathic surgery?

There are quite a few conditions that indicate that you may need jaw surgery. Some of those include:

  • Sleep Apnea (breathing problems during sleep)
  • Protruding jaw
  • Open bite (someone who is unable to fully close their mouth)
  • Chronic mouth breathing and dry mouth
  • Difficult biting food or chewing
  • Difficulty swallowing
  • Chronic joint or jaw pain (TMJ)
  • Excessive wear on teeth

Evaluating Your Need For Jaw Surgery

We will work with your orthodontist and general dentist to evaluate your need for jaw surgery. In a great number of cases, patients need to have orthodontic work done before and after surgery. Jaw surgery is a lengthy and delicate process. In most cases, the whole process, including orthodontic work, will last 1-2 years. We will evaluate you thoroughly and realistically so that you may make the most informed decision possible.

How will I benefit from having jaw surgery?

Corrective jaw surgery will benefit you in numerous ways. After surgery, your jaw will be more aligned and balanced, and you will have more a far more functional and healthy jaw. While recovery may be lengthy, we will keep you comfortable along the way. With jaw surgery, patients can see an improvement in speech, eating, chewing and also breathing. Many patients see a positive change in their facial structures aw well after their jaw has been realigned.

To find out if you are a good candidate for corrective jaw surgery, please call us at Virginia Beach, Nimmo Phone Number 757-426-6155.

Are You At Risk for Oral Cancer?

'cancer cells'Are You At Risk For Oropharyngeal Cancer?

Early diagnosis can be a key component to giving you a fighting chance against the various types of head and neck cancer. There are many physical symptoms to look for when recognizing the signs of oral cancer aside from more commonly known warning signs such as a lump in the throat, mouth sores, and swelling of the jaw. These often mimic less serious conditions such as headaches, coughing, vocal changes, and a sore throat. Some also report ear pain, loss of hearing, or a ringing in the ears.

Risk Factors for Oral Cancer

Factors found to put you at a greater risk for oropharyngeal cancer include poor nutrition, using tobacco products, sunlight exposure (particularly in cases of lip cancer), alcohol abuse, radiation exposure (usually from a previous treatment) and HPV.

Alcohol, Tobacco and Oral Cancer

It is believed that at least 75% of head and neck cancers are linked to tobacco and alcohol use. Abstaining from using these substances can drastically decrease your risk, but it is also important to realize that genetics play an important role in the way that our immune system reacts and so some will be more genetically predisposed to cancer than others.

HPV and Oral Cancer

Another large factor causing oropharyngeal cancer (involving areas such as the back of the throat, tongue, and tonsils) is the Human Papilloma Virus (HPV). Doctors have recently found that somewhere between 50-70% of oral cancers are caused by HPV, which doesn’t show symptoms in those it infects until much later according to the Head and Neck Cancer Alliance. Although there is a vaccination for this virus, there is currently no cure. There are nearly two hundred strains of it, and it is estimated that somewhere between nine and fifteen are cancer causing. About fourteen million people become newly infected each year and most sexually active men and women will contract at least one type of HPV at some point in their lifetime.

While studies now show that HPV now accounts for about 70% of oropharyngeal cancer, many cancers are believed to be a caused by a combination of using tobacco and alcohol as well.

In any case, early detection is the key to leaving yourself open to the best possible outcome. Call us at Virginia Beach, Nimmo Phone Number 757-426-6155 to schedule a screening today!

How to Make Your Own Ice Cream

'ice cream'As you may or may not know, July is officially National Ice Cream Month! While it is fun to go and grab ice cream from your local shop down the street, it can be more fun and rewarding to make your own ice cream for you and your family to enjoy. Ice cream is also a great treat to enjoy after different types of oral surgery. You don’t need an ice cream maker in order to make delicious, creamy ice cream. Just follow our instructions below!

Servings: 2-3

Ingredients:

– 2 cups of milk
– 3 tablespoons of sugar
– 2 teaspoons of vanilla

Materials:

– 3-4 cups of ice
– 2/3 cup salt
– 1 quart sized Ziploc bag
– 1 gallon sized Ziploc freezer bag

Instructions:

– Combine milk, vanilla and sugar in quart sized bag
– Press any air out of bag and seal tightly
– Mix ice and salt in gallon sized bag
– Place quart sized bag into gallon sized bag and seal tightly
– Shake the bag vigorously for about 5 minutes.
– It will be very cold, be careful!
– Liquid inside smaller bag should start to harden
– Let bags sit for a few minutes with ice in large bag surrounding small bag
– Open bags up and scoop ice cream out
– Enjoy!!

As you can see, it isn’t hard to shake up some ice cream that the whole family can enjoy, using fairly standard household ingredients. Use chocolate/strawberry milk instead of regular milk to change the flavor, or use half and half for a creamier product. This year, celebrate National Ice Cream month by making your own ice cream at home!

Dental Implants: The Recovery

'recovery'The recovery time following dental implant surgery tends to vary, but is usually based on the amount of teeth being implanted, whether or not a bone graft was needed and the individual and how well they manage their recovery. Luckily, the science and technology behind dental implants has improved drastically over the last few years, improving post-surgery pain and comfort for patients.

The patient requiring the least amount of recovery time would be one who had a standard, single dental implant placed with no bone grafting. With a simple procedure like this one, there is very little discomfort or pain after the surgery. Mild bruising and soreness can occur, but is typically manageable with over the counter pain relievers. In more severe implant cases, such as those where multiple teeth are implanted or severe bone grafting needed in order to accomplish the implant, the recovery time tends to be longer and the discomfort can be more intense.

In any cases, it is important to keep your mouth clean after surgery, which can be done by rinsing your mouth gently with salt water beginning the day after surgery. You may begin brushing your teeth the night after the surgery, but make sure to keep it light around the surgery area as to not disrupt the healing in that area. It is also important to remember that in the week following your surgery, there should be no smoking and no sucking through a straw, as this can seriously inhibit your healing process. It is important to stick to a diet primarily consisting of soft foods for the first 7-10 days following your surgery before beginning to return to your normal diet.

As you can see, the recovery process after receiving a dental implant is fairly predictable and comfortable. It is important to follow the instructions that we give you at Coastal Virginia Oral and Maxillofacial Surgery, and to always remember that if you have any questions or concerns regarding a procedure or following your surgery, you can always give us a call at Virginia Beach, Nimmo Phone Number 757-426-6155.

Oral Cancer Among Men to Increase in 2017

'man with folded arms'A recent study by the American Cancer Society reports that oral cancer cases in men is expected to increase in 2017 by 4%, while the rate of new cases among women stays the same year over year. “Oral Cancer”, which is a common way to refer to all head and neck cancers, involves cancer of the oral cavity, lips, tongue, pharynx and esophagus.

Unfortunately, oral cancers often go undetected until their later stages when they are more difficult to treat, giving them an even worse reputation than many other cancers.

Oral cancer is more likely in those who:

  • Drink Alcohol Excessively (more than 2 drinks a day for men and more than 1 drink a day for women)
  • Smoke or Chew Tobacco
  • Have HPV (certain strains of the HPV virus are known to cause oral and other cancers)

HPV and Oral Cancer

Along with the rise of HPV among men has come the rise of oral cancers as well. Unfortunately, it has now been estimated that half of U.S. men are infected with HPV. While most of these will not go on to develop cancer, certainly, these increases may continue to create a rise in head and neck cancers until the disease is brought under control.

What You Can Do

Prevention and detection are the most important things when it comes to the fight against oral cancer. With early detection, we can do better for survival rates and, as we have seen with general cancer cases, prevention in the form of abstaining from tobacco and drinking in moderation can reduce the number of cases over time. In order to protect yourself and your family and help us with survival rates, we urge you to see us for an oral cancer screening. It only takes a few minutes for us to examine you – and it could save your life.

For more information on oral cancer, call us at Virginia Beach, Nimmo Phone Number 757-426-6155 or visit oralcancerfoundation.org.

Autograft Vs. Allograft

'woman with glasses smiling'So, you were recently told by your doctor that you need a bone graft, but you aren’t quite sure what that means.

A bone graft is a surgical procedure that is used to fix bones or joints that were damaged by trauma, and it is also used to replace bone that is missing to provide structural stability around the body, including the jawbone. There are many types of bone grafts we can use to grow bone – the two most common are autografts and allografts.

An autograft is a bone or tissue that is transferred from one spot to another on the patient’s body. It is often thought of as the “gold standard” in bone grafting because of its reliability. Its high success rate is due to the fact that it is living tissue and thus its cells are kept intact.

An allograft is a bone or tissue that is transplanted from one person to another. They typically come from a donor, or cadaver bone. The allograft is safe, ready to use and available in large amounts. The main advantage of an allograft is that it requires one less procedure than the autograft, which must first be taken from the patient. Surgical time is minimized and the recovery can be quicker. The allograft comes from a reputable and reliable tissue bank.

Knowing which bone-grafting option you will need can be confusing, but we are here to answer any questions you may have. Please schedule a bone grafting consultation with us by calling Virginia Beach, Nimmo Phone Number 757-426-6155. We will perform a thorough evaluation of your oral health. After our evaluation, we will recommend what bone graft is best for you. We are happy to discuss your options and answer any questions you may have. We want you feeling confident with our choice and worry free.

Tooth Extraction – Managing Pain

'man kicking pain'The Procedure Itself

Thanks to a wide variety of anesthesia choices available to us these days, you should feel no pain during your extraction.

 

After the Surgery

 

  • Over-the-Counter Medicines: Generally speaking, over the counter non-steroidal anti-inflammatory medications such as Ibuprofen are all that you will need following your surgery.
  • Staying On Top of Pain: It is very important to stay on a strict schedule of medication the first few days following your surgery. Getting behind on medication will result in more pain and may even make it difficult to catch up with pain control again.
  • Ice for Swelling: We want you to ice your cheeks for the first 24 hours following surgery, twenty minutes on and twenty minutes off alternating. Managing swelling can help greatly with pain management, and the act of icing may even feel good on its own.
  • Rest: Your body was expertly designed with high-tech systems in place to heal – but you have to give it the space and conditions to do so. Rest is one of the most important things you can do to help your body heal faster.
  • Salt Rinse the DAY AFTER Surgery: The day after surgery, you should rinse your mouth very gently with a mixture of one cup of warm water and ½ teaspoon of salt. You may do so up to 4 times a day. Designed to gently clean the wound site (but NOT dislodge the blood clot), some patients also feel that the warm water helps with pain relief.
  • Prescriptions: Most often, our patients do not require prescription pain medication post-op. However, in the case that we feel your case calls for such, please keep the following in mind:
    • Antibiotics – If we have ordered antibiotics for you, you must take them on schedule and for as long as we prescribe – Never stop antibiotic treatment prematurely without our specific orders.
    • Pain-Killers – In the event that you require prescription pain killers, please note that we are required to prescribe these sparingly and in accordance with certain laws, due to rising rates of substance abuse. You can help keep these drugs off the street by taking only what you need, and taking unused pills to a pharmacy for safe disposal – never “keep them around” in your cabinet for future use.

For more information, please visit our surgical instructions page and feel free to call us at Virginia Beach, Nimmo Phone Number 757-426-6155

Immunotherapy and Oral Cancer

You may have heard: Immunotherapy is proving to be very promising in the treatment of a variety of cancers, in particular lung cancer and advanced melanoma. However, immunotherapy has not found its way (yet!) into the treatment regimen for head and neck cancers. 'woman looking straight ahead'

What is immunotherapy?

Immunotherapy is the process of enlisting the patient’s own immune system in the fight against cancer cells. Several drugs have been used successfully to aid in the treatment of advanced lung cancers and melanoma, giving patients a longer prognosis in many cases.

Cancer Cells are Tricky

Cancer cells are notoriously sneaky – their ability to hide from immune cells is one of the reasons that cancer is so hard to treat. This is where “checkpoint inhibitors”, one of the most common classes of immunotherapy drugs in cancer treatment, come in. These drugs help to block the activation of proteins that help cancer cells hide from immune cells.

The Connection with Oral Cancer

Recurring head and neck cancers are very difficult to treat. Often they are resistant to the best chemotherapy drugs, so the hope has always been that immunotherapy drugs may some day step in to assist with the oral pathology fight. A recent trial in the UK has shown that the day may be coming sooner than we thought! The trial proved successful in extending prognosis for many of the patients.

Reduced Side Effects

The research also noted that side effects were reduced to give patients a better quality of life during treatment.

More Testing Needed

While more research is needed before the drugs receive FDA approval for the treatment of oral cancer, the good news is that because these drugs are already approved and on the market for other cancers, the application process for use in oral cancers will be quicker (and smoother) than it would be for a new drug.

At Coastal Virginia Oral and Maxillofacial Surgery, our commitment to your care, comfort, health and safety is evident from the minute you walk through our door. Call us at Virginia Beach, Nimmo Phone Number 757-426-6155 for more information about oral cancer.

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3D Printers and Bone Grafting

There is exciting news in bone grafting technology that will hopefully find its way into the oral surgeon’s office over the next decade! Researchers have been able to create a synthetic bone material using 3D printers that may be better than what is being used now. '3D image of 3D' '3D printing for bone grafting'

3D printers create three-dimensional objects out of a variety of materials using a computer as a precise guide. Although the concept has been in the news a lot recently, the practice actually dates back to before the 21st century. In fact, 3d printing’s roots go back to the early 1980s. Since then, everything from jewelry to synthetic human organs has been printed, much to the amazement of modern society!

And now, surgeons have successfully implanted the 3D-printed synthetic bone grafting material into animals with bone defects. This “hyperelastic bone” was made using just the right combination of bioactive materials and polymers to make a material that could be layered while still wet, allowing for better adherence between layers.

Here are some of the expected benefits of this new material:

  • Very elastic, allowing for cutting without crumbling, which can be a problem with current grafting materials.
  • Blood vessels move in quickly because the material is porous.
  • Biodegradable as the body replaces it with genuine tissue.
  • Doesn’t dry out right away.
  • So far the animals haven’t rejected the implant, which could mean less complications for humans as well.
  • Could be a great option for children since it will grow with them.

While human trials are potentially five or more years away, the news is very exciting for the surgical community, and we are can’t wait to see what benefits this will bring to our patients.

To find out more about bone grafting in general or to set up a consultation with our office, please call us at Virginia Beach, Nimmo Phone Number 757-426-6155.

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Preserving your Jaw after Extraction: Socket Preservation

If you come to see us for an extraction, you may hear us talking about “socket preservation” or ”ridge augmentation”, and you might be wondering, what is that?'x-ray of skull with highlight on jaw pain'

Socket preservation is a procedure we will sometimes recommend when you are having a tooth extracted. The bones that hold your teeth require frequent use to maintain their size and shape, otherwise they start to recede as they are no longer needed.

When a tooth is extracted, it leaves behind a hole (or “socket”) in the alveolar ridge bone, making it vulnerable to shrinkage. In fact, some studies show that bone loss can be 50% in the first 12 months after extraction.

You may be wondering, “Why does bone loss matter if I don’t have a tooth there anyway?” Unfortunately, without teeth and adequate bone structure, several unwanted oral health problems may occur:

  • Aesthetics: Without adequate bone structure and teeth, your smile starts to cave in in that area, causing undesirable aesthetic consequences. Your skin may begin to look shriveled over time and your smile will be unbalanced and unnatural.
  • Alignment Issues: Your teeth are always moving, particularly into open spaces. A hole on one side of your smile can lead to a severe shift of your teeth over time, affecting your smile and subsequently requiring orthodontic treatment.
  • Implant Complications: The damaged and recessed bone often ensures complications if you plan on getting a dental implant to replace the extracted tooth in the future.

This is where socket preservation comes in. Typically done at the end of your extraction procedure, we place bone-grafting material into the socket and a collagen membrane on top to encourage bone growth in the area. Because the procedure can be done at the same time as your extraction, no additional anesthesia or appointments are necessary.

If you are facing extraction, call us at Virginia Beach, Nimmo Phone Number 757-426-6155 to see if socket preservation is an option for you – it could save your smile!

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