Texas Oral Surgery Group

Oral Surgeons Role in the Management of Hospitalized Patients

Oral Surgeons Role in the Management of Hospitalized Patients

oral surgeon hospitalized patientsThe field of oral surgery is unique in that it combines the art and science of both dentistry and medicine. Oral and maxillofacial surgeons have a distinctive set of knowledge and skills that enables them to diagnose and treat a spectrum of conditions in the head and neck region.

In addition to advanced training that includes four years of dental school followed by a four or six-year, hospital-based residency program focused on the complexity of facial structures, oral surgeons also have access to the most cutting-edge technology available today. From 3D imaging to advanced computer guided surgeries, the Texas Oral Surgery Group uses the latest technology available to ensure the best results and patient experience possible. Additionally, Drs. Stewart and Michael maintain privileges at Medical City Plano, a Level I Trauma Center located in Plano, Texas.

Texas Oral Surgery Group has served the greater Dallas/Fort Worth community for over three decades. Our combination of cutting-edge technology and experienced and caring surgeons and staff make us the right choice for your oral and maxillofacial needs. From the removal of wisdom teeth to more severe cases such as those highlighted below, you can be confident in our ability to treat you and your loved ones.

Traumatic Facial Injuries

While all injuries have an element of trauma, facial injuries often add an emotional element. It is not uncommon for patients to be worried that their injuries will permanently affect their vision, hearing, taste, or sense of smell. Compounding the distress is the vital role the face plays in an individual’s personality and self-image. Given the sensitive nature of these injuries, it’s no surprise that one study reported one out of every four patients treated for facial trauma at an urban hospital met the criteria for post-traumatic stress disorder one-month post-injury .

Drs. Stewart and Michael’s extensive education and training not only make them well-versed in emergency care, acute treatment and long-term reconstruction and rehabilitation, but with over 40 years of combined experience they are adept at establishing the type of long-term patient relationships required to successfully treat and rehabilitate facial traumas.

Surgical correction of developmental and congenital facial deformities

According to the Center for Disease Control’s National Center on Birth Defects and Developmental Disabilities, approximately one in every 33 babies born in the United States has a congenital anomaly . Of these, birth defects of the face and mouth, specifically cleft palate and cleft lip, were most common.

A cleft lip is an abnormality in which the lip does not completely form. The degree of the cleft lip can vary greatly, from mild (presenting as a notching of the lip) to severe (large opening from the lip up through the nose). A cleft palate occurs when the roof of the mouth does not completely close, which leaves an opening that can extend into the nasal cavity. The cleft may involve either side of the palate and can extend from the front of the mouth (hard palate) to the throat (soft palate). In some cases, the cleft may also include the lip.

Children born with these conditions are faced with a range of associated problems that include issues with feeding, speech, hearing and psychological development. Care for children with a cleft lip and/or cleft palate often involves a team of doctors and experts, including Ear, Nose & Throat doctors, pediatricians, and oral surgeons. In most cases, surgery is recommended to repair and reconstruct the effected areas.

Oral surgeons use the same combination of surgical skills and patient rapport to treat other craniofacial abnormalities such as skeletal and maxillofacial deformities and hypodontia (the absence of teeth). In addition to the apparent cosmetic differences, these conditions often impede daily functioning, affecting the ability to breathe, eat and speak properly. Drs. Stewart and Michael understand the profound impact the treatment they provide has on their patients’ ability to lead productive lives.

Treatment and management of Head and Neck Cancer patients

Oral surgeons also play an important role in the treatment and management of head and neck cancers, which account for approximately 4% of all cancers in the United States . Cancers that are known collectively as head and neck cancers usually begin in the squamous cells that line the moist, mucosal surfaces inside the head and neck (for example, inside the mouth, the nose, and the throat). These cancers are further categorized by the area in which they begin – the oral cavity, pharynx, larynx, paranasal sinuses and nasal cavity, and salivary glands.

According to the American Cancer Society, 11.6% of all head and neck cancers begin in the area of the oral cavity/pharynx . The treatment plan for individual patients depends on a number of factors, including location of the tumor, stage of the cancer, as well as age and general health of the patient. Due to the complexity of these cases, head and neck cancers are best treated by multi-disciplinary cancer care teams that include oral surgeons and other specialists.

Oral Surgeons can also play a critical role in the early diagnosis of head and neck cancers by examining the oral cavity, oropharynx, facial and neck skin as a form of screening during routine visits. Some patients may present with pre-malignant lesions, which are likely to progress to established cancers; however, their removal may prevent the development of an established cancer.

At Texas Oral Surgery Group, we value the important role we play in patient care. From your first call and consultation with Drs. Stewart and Michael through the entire treatment process, our team is dedicated to providing the highest quality patient care possible. We invite you to contact any of our locations (Denton, Plano, Decatur, Gainesville) to schedule a consultation.

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Zygoma Implants

Zygoma Implants

Zygoma Implants North TXWhen exploring dental implants there are a number of factors to bear in mind, particularly if you’ve experienced bone loss. Why? Because regardless of technique, dental implants require healthy bone. This isn’t an issue if a patient is in good oral health and has sufficient bone to support implants; however, those with severe bone loss in the upper jaw may need an advanced option – Zygoma implants.

What are Zygoma implants and how are they different?

Traditional dental implants involve drilling directly into the upper jaw bone, which often requires a bone grafting procedure to ensure proper implant placement. Unfortunately, for those with severe bone loss in the upper jaw, such bone grafting techniques may not be suitable. Zygoma implants, however, offer an alternative. Instead of using the upper jaw bone as an implant anchor, Zygoma implants take advantage of the neighboring healthy cheek bone (i.e., zygomatic bone). Longer in size than conventional dental implants, Zygoma implants are designed to provide a secure foundation in situations where traditional dental implants may not be possible.

What are the benefits of using Zygoma implants?

Beyond giving patients with severe bone loss a viable implant option, Zygoma implants have a number of advantages over traditional dental implants. These include:

Immediate function (aka, “teeth-in-a-day”) – Zygoma implants are a “graft-less” procedure which expedites the entire experience allowing patients to leave with immediate aesthetic and functional improvements. When bone grafting is needed, patients may be required to wait up to 12 months for complete healing to occur before restorations can be placed. This is not necessary with Zygoma implants, as temporary restorations and zygoma bone implants can be put in place during the same appointment.

Faster recovery – Because the overall process is shorter, patients require fewer visits than are necessary with traditional implant treatments. In addition, they are able to return to work and resume normal routines faster because healing time is significantly shorter.

Improved bone strength – Zygoma dental implants are made of titanium which stimulates the surrounding bone to develop new bone structure via a process known as osseointegration. Not only does this help to secure the implant, it also strengthens the surrounding bone.

Minimally invasive – Unlike traditional implant techniques that require invasive bone grafting, Zygoma implants use 3D scanning for accuracy and are generally performed under IV sedation.

Am I a candidate for Zygoma implants?

Zygoma implants may be an option if you’ve previously been told you don’t have enough bone for traditional dental implants. Though the thought of anchoring implants to your cheek bones may be off-putting, the use of Zygoma implants reduces overall treatment time and is much less invasive than other dental treatments, making it a great option for those with severe upper jaw bone loss.

Where do I go from here?

Regardless of the method used, dental implant surgery is a subject that requires serious consideration. Contact any of our locations (Denton, Plano, Decatur, Gainesville ) to schedule a consultation. Drs. Stewart and Michael will assess your oral health and make a recommendation about the type of implants that are most appropriate for you.




Advanced Bone Grafting

Advanced Bone Grafting

Bone Grafting North Central TXThe unknown can be scary – especially when it involves you or a loved one undergoing surgery of any kind. At Texas Oral Surgery Group, we understand that our patients don’t live and breathe dental surgery – that’s our job!  We also know that surgical terms and medical jargon can be confusing, so we’ve provided an outline of some bone graft procedures to help eliminate some of the unknown.

What is bone grafting?

Bone grafting is a surgical procedure that replaces your missing jaw bone with material from either a patient′s own body or a substitute. The human body is an incredible thing, and bone tissue can regenerate if it’s provided the space in which to grow. And, as natural bone grows, it generally replaces the graft material resulting in a fully integrated area of new bone. The development of advanced bone grafting techniques has allowed us to be able to treat patients that were previously unable to receive optimal care.

When is bone grafting used?

Defects of the jaw caused by traumatic injuries, congenital defects or tumor surgery are generally treated with major bone grafts using the patient’s own bone – often taken from the skull, hip, or lateral knee. These types of bone graft procedures are performed in an operating room and require a hospital stay.  However, in the oral surgery office, bone grafting is more commonly used to allow for the proper placement of dental implants. In fact, anyone who has lost a tooth might need a bone graft before it’s possible to place a dental implant. Your body experiences bone loss every day a tooth is missing which, over time, leads to disuse atrophy in the jawbone. Disuse atrophy occurs when bone that is supposed to support teeth is reabsorbed resulting in poor quality and/ or quantity of bone suitable for placement of dental implants, or fixed or removable appliances.

Bone Grafting Procedures

Socket Preservation

Just as the name implies, the primary purpose of socket preservation is to prevent the atrophy, or preserve the health, of the alveolar bone (i.e. the socket that holds the tooth in place). This bone is often damaged by disease and/or infection, which necessitates a tooth extraction that can create a jaw deformity if preventative measures aren’t taken. These grafts are some of the most common and easiest bone grafts to perform and recovery is usually uncomplicated. Beyond cosmetic concerns, jaw defects also create major problems in performing restorative dentistry, which is why it’s important to speak with your dentist, about socket preservation if they recommend tooth removal.

Ridge Augmentation

Typically performed in Drs. Stewart and Michael‘s office under IV anesthesia, ridge augmentation helps recreate the natural contour of the gums and jaw which may have changed due to bone loss from a tooth extraction or traumatic injury. Ridge augmentation is achieved by placing bone graft material in the tooth socket. This procedure is often done immediately after a tooth is removed to avoid the need for a follow-up procedure, however it can be done on patients with long standing tooth loss.

Sinus Lift

This procedure is recommended when a patient needs an implant in the upper jaw but has a thin sinus floor that is unable to hold implants on its own. One of the most common bone grafting procedures for patients with bone loss in the upper jaw, a sinus lift grows bone in the floor of the maxillary sinus, increasing bone height and volume, to enable the secure placement of dental implants.

Types of Bone Grafts

Autogenous Bone Grafts

Autogenous bone grafts, or autografts, are made from your own bone and typically harvested from the chin, jaw, lower leg, hip or skull. Autogenous bone grafts are advantageous because the graft material is live bone containing living cellular elements that enhance bone growth. It also eliminates the risk of rejection, as it comes from your body. It’s important to note that this type of bone graft does require a second procedure to harvest bone from elsewhere in the body which, depending on your medical health, may not be in your best interest.


Allogenic bone grafts, or allograft, use dead bone that is harvested from a cadaver and processed using a freeze-dry method to extract the water and cellular components, via a vacuum. Unlike autogenous bone, allogenic bone cannot produce new bone on its own. Instead, it serves as a framework that bone from the surrounding bony walls can grow upon to fill the defect or void. This type of graft depends upon the patient having a good bone support structure in order to be effective.

Xenogenic Bone

This type of graft uses non-living bone from another species, usually bovine. To avoid contamination and the potential for rejection, the bone is processed at very high temperatures. Similar to allogenic grafts, xenogenic grafts serve as a framework for bone from the surrounding area to grow and fill the void. Both allogenic and xenogenic bone grafting have the benefit of not requiring a second procedure to harvest bone. However, since these options lack autograft’s bone-forming properties, bone regeneration may take longer and they tend to have a less-predictable outcome.

If Drs. Stewart or Michael determine that the best course of action is to use a real-bone substitute, there are a number of safe and proven synthetic alternatives, including:

Demineralized Bone Matrix (DBM)/Demineralized Freeze-Dried Bone Allograft (DFDBA)

This product is processed allograft bone (i.e. bone harvested from a donor). It contains collagen, proteins, and growth factors that have been extracted from the allograft bone. It’s available as powder, putty, chips, or a gel that can be injected through a syringe.

Graft Composites

Graft composites use other bone graft materials and growth factors to achieve the benefits of a variety of substances. Some combinations may include collagen/ceramic composite, which closely resembles the composition of natural bone; demineralized bone matrix combined with bone marrow cells, which aid in the growth of new bone; or a collagen/ceramic/autograft composite.

Bone Morphogenetic Proteins

Bone morphogenetic proteins (BMPs) are proteins naturally produced in the body that promote and regulate bone formation and healing. During surgery, BMP is soaked onto and binds with a collagen sponge. The sponge is then designed to resorb, or disappear, over time. As the sponge dissolves, the BMP stimulates the cells to produce new bone. The BMP also goes away once it has completed its task of jump starting the normal bone-healing process.

While synthetic materials have the advantage of not requiring a second procedure to harvest bone, each option has risks and benefits and Drs. Stewart and Michael will determine the type that best meets your particular needs.

Bone grafting, whether in preparation for restorative dentistry or for other reasons, is a technically sensitive procedure that requires a skilled professional. Texas Oral Surgery Group patients can feel confident knowing that in addition to Dr. Stewart’s extensive lecturing on the topic, he and Dr. Michael have a combined 50+ years of experience in the field.

We’re here to answer your questions. Please contact any of our four convenient office locations to schedule a consultation.

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What it Means to be a Diplomate of the American Board of Oral and Maxillofacial Surgery

What it means to be a Diplomate of the American Board of Oral and Maxillofacial Surgery

Diplomate of American Board of Oral Surgery LogoAt Texas Oral Surgery Group, we understand that choosing a surgeon – even under the best of circumstances – can be stressful. We also know that a doctor’s training and experience makes a difference. In addition to a combined 50 years of service, Doctors Stewart and Michael are Diplomates of the American Board of Oral and Maxillofacial Surgery, which means they are board-certified oral surgeons.

What is the American Board of Oral and Maxillofacial Surgery (ABOMS)?
ABOMS is the only certifying board in the United States recognized by the American Dental Association for the specialty of oral and maxillofacial surgery. Formed to elevate the standards of oral and maxillofacial surgery, ABOMS oversees certification and ongoing maintenance of that certification in an effort to promote the delivery of superior health care.

What goes into becoming board certified?
Board certification means that an oral and maxillofacial surgeon has met the highest requirements of competence within the field of oral and maxillofacial surgery. Achieving the status of board-certification demands an immense amount of dedication and hard work beyond the regular rigors of an oral surgeon’s education.

Following four years of dental school and a four or six-year, hospital-based residency program oral surgeons can elect to undergo an intense examination by the American Board of Oral & Maxillofacial Surgery. This process requires submission of cases that demonstrate a broad area of surgical expertise, an intensive written exam, and a lengthy oral exam.

Is board certification a one-time process?
Absolutely not! Beyond the initial certification diplomates must adhere to a certification maintenance process that ensures their commitment to lifelong learning, practicing in a safe and contemporary manner, and keeping current with the latest knowledge and skills. This includes maintaining active and unrestricted state licensure and continuous hospital privileges. Both Doctors Stewart and Michael maintain privileges at Medical City Plano, a Level I Trauma Center located in Plano, Texas.

Do I need to see a board-certified oral surgeon, isn’t a dental surgeon the same?
A dental surgeon is a regular or general dentist and while he or she likely performs procedures such as root canals, simple extractions, and some types of minor oral surgery the sole focus of their practice is not surgery. Conversely, oral surgeons are specialists who’ve undergone extensive surgical training and only perform surgery on a daily basis.

Beyond Doctors Stewart and Michael’s training, patients can feel confident knowing that the entire Texas Oral Surgery Group team across our four offices is as committed to patient care today as when we opened over 30 years ago.  We provide a full range of oral surgery services and invite you to contact any of our locations (Denton, Plano, Decatur, Gainesville ) if we can be of further assistance.

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Obstructive Sleep Apnea Treatment Options

Obstructive Sleep Apnea Treatment Options

Sleep Apnea North TexasDo you often experience fatigue or daytime sleepiness? Has a loved one expressed concern about how snoring could be impacting your health or, more likely, their ability to sleep?  Before you write these off, consider that the America Sleep Apnea Association estimates that 22 million Americans suffer from sleep apnea, and 80%  of moderate and severe obstructive sleep apnea cases go undiagnosed[1].

What Is Obstructive Sleep Apnea?
Obstructive sleep apnea (OSA) occurs when something partly or completely blocks your upper airway while you sleep. This blockage causes your diaphragm and chest muscles to work harder to open the obstructed airway resulting in breathing that repeatedly starts and stops. Breathing commonly resumes with a loud gasp, snort, or body jerk. However, you might not be aware of what’s occurring because the apnea alerts the brain just enough to restart the breathing process.

What Are the Risks of Sleep Apnea?
Some symptoms associated with sleep apnea such as snoring, fatigue, awaking with a dry mouth or headache, may seem to be more of an inconvenience than a serious medical concern. However, untreated OSA can raise the risk of dangerous health issues such as Type 2 diabetes, irregular heart rhythms, and high blood pressure. In addition, sufferers often experience moodiness, depression, and obesity[2].

Treatment Options
Oral and Maxillofacial Surgeons are uniquely trained to recommend the appropriate course of action based on the severity of your OSA. Treatment options focus on preventing airway obstruction and span the spectrum from behavior modification to use of an oral appliance or air pressure machine, to surgery.

Non-surgical Options
For some, non-surgical behavior modifications such as weight loss, avoidance of alcohol before bed, and sleeping on one’s side rather than stomach or back, may provide relief. In many cases, the condition is treated with the use of a continuous positive air pressure (CPAP) machine or custom oral appliance. Custom-fitted oral appliances worn at night are designed to keep the lower jaw in a forward position. These appliances provide mandibular support which helps prevent oral tissues from collapsing and blocking the airway. Other patients may require a CPAP machine to maintain air pressure and keep the airway open.

Surgical Options
Surgery may become necessary if non-surgical treatments cannot provide relief. Oral and Maxillofacial Surgeons can refine or remove soft tissues that cause airway blockage and /or reposition the upper and lower jaw to keep the airways open during sleep. Depending on your specific needs, your oral surgeon may recommend one of the following procedures:

Somnoplasty –  Doctors use radiofrequency energy to tighten the soft palate at the back of the throat.

Uvulopalatopharyngoplasty (UPPP) –  Soft tissue in the back of the throat and palate is removed to increase the width of the airway at the throat opening.

Hyoid Suspension – This procedure secures the hyoid bone, located above the Adam’s apple, to the thyroid cartilage to help stabilize the airway.

Mandibular/maxillary Advancement Surgery – Jaw and face bones are moved forward to create more room in the back of the throat. This procedure is generally only used for people who have severe sleep apnea and problems with their head or face.

Nasal Surgery – These operations correct obstructions in the nose, such as a deviated septum.

While surgery is a good alternative for some patients, it’s important to remember that no surgical procedure is effective in all situations.

If you have been diagnosed with OSA or are experiencing symptoms, please contact one of our four convenient office locations at Texas Oral Surgery Group to schedule a consultation.

[1] “Sleep Apnea Information for Clinicians.” SleepApnea.org, www.sleepapnea.org/learn/sleep-apnea-information-clinicians/.

[2] “Sleep Apnea.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 25 July 2018, www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631.

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What You Need to Know About Office Based Anesthesia for an Oral Surgery Procedure

What You Need to Know About Office Based Anesthesia for an Oral Surgery Procedure

Anesthesia Texas Oral SurgeryWhether the procedure is removal of wisdom teeth, bone grafting, or placement of dental implants, one thing many people say is that they don’t want to be awake for the procedure.  We hear this from patients daily, and we understand!   The next most common concern that patients express to us is their fear of “being sedated”, and we understand that as well!

Much of the fear and anxiety associated with being sedated is a result of unanswered questions and unknowns.  We make a point of spending as much time with our patients as needed during our consultation appointments to attempt to answer all those questions.  We understand that consultation appointments often provide patients with an overwhelming amount of information.  So we hope that this will provide some insight into being sedated for an oral surgery procedure, and in doing so, help to alleviate some anxiety.

Other than “not being aware of the procedure”, what benefit exists from sedation/anesthesia?

The benefits of office-based anesthesia are numerous for both oral surgeons and patients alike.

As mentioned above, the elimination of patient anxiety with oral surgery procedures is the most significant benefit.  But there are other, less obvious benefits.

               Keeps you motionless during surgery

In many instances surgical procedures require delicate instrumentation and manipulation of bone and tissue and sudden movement (usually unintentional) can negatively impact the outcome.  Adequate sedation/anesthesia will allow a patient to remain very still during surgery.

               Makes procedure seem like it lasts for 2 seconds

Some surgical procedures can be lengthy, and it is difficult for anyone to remain calm and still for a prolonged period.  This is not an issue when a patient is under sedation/anesthesia.

               Even when you are numb, you still feel pressure

Local anesthesia (numbing medicine) does not eliminate noises, feelings of pressure, or vibration during a procedure, and this is not an issue with sedation/anesthesia.

Plan ahead for post-surgery

Someone must bring you, stay in the office, take you home, and stay with you a while afterwards
Oral surgery procedures may be “outpatient” in nature, but that doesn’t mean you can go about your day like normal afterwards.  Once the initial sedation has worn off, you’re still going to be impaired for some time as you recover.  The amount of time varies with each individual, but generally people are impaired for 4 – 8 hours after getting home.  The person that brings you to the appointment needs to plan on caring for you at home for at least 4-6 hours. You’ll likely be aware of your surroundings, but still somewhat disoriented from the anesthesia – having a caregiver for the day is generally a smart idea!|

Anesthesia affects everyone differently

Just because your cousin threw up after anesthesia, doesn’t mean that you will too

Anesthesia has wide ranging effects on different people.

Most patients emerge from sedation and feel a little groggy for several hours.

On occasion, patients may emerge from sedation feeling disoriented, possibly nauseous, fatigued or confused.  It is usually impossible to know how you will feel when emerging.  Fortunately, the side effects of anesthesia are well known and precautions are taken to prevent the most common ones.

Just because it took your sister 6 hours to be able to dance, doesn’t mean it will take you that long

Recovery periods differ for each patient, and how you feel in the 24 hours after your surgery will depend on how your body metabolizes the anesthetic drugs.

Medications, medical conditions, age, sex, etc. can affect the length of recovery from anesthesia.

The best predictor of how you will respond is a previous experience with anesthesia; if this is your first time with office-based anesthesia, then you should understand that your recovery length may be unpredictable.

You’re constantly and thoroughly monitored while sedated

Many people have a conscious anxiety or fear of anesthesia: usually associated with the “loss of control”. Know that while you are sedated, your heart electrical activity (EKG), heart rate, blood oxygen saturation (pulse oximetry), blood pressure, respiratory rate, and end-expiratory carbon dioxide level are being constantly monitored by our team.

For the science nerds like us:  the carbon dioxide levels measured at the end of an exhaled breath (called ETCO2 or End Tidal CO2) provides critical information that can tell us if your breaths are too deep or shallow (tidal volume) or too rapid or slow (tachypnea or bradypnea).

We use state of the art monitoring equipment and are very strict about performing frequent monitor checks and calibrations.

Our assistants of are DAANCE (Dental Anesthesia Assistant National Certifying Exam) certified.

Dr Stewart and Dr Michael are BLS, ACLS, and PALS certified.  In fact, Dr Michael is a BLS instructor!

What happens if there’s a complication with the sedation?

The key is keeping calm

The great thing about office-based sedation/anesthesia is that complications are very rare when appropriate training is in place and precautions are taken (as is the case in our office).

Nevertheless, some things are beyond our control and the best policy is to make sure that we are prepared to handle any possible situation that may arise.

We maintain state of the art emergency equipment and emergency medications on hand.
We-as a team-undergo frequent training drills where we practice our roles in various emergency scenarios.  While we always hope that urgency or emergency scenarios do not arise, we are proud of the fact that we place so much emphasis on being well-prepared in case such a situation occurs.

What kind of training is involved to be able to perform office-based general anesthesia?

Oral and Maxillofacial Surgeons are unique

If you’re receiving office-based sedation/general anesthesia for an oral surgery procedure by an Oral and Maxillofacial Surgeon, know that it’s being delivered by a highly qualified individual.

In the U.S., Oral and Maxillofacial Surgeons are required to undergo intensive general anesthesia training in a hospital-based residency training program working alongside Anesthesiology residents and being trained by Anesthesiologists.  Oral surgeons can provide IV general anesthesia (this is different than a simple IV sedation or conscious sedation) that can assure your adequate level of anxiolysis and comfort.   A simple IV sedation (which requires significantly less training and expertise) is usually not optimal for patients undergoing most oral surgical procedures.

In order to be allowed to perform IV general anesthesia, Oral and Maxillofacial Surgeons in Texas must undergo a rigorous anesthesia evaluation of their office (including office layout, equipment, medications, and surgeon knowledge) by a peer from the Texas Society of Oral and Maxillofacial Surgeons.

Make sure your Oral Surgeon is Board Certified

Board Certification (American Board of Oral and Maxillofacial Surgery) is important to consider when evaluating the training of the individual administering your anesthesia.  Oral and Maxillofacial Surgeons undergo a very rigorous written and oral exam to become Board Certified, and anesthesiology is a large part of that exam.  You can be assured that a Board Certified Oral and Maxillofacial Surgeon has proven adequate training and knowledge in anesthesiology.

Don’t be afraid to ask questions!

The more you know….

If you’ve scheduled an oral surgery procedure and are feeling uneasy about it, never be afraid to speak with the oral surgeon or staff. Asking questions about the procedure, including the anesthesia, is all part of the process and could provide you the comfort and peace of mind you need. Coordinating with a friend or family member to care for you, having trust in your oral surgeon, and understanding the nature of office-based anesthesia are all important.

If you have any questions about anesthesia, we encourage you to contact our experienced oral surgery team at the Texas Oral Surgery Group.

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How Oral Surgeons Are Uniquely Qualified to Manage Complex Medical Conditions

How Oral Surgeons Are Uniquely Qualified to Manage Complex Medical Conditions

Oral SurgeonSometimes determining where to go for service can be hard – do you take your car to the dealership or the independent shop down the street? For most people the answer depends on the work they need done. While you probably don’t need the expertise of a dealership mechanic for a routine oil change, more complex issues, such as those related to your car’s computer, usually require specific expertise and advanced equipment only available at the dealership. While your health is far more valuable than any automobile, deciding where to go for treatment comes down to the same fundamental pillars of service– who is the best trained and equipped?

Oral surgery is unique in that it incorporates the art and science of both dentistry and medicine. As such, oral surgeons have a distinctive combination of knowledge and skills that enables them to diagnose and treat a number of conditions – from the removal of wisdom teeth to facial trauma and sleep apnea. In essence, these highly skilled professionals possess both the finesse of an automotive designer and the precision of a mechanical engineer.

Following four years of dental school, oral surgeons participate in a four to six-year, hospital-based residency program focused on the complexity of facial structures, specifically the mouth and jaw. The six-year residency programs incorporating a medical degree. In fact, Oral and Maxillofacial Surgery is the only hospital based, surgically trained specialty recognized by the American Dental Association (ADA). All OMS residents undergo extensive training in the administration of anesthesia: including intravenous (IV) sedation, nitrous oxide and general anesthesia.

At Texas Oral Surgery Group, we understand that surgery is never a minor consideration, and we want you to be confident knowing that we put our patients’ well-being above all else. That’s why our entire surgical team is Dental Anesthesia Assistant National Certification Examination (DAANCE) certified. This is the highest level of certification granted by the American Association of Oral and Maxillofacial Surgeons (AAOMS). Additionally, while most procedures today are office-based, Drs. Stewart and Michael maintain Active Staff privileges at Medical City Plano, a Level I Trauma Center located in Plano, Texas.

One benefit of choosing the dealership service department is that you know they have the most current information available, which helps with correct diagnosis and repair. Knowledge of the latest trends and service options is also important when selecting an oral surgeon.  A former president of the Texas Society of Oral & Maxillofacial Surgeons (TSOMS), Dr. Stewart is active in professional associations, lecturing extensively on implants and bone grafting procedures.  In addition, Dr. Stewart has been an associate clinical professor of Oral & Maxillofacial Surgery at TAMU College of Dentistry (formerly Baylor Dental School) for 24 years.  Staying current on the latest advancements in oral surgery is also of great importance to Dr. Michael who is a participating member of the AAOMS, TSOMS, American Dental Association, Texas Dental Association, and North Texas Dental Society.

In addition to advanced training, oral surgeons have access to the most cutting-edge technology available today. And, as even the best independent mechanic will tell you, access to the right equipment is essential. From 3D imaging to advanced computer guided surgeries the Texas Oral Surgery Group uses the latest technology available to ensure the best results and patient experience possible.

Deciding which dental professional to choose isn’t always easy, but we’re here to help. Contact any of our four locations today to find out if an oral surgeon best meets your needs.

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Facial Injuries Cause More than Physical Trauma

Facial Injuries Cause More than Physical Trauma

Plano Facial TraumaEach year, three million people are treated for facial trauma injuries in emergency departments across the United States.  Of these patients, more than half experience multi-system trauma that requires coordinated management between emergency physicians and surgical specialists in oral and maxillofacial surgery, otolaryngology, plastic surgery, ophthalmology, and trauma surgery.

These statistics underscore the importance of the American College of Surgeons’ recommendation that Level I and II trauma centers – those that treat the most serious and complex facial traumas – include an oral and maxillofacial surgeon as part of the trauma team. Oral and maxillofacial surgeons are uniquely trained to treat facial trauma, and are well-versed in emergency care, acute treatment, long-term reconstruction and rehabilitation.

While all forms of trauma have an inherent psychological component, facial trauma in particular is closely linked to symptoms of depression and anxiety. In fact, one study found that 25% of patients treated for facial trauma at an urban hospital met the criteria for post-traumatic stress disorder one-month post-injury.

Whether the result of a car accident, physical altercation, or athletic injury, facial traumas are generally sudden and unexpected – often resulting in intense physical pain and emotional distress. It is not uncommon for patients to be worried that their injuries will permanently affect their vision, hearing, taste, or sense of smell. The face is a vital part of an individual’s personality and self-image, which compounds the emotional element. This means that even relatively minor injuries can create serious concerns about potential lasting effects on physical appearance.  If you or a loved one has experienced facial trauma, it’s important to be aware of the possible psychological impact and seek support when needed.

Of course, prevention is still the best policy when it comes to facial injuries. When followed, the commonsense suggestions noted below can help to prevent the most common causes of facial trauma:

  • Use a seatbelt. Car accidents are a leading cause of facial trauma.
  • Wear a helmet when participating in activities that involve speed or impact (i.e. football, hockey, skateboarding, bicycle and motorcycle riding). Make sure that the helmet fits correctly and is appropriate for the activity.
  • When taking part in sports, purchase a custom-fit mouthguard. When properly fitted, mouthguards provide essential protection and should be worn even if their use is not mandated.
  • Follow safety guidelines at work and wear protective head gear when required.
  • Pay close attention when walking on slippery or unstable surfaces and in dimly-lit areas where you are more likely to stumble or fall.

Facial injuries are not always extensive; however, they are complex as the impacted area is critically close to the brain and essential to breathing, eating, speaking, seeing and hearing. Given that even a moderate facial injury can potentially be life-changing, seeking guidance from a trusted oral and maxillofacial surgeon as soon as possible is always recommended.

With 4 office locations in North Central Texas, The Texas Oral Surgery Group is well equipped to treat all types of facial injuries.  If you are experiencing any type of facial trauma, we encourage you to contact our experienced oral surgeons promptly and let us provide you with the care you deserve!

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Oral Cancer – A Topic Worth Covering

Oral Cancer – A Topic Worth Covering

Oral Cancer Plano TXAside from a handful of graphic smokeless tobacco warning ads and Michael Douglas’ cautionary PSA campaign, oral cancer probably hasn’t garnered enough media attention to create a blip on your radar – but it should!

While oral cancer (oral cavity and oropharynx cancers collectively) accounts for 2.9% of all cancers diagnosed in the United States, it is responsible for 1.6% of all cancer deaths. The death rate associated with oral cancer is particularly high because it is generally not discovered until late in its development.

Often painless, early stage symptoms can appear non-threatening – think a white or red patch of tissue in the mouth or a shallow lesion that resembles a common canker sore. Conversely, the symptoms associated with later stages of oral cancer are harder to ignore. They include:

  •  A sore that bleeds or doesn’t heal
  •  A growth, lump, or thickening of the skin or lining of your mouth
  •  Tongue pain
  •  Jaw pain or stiffness
  •  Difficulty or painful chewing, swallowing, or speaking
  •  Prolonged hoarseness
  •  Numbness in the oral / facial region
  •  Persistent earache in the same ear

As a rule of thumb, any of the above symptoms that persist for longer than a two-week period should undergo further examination by a medical professional.

While oral cancer isn’t new, recent years have seen a shift in risk factors and population segments impacted. Historically, the primary risk factors associated with oral cancer have been age (the average age at diagnosis is 62 years), tobacco use, excessive alcohol consumption, and the combination of the two (the risk being greater for people who use both tobacco and alcohol). However, recent data shows that the fastest growing segment of the oral cancer population is non-smokers under the age of fifty. According to the Academy of General Dentistry, a quarter of cases have no risk factors for cancers of the mouth (i.e. tobacco or alcohol use). This shift coincides with an overall decline in smoking (which is great) and an increase in the number of young people diagnosed with oral cancer related to human papillomavirus number 16 (HPV16), a disease transmitted through sexual contact.

So, how can you prevent oral cancer? Aside from the obvious – avoiding tobacco and excessive alcohol consumption – early detection is the key. This is one more reason why dental professionals play a vital role in your overall health. Not only do we examine the general health and appearance of your teeth, but also of your oral tissues. This is important because tissue changes in the mouth that might signal the beginnings of cancer often go undetected to the untrained eye, but these can be seen and felt easily by dental professionals. It’s also critical for patients to have an open line of communication with dental professionals. Be sure to let us know if you’ve experienced any changes in your medical history – even if you think it’s not important. This is also where patient transparency comes into play. Be honest about your tobacco and alcohol usage; we’re not here to judge!

Additionally, the importance of self-awareness cannot be overstated. To help increase the public’s knowledge of oral cancer and the role self-exams can play in early detection, the Oral Cancer Foundation launched www.checkyourmouth.org. This website is packed with great information, including a how-to video on self-screening. So, don’t wait until your next visit – open wide and take a look inside today!

If you notice any unusual changes in your mouth or experience any discomfort, please feel free to contact The Texas Oral Surgery Group with any questions or to schedule a consultation.  We are well trained to detect oral cancer and look forward to helping you maintain good oral health!

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Your Oral Surgery Experience

Your Oral Surgery Experience

Texas Oral SurgeryTo say that oral surgery isn’t on anyone’s bucket list is an understatement – we get it! Surgery can be intimidating, and oral surgery is no exception. Whether it’s dental implants or surgery to repair facial trauma, undergoing any medical procedure can be nerve racking. To help patients prepare, we’ve put together a quick checklist of important points to keep in mind.

Experience and Certifications

We pride ourselves on providing the safest patient care possible, and we have the certifications and experience to back it up. Patients can be confident knowing that Dr. Larry Stewart and Dr. Wayne Michael are not only Board Certified Oral and Maxillofacial Surgeons, but they have over 50 years of combined experience.  They are also both certified in advanced cardiovascular life support (ACLS) and pediatric advanced life support (PALS). Additionally, while most procedures today are office-based, Drs. Stewart and Michael maintain privileges at Medical City Plano, a Level I Trauma Center located in Plano, Texas.

Further, our entire surgical team at Texas Oral Surgery Group is Dental Anesthesia Assistant National Certification Examination (DAANCE) certified. This is the highest level of certification granted by the American Association of Oral and Maxillofacial Surgeons (AAOMS), and is only awarded after completion of a demanding, examination-based program on office-based anesthesia.

Knowledge is Power

Nowhere is the old adage, “knowledge is power,” more true than in the medical profession.  While this certainly extends to the doctor’s expertise, it also pertains to a patient’s understanding of the procedure.

Fear of the unknown is often the root cause of anxiety, and arming yourself with information is the best antidote. Ask questions! At Texas Oral Surgery Group, our job starts well before we put on the exam gloves. The team’s collective goal is to deliver the best patient experience possible, and that means making ourselves available for questions and ensuring patients understand the information provided. Patients who are prepared for both the procedure and associated healing period are more likely to have a smoother experience and faster recovery. So yes, questions are encouraged!

Open Communication

Communication is a two-way street, and just as it’s up to our team to ensure patients have all the information they need, the reverse is just as imperative. It’s vital that patients take an active role in sharing information. Medical history, including prescription, over-the-counter, or even recreational drug use, can greatly impact treatment and recovery. Now is not the time to be embarrassed; this is one scenario where over-sharing is encouraged.

We believe that while patients may not look forward to oral surgery itself, the experience doesn’t have to be frightening or uncomfortable. At Texas Oral Surgery Group, we work hard to make sure patients are informed and comfortable at every touch point. For over three decades, we have provided unsurpassed oral surgery treatment to residents of the Dallas – Ft. Worth area, and we continue to expand our reach with offices located in Plano, Denton, Decatur and Gainesville. Take a look around our website for more information on specific procedures and feel free to reach out if we can help in any way.

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