Texas Oral Surgery Group

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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Why Replacing Lost Teeth is Important

Why Replacing Lost Teeth is Important

Tooth Replacement PlanoFor those that have lost their teeth or have been suffering from missing teeth, it is important to understand the critical nature of this issue.  The reality is, that nobody wants to live their life with missing teeth.  In addition to it looking unsightly, it also affects your self-confidence, hindering you from being able to smile openly. Even though aesthetics are important, there are several other reasons why you should seriously consider replacing your lost teeth.

Reason people lose teeth

Why do people lose their teeth?  One of the most common reasons is changes associated with aging. As an individual becomes older, the strength of the outer shell of the teeth (known as enamel) diminishes, along with deterioration of jawbone support, reducing our ability to maintain our permanent teeth. As a result, the teeth become more fragile and progressive tooth loss occurs over time.

Some of the other common causes of teeth loss include: dental decay and (gum) disease.  Dental decay increases in older patients because of several factors: loss of manual dexterity, medical issues and medications along with changes in the saliva are big contributing reasons. Saliva is a “miracle mixture” having buffers, minerals and antibodies which protect the teeth. Saliva becomes diminished as we age, bringing with it a host of dental issues.   Periodontal (gum) disease increases as we age and often results in a person losing one or more teeth over the course of time.

People also struggle with losing their teeth because of sports injuries, accidents, and trauma that has been sustained to the mouth. As we all know, there is no age limit to slipping and falling, being involved in an accident, or experiencing physical contact to the mouth.

Importance of replacing lost teeth

Throughout adult life, it is imperative for those individuals who have lost teeth to have them replaced as soon as possible since missing several teeth can severely influence your daily life. It can affect your general health, your appearance and self-esteem.

Tooth loss disturbs the natural balance between teeth and bone. The jaw bone starts shrinking, once a tooth is lost and your gum recedes. This bone loss can weaken neighboring teeth causing further tooth loss! Opposing teeth, if left unsupported, can then move into the missing tooth space causing orthodontic and restorative problems.  Missing teeth and a diminished jaw bone can make your face look older than it should, causing your cheeks to become hollow and saggy.

  • Digestion

Chewing, food transport, and swallowing are a continuum. There is no doubt that the teeth are necessary,] to be able to tear, chew, grind, and bite food in your mouth. If you lose teeth, then it prevents your ability to conduct all these actions in an effective manner. Tooth loss also indirectly disturbs the coordinated execution of swallowing food. It has been shown that elderly people with reduced numbers of teeth complain of difficulty in chewing and swallowing, often opting for softer foods which have less nutritional value and are higher in calories. With a lack of teeth, it often becomes quite difficult to consume nutritional foods on a regular basis and a constant worry with what types of food to eat.  As a result, tooth loss reduces your ability to live life to the fullest!

  • Speaking

Even though it might be slightly hard to believe, your teeth play an important role in your ability to communicate and speak in an effective manner.  Teeth working in a coordinated fashion with your tongue and lips are used to enunciate properly, offset certain words, and form certain patterns of speech.  Individuals who have lost one or more teeth often find it quite difficult to talk properly. Since the holidays are near, you may remember the classic   song, “All I Want for Christmas Is My Two Front Teeth”. The humor is that the child singing the song can’t pronounce the word “Christmas,” because they have no front teeth. As a result, tooth loss can be very frustrating at times.

Best options for teeth replacement

If you are missing any teeth, it is in your best interest to look at all the options available. This is something which you should do at your earliest convenience. The longer you wait to get your teeth replaced, the more severe problems may become and the more challenge there is to deal with the consequences.

  • Dental implants

Amongst all the tooth replacement options available, most find dental implants to be the best option. This is because dental implants most realistically replicate natural teeth.   Dental Implants replace both the crown and the tooth and the root. Since the replacement tooth is embedded in the bone, it helps prevent the further loss of bone structure.  Simply put, an implant is an artificial tooth, and functions like a natural tooth.

In terms of its drawbacks, the only significant downside with dental implants is the healing time. From the time the procedure is completed, the healing process can take anywhere up to three months.  However, since you are obtaining permanent teeth, the implants are designed to last the rest of your life.  Implant treatment is a long-term investment into your health and your wellbeing – in short, an investment in your quality of life. Compared to other dental restorations, implants can seem more expensive initially, however, higher maintenance costs for other type restorations, the potential increase in jaw bone loss, and potentially, the loss of even more teeth can make other restorations more expensive over the long run.


No one should die with their teeth sitting in a glass of water”


In Memory of Per-Ingvar Brånemark (May 3, 1929 – Dec 20, 2014)

Father of modern Dental Implantology

If you are interested in restoring your mouth to good health, The Texas Oral Surgery Group can provide you with some great tooth replacement options.  We encourage you to contact one of our four office locations in Plano, Denton, Decatur, or Gainsville, to schedule a consultation and we can discuss the best options for you!


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5 Common Dental Implant Myths and the Facts

5 Dental Implant Myths and the Facts

Dental Implants PlanoWith the entire world becoming obsessed with their outward looks and appearance, you might also find yourself jumping on the bandwagon. While increased exposure to media and the Western world have been credited with this changing trend, there is no denying the fact that people independently are also becoming more aware. The days of just jumping out of bed, throwing on some clothes, and jumping in the car are long gone.  In current times, much more thought and planning goes into the entire process so that everyone can step out looking picture-perfect.

The same thing could be said in the case of our teeth as well. This is because a smile is considered to be one of the most important assets that we possess.  If that smile is tainted or damaged in any way, then our entire look and appearance is ruined.

In earlier times, damaged and misplaced teeth were treated with dentures, root canals, and bridges. While all these procedures were definitely effective, these treatments also tended to harm the adjacent teeth rather than supporting the damaged tooth. In addition, root canals were also considered to be one of the most painful procedures that one would be able to undergo. Even after the procedure, the patient would experience immense pain and only be permitted to have liquid food for a certain amount of time.

All this seems to have changed with the introduction of dental implants. To describe it quite simply, a screw or metal post is surgically positioned into the jawbone, located right beneath your gums. Once these are in place, it allows the dentist to mount the replacement teeth or cap on to them.  As a result, dental implants have been found to be the most effective procedure for tooth replacement and smile correction. With just one streamlined procedure, you are be able to restore your teeth and smile to its formal glory.  It does not get much simpler than this!

Despite the simplicity and effectiveness of implant treatment, you still find a large number of people remain hesitant when taking advantage of dental implants. This hesitance often results from a large number of implant myths that continue to float in the outside world.

If you are seriously considering dental implants, it is important to have a full understanding of this misunderstood procedure.  The first step is to discover if there is any truth to the numerous dental implant myths.  Specifically, we examine five of the most common myths that seem to exist for dental implants, along with the facts:

  1. A painful procedure

The group of people who are against dental implants would say that it is a painful procedure, both during and after the procedure. However, this has been found to be completely untrue. This is because dentists now provide this service under local anesthesia, which means that you are not subjected to any pain. Also, an experienced and knowledgeable dentist would be familiar with the entire process of tooth implantation. As a result, they are able to offer you a wide variety of anesthetic options to suit your preferences and needs.

  1. Risky

Again, this is another common dental implant myth!  The fact is that dental implant technology has been continuously evolving for the past thirty years, with new advancements being introduced almost every other year. As a result, dentists are able to guarantee a success rate a whopping 95% of the time. This high success rate is due to experienced dental practitioners carefully performing the procedure in order to avoid any complications. All you need to do is select the right dental professional!

  1. Extremely expensive

When choosing dental options, it is quite normal to select the most affordable option. Most individuals would prefer to not spend an exorbitant amount of money, unless it is absolutely  necessary.  While dental implants are definitely not as expensive as you may be thinking, there is some investment involved.  However, when you examine the big picture and other alternatives, the investment is well worth it.  When you compare dental implants to other treatment options, it is important to remember that most people only need dental implants once.  So if there is a little more cost involved than some implant alternatives, it would definitely be worth it!

  1. It takes too long to heal from dental implant surgery

This myth has also been found to be misleading for a number of dental implant patients. This is because the complete healing time could span from one day to six months, depending on a number of factors.  In addition, the healing time can vary greatly from one patient to another. It is surprising to see many patients opting for same day implants, also known as immediate loading implants. This quick implant treatment option allows patients to solve their tooth problem without having to disrupt their busy schedule.

  1. Involves special care and maintenance

This myth has been found to be completely baseless. This is because dental implants do not require cleaning, extraneous removal, or any sort of maintenance hassle. All you need to do is take care of your implants – the same way you take care of your natural teeth. This entails brushing, flossing, and going for regular dental checkups.

Hopefully, this shed some light on some of the most common misunderstood aspects of dental implants.  While you will definitely come across more dental implant myths, you should now understand that most of these myths are completely baseless and do not have any solid evidence to back up their claims.

Before you proceed with any type of dental implant treatment, it is always a good idea to schedule schedule a consultation with a dental professional so they can walk you through the entire process and assist you with selecting the most suitable option for you.  With over 40 years of combined experience, Dr. Larry Stewart and Dr. Wayne Michael are considered the leading providers of dental implants in Plano, Denton, and the North Texas area.  Individuals in need of dental implants enjoy being able to choose from one of our 4 convenient office locations in Plano, Denton, Decatur, and Gainesville. We encourage you to contact us for a free consultation and ask about our dental implant specials!  The Texas Oral Surgery Group will make sure your implant experience is an enjoyable one!

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An Interesting Case of an Unusual Radiologic Finding

An Unusual Radiologic Finding

Last year in June, I saw pleasant 18-year-old young lady or consultation regarding removal of her impacted and malposed wisdom teeth. At the consultation a thorough history was taken and her past medical history reviewed. Everything was negative except for a history of cavernous hemangioma involving lower lip and buccal mucosa. There was no obvious clinical involvement of the mandible or the area of the wisdom teeth.



The patient successfully underwent removal of her wisdom teeth and had an uneventful recovery. On routine examination at her dentist this year, he noticed some unusual calcifications in the area near the extraction site #17, and referred the patient for evaluation. Upon clinical exam of the patient I could palpate no obvious mass around the extraction site and the tissues in the area appeared within normal limits. Her hemangioma had not appeared to increase in size, but it did have a somewhat lumpy consistency in certain parts of the mass. The remainder of her oral examination was within normal limits.

Based upon my examination I referred the patient for a CBCT and obtained the following images:

What is your diagnosis of this interesting finding?

Answer: Phleboliths in the cavernous hemangioma of the left buccal mucosa.

Phleboliths are a rare finding in hemangiomas and are areas of dystrophic calcification within the mass of the hemangioma. Their cause is not clear, but thought to be due to altered blood flow hemodynamics, with areas of venous pooling which then go on to calcify. Because this particular hemangioma is not facially disfiguring for the patient, no further treatment is recommended. Treatment of facial hemangiomas is a challenging effort and most often involves a team approach including interventional radiology and surgery.

If you are experiencing any discomfort or pain with your wisdom teeth, we encourage you to contact the Texas Oral Surgery Group.  With offices in Plano, Denton, Decatur, and Gainesville, our elite oral surgeons have extensive experience providing wisdom teeth treatments to residents of the greater Plano region.  We look forward to assisting you!