Surgical Arts Blog

One of the best ways to help your healing process after dental surgery is proper aftercare. Your dentist will provide instructions on how to take care of yourself after your surgery, so be sure to follow these instructions to prevent complications and to ensure a comfortable recovery.

Taking Care of Yourself After Oral Surgery

One mistake many people make after oral surgery is to try to go back to work and to regular activities too soon. To ensure a comfortable recovery, rest and take care of yourself for however long your oral surgeon suggests. This will help ensure your healing progresses well and will help avoid complications.

Some measures you can take at home to help minimize your discomfort while you heal include:

•    Use ice packs to reduce swelling
•    Take prescription medications as instructed
•    Avoid spitting, smoking, or use of straws for three days
•    Use a salt-water rinse as directed by your surgeon
•    Elevate your head to reduce swelling

Your oral surgeon might provide other guidelines that will help you heal more quickly and comfortably. Be sure to follow all these instructions carefully and ask if you have any questions. The best way to be sure you understand all your post-operative instructions is to go over them before your surgery and have someone with you to take notes. This way you’ll have all the information close at hand, and someone else to ensure you don’t misunderstand anything.

Possible Complications After Oral Surgery

If you experience any complications after dental surgery, you should bring these to your dentist’s attention immediately. Some specific symptoms to be aware of include:

•    Fever or inflammation
•    General feeling of illness or fatigue
•    Excessive bleeding
•    Dry socket if you have had teeth removed
•    Extreme discomfort

These symptoms should be treated right away, as they could indicate infection or other problems that can lead to long-term issues or incomplete healing. If you have any questions about symptoms or about proper aftercare, call the office of Dr. Chris L. Tye right away.

Since implant surgery is an oral surgery procedure, you will require some kind of anesthesia to keep you comfortable during the process. The type of anesthesia used depends upon how many implants you are having placed, the preference of your oral surgeon, and your personal comfort levels.

Determining the Type of Anesthetic

If you are only having one or two implants placed, you might not require general anesthetic. Local anesthetic should be sufficient to keep you comfortable while your implants are placed. However, if you must have a bone graft in which bone is harvested from elsewhere in your body, your oral surgeon might prefer to work with you under a general anesthetic.

Another option for dental implant procedure is conscious sedation. Sedation helps you relax during your oral surgery and is often used in conjunction with local anesthetic. The sedative is typically administered in pill form or by using nitrous oxide. Sedation allows you to remain conscious, so you are aware of your surroundings and can respond to your doctor’s questions and instructions, but you will be completely relaxed, almost in a dream-like state. Conscious sedation is a great option for those who experience dental anxiety, or if you are particularly concerned about how you might react to implant surgery.

Though it might seem preferable to have your surgery under general anesthesia, it is generally unnecessary. Local anesthesia with or without conscious sedation is safer and less likely to produce unpleasant side effects. Be sure to discuss your anesthesia options with your oral surgeon to be sure you make the best choice for you.

Choosing Dental Implants

If you have missing teeth, dental implants can be an excellent option for replacement. Consulting with an implant dentist will help you decide if they’re a good choice for you. If you are in good overall health, do not smoke, do not have diabetes or an immune system disorder, and have sufficient mass in your jawbone to support implants, this might be the best way to restore your smile.

Contact our skilled dental team at 817-552-3223 today and find out if dental implants are the right option for you.

While the complexity of the Dental Implant Treatment planning is case dependent, there are two basic fundamentals that apply to every case: First implants must be surrounded by a sufficient amount of gum tissue and jaw bone, and second implants must be positioned properly to facilitate the final restoration.

It’s not enough for an implant that has been placed to simply allow for a crown restoration. In a properly planned case the implant should be placed in proper 3D position in relation to adjacent teeth, gum tissue and bone so that it allows for the desired crown restoration. Proper implant planning requires an evaluation by a skilled surgeon and proper radiographs including a 3D Cone Beam Cat Scan.

In order to know where an implant is to be placed there must be a clear plan ahead of time in regards to the final crown restoration. While it’s imperative that any implants be placed to facilitate the planned restoration they must also be placed in sufficient bone and have adequate gum tissue for long term health.

So what does this all boil down? We have to know where we need an implant or implants for the proposed crown restorations, and if there is not enough tissue, either gum or bone, we need to graft it properly. If that’s not possible, we must adjust the treatment plan as needed prior to starting any treatment.

John R. Carson, DDS, PC, Spear Visiting Faculty

Chris L. Tye, MD, DDS, Oral Surgeon, Spear Club Leader

Sleep apnea can cause serious symptoms and unwanted side effects, and in some cases can be life threatening, but it usually does not require surgery for effective treatment. Certain kinds of oral surgery, though, have been found to be helpful for some types of sleep apnea. Your oral surgeon can help diagnose your apnea and determine the best treatment.

What is Sleep Apnea?

Sleep apnea occurs when your breathing is interrupted or obstructed during sleep, causing you to stop breathing for a short period of time. This causes you to awaken very briefly. The breathing interruptions typically happen many times during the night. As a result, you do not get enough rest, and your body can be deprived of vital oxygen, leading to fatigue, flu-like symptoms, and other problems that can be chronic, uncomfortable, and sometimes difficult to diagnose.

Obstructive apnea occurs when your airway becomes obstructed, usually by tissues at the back of your throat or by tension in the muscles around the airway. Traditional treatments for apnea include oral appliances that keep the airway open and CPAP machines that provide a constant flow of oxygen into your airways. Sometimes, though, these treatments do not work. In these cases, an oral surgeon might be able to help.

Surgical Treatments for Sleep Apnea

If your breathing is being obstructed by tissues in the back of your throat or because your airway is constricted when you sleep, some types of surgery can help keep the airways open. One of these, called uvulopalatopharyngoplasty, removes tissue from the area around your uvula and restructures the soft palate to be sure your airways remain open. This procedure is relatively new, but has had promising results.

Other surgical treatments include:

• Shifting the jawbone to open the air passage
• Using plastic implants to open your palate
• Nasal or sinus surgery to remove obstructions in the nose or sinuses
• Tonsil or adenoid removal
• Creation of a new airway

Before choosing surgery, your oral surgeon will probably want to try less invasive treatments. To find out more about how your sleep apnea can be treated, please contact the office of Dr. Chris Tye for a consultation.

TAMPA

By Irene Maher, Times staff writer
In Print: Thursday, January 24, 2013

Every night for 10 years, Tim Holler serenaded his family at bedtime with an unwelcome tune: loud snoring. He had to sleep in another room so his wife could get some rest.

“I was so loud, she couldn’t even sleep with ear plugs,” says the Bradenton small business owner.

A sleep study revealed Holler, 45, did more than snore loudly at night. He had obstructive sleep apnea, a dangerous condition that caused him to stop breathing hundreds of times a night and wake up gasping for breath.

“It would scare me,” said Lisa Holler, Tim’s wife of 14 years. “He was so embarrassed and self conscious about the loud snoring and gasping, he wouldn’t travel or stay in a hotel because he worried about disturbing other people.”

In obstructive sleep apnea, tissue and muscles in the back of the throat relax, narrowing the airway. The loose tissue vibrates as you drift off to sleep, causing snoring. Then, as you shift into deeper, more relaxed sleep, the tissue collapses partially or completely, blocking the airway until the brain tells you to wake up and breath.

Susan Yeatts of Tampa sometimes went as long as a minute without breathing, before she awakened gasping. She was diagnosed with obstructive sleep apnea in 1990, but believes she had the problem since birth. “My mother said I snored so badly as an infant that she couldn’t keep my bassinette next to her bed,” said Yeatts, now 51 and a pharmacy researcher. A sleep study confirmed that she stopped breathing an average of 73 times an hour, all night long. “I was exhausted all the time,” she said. “I never got deep sleep. I was always tired.”

Mild sleep apnea can usually be resolved with lifestyle changes like losing weight, not smoking, avoiding alcohol before bedtime and sleeping on your side instead of your back. Dental appliances worn during sleep that keep the lower jaw forward and the airway open, also help in some mild cases.

Mild to moderate apnea may be treated with surgery, including removal of tissue from the back of the mouth and throat, including the uvula, tonsils and adenoids; plastic rod implants are also sometimes used to stiffen the soft palate, making it less likely to vibrate.

When apnea is moderate to severe, the gold standard of treatment is continuous positive airway pressure, commonly known as CPAP. This is a machine that delivers air through a hose or tubing connected to a mask worn while you sleep. The mask fits over the nose or has prongs that fit inside the nose. The air pressure is just enough to keep the airway open and prevent apnea and snoring.

Yeatts was prescribed CPAP right after her diagnosis, but found it cumbersome, difficult to sleep with and awkward, especially as a young woman. Still, she used it on and off for 20 years.

“It worked,” she admits, “But it’s noisy and intrusive and it’s for the rest of your life. Who wants that?”

That was Holler’s biggest objection, too. “I would have to use it for the rest of my life,” he said. Plus, he found that he tossed and turned too much for CPAP, which “requires you to sleep in one position, on your back, and stay there.”

“I wanted a permanent solution,” he said.

Holler and Yeatts both turned to Tampa craniomaxillofacial surgeon Pat Ricalde for a radical procedure that moves the mouth, tongue and chin forward permanently to enlarge the airway.

Maxillomandibular advancement, or MMA, isn’t for everyone with apnea, said Ricalde, especially those doing well with CPAP or other conservative treatment.

“The people who come to me have severe apnea and are desperate for a solution,” she said. Her patients are so sleep-deprived, they aren’t daunted by major surgery.

MMA involves cutting several bones in the face and reconnecting them with small titanium screws and plates. It takes about four hours, requires at least two nights in the hospital and means missing work for two weeks. They can resume normal activities and diet in five to six weeks. The hardware is permanent, but won’t set off security alarms at airports, Ricalde says of a frequently asked question.

“Yes, the surgery is a big deal, but the condition—obstructive sleep apnea—is a big deal. It’s more than just snoring. Their oxygen levels drop so low that, over time, it increases their risk of heart attacks, strokes and some cancers,” said Ricalde.

Dr. Tapan Padhya, co-director of the sleep disorders and snoring clinic at USF Health and Tampa General Hospital says MMA is “an appropriate, accepted surgery.” But few of his patients who are eligible have it done, “usually because of the long recovery period or insurance issues.” The cost can run about $40,000.

Yeatts said it took a year before her insurance company would approve the procedure. She had the surgery six months ago.

“It’s made an amazing difference,” she said. “I’m happier, more alert, I can stay awake later at night and I can breath easier.” She still has some numbness in her bottom lip, but said it has been slowly improving.

Holler had the surgery last April and also has some residual numbness in his lower lip and chin. “It’s a weird feeling, but it was worth it,” he sys.

He snores much less now and his apnea episodes have dropped from 88 an hour to just three. He and his wife are able to sleep in the same room again and recently took a family vacation for the first time in years.

Full Story Here

We offer several surgical solutions to treat severe sleep apnea.  Call us today to schedule a consultation.

As we strive to improve our oral and maxillofacial practice and provide even better care for patients, we have invested in the CS 9300 system from Carestream Dental.

This powerful device offers a full 3D CBCT Craniofacial field of view and allows the selection of up to seven fields of view for 3D images, ranging from 5 cm x 5 cm to 17 cm x 13.5 cm, as well as 2D digital panoramic imaging with variable focal trough technology, thereby minimizing unnecessary radiation exposure.  With precise 3D panoramic images, it has unprecedented levels of clarity – up to 90μm – to assure diagnostic confidence and acceptance of treatment plans.

We’ve found that this versatile cone beam 3D system meets a full range of OMS imaging needs. Crystal-clear Panoramic radiographs form the foundation of most OMS cases, and the CS 9300 provides these with its variable focal trough technology.  Because some cases call for additional anatomical detail, the 3D CBCT also gives us the option of multiple fields of view that we can collimate to the precise region of interest, in adherence with the ALARA principle – “As low as reasonably achievable.”  The Kodak 9300 CBCT radiation dosage is much lower than low-dose and standard conventional CT (MDCT) exams.

Cone beam 3D technology allows us to collect valuable diagnostic information for a large variety of clinical applications, including the evaluation of:

• Implant Site Evaluation: Bone density, anatomy & proximity to pertinent anatomical areas give the surgeon a precise anatomic roadmap for implant placement improving clinical outcomes.
• Impacted teeth: Position and relative anatomy for removal or exposure of teeth.
• Pathology:  Precise view of pathologic boney lesions in the dentoalveolar and maxillomandibular regions including dentoalveolar periapical pathology.
• Trauma and Reconstruction: 3D CBCT is the gold standard in evaluation of osseous pathologic defects.
• Airway:  3D rendering of hypopharyngeal airway.
• Paranasal Sinuses: superior isotropic spatial resolution promotes better visualization of sinus structures
• TMJ Pathology:  Anatomic detail in evaluation of Condyle and TMJ.

To further aid in collaboration, three-dimensional images from the CS 9300 are generated in standard DICOM format for easy image sharing, should we ever need to review and discuss images from a specific case. We can quickly and simply share high-resolution images of the area of concern via USB drive or CD – allowing us to collaborate on treatment planning, improving the patient’s experience.

We feel that this new system helps us significantly improve what matters to us most: patient care. We appreciate the trust you put in our practice and look forward to continuing our relationship for many years to come.

Sincerely,

Chris L. Tye MD, DDS

Many dental practices, including regular cleanings, X-rays and everyday hygiene, are focused on preserving your teeth. However, sometimes tooth extraction is inevitable. This is most common in the instance of wisdom teeth, but sometimes other teeth must be removed as well. Preparing for an extraction procedure can help you be less anxious and enable faster recovery.

Consulting with Your Dentist

One of the best ways to prepare for a dental surgery, including a tooth extraction, is to discuss your procedure with your dentist or oral surgeon ahead of time so you know what to expect. Some questions you might want to ask include:

• What kind of anesthetic is appropriate?
• How many teeth need to be removed?
• Can I choose conscious sedation in addition to local anesthetic?
• What can I expect during recovery?
• What kind of medication can I take during recovery?
• Can I take medication before the extraction to reduce discomfort?

These questions will help you get a good idea of what your procedure will be like and how your recovery is likely to go. This type of foreknowledge will help your procedure go smoothly and also help ensure a comfortable recovery.

Getting Ready for Your Visit

You will probably wish to have someone take you to your appointment and drive you home, just to be on the safe side. This is particularly true if you have received oral sedation to help you remain more comfortable during your procedure. Oral sedation takes some time to clear out of your system, so it probably will not be safe for you to drive.

If your oral surgeon has prescribed or recommended medication before your procedure, be sure to have it ready or take it during the time period your doctor recommends. Also be sure to ask any last-minute questions you might have or clarify any instructions before your procedure begins. If possible, take notes or have someone take notes for you so you won’t forget what the surgeon tells you. By following  these simple steps, you’ll be sure your extraction goes as smoothly and comfortably as possible.

Contact our experienced team at Surgical Arts if you have any additional questions regarding an upcoming tooth extraction. Call us at 817-552-3223 and schedule an appointment today.

Wisdom teeth are the last set of molars to emerge in your mouth, usually arriving in the late teens or early twenties. In most cases, there is not enough room for these teeth. They often become impacted or even infected and must be removed. Since the teeth usually need to be removed, you might wonder why we have wisdom teeth in the first place.

A Possible History of Wisdom Teeth

Scientists and dentists are unsure why we get wisdom teeth. One theory, though, is that in the distant past they might have served as replacements for teeth we were likely to lose. In the early days of humanity, we ate much coarser, rougher food and were not always able to take good care of our teeth. So when a back molar or two eroded or needed to be removed, these additional molars would emerge later to take their place so we could still eat normally.

However, as humans evolved, our jaws became smaller. We also learned more about how to take care of our teeth and developed a more refined diet. As a result, we were less likely to lose our other molars, leaving no room for the wisdom teeth. Today, we need them even less, and are more and more likely to simply have them removed.

How to Know if You Need Your Wisdom Teeth Removed

If your third molars are emerging, you may or may not have to have them removed. If your teeth are emerging or attempting to emerge, and you experience any of the following symptoms, you should see an oral surgeon to have them removed.

• Swelling or discomfort
• Discomfort in the adjacent teeth
• Persistent toothache
• Decay in the tooth
• Infection
• Impaction of the tooth

Your dentist can take X-rays to determine if your teeth are impacted. Impaction often requires oral surgery, since the tooth has not erupted. Other issues should be evaluated by your dentist to determine if action is required.

Schedule an appointment with the office of Dr. Chris Tye today to decide if you should have your wisdom teeth removed.

Dental implants are a permanent means of replacing missing teeth. In order for implants to be successful, there must be enough bone present to support them. One way of correcting a lack of sufficient bone is sinus augmentation. This oral surgery procedure adds bone to the upper jaw to help support your new implants.

How Dental Implants Work

Dental implants are a titanium screw that serves to replace the tooth root. Titanium bonds to bone naturally, although this takes a period of time. After the initial placement of the tooth root, a healing period of several weeks is necessary for this bonding to occur. In some cases, the implants are placed at the same time as the grafts. Be sure to ask your oral surgeon about the best approach to your implant procedure.

Because the bonding of the implant to the jawbone is important to the implant’s success, your oral surgeon will evaluate the density of the bone in your jaw. If you have experienced bone loss in either the upper or lower jaw, he might recommend bone grafts or sinus augmentation to support your implants.

What is Sinus Augmentation?

In a sinus augmentation procedure, an oral surgeon adds bone grafts to the upper jawbone. This procedure is also referred to as a sinus graft or sinus lift. The grafts can be made of material from elsewhere in your body or from donor material. Synthetic bone is sometimes used as well.

Adding bone grafts to the upper jawbone is a slightly more complex procedure than adding to the lower jawbone because of the involvement of the sinuses. You must be evaluated to determine your sinuses are healthy, and the procedure must be carefully performed to prevent damage to the sinus cavities.

Before recommending implants, your dentist will evaluate your overall health to be sure your implants will have a good chance of success. If you have severe gum disease, are a smoker, or have a systemic health problem such as diabetes, you might not be a good candidate for dental implants.

If you are considering dental implants, schedule an appointment with Surgical Arts to learn if you may also need a sinus augmentation. Call 817-552-3223 to talk with our skilled team.

Orthognathic surgery is surgery to the jaw or the face used to correct problems such as sleep apnea, temporomandibular joint disorder (TMD), malocclusion, or serious issues such as cleft palate. Orthognatic surgery is performed by an oral surgeon, often working with an orthodontist. This kind of surgery can be extremely successful in treating chronic conditions that don’t respond to other treatments.

Conditions Treated with Orthognathic Surgery

Misalignment of the jawbone can lead to a wide range of problems. In many cases, these problems are treated with traditional orthodontics or other methods. These methods can change the alignment of the teeth, but if the root cause of the malocclusion is the position of the jaw, there still might be issues that can lead to abnormal wear or uncomfortable symptoms such as headaches and earaches.

When orthodontics or other methods are not sufficient to correct malocclusion or jaw misalignment, orthognathic surgery can provide an effective, permanent solution. Some conditions that can be treated with this type of dental surgery include:

• TMD – This chronic disorder occurs when the jaw joint is misaligned.
• Malocclusion – A severe misalignment of the teeth.
• Sleep apnea – A condition in which breathing stops periodically during sleep.

Orthognathic surgery can be used to move the jaw into optimal alignment. This can correct the improper alignment of the joint itself or correct how the top and bottom teeth meet. In the case of sleep apnea, orthognathic surgery can increase air flow, making it easier to breathe during the night and reducing symptoms of sleep apnea.

Why Orthognathic Surgery?

Orthognathic surgery might seem like a drastic measure for some people. This can especially be true if you are not familiar with this type of surgery or have only been aware of orthodontic treatments for conditions where surgery can be a better option.

If your dentist or oral surgeon recommends this type of surgery, be sure to ask as many questions as you need to so that you feel comfortable with both the diagnosis and the treatment. To find out more about orthognathic surgery, please call the office of Dr. Chris Tye to schedule a consultation.