sheppard

Oral & Oropharyngeal Cancers

Worldwide, over 550,000 new cases of Oral, Head and Neck cancer are diagnosed each year.

'bacteria entering mouth'Oropharyngeal cancer is slightly different from oral cancer. Oropharyngeal cancers are related to HPV (Human papilloma virus) and usually occur in the tonsils or at the base of the tongue, while oral cancers are in the mouth and usually associated with tobacco use.

The Oral Cavity

The oral cavity includes the lips, the inside lining of the lips and cheeks, the teeth, the gums, the front two-thirds of the tongue, the floor of the mouth below the tongue, and the bony roof of the mouth – also known as the hard palate.

The Oropharynx

Behind the wisdom teeth is considered the oropharynx, which is part of the throat just behind the mouth. It also includes the base of the tongue, the soft palate (back of the mouth), the tonsils, and the side and back wall of the throat.

Categories

Oral and Oropharyngeal cancers are sorted into 3 categories: Benign (non-cancerous), harmless growths that may develop into cancer, and cancerous tumors. This is why regular check-ups with your dental professional are key to your overall well-being.

The Team Involved

The treatment of head and neck cancers does not involve just your dental team, the assistance of many different professionals contributes is required. There may be surgeons, radiation oncologists, medical oncologists, dentists, nutritionists, and speech therapists all involved in your treatment.

Oral cancers are found as late stage three and four diseases about 66% of the time.
It is very important for you to check yourself at home as well as visiting your dentist.

Call Center for Oral & Dental Implant Surgery to schedule your routine dental check up and oral cancer screening today 817-477-0922

Little, Medium, Big Bone Grafts!

Bone grafting is a straightforward procedure that is immensely beneficial for numerous reasons. In the instance of a missing tooth (or teeth), the jawbone can begin to slowly degrade. The jawbone holds teeth in place, and once a tooth is no longer present, the bone doesn’t have anything to support. There are different types of bone grafts:

'tooth needing bone graft'Little Bone Graft

In the case of a simple, single lost tooth, the ideal course of action is to not lose excess bone. In this process, sterile, demineralized human bone granules are packed into the tooth socket immediately after tooth extraction. This procedure is very simple, and does not add anything to your recovery time. Over the next several weeks, your own bone will fill the tooth socket and preserve the bone height enough for you to have the area restored.

Medium Bone Grafts

If a tooth was removed a long time ago, there is likely to already be some bone loss impeding the restoration of the area. In this case, the area of the missing tooth is opened with a small incision, the bone surface is prepared, and demineralized bone graft granules are used to build up the area. Many surgeons prefer to use a little bit of the patient’s own bone in this procedure in order to ensure the best results possible. If your own bone is used, your surgeon will take it from another area of the jaw bone, usually near the wisdom tooth area, shaving off tiny granules and combining them with the demineralized bone. The bone graft will heal and integrate with the surrounding bone tissue. This type of graft can be used for one or multiple areas of missing teeth.

Big Bone Graft

Patients who have many missing teeth and who have been missing many teeth for many years, have often experienced advanced bone loss. In those who wear dentures, the lower jaw bone often recedes so severely that they can no longer wear them. Extensive bone grafting is necessary in order to consider restorative methods. A combination of demineralized, sterile human bone and the patient’s own bone is used to restore the jaw bone, creating enough width and height to consider dental implants. The patient’s bone is supplied by another part of the jaw, hip, or tibia. Bone granules are also used to enhance and strengthen the graft.

Bone grafting is a surgical procedure that takes time. However, it plays an essential role in making new teeth possible, and will ultimately be a positive process! For more information, call 817-477-0922 today for a consultation with Center for Oral & Dental Implant Surgery.

Dental Implant Success

What do you use your teeth for? Eating, drinking, speaking, laughing, the list goes on! How are these affected when you have tooth loss?
'dental implant between teeth'If you have missing teeth, you could be missing a lot! A very reliable and safe method for replacing teeth is dental implants.

Dental implants permanently attach prosthetic teeth to small posts or “roots” that are embedded in the jaw. These posts are made of titanium, and securely fuse to the jaw bone, this helps restore the full functionality of previously missing teeth.

Dental implants not only effectively and reliably replace missing teeth, but also help prevent the loss of jawbone density, restore the support of facial structures, and provide you with the support you need to effectively use your teeth.

The procedure for dental implants can be a quick and easy, and in some cases, can be done in a single day. Your implants become part of you, so they eliminate the discomfort of removable dentures. They also prevent the embarrassment of removing dentures at every snack or meal, as well as the need for denture adhesives.

Sliding dentures can make chewing difficult. Dental implants function like your own teeth, allowing you to eat your favorite foods with confidence and without pain. Nearby teeth are not altered in order to support a dental implant, thus more of your own teeth are left intact, improving oral health in the long-term as well as your oral hygiene.

Dental implants are very durable, lasting several years, and if they are in good care, can last a lifetime.

Don’t miss out with missing teeth, get your smile back and feel better about yourself!

Here at Center for Oral & Dental Implant Surgery we specialize in dental implants, so give us a call today at Center For Oral & Dental Implant Surgery Phone Number 817-477-0922 to discuss your future implant success!

Dental Implants 101

'Dental Implants 101'Whether you are missing a tooth, or at risk of losing many, dental implants may be a great solution   for you. Dental implants are an increasingly popular fix for missing or dying teeth, and have many benefits.

What is a Dental Implant?

Dental implants are high tech teeth. The root of your current tooth is removed, and replaced with a screw attached to a ‘cap’ that looks identical to a natural tooth. Many people report higher confidence and comfort after receiving their new tooth.

What’s so Great About Them?

The cool thing about implants is that if taken care of, they can last for life. Usually all that needs to be replaced, if anything, is the cap. The other great thing about implants is that they can’t die like natural teeth. You still have to clean and maintain them like your other teeth, but no roots are any longer at risk of causing that tooth to fail. In addition to that, many implants can last a lifetime!

What is the Surgical Process Like?

The process is done either all at once, or in steps. This depends on the recommendations for your particular case. The first step is to remove the root of your natural tooth, and place the implant in its place. If there is not enough bone to place the implant, we may encourage you to have bone grafting first. The gum is then stitched closed and allowed to heal. This can take five to six months. The next step is to reopen the gum and place an abutment on the implant, along with a temporary crown so you can heal while the permanent crown is made for you. You then return to get your permanent crown attached in a few weeks. In other cases, all of these steps can be done in a single visit, but it depends on your specific case.

If you have any questions, please call our office for more information, we would be glad to help!

Wisdom Tooth Removal – Aftercare

'woman smiling after wisdom tooth removal'Having your impacted wisdom teeth removed is a serious surgical procedure, and post-operative care is extremely important! Read on for instructions on how to care for your sore mouth, and how to minimize unnecessary pain and complications.

Immediately Following Surgery

Keep a firm, yet gentle, bite on the gauze packs that have been placed in your mouth to keep them in place. You can remove them after an hour if the bleeding is controlled. If the surgical area continues to bleed, place new gauze for another 30 to 45 minutes.

Be careful!

Do not:
• Rinse vigorously
• Probe the area
• Smoke (hopefully you don’t!!)
• Participate in strenuous activities
You can:
• Brush gently (but not the area)
• Begin saltwater rinses 24 hours after surgery (mix 1 tbs of salt with 1 cup of water). Make sure to swish gently. These rinses should be done 2-3 times a day, especially after eating.

Enjoy some down-time!

Keep activity level to a minimum! Enjoy a day of couch or bed-rest, as being active could result in increased bleeding. Avoid exercise for 3-4 days, and when you do begin exercising again, keep in mind your caloric intake has been reduced so you may feel weaker.

Bleeding

As you’ve just had surgery, some bleeding will occur and it’s not uncommon to ooze blood for 24-48 hours after your procedure. REMEMBER-the blood you see is actually a little blood mixed with saliva, so don’t panic!
If excessive bleeding persists:
• Try repositioning the packs. They may not be putting enough pressure on the site.
• Sit upright and avoid physical activity.
• Use an ice pack and bite on gauze for one hour.
• You can also try biting on a moistened tea bag for 30 minutes (the tannic acid in tea promotes blood clotting).
• If bleeding persists, please call our office at 817-477-0922.

Pain

Unfortunately, some pain is to be expected after surgery. Try not to let the anesthetic wear off before taking your prescribed pain medication. Dr. Sheppard will have discussed a plan to manage your pain, make sure you follow these instructions.

Diet

Eat nourishing food that takes little effort.
Avoid:
• Extremely hot foods
• Straws (for the first few days)
• Chewing (until tongue sensation has returned)
• Smaller foods that can become stuck in the socket area
• Skipping meals—while eating may seem like a lot of work, you need your nourishment to be able to heal and feel better!

Day 2 and 3 Following Surgery

Swelling

Swelling is a completely normal occurrence. Keep in mind, swelling will usually be at it’s worst in the 2-3 days after surgery. You can minimize swelling by applying a cold compress (covered with a towel) firmly to the cheek next to the surgical area. Apply the pack with 20 minutes on, and 20 minutes off for the first 24-48 hours. Also make sure to take the medication prescribed by Dr. Sheppard. This helps with pain and swelling.

Keeping your mouth clean

Keeping your mouth clean is very important! Continue saltwater rinses as often as you’d like, but at least 2-3 times a day. Begin your normal oral hygiene (remember to brush softly and don’t do anything that hurts)!

Healing

Everyone heals differently, but your timeline should look similar to this:
• Day 1-2 will be the most uncomfortable and you will experience some swelling.
• Day 3 you should be more comfortable and while still swollen, you should be able to begin a more substantial diet.
• Day 4 and on you should see a gradual and steady improvement.

Other Normal Things

• Discoloration. Bruising is a normal post-operative occurrence you may notice 2-3 days after surgery.
• Stiff jaw muscles. You may find it difficult to open your mouth wide in the days following your surgery. This is normal and usually resolves itself within a week after surgery. Stretching these muscles may help to speed up recovery.
Since no two mouths are alike, do not take advice from friends (even well-intended advice could cause a healing set-back). The advice given to you from Dr. Sheppard and the Center for Oral & Dental Implant Surgery team are tailored to fit your needs. Please call us at 817-477-0922 if you have any questions or concerns about your recovery. Happy healing!

Learning the Lingo – Dental Implants

'dental implant and tooth'Dental implants are a safe and effective replacement for a missing tooth or teeth. The implant is placed in your jawbone and integrates with your natural bone. This implant then forms a stable, sturdy base for your new teeth.

What They Are

Implant: The implant itself is a rod that is screwed into the jawbone.

Abutment: This is the connection between the implant and the crown.

Crown: A tooth shaped cap that is attached to the abutment. It is the part of the tooth that is visible above the gum line.

What They’re Made Of

Titanium: Most implants are typically made of titanium, a biocompatible metal.

Zirconia: Often used for crowns and bridges and can be used as a metal-free option. Zirconia is biocompatible just like titanium.

Where They Go

Endosteal Implants: Placed in the jawbone. These implants are typically shaped like small screws, cylinders or plates, and they are the most commonly used.

Subperiosteal Implants: Placed under the gum, but on or above the jawbone. These implants are mostly for people with smaller jaws or shallow jawbones.

What Happens To Them

Osseointegration: Creates strength and durability by fusing directly to the bone and is bio-compatible. Bone cells attach themselves directly to the titanium/zirconium surface, essentially locking the implant into the jaw bone. Osseointegrated implants can then be used to support prosthetic tooth replacements of various designs and functionality. Anything from a single tooth, to all teeth in the upper and lower jaws. The teeth/crowns are usually made to match the enamel color of the existing teeth to create a natural appearance.

Bone augmentation: Some people do not have enough healthy bone to support dental implants, so bone must be built. Procedures can include bone-grafting which means adding bone to the jaw.

Talk to us today at Center for Oral & Dental Implant Surgery to discuss your options with an implant specialist!

Pre Implant Bone Augmentation

'man lifting weights'We are all unique, and so is your mouth! Sometimes, your jaw needs to be beefed up a little, and we’re not talking a hefty workout at the gym.
You may have lost teeth due to gum disease which has resulted in bone loss, or you could just have been “born that way” and need a little help expanding!

Don’t let life get you down! We’ve got these options for you;

Sinus Lift or Sinus augmentation:

A sinus lift is often performed on people who have lost teeth in their upper jaw or are lacking adequate bone density. This procedure adds bone between your jaw and the maxillary sinuses (which are on either side of your nose), the area of your molars and premolars. To make room for the bone, the sinus membrane has to be moved upward, or “lifted.”
The new bone means implants can be placed. This procedure does not affect speech, intonation or cause sinus problems.
Sometimes this procedure is required in the alveolar ridge. The alveolar ridge is the part of the gums immediately behind the upper front teeth. Alveolar ridges contain the sockets, or alveoli, of the teeth. You can feel it on the upper palate if you say words like “tight”, “dawn” because the consonants are made with the tongue tip or blade reaching for this alveolar ridge.

Ridge Expansion or modification:

If your jaw isn’t wide enough to support dental implants, bone graft material can be added to a small ridge, or space that is created along the the jaw. Malformation in the lower jaw can result in not enough bone to place dental implants and it can also cause an unattractive indentation in the jaw line near the missing teeth that may be difficult to clean and maintain.

During ridge expansion, the bony ridge of the jaw is increased and bone graft material is inserted and allowed to heal before placing the implant.
Ridge modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come. It can enhance your restorative success both aesthetically and functionally.

Whether you require a lift or expansion, the bone usually will be allowed to develop for about four to 12 months before implants can be placed. However, in some cases, the implant can be placed at the same time the ridge is modified.

What are you waiting for? Ask us today what your implant options can be!

Bite Sized Wisdom- Knowing the Facts on Wisdom Teeth

Wisdom teeth, the late blooming elder teeth of your mouth, behave a little differently than your other teeth.

'impacted wisdom tooth'Know the facts:

  • Wisdom teeth get their name from the time frame at which they finally show up in your mouth. They typically appear in a person’s late teens or early twenties, sometimes called “The Age of Wisdom,” though your parents may disagree.
  • Wisdom teeth cause trouble because they often grow at odd angles. This makes it hard for them to break out of your gum, if at all.
  • Another reason wisdom teeth often can’t get out of gums is because there is not enough room for them. The plus side is that this could be because you’ve kept your teeth nice and straight.
  • Some people never grow wisdom teeth!
  • Wisdom teeth, among other teeth, house valuable stem cells that can be saved to help you treat other conditions you may have down the road. A pearl of wisdom for you.
  • Wisdom teeth removal, with proper sedation, is painless. The tough part is recovery, which can last a few days to several weeks. Following your physician’s instructions will help you through recovery as quickly as possible.
  • In ancient times, when diets were harder on teeth, wisdom teeth made more sense. People couldn’t influence the way their teeth moved around so it was easier for wisdom teeth to find space to pop in. With today’s high-quality dental care, wisdom teeth aren’t necessary.
  • Given that most people end up removing these teeth surgically, research is being done to find ways to prevent their growth altogether. This would save a trip to the surgeon!
  • You may or may not ever notice that your wisdom teeth need to be removed. Some people notice some pain or irritation, some notice nothing at all. Making an appointment with our office is the only way to know for sure.
  • Most people have four wisdom teeth. It’s possible to have fewer or more than four, though it’s very uncommon.

Wisdom teeth can be quirky and troublesome. To make sure you or your child’s wisdom teeth aren’t creating difficulties down the road, make an appointment with us today!

Oral Cancer and Hepatitis C

'Oral Cancer' 'Hepatitis C'The Journal of the National Cancer Institute (JNCI) recently found that individuals infected with the hepatitis C virus are two to five times more likely to develop head and neck cancers. The JNCI study found that the risk for hepatitis C patients of developing head and neck cancers more than doubled for oral cavity and oropharynx cancers, and increased nearly five times for larynx cancers. As well, patients that are hepatitis C virus-positive were also more likely to test positive for human papillomavirus (HPV).

The question remains, how does hepatitis C virus increase oral cancer risk?

The JNCI research found that patients infected with the hepatitis C virus had a higher odd ratio of having cancer of the oral cavity, oropharynx, or larynx than those without hepatitis C virus infection. Enhanced replication of hepatitis C virus in oropharyngeal tissues may in fact contribute to chronic inflammation, ultimately prompting cancer development. Human papillomavirus is known to suppress local immune response, which may accelerate the production of hepatitis C virus in oropharyngeal cells. The JNCI notes that human papillomavirus and hepatitis C virus may play a “synergistic role” in the development of oropharyngeal cancers by stimulating loss or destruction of tumor suppressor proteins p53 and retinoblastoma protein.

The JNCI notes that one of the study’s limitations is that it didn’t include individuals with hepatitis C virus who didn’t have oral cancer. All and all, it is important to take away from The Journal of the National Cancer Institute’s study that it is important to educate Hepatology (study of liver, gallbladder and pancreas health) and infectious disease specialists. These doctors who treat patients with hepatitis C virus need to understand that the hepatitis C virus not only drastically affect liver health, but it’s also a systemic infection that can drastically affect oral health.

Your oral health is important to us. If you suspect that your oral health is at risk, give Center for Oral & Dental Implant Surgery a call today and schedule an oral cancer screening!

On the Lookout for Oral Cancer

Oral cancer screenings are performed regularly at dental exams, but that doesn’t mean you shouldn’t be paying attention to your dental hygiene between appointments. Taking matters into your own hands is the best way to maintain your oral health. Not sure how to screen for oral cancer? We’ll show you! 'woman getting checked for oral cancer'

What is oral pathology?

This branch of dentistry involves the evaluation and treatment of diseases of the mouth. The most dangerous, but not always the most obvious, of these diseases is oral cancer.

What should I look for?

Keep an eye out for these oral cancer symptoms during your self-screenings:

  • Red or white patches in the mouth
  • Lumps on the tongue or lining of the mouth
  • Mouth sores that won’t heal
  • Unexplained bleeding
  • Chronic throat soreness
  • Difficulty chewing or swallowing
  • Mouth numbness

How do I perform an oral cancer self-exam?

  1. When performing your oral cancer self-screening, be sure to check all areas of the mouth, including the roof, floor, tongue, lips, cheeks and the back of your throat.
  2. Examine your face in the mirror for abnormal asymmetry and irregularities.
  3. Feel your neck and the back of your head with your fingers to look for any bumps or changes in texture.
  4. Examine your throat by placing your fingers around your thyroid cartilage (Adam’s apple) and swallowing.

How often should I perform a self-exam?

Self-exams should be performed at least once a month. Changes to your oral health can occur rapidly, so it’s important to stay on top of things. Treatment is most effective if we detect symptoms early.
Ask us about performing an oral cancer screening when you visit – we’re here to ease your mind and give you the tools you need to maintain your health!