We pride ourselves in utilizing the most modern equipment and methods available. Some of the services we offer can be found below:
- Anesthesia Options
- Blood Thinner and Dental Procedures
- Bone Grafting
- Dental Implants
- Extractions/Impacted Teeth
- Oral Cancer Screening
- Oral Diagnosis and Biopsies
- Oral Pathology
- Sedation Dentistry
- Special Services (PRP,BMP)
- Wisdom Teeth
In order to provide the best care for our patients, our office uses many state-of-the-art technologies.
Optimum use of technology may provide more efficiency and better outcome of treatment.
There are some occasions when a tooth may need to be extracted. A tooth may need to be extracted if the following occurs:
- Severe decay
- Periodontal disease
- Denture placement
- Implant replacement
After careful examination, Dr. John may advise to have a tooth extracted. Before a tooth is removed, an x-ray will be taken to allow diagnosis and to plan a treatment. The x-ray will show the shape and position of the tooth and surrounding bone and any lesions. Based on the degree of difficulty, this may be a simple extraction or require surgery. If you have had a recent x-ray taken in the last six month, you may bring it from your dentist or your dentist may e-mail a digital image to Dr. John and save the expense of having another one taken.
Wisdom teeth are the last teeth to erupt within the mouth. A wisdom tooth is any of the usually four third molars. Wisdom teeth usually appear between the ages of 16 and 25. Most adults have four wisdom teeth, but it is possible to have more. Wisdom teeth commonly affect other teeth as they develop, becoming impacted or “coming in sideways.” They are generally extracted when this occurs.
Impacted wisdom teeth may also be categorized on whether they are still completely encased in the jawbone. This is a bony impaction. If the wisdom tooth has erupted out of the jawbone but not through the gumline, it is called a soft tissue impaction.
In a small portion of patients, cysts and tumors occur around impacted wisdom teeth, requiring surgical extraction.
Sometimes the wisdom tooth fails to erupt completely through the gum bed and the gum at the back of the wisdom tooth extends over the biting surface, forming a soft tissue flap or lid around the tooth. The tooth can be difficult to clean and debris and bacteria can easily accumulate under the tissue flap causing an infection to set in. Common symptoms include a swelling and redness of the gum around the eruption site, difficulty in opening the mouth, a bad odor or taste in the mouth, and pain in the general area which may also run down the entire lower jaw or possibly the neck. Untreated the infection may become more severe.
Wisdom teeth are extracted for two general reasons: either the wisdom teeth have already become impacted, or the wisdom teeth could potentially become problematic if not extracted. Potential problems caused by the presence of properly grown-in wisdom teeth include infections caused by food particles trapped in the jaw area behind the wisdom teeth. Such infections may be frequent, and cause considerable pain and medical danger. Other reasons wisdom teeth are removed include misalignment which rubs up against the tongue or cheek causing pain, potential crowding or malocclusion of the remaining teeth. (a result of there being not enough room on the jaw or in the mouth).
With an oral examination and x-rays of the mouth, Dr. John can evaluate the position of the wisdom teeth and foresee if there may be a present or future problem. Early evaluation and treatment make for a better outcome for the patient.
All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. Dr. John has the training, license and experience to provide, local, I.V. sedation or general anesthesia for patients to select the best alternative.
A Swedish scientist and orthopedic surgeon, Dr. Per-Ingvar Branemark, developed this concept for oral rehabilitation more than thirty-five years ago. With his pioneering research, Dr. Branemark opened the door to a lifetime of renewed comfort and self-confidence for millions of individuals facing the frustration and embarrassment of tooth loss. A dental implant is a titanium “root” device or post surgically inserted into the jawbone to support restorations that resemble a tooth or group of teeth to replace missing teeth. The bone bonds with the titanium, creating a strong foundation for artificial teeth.
Dental implants also help preserve facial structure, preventing bone deterioration that occurs when teeth are missing. 20% of bone loss is in the first year after a tooth is extracted. Implants can help restore this bone loss and prevent any future bone deterioration in the extraction site.
Dental implants can be used to support a number of dental prostheses, including crowns, implant-supported bridges or dentures. They can also be used as anchorage for orthodontic tooth movement.
The placement of dental implants involves two surgical procedures in most patients. First, Implants are placed within your jawbone and covered with a ‘healing abutment’ or ‘cover screw’ which is flush with the surface of the dental implant . There is an initial healing time of three to six months (varies with patient depending on the quality and quantity of the bone and difficulty of the individual situation), when the implants are bonding with the jawbone. A temporary prosthesis or denture that is made by your dentist will be worn during the healing time.
After the implant has bonded to the jawbone, the second phase begins. Dr. John will uncover the implants and attach small posts, which will act as anchors for the artificial teeth. These anchors will protrude through the gum but will not be seen when the artificial tooth is placed by your dentist.
In carefully selected cases, patients can be implanted and restored in a single surgery, known as “Immediate Loading”. This is the placement of a dental implant into a recent extraction site. Dr. John will discuss all options to the patient for the best procedure for each individual.
Prior to surgery, careful and detailed planning is required to identify vital structures such as the shape and dimensions of the bone to properly orient the implants for the best outcome for the patient. Sometimes, a CT scan will be needed. Specialized 3D CAD/CAM computer programs (such as Simplant) may be used to plan the case.
A ‘stent’ often is used to facilitate the placement of implants. A surgical stent is an acrylic wafer that fits over either the teeth, the bone surface or the mucosa with pre-drilled holes to show the position and angle of the implants to be placed.
Implant surgery is usually performed as an outpatient in the office. General anesthesia, intravenous sedation, oral conscious sedation, nitrous oxide sedation, and/or local anesthesia are utilized by Dr. John.
Dental implant success is related to operator experience, quality and quantity of the bone available at the site, and the patient’s oral hygiene, habits and health. Patients that smoke have a higher risk of complications.
Sinus lifting is a common surgical intervention where the oral surgeon thickens the inadequate part of atrophic maxilla towards the sinus with the help of bone graft materials. This results in more volume and quality bone for the implantation.
Bone grafting will be necessary in cases where there is a lack of adequate maxillary or madibular bone in terms of front to back (lip to tongue) thickness; top to bottom height; and left to right width. Sufficient bone is needed in three dimensions to securely integrate with the implant. Improved bone support is important to assure ample anchorage of the implant’s root-like shape because it has to support the mechanical stress of chewing, just like a natural tooth.
For a dental implant to work, there must be enough bone in the jaw, and the bone has to be strong enough to hold and support the implant. If there is not enough bone, it may need to be added with a bone graft procedure. Sometimes, this procedure is called bone augmentation. In addition, natural teeth and supporting tissues near where the implant will be placed must be in good health.
A wide range of grafting materials and substances may be used during the process of bone grafting/bone replacement. They include the patient’s own bone (autograft), which may be harvested from the jawbone; processed bone,(human or animal); or artificially produced bone; or bone generating ( BMP) products.
Bone grafting has its own standard of care. In a typical procedure, Dr. John creates a flap of the gum to fully expose the jaw at the graft site, performs grafts in and on existing bone, then installs a barrier membrane designed to protect the graft. The mucosa is carefully sutured over the site. Antibiotics and topical antibacterial mouth rinses are used to minimize risk of infection. The graft is allowed to heal and usually needs three to six months.
Through his oral and maxillofacial surgery training and experience, Dr. John deals with the nature, identification and management of diseases affecting the oral and maxillofacial regions. Salivary Gland Disease
There are both major and minor salivary gland in the mouth which secrete saliva and a variety of enzymes to help process foods and make swallowing easy. These salivary glands can get infected or inflamed and can also be very painful; sometimes the salivary glands also develop benign and malignant cancers. However, the most common problem with salivary gland is formation of stones in the small duct which prevent free flowing of saliva. The gland swells as they cannot empty and often get infected. While most stones in the duct may resolve, sometimes surgery and antibiotics are required.
Bad breath has many causes including smoking, alcohol, poor care of dentures, gum disease, chronic lung disease, breathing through the mouth, sinusitis, liver disease, diabetes, pregnancy, not brushing or flossing on a regular basis. Medications that cause dryness in the mouth can also cause bad breath. These include antidepressants, anti histamines and antipsychotics. The best way to prevent bad breath is to brush teeth frequently, clean the tongue, keep the nose and sinus clean and drink adequate water.
Candida is a very common infection of the mouth in individuals who have undergone a transplant, HIV, cancer or use corticosteroids. Other risk factors are dentures and tongue piercing. The typical signs are a white patch that may be associated with burning, soreness, irritation or a white cheese like appearance. Once the diagnosis is made, candida can be treated with a variety of anti fungal drugs.
Another very common disorder of the mouth is herpes simplex infection (HSV). This virus causes blisters and sores around the mouth and lips. HSV infections are not only annoying but also painful and may keep on recurring. Although many people get infected with the virus, only 10% actually develop the sores. The sores may last anywhere from 3-10 days and are very infectious. Some people have recurrences either in the same location or at a nearby site. Unless the individual has and impaired immune system, e.g., owing to HIV or cancer-related immune suppression, recurrent infections tend to be mild in nature and may be brought on by stress, sun menstrual periods, trauma or physical stress.
Burning Mouth syndrome (BMS) is a very painful annoying disorder that causes a sensation of burning on the lips, tongue, mouth and gums. The disorder can affect anyone but tends to occur most often in middle-aged women. BMS has been linked to a variety of dental and medical disorders like menopause, dry mouth and allergies. Some individual develop one episode of BMS and others develop recurrent episodes which last months or years. There is no cure for this disorder and treatment includes use of hydrating agents, pain medications, vitamin supplements or the usage of antidepressants.
Oral Cancer may occur on the lips, tongue, gums, floor of the mouth, palate, inside the cheeks, and on the face or neck. The majority of cancers of the mouth are squamous cell carcinoma. Oral cancers are usually painless in the initial stages or may appear like an ulcer. Some causes of oral cancer include smoking, excessive alcohol consumption, exposure to sunlight (lip cancer), chewing tobacco. The earlier the oral cancer is diagnosed the better the chances for full recovery. If you have a suspicious mass or ulcer on the mouth call for a consultation and Dr. John will do a biopsy. This is an office procedure.
Signs to look for:
- Reddish or whitish patches in the mouth
- A sore that fails to heal and bleeds easily
- A lump or thickening on the skin lining the inside of the mouth
- Chronic sore throat or hoarseness
- Difficulty in chewing or swallowing
We use digital imaging software in our office, which allows us to take a digital picture of you and use our imaging system to predict how a particular treatment or cosmetic procedure would change the appearance of your teeth. This software is beneficial for patients who are considering cosmetic procedures but are not sure if they're ready for dramatic changes. Digital imaging also allows us to document your dental case and procedures very well. We take digital images of your face, teeth and smile to provide us with a permanent dental record and to provide a visual documentation of treatment.
Our office utilizes electronic claims processing. This means that rather than sending your dental claim through the mail, it is sent electronically to your insurance company with the click of the button. By filing your claim electronically, information is submitted more efficiently and with fewer errors. This benefits our patients because the turn around time on claims is faster and fewer claims are returned or denied. We are happy to submit your dental claims to your insurance company on your behalf.
We use small cameras about the size of a pen, called intraoral cameras, to help clearly see the condition of your teeth and gums.
With this advanced technology we can zoom in on small diseased areas, cracks, chips and worn metal fillings with extreme precision. The full-color images taken with the intraoral camera are sent to a computer screen so we can clearly see and diagnose dental problems much earlier than with traditional dental technology. Because images are displayed on our screens, patients will also be able to see areas being worked on and are able to gain a better understanding of dental procedures being performed.