Wagner Oral Surgeon & Dental Implant Specialists

National Ice Cream Month: Fun Facts About Your Favorite Summer Treat!

I scream, you scream, we all scream for ice cream! Flashback to when you were a child on a hot summer day, when all of the sudden you hear that magical jingle that captivated all of our hearts; the ice cream truck! In the year 1984, President Ronald Reagan decided that from then on out, the Month of July would be recognized as National Ice Cream Month! Because really, what’s better than a big, cold, scoop of ice cream on a hot summer day? That was a trick question—there is nothing better. Whether it’s vanilla, chocolate, mint chip, or pistachio, there’s a flavor for everyone. Ice cream has that ability to brighten anybody’s day and for that, we’re eternally grateful. With that being said, let’s celebrate this month by highlighting some of the most fun facts about ICE CREAM!

#1: The best way to eat ice cream? In a waffle cone of course! However, it wasn’t until 1904 when an American ice cream vendor at World’s Fair in Missouri ran out of cups due to the high demand of guests, so he quickly rushed on over to a local waffle vendor and asked him to roll up his waffles so that they could hold the ice cream. The rest is history!

#2: Do us a favor really quick. Open your Freezer. Is there at least one form of ice cream in there? There should be! In fact, approximately 98% of all U.S families have ice cream in their homes at ALL TIMES! So, if your freezer is lacking, run to your local grocery store and pick up a pint so you’re not the odd one out!

#3: Brain freezes…. Ice cream’s arch nemesis. A brain freezes is a short-lasting sensation, normally lasting for about ten seconds, that often occurs when you eat or drink cold items in a short amount of time. The most tried and true way to get rid of a brain freeze? Place your tongue on the roof of your mouth and wait it out!

#4: Did you know one that one of the biggest ingredients in ice cream is AIR? That’s right, air. Air is added cream to make the consistency lighter, while also improving the texture. It’s often said that the amount of air added to the batch will determine the overall quality (the more air, the cheaper the quality).

#5: Throwback to the year 1665, when the first documented ice cream recipe was handwritten in a recipe book. The ingredients? Orange flower water, mace, and ambergris, also known as whale barf. Let’s just say we sure are grateful for how far the flavors have evolved….

This month, we want you to enjoy all that ice cream has to offer. We challenge you to try a new flavor that may be out of your comfort zone; who knows…maybe it’ll be your new favorite. Give us a call at Racine Phone Number 262-634-4646 if you have any questions or concerns regarding your oral health!

Common Dental Implant Myths

common dental implant myths

Insecure about a missing tooth? Don’t be. With dental implants, you can get your smile back to looking perfect. For many, dental implants provide the feeling of having their natural teeth back again. This is because instead of being a removable type of device, such as a dental flipper, dental implants are permanently embedded into the jaw, which then allows a dental crown to take the place of the missing tooth. We understand that this procedure may seem intimidating, but we’re here to reassure you it’s not as bad as it sounds. Below are the top three common misconceptions when it comes to getting dental implants.

Myth #1: Dental Implants are painful

This is a common fear. Many people hold back from pursuing a dental implant, simply because they’re afraid the procedure might be too painful. However, this is not true. The procedure itself is pain-free. As always after surgery, there may be some temporary discomfort, but your doctor will work very closely with you to ensure your comfort and ease.

Myth #2: Dental Implants are expensive

Although dental implants aren’t cheap, they’re a much better investment than dental bridges, which need replacing every 7-15 years. Dental Implants cost may be high initially, but it’s a better financial decision in the long run.

Myth #3: Dental Implants cause headaches

It’s a fairly common myth that dental implants can cause migraines or headaches. However, we’re here to let you know that this is not true. There is absolutely no scientific evidence to support this. After the dental implant has successfully bonded with the jaw/gums, you should experience zero pain.

If you have any questions or concerns regarding dental implants, give our office a call at Racine 262-634-4646 Kenosha 262-654-4222 so we can discuss the next steps.

MANAGEMENT OF THE MAXILLARY DIASTEMA IN YOUNG CHILDREN

I read with interest an article in our recent journal about how various dental specialties treat maxillary diastemas in children. (J Oral Maxillofac Surg 76:709-715, 2018) According to this article pediatric dentists and orthodontists generally agreed that frenectomy should not be performed before the permanent canines are erupted and that the operation should follow orthodontic closure of the space. I could not disagree more. I have seen this treatment sequence carried out for 30 years and I often get to see these patients in their 20s and 30s where there diastema has relapsed or they are having gingival problems between the central incisors. It is simple to understand and simple to manage. I have successfully treated many of these patients on referral by their general dentists who understand the logic of my method.

The maxillary midline diastema, a space between the upper front teeth, is typically caused by a thickened band of tissue under the upper lip that is abnormally attaching through to the palatal aspect rather than inserting in the more normal position on the front side of the upper jaw. The diastema and abnormal frenum attachment are easily seen in the pediatric patient as a thickened tissue band extending between the upper front teeth holding the primary/baby teeth apart. I recommend treatment at about age 5 or 6. I find it best to treat it before the primary teeth are lost, but at a time where the permanent teeth are close to coming into the arch.

This is not a simple snipping or cutting of the muscle attachment under the lip. That will not resolve the problem. It is important to excise the fibrous attachment between the central incisors as well (frenuloplasty and fiberotomoy). In most cases, we have found that the primary central incisors will drift into a more normal position and permanent central incisors will erupt into a completely normal position. Without the procedure, the adult incisors come in with the same diastema space.

It is a no-brainer to me that you would take care of this as a preventative treatment even if it requires a surgical procedure. I have had several of my dental colleagues, dental assistants, and even orthodontist’s assistants come to me for this procedure for their childrens’ care and with consistently good results. There is no question that I would recommend this for a child with a maxillary midline diastema.

MAGNETIC RESONANCE NEUROGRAPHY FOR TRIGEMINAL NEUROPATHIES

This article brings up an important point in the proper diagnosis of nerve injuries involving branches of the trigeminal nerves. That point is that MRI (magnetic resonance imaging) can be very helpful in diagnosing the problem and verifying the potential location of the problem. (J Oral Maxillofac Surg 76:725-736, 2018)

This article brought out a specific area of interest for me and that is the diagnosis and treatment of neuropathies of the lingual nerve after third molar surgery. I have been fortunate that this has been an extremely rare complication in our practice and, at the time of this writing, when it has occurred, we have never had a problem with a permanent injury such as permanent pain or numbness. I recognize that it could happen tomorrow – but we use a technique in how we approach teeth, and with the use of cone beam scanning as a pre-op study for more complicated cases, we have experienced a low complication rate.

We do however, get referred cases for treatment where other practitioners have treated a patient with a resultant nerve injury and they come to us for evaluation for repair. The first point is that early diagnosis and treatment give the best chance at resolving a nerve injury – so do not put off care waiting for the problem to resolve. There are definitely exceptions to this – such as a partial numbness or a light “tingling”. But if there is a complete numbness on the side of the tongue and it is getting past 3 months post-treatment, an MRI and surgical evaluation should be considered.

The second point is that the approach to the lingual nerve is critical. Many surgeons will make an incision back by the third molar region to access that area. There is a much easier and much better way and that is to approach the area much like one would approach the removal of exostoses – that is an incision along the back teeth and a releasing incision extending across the third molar area to the lateral aspect. A full thickness flap is then made to expose the tongue side of the jaw bone. In most cases, you will find an area where the bone is disrupted in the area of the previous surgery and the tissues along with the nerve are “pulled into” the third molar healing defect. Teasing these tissues out, and “releasing” scare tissue bands, and placing a surgical barrier graft over the bone defect will often times relieve the problem. If it is found that the nerve is severed you can try to approximate the ends, however it has never been my experience that the nerve has been cut and it is my opinion that the prognosis for repair in that case would be poor.

The third point is that if at the time of MRI and evaluation that the nerve is noted to be cut, then a microneurosurgical consult should be sought out. Going back to the beginning of this discussion, the MRI can be helpful in determining the location and the extent of these types of injuries.

5 Perks of Getting Your Wisdom Teeth Removed

perks of wisdom teeth removal

For some reason there is this negative stigma surrounding wisdom teeth removal when in reality there are more perks than you would think. Odds are you will have to get your wisdom teeth removed, so it’s in your best interest to accept the good and the bad of this procedure. So let’s focus on the good!

1. No More Pain: Whether this was a preemptive procedure or a tad bit rushed due to pain, the whole reason for removal is to ensure your wisdom teeth won’t ever be an issue again. Even though there can be negative side effects to removal, it doesn’t mean that all will apply to you. By making sure you keep up with all of your doctor’s instructions after the procedure you can avoid any further discomfort and remain pain free moving forward.
2. Time Off: The average amount of wisdom teeth recovery time is about three to four days depending on the severity of impaction. More than not people tend to take a full week off, maybe even more, to have enough time to fully heal before getting back into the swing of things. Take advantage of the mandatory down time you have.
3. Ice Cream: Not like you ever need an excuse to eat an unlimited amount of ice cream but having your wisdom teeth removed is basically a get out of jail free card. It’s in your best interest to choose a flavor without any huge chunks to avoid irritating the sensitive areas surrounding your extracted wisdom teeth.
4. Unlimited Movies: There is no shame in binge watching your favorite TV shows or movie trilogies because technically it’s the doctors’ orders. Rest and relaxation is your top priority for the first couple days after removal. Although you physically won’t be productive during this time it doesn’t mean you can’t productively cross off all of your shows you’ve been waiting to watch.
5. Sympathy: A majority of the time you end up looking worse than you feel which can work in your favor. More than likely the majority of your friends and family will have already had the procedure and can relate to it. It won’t be long until your friends and family show up with thoughtful surprises, like wisdom teeth removal friendly snacks, movies and a good book.

To schedule your root canal therapy consultation make sure you give our office a call! Racine 262-634-4646 Kenosha 262-654-4222

4 Types of Foods You Can Eat After You Have Had Your Wisdom Teeth Removed

indulge after surgery

About 90% of people need to get their wisdom teeth removed. If you are a part of that 90%, you might be wondering what the steps are post-surgery. Taking it easy and getting a lot of rest is a key step to a quick recovery. Another big step is knowing what you can and can’t eat. Here is a list of foods you can indulge in post-surgery.

  1. Ice Cream: After having a minor surgery, it’s okay to treat yourself with a little sweet. The coolness will not only feel good, but it will also help sooth inflamed tissue. Try to avoid eating cones and flavors of ice cream with large chunks in them like chocolate chips and nuts.
  2. Soup: Soup is a great food to have on hand after your surgery. It provides protein and the broth is easy to eat. If you choose this brothy goodness, make sure you aren’t eating large pieces of vegetables and the temperature of the soup isn’t too hot.
  3. Mashed potatoes: Not only are mashed potatoes delicious, but they are easy to make and they really are the perfect post-surgery food. You can smother them with gravy, butter or sour cream. Top the meal with whatever sounds good to you, but make sure there aren’t large potato chunks you’ll have to chew. Another route you could take is mashed sweet potato. Top it with butter and cinnamon to take this savory treat to sweet!
  4. Smoothies (NO STRAWS): Smoothies are a great source to get all the nutrients your body will need. You can make different flavors with fruits and vegetables. Prepack your smoothie packs before you have your surgery so all you have to do is blend and enjoy. You could also add in different protein powders or vitamins to help your body. If you choose to make a smoothie, DO NOT USE A STRAW. Sucking on a straw could disrupt your healing process and create dry sockets.

These are just a few ideas of what you can eat post-surgery. There are a ton of other options. Get creative and indulge in the snacks you wouldn’t normally eat for your main course. If you have any hesitations or questions on what you can’t and can eat, call our office. We are happy to answer any questions you may have. Racine Phone Number 262-634-4646

What You Need to Know About Oral Cancer

what are you waiting for?

One of the most important jobs we have is to examine, monitor, and diagnose oral cancer in our patients. Every year, nearly 52,000 Americans are diagnosed with oral cancer. More than 8,000 of those people will die. This is why it is crucial to get routine oral exams and keep a close eye on the state of your mouth.

To make sure that you stay educated and healthy, here is a list of the most important facts you should know about oral cancer:

  • 90% of oral cancers begin in the surface area of the mouth, tongue, and lips. We highly recommend performing regular self-exams, which your dentist can review with you!
  • Cancer found on the tongue, gums, lips, throat, or back of mouth is considered oral cancer.
  • Largest risk factors: Tobacco and alcohol use are two of the biggest risk factors for oral cancer.
  • Other risk factors: Pre-cancerous oral lesion, excessive UV/sun exposure, human papilloma virus (HPV), certain drugs and genetic syndromes.
  • If you are experiencing these common oral cancer symptoms, call our office: Sores that don’t heal, lumps inside the mouth, white or red patches on soft tissues in the mouth, bleeding, pain when swallowing or chewing, numbness, difficulty moving the jaw or tongue, lumps in neck, hoarseness, and more.
  • To diagnose oral cancer, we will examine the mouth and neck, inquire about your exposure to risk factors, and possibly order biopsies and imaging of the head (CT, MRI, etc).
  • Pain is not typically present with early stage oral cancer, so it is crucial to get routine oral checks!

If you are experiencing any of these symptoms, do not hesitate to call our office and schedule an appointment! Racine Phone Number 262-634-4646

LOSS OF TASTE SENSATION AFTER WISDOM TOOTH/THIRD MOLAR REMOVAL

In the United States, most oral surgeons remove wisdom teeth through the lateral and distal approach – rather than from the tongue or lingual aspect which is the case in certain European and European influenced locations. As far as I know, I have never had a case of diminished taste sensation after third molar/wisdom tooth removal. A recent article in the Journal of Oral and Maxillofacial Surgery (J Oral Maxillofac Surg 76:258-266, 2018) addresses the question and reports a certain level of prevalence as a problem after removal of more difficult types of third molar teeth. This study comes out of a dental college in India; I might expect that they approach wisdom teeth from the lingual aspect (tongue side approach) to account for these results.

The anatomy of the “taste” nerve (chorda tympani) is different than the “feeling” nerve (trigeminal nerve); although both of them run along the tongue side of the lower jaw on each side along the third molar/wisdom tooth areas. Injury to this nerve is rare, but possible.

Clearly this is a risk that increases with age/difficulty of the extraction and represents another reason why it is wise to have the wisdom teeth evaluated at an early age (about 15 years old) and removed if there are risk concerns. At the younger age the risks are essentially zero.

No matter your age, the risk is almost always less when you are younger. Make sure to go to a competent, gentile, careful OMS for this care, especially if there are increased risks.

RISKS AND BENEFITS OF PERIODOTNAL PROBING AROUND DENTAL IMPLANTS

Over the years we have vacillated as to whether it is acceptable to perform periodontal probing around dental implants. We have generally advocated for checking periodontal health this way, but recommended plastic probes and avoiding deep probing. There are some common sense ideas I will share here, but as a general answer, there is no problem with gentile (less than 0.25 Ncm = gentile touch pressure) periodontal probing around the neck of an implant to evaluate pocket depth. 1) Risk of damaging the tissue around the implant. As long as the tissues are healthy this should not be a problem. I feel that the general health of the patient is most important here. If there is immune disease, decreased resistance to infective diseases, or the presence of chronic generalized gingival conditions such as might appear with a diabetic or a mouth breather, it would be wise to minimize probing. Use of a softer probe such as a flexing plastic probe may be helpful. 2) Risk of damage to the implant surface by the probe. I feel that this concern is unfounded. Studies have shown the opposite; that any roughening of the surface actually makes it more “sticky”. Also, the contamination by dissimilar metals has been shown to be a false idea or at least very rarely a problem. 3) Risk of bacterial inoculation (introduction of bacteria). Again, this is an individual case and individual health/resistance to disease concern. If you know that the implant is buried deeper than normal – such as may be the case with an anterior tooth – deeper probing should be avoided. Let me explain this again. When we place implants in the “esthetic zone” – front tooth area – especially if there is a lot of tooth and gums showing in the smile – we have to place them deeper in the gum tissue to have them “emerge naturally” or look natural as the crown appears to come out of the gums. These tissues are often naturally thinner and more fragile. I would avoid regular or “routine” probing unless there are clinical signs that warrant the check. The gum tissues around implants “like” the titanium surface and will adhere to it if they are not disturbed. The act of probing deeper tissues also places germs in the deeper tissues. If this is going to be done I would suggest irrigating the area with a dilute 1-to-100 povidone iodine irrigation before and after probing to help reduce the germ counts.

Overall, for otherwise healthy individuals it is fine to check periodontal health around implants with a careful, gentile technique.

 

Facts About Bone Grafting

know the facts

Modern bone grafts can be used to fix a number of dental and facial issues and are often required. Dental implants often cannot be placed without first getting a bone graft. If you are considering getting dental implants or think you’re in need of a bone graft, here are some things you may want to know!

Bone grafting is a routine procedure!

Over the years, bone grafting has become a standard and highly-practiced procedure. The procedure is typically performed in the office, depending on each individual case and a local anesthesia or conscience sedation is available if needed in order to block the pain and calm any anxiety you may be feeling!

A number of materials can be used!

The bone grafting material that we use may come from a variety of sources. If we are able, we generally like to use bone from your own body, which decreases the chance of your body rejecting the graft. If possible, we will take this bone from your hip, jaw, or lower knee. If this is not an option, we are able to obtain bone from a tissue bank.

Bone grafting allows for your body to rebuild itself!

Your body will use your new bone graft as a sort of frame to grow new bone. Over time, the graft will be replaced with new bone that your body has grown during its own regeneration process. Keeping a healthy amount of bone tissue around your teeth is crucial in maintaining great oral health.

If you are in need of a dental implant, have a congenital defect, or have suffered a traumatic facial injury, and you’re wondering if you might need a bone graft, give our practice a call! We can assess your case, answer your questions and come up with the best possible treatment option for you! Racine Phone Number 262-634-4646