Brown & Neuwirth Oral & Cosmetic Surgery Center

Where do Dental Implants come from?

kids studying archaologyDental implants have a surprisingly rich and interesting history. Across centuries and throughout cultures around the world there is evidence of attempts at replacing missing teeth with various objects and materials.

The oldest dental implants can be traced back to 2000 BC in China, where missing teeth were substituted with bamboo pegs.

Fast forward a bit to around 1000 BC and you’ll find an ancient Egyptian King whose tomb was recently discovered along with his mummified remains; a copper peg hammered into place where a tooth once lived. This may have been the first time in history that we know of when metal implants were used.

Across the globe some time around 300 BC, an iron tooth was found in a French grave thought to be Celtic in origin. It is possible this implant may have been a post-mortem placement to honor the dead, as an attempt to perform the surgery using a live patient would have been an excruciatingly painful process.

Just 2000 years ago missing teeth were being substituted for animal teeth, and the poor were even selling their teeth to the wealthy, just to make ends meet! The body often rejected these surrogate teeth, causing infection.

More recently in 1931 in Honduras, Dr. Wilson Monroe and his wife found a jawbone amongst other artifacts, with teeth fashioned from shells and attached to the jawbone of an ancient man.

Today we are lucky enough to have dental implants that not only look and feel like real teeth, and anesthesia for the pain is also a plus. Thanks to studies conducted by Per-Ingvar Brånemark of Sweden in the 1950’s, oral surgeons have been able to perfect the process over the years to create today’s implants, which have a 98% success rate! Through a process known as osseointegration, metals and other implant materials are able to be skillfully placed so that your jaw bone actually attaches itself to the implant creating a seamless support system.

Missing a tooth or two? Give us a call at Hickory Office Phone Number 828-327-7867 to discuss your dental implant options today!

Tooth Extraction – Managing Pain

cartoon image of man kicking painThe Procedure Itself

Thanks to a wide variety of anesthesia choices available to us these days, you should feel no pain during your extraction.

After the Surgery

  • Over-the-Counter Medicines: Generally speaking, over the counter non-steroidal anti-inflammatory medications such as Ibuprofen are all that you will need following your surgery.
  • Staying On Top of Pain: It is very important to stay on a strict schedule of medication the first few days following your surgery. Getting behind on medication will result in more pain and may even make it difficult to catch up with pain control again.
  • Ice for Swelling: We want you to ice your cheeks for the first 24 hours following surgery, twenty minutes on and twenty minutes off alternating. Managing swelling can help greatly with pain management, and the act of icing may even feel good on its own.
  • Rest: Your body was expertly designed with high-tech systems in place to heal – but you have to give it the space and conditions to do so. Rest is one of the most important things you can do to help your body heal faster.
  • Salt Rinse the DAY AFTER Surgery: The day after surgery, you should rinse your mouth very gently with a mixture of one cup of warm water and ½ teaspoon of salt. You may do so up to 4 times a day. Designed to gently clean the wound site (but NOT dislodge the blood clot), some patients also feel that the warm water helps with pain relief.
  • Prescriptions: Most often, our patients do not require prescription pain medication post-op. However, in the case that we feel your case calls for such, please keep the following in mind:
    • Antibiotics – If we have ordered antibiotics for you, you must take them on schedule and for as long as we prescribe – Never stop antibiotic treatment prematurely without our specific orders.
    • Pain-Killers – In the event that you require prescription pain killers, please note that we are required to prescribe these sparingly and in accordance with certain laws, due to rising rates of substance abuse. You can help keep these drugs off the street by taking only what you need, and taking unused pills to a pharmacy for safe disposal – never “keep them around” in your cabinet for future use.

For more information, please visit our surgical instructions page and feel free to call us at Hickory Office Phone Number 828-327-7867

Why do we have wisdom teeth, anyway?

woman wondering about wisdom teeth

Wisdom teeth were once an extremely valuable asset to our ancestors. When a typical diet consisted of chewy plants and uncooked meat, third molars (wisdom teeth), which fit easily into our ancestors’ larger jaws, were absolutely necessary. Wisdom teeth were the evolutionary answer to the need for chewing power to combat excessive wear.

Today, our diets are not as rough as those of our ancestors. With modern marvels like forks, spoons, and knives, as well as softer food, the need for wisdom teeth is virtually nonexistent. And yet, on average, about 65% of the human population is born with wisdom teeth which usually erupt between the ages 17 and 25.

Although wisdom teeth were incredibly advantageous for our ancestors, they pose a bit of a problem for the modern mouth. Humans have evolved to have smaller jaws, and so wisdom teeth are often either too big for the jaw or the jaws themselves are just too small. Either way, third molars crowd the mouth. Because of this lack of space, molars often grow sideways, only partially emerging from the gums, or actually get trapped inside the gums and jawbone.

These impacted wisdom teeth can be chronically contaminated with bacteria associated with infection, tooth decay, inflammation, and gum disease. And because they’re so far back in the mouth or trapped underneath gums, it’s difficult and sometimes impossible to keep them clean. Even when wisdom teeth come in fully, they are so far back in the mouth that it’s just too easy for food to get trapped, leading to plaque, cavities, and gum disease.

Although wisdom teeth were very important to our ancestors, nowadays, they pose a serious problem to oral health. Call Brown & Neuwirth Oral & Cosmetic Surgery Center to find out if your wisdom teeth are ready to come out!

Missing Teeth: More than Just a Gap in Your Smile

man smiling with dental implants

While it is true that the most obvious effect of missing teeth is a gap in your smile, missing teeth can cause other problems that you might not be immediately aware of. For example, did you know that for every missing tooth you have you lose 10 percent of your chewing ability? Read on to get a better idea of how a missing tooth can affect your life.

Surrounding Teeth

A missing tooth usually means more stress for the remaining teeth. In addition to that, if you are missing a tooth on the lower jaw, the opposing tooth on the top can grow longer to fill the gap in a process known as superuption or extrusion. This could lead to teeth tilting and move out of place by drifting into the space that was left by your missing tooth – a disaster for your beautiful smile!

Digestive Health

If you are missing teeth, you can’t enjoy all of the foods that you are used to eating – bad for your health and bad for your mood! Say goodbye to caramel apples, saltwater taffy, crunchy carrots and even gum. And because the variety in your diet is reduced when a tooth is missing, digestive problems are unfortunate yet common.

Decay and Hygiene Problems

The shifting of your teeth may cause new hygiene issues as it may be difficult to brush and floss like you normally would. This leaves your mouth more vulnerable to gum disease and tooth decay.

Facial Aesthetics

People with more than one missing tooth may also have issues with a collapsed bite which causes a loss of vertical dimension. This could make your face appear shorter, as the distance between the tip of your nose and your chin would decrease.

The good news is that you don’t have to suffer anymore! Dental implants can help you avoid all of the problems listed above and let you live your life normally again. It’s never too late for a dental implant, give us a call at Hickory Office Phone Number 828-327-7867 to find out about this life-changing procedure.

3D Printers and Bone Grafting

3D bone grafting

There is exciting news in bone grafting technology that will hopefully find its way into the oral surgeon’s office over the next decade! Researchers have been able to create a synthetic bone material using 3D printers that may be better than what is being used now.

3D printers create three-dimensional objects out of a variety of materials using a computer as a precise guide. Although the concept has been in the news a lot recently, the practice actually dates back to before the 21st century. In fact, 3d printing’s roots go back to the early 1980s. Since then, everything from jewelry to synthetic human organs has been printed, much to the amazement of modern society!

And now, surgeons have successfully implanted the 3D-printed synthetic bone grafting material into animals with bone defects. This “hyperelastic bone” was made using just the right combination of bioactive materials and polymers to make a material that could be layered while still wet, allowing for better adherence between layers.

Here are some of the expected benefits of this new material:

  • Very elastic, allowing for cutting without crumbling, which can be a problem with current grafting materials.
  • Blood vessels move in quickly because the material is porous.
  • Biodegradable as the body replaces it with genuine tissue.
  • Doesn’t dry out right away.
  • So far the animals haven’t rejected the implant, which could mean less complications for humans as well.
  • Could be a great option for children since it will grow with them.

While human trials are potentially five or more years away, the news is very exciting for the surgical community, and we are can’t wait to see what benefits this will bring to our patients.

To find out more about bone grafting in general or to set up a consultation with our office, please call us at Hickory Office Phone Number 828-327-7867.

Little Medium Big Bone Grafting

Bone grafting is a straightforward procedure that is immensely beneficial for numerous reasons. In the instance of a missing tooth (or teeth), the jaw bone can begin to slowly degrade. The jaw bone 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:

Little Bone Graft

'bone graft' 'bone tissue'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 828-327-7867 today for a consultation with Brown & Neuwirth Oral & Cosmetic Surgery Center

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How Are Wisdom Teeth Removed

Don’t be worried about your wisdom tooth extraction, let us outline the whole process for you:

Treatment Development

wisdom teeth diagramDuring late adolescence, wisdom teeth start to appear and occasionally are accompanied by oral pain, as well as an increased risk of dental issues such as pericoronitis, gum disease, and tooth decay. Through evaluation, your oral surgeon will determine the number of wisdom teeth present, as well as how they are developing in relation to the rest of your teeth. Using advanced imaging technology, an oral surgeon will discover if the teeth are partially or fully impacted, and then will create a strategic treatment plan in order to remove the teeth and ensure successful recovery.

Preparation

Although sedation is not always necessary, many patients have found anesthesia to be helpful in relaxation and reducing pain during the procedure. If sedation is chosen, there are certain preparations that must be made: patients must enlist the help of family or friends to bring them back home after their surgery.

The Procedure

Local anesthesia is applied to the area. Then, a surgical tool is used to reveal the bone and tooth. After the tooth is clearly visible, it is removed. Once the tooth is extracted, the gums and bone are left to heal.

Healing

Wisdom tooth extraction can be an uncomplicated procedure that ultimately will protect your long-term oral health. For more information about wisdom tooth extraction, schedule your consultation at Brown & Neuwirth Oral & Cosmetic Surgery Center today!

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Dental Implant Recovery

dental implantsDental implants, titanium posts that are placed within your jawbone, are an excellent option for restoring missing teeth. The process of getting dental implants typically takes a few appointments over the span of several months, and since the strength of dental implants comes from their fusion with the jawbone, proper healing from this surgery is absolutely essential. Here are some tips for a speedy and well-healed recovery!

Prepare

One of the best ways to promote a speedy recovery is to properly prepare for dental implant placement. Get ready for your procedure by:

● Getting plenty of sleep
● Avoiding smoking or drinking excessively
● Maintain your oral health! Brush twice a day and floss once a day!
● Arrange for someone to drive you to and from your procedure
● Plan to take some time off work so you can really focus on resting and recovering
● Pick up post-surgical prescriptions, gauze, cold compresses, and any other supplies
● Ask for a recovery timeline

Getting ready before your dental implant surgery can make a huge difference in the recovery afterwards!

Recovery Time Factors

Recovery time for the dental implants procedure depends on several factors. While each patient’s case is slightly different, these following factors are the main contributors to healing time:

● The number of implants: Having a single implant may take less recovery time than multiple implant placement.
● Whether or not you require preparatory procedures such as bone grafting
● Your oral and overall health: the healthier you are, the easier it will be for you to heal quickly.

Your oral surgeon will explain your unique estimated recovery time based on these and other factors at your initial consultation.

After Your Surgery

After the procedure, the healing process can be sped up through:

● Biting down on gauze to staunch the bleeding
● Avoiding any activity that could put pressure on your mouth
● Taking proper prescribed medication
● Eating soft foods and avoiding chewing near the treatment area
● Rinsing your mouth with warm saltwater between meals
● Using a cold compress to reduce swelling
● Gently retaining oral health routines like brushing and flossing

Following these guidelines, you will be able to heal comfortably and successfully!

To learn more about this treatment, or schedule a consultation, call 828-327-7867 and come see us at Brown & Neuwirth Oral & Cosmetic Surgery Center today!

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Wisdom Tooth Removal – Aftercare

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:
woman smiling after Wisdom Tooth Removal• 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:
1. Try repositioning the packs. They may not be putting enough pressure on the site.
2. Sit upright and avoid physical activity.
3. Use an ice pack and bite on gauze for one hour.
4. You can also try biting on a moistened tea bag for 30 minutes (the tannic acid in tea promotes blood clotting).
5. If bleeding persists, please call our office at 828-327-7867.

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. Brown or Dr. Neuwirth 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 Drs. Brown or Neuwirth. 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:
1. Day 1-2 will be the most uncomfortable and you will experience some swelling.
2. Day 3 you should be more comfortable and while still swollen, you should be able to begin a more substantial diet.
3. 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 Drs. Brown or Neuwirth and the Brown & Neuwirth Oral & Cosmetic Surgery Center team are tailored to fit your needs. Please call us at 828-327-7867 if you have any questions or concerns about your recovery. Happy healing!

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Oral Cancer and 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?

Oral Cancer and Hepatitis CThe 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 Brown & Neuwirth Oral & Cosmetic Surgery Center a call today and schedule an oral cancer screening!

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