QB sensation Johnny Manziel has had a varied career in professional football. After playing two seasons for the NFL Cleveland Browns, he quarterbacked for a number of teams in the Canadian Football League. More recently, he joined the Zappers in the new Fan Controlled Football league (FCF). But then with only a few games under his belt, he was waylaid by an emergency dental situation.
It's unclear what the situation was, but it was serious enough to involve oral surgery. As a result, he was forced to miss the Zappers' final regular-season game. His experience is a reminder that some dental problems can't wait—you have to attend to them immediately or risk severe long-term consequences.
Manziel's recent dental problem also highlights a very important specialty of dentistry—oral surgery. Oral surgeons are uniquely trained and qualified to treat and correct a number of oral problems.
Tooth extraction. Although some teeth can be removed by a general dentist, some have complications like multiple roots or impaction that make regular extractions problematic. An oral surgeon may be needed to surgically remove these kinds of problem teeth.
Disease. Oral surgeons often intervene with diseases attacking areas involving the jaws or face. This includes serious infections that could become life-threatening if they're not promptly treated by surgical means.
Bite improvement. Some poor bites (malocclusions) arise from a mismatch in the sizes of the jaws. An oral surgeon may be able to correct this through orthognathic surgery to reposition the jaw to the skull. This may compensate for the difference in jaw sizes and reduce the bite problem.
Implants. Dental implants are one of the best ways to replace teeth, either as a standalone tooth or as support for a fixed dental bridge or a removable denture. In some cases, it may be better for an oral surgeon to place the implants into a patient's jawbone.
Reconstruction. Injuries or birth defects like a cleft lip or palate can alter the appearance and function of the face, jaws or mouth. An oral surgeon may be able to perform procedures that repair the damage and correct oral or facial deformities.
Sleep apnea. Obstructive sleep apnea is usually caused by the tongue relaxing against the back of the throat during sleep and blocking the airway. But other anatomical structures like tonsils or adenoids can do the same thing. An oral surgeon could address this situation by surgically altering obstructing tissues.
It's likely most of your dental care won't require the services of an oral surgeon. But when you do need surgical treatment, like Johnny Manziel, these dental specialists can make a big difference in your oral health.
If you would like more information about oral surgery, please contact us or schedule a consultation.
Once consigned to an extraordinary divine intervention, the term "miracle" is often used today for anything out of the ordinary. But even if the usage has become a little worn, there are things that, though not of supernatural origin, may still deserve the description. In that regard, today's surgical techniques to correct lip or palate clefts and the impact they can have on lives is well-nigh miraculous.
Before the 1950s, though, there was little that could be done to correct these kinds of birth defects. That all changed, though, with a "bolt from the blue" discovery by a military doctor over a half century ago. During Cleft & Craniofacial Awareness & Prevention Month this July, we recognize that doctor's breakthrough insight and the vast progress since then in cleft reconstruction surgery.
Affecting more than 4,000 babies each year, clefts develop during early pregnancy as portions of the face, typically the lips or extending into the palate, don't completely unite with each other. As a result, gaps (clefts) occur where the tissues should be uniform, forming on one side of the face or both.
Clefts can have a harmful effect on a baby's ability to feed or even breathe, and they can interfere with speech development as the child gets older. But what may cause the most emotional pain is the alteration of a person's normal appearance, which may inhibit their ability to socially interact with others.
But a child today with a lip or palate cleft can reclaim a more normal appearance through a series of surgical repairs. The genesis for this began when a U.S. Naval surgeon named Ralph Millard stationed in Korea in 1950 noticed something when studying photographs of his cleft patients. He realized there was no missing tissue with a cleft—all the "parts" were still there and only needed to be "rearranged" surgically.
Today's surgeons do just that, having built modern cleft correction on Dr. Millard's original procedures. And although it involves multiple procedures and often a team of surgeons, dentists and orthodontists, the end result is life-changing.
As amazing as these results may be, cleft correction is a process that can take years, taxing the stamina of both patients and their families. But with ample support, a child with a cleft now has a chance to enter adulthood with a normal smile and appearance. If anything deserves the title "miracle," surely cleft reconstruction surgery does.
If you would like more information about cleft treatment and reconstruction, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Cleft Lip & Cleft Palate.”
One in 700 babies are born each year with a cleft lip, a cleft palate or both. Besides its devastating emotional and social impact, this common birth defect can also jeopardize a child's long-term health. Fortunately, incredible progress has occurred in the last half century repairing cleft defects. Today's children with these birth defects often enter adulthood with a normal appearance and better overall health.
A cleft is a gap in the mouth or face that typically forms during early pregnancy. It often affects the upper lip, the soft and hard palates, the nose or (rarely) the cheek and eye areas. Clefts can form in one or more structures, on one side of the face or on both. Why they form isn't fully understood, but they seem connected to a mother's vitamin deficiencies or to mother-fetus exposure to toxic substances or infections.
Before the 1950s there was little that could be done to repair clefts. That changed with a monumental discovery by Dr. Ralph Millard, a U.S. Navy surgeon stationed in Korea: Reviewing cleft photos, Dr. Millard realized the “missing” tissue wasn't missing—only misplaced. He developed the first technique to utilize this misplaced tissue to repair the cleft.
Today, skilled surgical teams have improved on Dr. Millard's efforts to not only repair the clefts but also restore balance and symmetry to the face. These teams are composed of various oral and dental specialties, including general dentists who care for the patient's teeth and prevent disease during the long repair process.
Cleft repairs are usually done in stages, beginning with initial lip repair around 3-6 months of age and, if necessary, palate repair around 6-12 months. Depending on the nature and degree of the cleft, subsequent surgeries might be needed throughout childhood to “polish” the original repairs, as well as cosmetic dental work like implants, crowns or bridgework.
In addition to the surgical team's skill and artistry, cleft repair also requires courage, strength and perseverance from patients and their parents, and support from extended family and friends. The end result, though, can be truly amazing and well worth the challenging road to get there.
If you would like more information on repairing cleft birth defects, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Cleft Lip & Cleft Palate.”
Somewhere between bites during a recent meal, the inside of your cheek found itself in the way of your teeth. You winced with pain at the resulting bite, and while it was sore for a day or two it seemed to heal over. Now, though, you’re noticing this same area of your cheek gets in the way of your teeth a lot more often, with more bites and sores.
What’s likely happened is that you have developed a traumatic fibroma. When the soft tissues of the inner cheek, lips or tongue heal after being injured, a small bit of fibrous tissue composed of the protein collagen forms like a callous over the bite wound to protect it after it heals. If, however, the process is interrupted by another bite, the fibrous tissue that subsequently forms may be thicker and thus more raised on the surface of the skin. This higher profile makes it more likely the site will be involved in repeated episodes of biting.
If the fibroma continues to be a problem, it can be solved with a simple surgical procedure. A surgically-trained dentist or oral surgeon will remove portions of the fibroma (usually with local anesthesia) to flatten the skin profile, and then close the resulting wound with a couple of stitches unless a laser was used. Any discomfort after the procedure can usually be managed with a mild anti-inflammatory drug like aspirin or ibuprofen, and the site should heal in just a few days to a week.
Although the vast majority of fibromas aren’t dangerous, it’s routine practice to have the excised tissue biopsied for abnormalities. More than likely the fibroma tissue will be normal; but by having the fibroma removed and examined, you’ll gain peace of mind about your oral health. In the process, you’ll also eliminate a bothersome and painful problem.
If you would like more information on mouth sores, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Common Lumps and Bumps in the Mouth.”
The final emergence of permanent teeth in late adolescence marks the end of a long process beginning in the womb with the formation of our primary or “baby” teeth. Permanent teeth form in a similar way as buds high in the jaw, continuing to grow until the primary teeth ahead of them fall away. The crowns of the new adult teeth eventually break through the gum tissue and emerge (erupt) into view.
At least, that’s normally what should happen; sometimes, though, a tooth may only erupt partially or not at all, a condition known as impaction. The crown remains partially or fully submerged below the gum line, causing the tooth to press against other teeth, potentially damaging them. It can also make periodontal (gum) tissues adjacent to the area more susceptible to disease. Wisdom teeth are especially prone to this kind of impaction, to the extent they’re often surgically removed (extracted) to avoid future problems to adjacent teeth or the bite.
Upper canines (the “eye teeth” normally located directly below the eyes) are also subject to impaction. But because of their highly visible position, extracting them could have an adverse impact on the patient’s smile. In this case, we often attempt instead to expose and ultimately save the tooth.
Before taking any action, however, an orthodontic examination is conducted first to pinpoint the exact position of the impacted tooth and determine how that position might affect moving teeth into a more desired alignment. If we find the impacted canine is in a workable position, the next step is to surgically uncover the tooth from the gum tissue (a minor procedure usually performed by an oral surgeon or periodontist). Once exposed, an orthodontic bracket with a small attached gold chain is bonded to the tooth. The gums are then sutured back into place with the chain exposed and allowed to heal.
At some future point an orthodontist will attach the chain to orthodontic hardware that will pull the impacted tooth into proper position over several months. As a result, the upper canine becomes “un-impacted”; the dangers to surrounding teeth and tissues are also reduced. And, just as important, we can preserve the tooth and with orthodontics achieve an attractive, normal smile.
If you would like more information on the effects and treatment of impacted teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Exposing Impacted Canines.”