Oral & Maxillofacial Surgery of Westfield

Toothbrush Care: Cleaning, Storing and Replacement


Your Dental Benefits: Use Them or Lose Them


Did his artificial hips put him at risk of infection when he saw the dentist?




Your Teeth

The goal of dental implants is to replace a single tooth, several teeth, or all of the teeth in your mouth. You may have lost teeth from decay, gum disease, or an injury. Or, you may have a problem tooth that just needs to be removed and replaced.
There are 2 major parts to your teeth: the crown (which is the part you see), and the root (which is hidden below the gum line). Below the root are nerves that control feeling in your jaw, chin, tongue, gums, lips, and teeth. Above the upper jaw are your sinuses and nose. Sinuses are air-filled, bony pockets connected to your nose.
What are Implants?
Implants are small titanium that replace the root of your tooth. Your new tooth, bridge, or denture is placed on top of the implant. Dental implants look like, and have the strength of, natural teeth.
There are three basic parts to your final replacement tooth or denture. The implant is the post. And the “abutment” is attached to the implant and comes through the gums. When replacing a single tooth, the custom-made crown fits over this abutment.
Implants can replace a single tooth, several teeth in the same area, or all of the teeth in your jaw. The whole implant process can take anywhere from three months to a year, depending on your case.
Dr. Gold will place your implant, and your general dentist will fit your final replacement teeth. This is called “team treatment.”
Placing implants into your jawbone is surgery. Creating the new replacement tooth, bridge, denture, or full-arch prosthesis takes time. When replacing a single tooth or partial bridge, there is no such thing as having the implants placed and getting your final teeth the same day. It is possible to have your problem tooth removed, implant placed, and get a temporary tooth that day (although this is sometimes contraindicated.) Everyone’s situation is a little different. Dr. Gold will help you decide what’s best for you.

Before Your Surgery

Dr. Gold will examine your mouth and take certain x-rays to plan your treatment. When teeth are lost, the jawbone begins to shrink. Dr. Gold can use x-rays to see how solid your jawbone is and to look at its shape. Some patients may need a CT Scan (a special kind of x-ray) to show the position of their nerves or sinuses, and the shape and size of their jawbone.
Then, Dr. Gold will take a look at:
• The overall health of your teeth and gums
• How well you take care of your teeth
• How much jawbone you have
• Where the implant should be placed
• Your general health and health history
Dr. Gold needs to know:
• If you have any allergies
• What kinds of medications you take (including prescription and over-the-counter medications, herbal supplements, and vitamins)
• If you have a hip or knee replacement, heart murmur, or mitral valve prolapse
Dr. Gold may prescribe antibiotics for you to take before surgery to help prevent infections.
About smoking, alcohol, and diabetes
One thing to know is that implants have a higher chance of failure in people who smoke. Some surgeons won’t place implants in smokers at all. The same is true for people who have diabetes but don’t control it very well and for those who drink alcohol heavily.
If you’re a good candidate, Dr. Gold will explain your treatment plan to you. This includes the number of implants you’ll need to support your new replacement crowns, bridge, or dentures. If your implants will hold bridges or dentures, you may have the choice of getting removable or fixed teeth. This is something to talk about with Dr. Gold and your general dentist who will be fitting your final teeth. If you don’t have enough bone or gum tissue to hold an implant, you might need to have some surgery to add more bone. This is called a “bone graft.”

Placing the Implant

Implants can be placed in 1 stage or 2 stages. Both approaches start the same way. Dr. Gold opens the gum tissue where the tooth is missing. A very precise drill hole is made into the jaw so that the implant can fit exactly. Dr. Gold then puts the implant into the hole.
1-stage implants
If you are having 1-stage implants, Dr. Gold may attach a healing collar that sticks through the gums. This collar gets the gums ready for the new tooth.
2-stage implants
If you are having a 2-stage implant, Dr. Gold will place a cover screw over the implant that does NOT stick through the gums. The gum tissue will be closed over the implant, usually with stitches.
Either way, you’ll have to wait anywhere between 3 to 6 months (usually 3-4 months) so your jaw bone and implant can fuse together. This allows your implant become strong and stable.
• In a 1-stage implant, a healing collar is already sticking through the gums. Once you get the okay, your general dentist can begin the process of making the final teeth.
• In a 2-stage implant, Dr. Gold will need to open up the gum area before placing the healing collar. You’ll wear this anywhere from 2 weeks to 1 month. Then, you’ll go to your general dentist to begin the process of making the final teeth.
After Your Surgery
After surgery, most people have very little pain.
• Dr. Gold will give you a prescription for antibiotics and pain medications to take as directed.
• It’s very important that you do not smoke for at least 2 to 3 weeks after your implants are placed. Smoking increases the chances of failure.
After you have your final replacement teeth fitted and made, cleaning those new teeth is very important. You need to keep those teeth even cleaner than you would your natural teeth. In fact, there are special mouth rinses that you could ask your dentist to prescribe for you.
How long can implants last?
Dr. Gold and your general dentist cannot guarantee a number of years. If you take good care of the implant or implants they could last you a long time.

Risks and Benefits

The benefits of implants
• A natural look
• A stronger bite
• An improved confidence in your smile
• Prevention of more bone loss
If you wear regular dentures, you know that they can come loose and be uncomfortable. Implants replace the root of the tooth, giving your replacement teeth a strong base so you can feel confident.
Implants also prevent future bone loss. When the root of your tooth is missing, the jawbone can start to shrink (which may change your facial appearance). Regular dentures cannot stop this bone loss.
Dental implants have a high success rate and are known to be very safe. But, like any surgery, there are some risks. There are some very rare and unusual risks that will not be covered here. Dr. Gold will discuss those risks as they pertain to your individual treatment


Regular bridge
A regular bridge is made to replace one or two missing teeth. It’s cemented to the teeth on either side of the missing tooth. Your general dentist will need to grind down the neighboring teeth to make room for the caps. When taken care of, regular bridges can last many years.
Regular dentures
Regular dentures are another option. A complete denture sits on your gums. Everyday, dentures put pressure on your gums that can cause your jawbone to shrink. Because of this, dentures can come loose and lose their fit. Your general dentist can adjust your dentures regularly to improve the fit. But, over time, you could end up losing too much bone, preventing your dentist from making a well-fitting denture. If you are heading in this direction, implants may be your best choice.
As dental implants become more popular, you may hear news about them on TV or read reports in the media or on the Internet. Not all the information is good information. The best thing to do is talk it over with Dr. Gold or your general dentist to see if what you’ve learned makes sense for you.

Wisdom Teeth

Wisdom Teeth
Wisdom teeth, also known as third molars, are the last teeth to erupt in your mouth. This generally occurs between the ages
of 17 and 25, a time of life that has been called the “Age of Wisdom.” Anthropologists note that the rough diet of early humans
resulted in the excessive wear of their teeth. Normal drifting of the teeth to compensate for this wear ensured that space
was available for most wisdom teeth to erupt by adolescence. The modern diet, which is much softer, and the popularity of
orthodontic tooth straightening procedures produce a fuller dental arch, which quite commonly doesn’t leave room for the
wisdom teeth to erupt, thereby setting the stage for problems when the final four molars enter the mouth.

What is an Impacted Tooth?

A tooth becomes impacted when there is a lack of space in the dental arch and its growth and eruption are prevented by
overlying gum, bone or another tooth.

How Serious is an Impacted Tooth?

Impacted teeth can be painful and lead to infection. They may also crowd or damage adjacent teeth or roots.
More serious problems may occur if the sac surrounding the impacted tooth becomes filled with fluid and enlarges to
form a cyst. As the cyst grows it may hollow out the jaw and permanently damage adjacent teeth, the surrounding bone and
nerves. Rarely, if a cyst is not treated, a tumor may develop from its walls and a more serious surgical procedure may be required to remove it. Despite the considerable concern regarding impacted third molars, a recent study sponsored by the American Association of Oral and Maxillofacial Surgeons and the Oral and Maxillofacial Surgery Foundation finds that third molars which have broken through the tissue and erupted into the mouth in a normal, upright position may be as prone to disease as those third molars that remain impacted. Complications such as infection, damage to adjacent teeth and the formation of cysts may arise from impacted teeth.

Must the Tooth Come Out if it Hasn’t Caused Any Problems Yet?

Not all problems related to third molars are painful or visible. Damage can occur without your being aware of it. As wisdom teeth grow, their roots become longer, the teeth become more difficult to remove and complications become more likely. In addition, impacted wisdom teeth are more likely to cause problems as patients age. No one can predict when third molar complications will occur, but when they do, the circumstances can be much more painful and the teeth more difficult to treat. It is estimated that about 85% of third molars will eventually need to be removed.

When Should I Have My Wisdom Teeth Removed?

It isn’t wise to wait until your wisdom teeth start to bother you. In general, earlier removal of wisdom teeth results in a less complicated healing process.The AAOMS/OMSF study strongly recommends that wisdom teeth be removed by the time the patient is a young adult in order to prevent future problems and to ensure optimal healing. The researchers found that older patients may be at greater risk for disease, including periodontitis, in the tissues surrounding the third molars and adjacent teeth. Periodontal infections, such as those observed in this study, may affect your general health.

What Happens During Surgery?

Before surgery, Dr. Gold will discuss with you what to expect. This is a good time to ask questions or express your concerns. It is especially important to let Dr. Gold know about any illness you have and medications you are taking. The relative ease with which a wisdom tooth may be removed depends on several conditions, including the position of the tooth and root development.
Impacted wisdom teeth may require a more involved surgical procedure. Wisdom teeth are easier to remove when the patient is younger, since their roots are not completely formed, the surrounding bone is softer, and there is less chance of damaging nearby nerves or other structures. Removal of wisdom teeth at a later age becomes more complicated as the roots have fully developed (may involve the nerve), and the jawbone is denser. Most wisdom tooth extractions are performed in the office under local anesthesia, nitrous oxide or intravenous sedation. Dr. Gold will discuss the anesthetic option that is right for you.

About Oral and Maxillofacial Surgery

Oral and Maxillofacial surgery is the specialty of dentistry that includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and aesthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
An oral and maxillofacial surgeon is a graduate of an accredited dental school who has completed an additional four or more years of training in an accredited, hospital-based oral and maxillofacial surgery residency program.
Oral and Maxillofacial surgeons are an important link in the referral network for primary care providers. Through appropriate referrals, patients can be provided with expedient and cost-effective health care for conditions relating to the specialty of oral and maxillofacial surgery.


6 Serious Health Problems Your Dentist Might Find