Park Avenue Oral & Facial Surgery, P.C.

Implant Supported Dentures

implantdenturesMost patients see dental implants as a procedure that is perfect for replacing one or two teeth. They don’t, however, conclude that a dental implant surgery is the solution for missing an entire row of teeth. In this instance, most people are still reverting to the outdated methods of receiving dentures. But there is actually an efficient way to obtain a mouth full of secure teeth through the dental implant process. This new technique is called “implant supported dentures,” which gives patients new reasons to smile.

A Team of 4 is Stronger Than 15 Individuals

I know what you’re probably thinking. “Wouldn’t it be a long, grueling process to take in 15 or so dental implants in the same surgery?” That is hard to argue with. A mouth with 20 dental implants drilled into it seems like too many metal rods for one person to own. They probably wouldn’t be allowed on airplanes. This is why oral surgeons now have a procedure where they use 4 titanium implants to connect an entire row of teeth. Picture it as 4 pillars with metal bridges connecting them. On the metal bridges is were the fully customized row of teeth will be placed.

Too Real to be Called Artificial

The word “artificial” is misleading when describing the new set of teeth. These teeth are now permanent, and will be treated the same as natural teeth. They need to be well maintained as regular teeth do, and cannot be taken out. It is impossible to distinguish implant-supported dentures from natural teeth. Even oral surgeons would have trouble picking apart the differences. Most patients are concerned with not being able to enjoy food like they used to. These new rows of teeth know when they encounter hot and cold food, and can still bite through the roughest of surfaces. Ultimately, “new and improved” is an acceptable replacement for “artificial” when describing implant supported dentures.

The Time is Now

The oral surgeons who are trained at this process are able to have the patient’s teeth completed in roughly 2.5 hours. This surgery leads to lifelong fulfillment of having a lively smile, so this may be the most productive 2.5 hours ever spent. When the entirety of one’s mouth looks like it’s ready for a makeover, implant supported dentures are the key to rebuilding.

3 Reasons to Have Corrective Jaw Surgery

jawpainJaw Surgery might sound intimidating, frightening, or both. It isn’t easy to process the fact that your jaw needs to be realigned. Ultimately, overcoming the surgical aspects of orthognathic surgery is well worth the years of having a symmetric, visually appealing jawline. Here are the top reasons why more and more patients are considering jaw surgery:

1: Improvement in Chewing and Biting Foods: Have you ever been unable to enjoy food due to a physical complication? Those who have had their wisdom teeth out can admit to this, as well as those who have once had severe cuts on the insides of their mouths. However, there are food lovers out there who regularly cannot enjoy the full satisfaction of eating food due to their jaw’s misalignment. A world where one has to proceed with caution before chowing down lunch is a world that needs to be fixed – with jaw surgery.

2: Reduce of Chronic Headaches:  Oral Surgeons notice that when patients have TMJ disorder, they have tendencies to grind their teeth at night. Most of these teeth-grinders do so unconsciously, which results in morning headaches. Most people with chronic headaches simply take their pain relievers and move on without receiving any significant treatment. Corrective jaw surgery will cease the teeth-grinding, which will ultimately reduce daily headaches.

3: Improving Overall Facial Appearance: Having and underbite or an overbite is certainly unfortunate, but fixable. Even if one’s bite needs to be fixed by a millimeter; this millimeter can go a long way. If one’s mandible projects outward, he/she has an underbite. This gives the appearance of an oversized jaw, which can harm the beauty of his/her smile. By contrast, an overbite makes one look as if their jaw isn’t fully developed. The jaw bone is surgically moved forward or backwards accordingly.

The process of getting Jaw Surgery is seemingly a long one, but well worth it in the end. Patients who have had jaw surgery are thrilled about their new and improved smile and overall confidence. Improving appearance, preventing headaches, and being able to thoroughly enjoy food are three worthy reasons to consider an orthognathic treatment.

Three Superstar Teeth Corrections

When we see celebrities walking on the red carpet with their dazzling smiles, it’s hard to believe that their teeth were ever imperfect. Unfavorable teeth, however, were common for many of today’s hottest stars. They realized the magnanimous impact a beautiful smile could make, and took action. Lets look at a few celebrities who transformed their smiles into superstars.

                                                                                    50 Cent

In the hip hop industry, rappers are continuously searching for ways to ridicule the competition. When rapper 50 cent realized that his teeth were becoming the laughing stock of the rap business, he decided to straighten things out- literally. He fixed his disproportionate teeth by receiving an entirely new set. Now, 50 cent can officially say he is shining from head to toe.

50 Cent Celebrity Teeth

                                                                                                     Matthew Lewis:

We all remember the chubby, crooked teethed “Neville Longbottom” in the Harry Potter movies. Matthew Lewis, who played Longbottom, was told on his contract that he must not fix his teeth or lose weight. Sadly, the teenager who was on set with numerous attractive women, was forced to maintain his unattractive appearance for the greater good of the legendary Harry Potter saga. Once his role in Harry Potter was ceased, he immediately fixed his teeth, which made him unrecognizable in comparison to his teenage days. Changing your teeth can change the overall nature of your look, as shown below:

Matthew Lewis Celebrity Teeth

                                                                             Miley Cyrus

Lets pretend that we aren’t familiar with Miley’s recent media meltdown, and simply focus on her improvements over the years. When she started as a Disney channel actress, most viewed her as the perfect child. Unfortunately, her teeth were miles from perfection. While her current persona may be a bit crooked, her teeth are perfectly straightened, which she credits her dentist for.

Miley Cyrus Celebrity Teeth

 

For many celebrities, the first task at hand after being nationally endorsed is fixing their teeth. Their publicists and stylists all admit that superstardom does not align with uneven teeth. But celebrities aren’t the only ones who promptly need beautiful teeth.

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What To Expect When Having a Tooth Extracted

What-To-Expect-When-Having-a-Tooth-Extracted One of the most common procedures done in our office is tooth extraction. The removal of teeth can be necessary for a number of reasons, including:

  • Joint problems in your jaw
  • Shifting teeth
  • Too much damage to tooth to be repaired
  • Baby teeth that don’t fall out
  • 3rd molars (Wisdom Teeth) impacted (wedged between the jaw and another tooth or teeth)
  • May be needed to create room for other teeth (such as when you’re getting braces)

Prior to Surgery

In preparation for surgery, we will obtain a full medical and dental history, as well as a list of all medications you take. This includes any vitamins, supplements, or over-the-counter drugs, as well as any medications you are allergic to.

An x-ray is then taken to assess the best way to remove the affected tooth.

You may be required to take antibiotics before or after surgery, depending on the duration of the surgery, or if you have a specific medical condition. Dr. Dr. Cohen will discuss this with you if necessary.

Day of Surgery

At the time of surgery, your oral surgeon will numb the area around the tooth or teeth to be extracted with a local anesthetic, specifically numbing the affected tooth or teeth, your jawbone and the surrounding gums.

During the simple extraction process it is common to feel a lot of pressure. The affected tooth is firmly rocked back and forth so as to loosen it for removal. You should not feel any pain, just pressure. If, for any reason, you feel pain, please notify your oral surgeon immediately so that they can administer more numbing agent.

Surgical Extraction

A surgical extraction is a slightly more complex procedure that occurs when a tooth has not yet broken through the gum line, or has not yet fully grown into the mouth. When a surgical extraction is needed, your oral surgeon makes a small incision into your gum in order to access the affected tooth. From here, the procedure is similar to a simple extraction. Your oral surgeon may stitch the incision site if necessary.

After Oral Surgery

After the extraction you will be asked to bite down on a piece of gauze for 20-30 minutes. This pressure helps to form a blood clot in the extraction site, a crucial part of the healing process. Be careful not to dislodge the clot.

It is common to have a small amount of bleeding 24 hours after surgery. We will provide you with detailed instructions after your procedure, but here are some important things to remember:

Medications/Pain Management

  • Take pain medication as prescribed and recommended by your oral surgeon
  • Research has shown that taking anti-inflammatory drugs, such as Advil and Motrin (NSAIDs) greatly decrease pain after an extraction
  • Using an ice pack on your jaw can reduce swelling. 10 minutes on and 20 minutes off is standard for the first 24 hours. A warm compress can be used if your jaw is sore after the swelling has gone down

Eating/Drinking

  • Eat soft and cool foods for the first few days
  • Avoid hot foods and alcoholic beverages for the first 24 hours
  • Chew food away from the extraction site
  • Do not use a straw or spit after surgery. This can cause the blood cut to dislodge, greatly delaying healing

Brushing/Cleaning

  • Avoid brushing the area around the extraction site for the first 24 hours
  • Avoid using antiseptic and commercial mouth rinses – they can irritate the extraction site
  • 24 hours after surgery you can rinse with warm salt water after each meal and before bedtime (1/2 teaspoon in one cup of warm water)

Healing

The extraction site will generally close up in about 2 weeks time, but it can take three to six months for the bone and soft tissue to regrow. Remember, tooth extraction is a common procedure and our caring team has years of experience helping patients through this easy treatment.

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Park Avenue Oral and Facial Surgery Earns AAAASF Accreditation!

Dr. Cohen

Park Avenue Oral and Facial Surgery has become the second oral and maxillofacial practice in New York, New York accredited by the AAAASF (American Association for Accreditation of Ambulatory Surgery Facilities). The AAAASF is a prestigious organization with standards that ensure the highest quality patient safety in the ambulatory surgery setting. Not only did Park Avenue Faces adhere to the requirements, but they passed them with flying colors, meeting 100% of the AAAASF‘s standards. The purpose of the AAAASF is to assure patients that the practice they visit delivers safety and quality in all aspects of their outpatient surgery experience. Dr. Cohen is thrilled about this accreditation, and will continue to preach the importance of patient safety in his practice. Visit the AAASF’s website at http://aaaasf.org/

Cohen Accred

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The Evolution of Dental Care: From Finger to Floss

Did you know that the toothbrush is one of the oldest tools that humans still use? In fact, in a survey conducted in 2003, Americans chose the toothbrush as the number one invention over the car, personal computer, cell phone, and microwave. This may come as a shock in a day and age obsessed with technology, but it just goes to show how much value we place on our pearly whites. But it makes you wonder… how have people kept their teeth clean throughout the centuries? How did the toothbrush, toothpaste, and floss come into existence and how have they evolved over time?

One would assume that the first toothbrush was surely the finger, but evidence has shown that as far back at 3500 BC to 3000 BC chewing sticks were used in Babylonia. These chewing sticks were essentially a stick from an astringent tree with a frayed end that acted as bristles to clean teeth. These chewing sticks have also been found in ancient Egyptian tombs. Their predecessors are still commonly used in certain areas of the Middle East, Africa, Asia, and South America and are known as miswak or mswaki sticks.The Evolution of Dental Care

When excavating Ur in Mesopotamia, ornately decorated toothpicks were found that dated back to 3000 BC. Other archaeological digs have recovered various tree twigs, bird feathers, animal bones, and porcupine quills as the earliest toothbrushes and toothpicks. An ancient Sanskrit text on surgery dating back to the 6th century describes severe periodontal disease and stresses oral hygiene; “the stick for brushing the teeth should be either an astringent or pungent bitter. One of its ends should be chewed in the form of a brush. It should be used twice a day, taking care that the gums not be injured.” Pretty sound advice, even by current standards! Ancient Greek and Roman literature referenced the use of toothpicks to keep their mouths clean, and ancient Roman aristocrats kept special slaves for the sole purpose of cleaning their teeth. Imagine that job!

Ancient Chinese writings from around 1600 BC portray chewing sticks that were derived from aromatic trees and sharpened at one end to act as a toothpick. In the thirteenth century, the Chinese began to attach boar bristles to bamboo, essentially fashioning the first toothbrush. The optimal choice for bristles was taken from the back of the necks of cold climate boars, generally found in Siberia. Traders introduced these toothbrushes to the West and they quickly gained popularity. At that time Europeans were brushing their teeth by dipping a linen cloth or sponge in sulfur oils and salt solutions to rub away tooth grime. This was referred to as “The Greek Way”, as Aristotle had recommended this method to Alexander the Great. As these toothbrushes spread from East to West, in the West they preferred softer horse hairs over the coarse boar bristles, yet horses were deemed too valuable for the sake of toothbrushes, making boar bristles popular well into the early 1900’s.

Fast-forward to 1780 and we meet a man named William Addis of Clerkenwald, England. Addis was sitting in Newgate Prison for allegedly inciting a riot. The method for brushing teeth in jail was to take a rag and dip it in a solution of soot and salt and rub it onto the teeth. Addis believed there had to be a more efficient way, so while he passed his time in jail he began to think up solutions. Spying a broom, inspiration struck him and he took a small animal bone leftover from his meal and drilled holes into it. He then tied some swine fibers into bunches, strung them through the holes, and glued them into place. At this time in Georgian England, refined sugar was being shipped in from the West Indies in mass quantities. This caused a huge increase in the consumption of sugar for Londoners who then suffered from rotting teeth, the only treatment for which was to pull the infected teeth. When Addis was released from jail, he went on to market and sell his toothbrush under the name Wisdom Toothbrushes, which went on to become a very successful business that is still around today.

Toothbrushes continued to be made with animal bone handles and more often than not, boar bristles, although fancy toothbrushes were made with badger hair for those who could afford them. Celluloid handles were introduced in the 1900’s and quickly replaced bone handles. In the 1920’s a new method of attaching bristles to the handle was developed: holes were drilled into the brush head, bunches of bristles were then forced through the holes, and secured with a staple. This method is the same method that is commonly used today.

The next evolution in toothbrushes occurred when Wallace H. Carothers of Du Pont Laboratories invented nylon in 1937. Nylon bristles quickly overtook animal hair bristles for sanitation and cost-effective purposes. Although boar hair bristles often fall out, do not dry well, and are prone to bacterial growth, they strangely still account for 10% of the toothbrushes sold worldwide. The new nylon bristled toothbrushes were sold as “Doctor West’s Miracle-Tuft Toothbrush” due to its more hygienic properties.

With World War II looming in the background, British and American housewives were instructed to waste nothing, which translated to no more bone handles for toothbrushes. Bone handles had long been popular for things like toothbrushes, knives, guns, and handles for many more items. The shift to celluloid was a natural progression as soup bones were needed more than ornate bone handles. World War II gave oral hygiene an unexpected boost. The soldiers in World War II were expected to brush twice daily, a habit they brought home with them, likely due to the fact that Trench Mouth had become so rampant during World War I.

And what about toothpaste? Well, ancient Egyptians were making a “tooth powder” as far back as 5000 B.C.E. It was made from ox hooves, myrrh, eggshell fragments, and pumice. No device was found with the remnants of the tooth powder, which is why it is assumed that the finger was the first actual toothbrush. Other early tooth powders contained mixtures of powdered salt, pepper, mint leaves, and iris flowers. In Roman times, urine was used as a base for toothpaste. And since urine contains ammonia it was likely an effective whitening agent. In later times, homemade tooth powder was made of chalk, pulverized brick and salt. It is said that Napoleon Bonaparte regularly brushed his teeth with an opium-based toothpaste. In 1873, Colgate mass-produced the first toothpaste in a jar called Crème Dentifrice. By 1896, Colgate Dental Cream was packaged in collapsible tubes. Finally, by 1900, a paste of hydrogen peroxide and baking soda was developed, and by 1914 fluoride was introduced and added to the majority of toothpastes on the market at that time.

And what of floss? Researchers have found floss and toothpick grooves in the teeth of prehistoric humans. But it wasn’t until 1815 when a New Orleans dentist named Levi Spear Parmly promoted flossing with a piece of silk thread that floss really gained notoriety. Levi went on to be credited for inventing the first form of dental floss. By 1882 the Codman and Shurtleft Company of Randolph, Massachusetts began mass-producing unwaxed silk floss for commercial use. In 1898 Johnson & Johnson received the first patent for dental floss.  Dr. Charles C. Bass then developed nylon floss, which performed better than silk because of its elasticity. Today floss is still made of nylon.

Who would’ve thought that the history of dental care would be so fascinating? And who would’ve guessed that the toothbrush we use today evolved from a stick and was perfected by a convict? Today, there are over 3,000 patents worldwide for toothbrushes. Regardless of how they got here, toothbrushes, toothpaste, and floss are a necessity in our daily lives.

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Will Wisdom Teeth Someday Become Obsolete?

Most people are familiar with third molars, more commonly known as “wisdom teeth”.  It is usually suggested that a young adult entering the “age of wisdom” have any existing wisdom teeth removed prior to developing any problems. Because most people’s mouth do not have room for these third sets of molars, the remaining wisdom teeth often fail to erupt and can cause pain, infection or Will-Wisdom-Teeth-Someday-Become-Obsolete copyinflammation.

However, you might not realize that about 35 percent of the population doesn’t experience any third molar development. This percentage is slowly growing, begging the question of whether we are on an evolutionary track of losing them completely.

Scientists still aren’t sure of the role that DNA plays in third molar development. One large difference in third molars is that they are the only teeth to develop entirely after birth, which makes it harder for nature to select against them. There may also be environmental factors at work. Studies show that certain cultures have fewer incidences of third molars, but scientific evidence of influencing factors is still to be determined.

As science progresses, many believe bioengineering could be used to prevent the development of third molars altogether. For wisdom teeth to form, a special tissue that promotes the bone growth has to migrate back into the mouth to interact with jaw tissue. Some scientists have begun work on administering a laser or chemical agent that would prevent this process.

It is hard to say what the future might hold for wisdom teeth. For now, we continue to recommend removing your wisdom teeth to avoid the pain and periodontal disease that results from impaction of wisdom teeth. Moreover, this surgery should take place during the young adult years prior to the teeth attaching to the jaw and becoming more difficult to extract.

Wisdom tooth removal in our office is a relatively simple process. Call us to reserve a consultation today.

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FAQs Regarding General Anesthesia for Oral Surgery

Here in our office we perform a variety of treatments including dental implants, facial reconstruction and teeth removal. If you haverecently been diagnosed with a condition that requires any of these types of treatment, you will likely be required to go under general anesthesia. 

For some people, impeding anesthesia can induce a bit of anxiety. We completely understand what you are feeling and believe that proper education can help put your fears at ease. The following are some of the most common questions our patients have before “going under”.

What is exactly is general anesthesia?

General anesthesia is a medically induced loss of consciousness (also called coma) that affects your entire body. This administration of a variety of medications is extremely beneficial for both our patients and our oral surgeons. The side effects include:

The purposes of general anesthesia include:

FAQ-Regarding-General-Anesthesia

 

1. Analgesia (loss of pain)

2. Amnesia (loss of memory)

3. Immobility

4. Unconsciousness

5. Skeletal muscle relaxation.

 

Is anesthesia safe?

Due to many advances over the past 25 years, the risks of anesthesia are very low. Certain types of illnesses, such as heart disease, high blood pressure and obesity, can increase your anesthesia risks. Still, even very sick patients are routinely brought through major operations safely.

Adverse events are very rare. The specific risks of anesthesia vary with the particular procedure and the health of the patient. You should ask your oral surgeon about any risks that may be associated with your specific condition.

What should I know before I come in?

Before you go to have your procedure completed under general anesthesia, here are a few requirements:

  • Have a responsible adult accompany you to drive you home.
  • Do not eat or drink anything before 8 hours of surgery.
  • Do not drive or operate machinery for 24 hours after surgery.
  • Do not wear contact lenses, jewelry, or dentures during the time of your procedure.
  • Do not wear excessive makeup, lipstick, or nail polish on day of surgery.
  • Make sure to notify your oral surgeon of any illness, cold, sore throat, or upset stomach.

Are there side effects I should be aware of?

There are a few different side effects of general anesthesia. The most common are nausea, sore throat, sleepiness, and shivering. However, effects may vary greatly with each patient — it all depends on how your body reacts to it. It’s a good idea to consider any prior experience(s) with general anesthesia to get an idea of to know what t expect during your next oral procedure.

Please do not hesitate to contact our office with any remaining questions you have. We are happy to answer them!

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Dentures – The End of An Era

Dentures---The-End-of-An-Era

You may have heard the term “edentulous”, a term that describes someone that has no teeth. Incredibly, more than 35 million Americans do not have any teeth. Despite advances in dentistry, this number is expected to grow in the next two decades along with an aging baby boomer generation. Tooth loss commonly results from decay and gum disease.

Up until now, the only option for edentulous patients has been dentures. Their history is a long one. Scientists have found evidence of early dentures, dating back to 700 BC in present-day northern Italy, made of human and animal teeth. Over the years, the materials changed, but the inconvenience of ill-fitting dentures did not.

While dentures are extremely common, most patients find them uncomfortable and awkward. They can make daily tasks most of us take for granted, like talking and eating, difficult.

Presently, dental implants are rapidly becoming the standard of care. The biggest difference in the patient’s experience is that dental implants look and function just like their natural teeth. Most dental implant patients even report not being able to feel a difference! They do not slip or move inside the mouth as dentures are prone to do. Dental implants will generally last longer, as well. This is an important point to consider when comparing costs. While implants are more expensive, they usually last a lifetime. Dentures, on the other hand, can wear down and require replacement.

For patients looking for a more affordable replacement option, with the increased stability of implants, they may want to consider implant-supported dentures. Unlike traditional dentures, which rely on suction, implant-supported dentures are secured by dental implants. Regardless of which route an edentulous patient takes, it is clear that benefits of implants far outweigh those of dentures and will pave the way for a new era in tooth replacement.

If you are interested in exploring dental implants as a replacement for your own dentures, give our office a call to reserve a consultation today!

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Could Diamonds be an Oral Surgeon’s Best Friend?

 

Dr. CohenCould Diamonds be an Oral Surgeon's Best Friend routinely replaces missing teeth with dental implants here in our office.  Dental implants are artificial tooth “roots” made of titanium, used to anchor dental prostheses, including crowns, and implant supported bridges and dentures. One of the largest factors in successful dental implant placement is adequate, healthy bone density to anchor the post.

Unfortunately, not all patients have the proper bone in their jaw to support a dental implant. Some patients suffer from Osteonecrosis, a disease caused by reduced blood flow to bones. When there is not enough blood flow, bone can start to die and break down. This makes dental implants for these patients particularly susceptible to becoming loose or failing. Osteonecrosis can be a side effect of chemotherapy.

Scientists from the UCLA School of Dentistry have discovered that nanodiamonds could be used for stronger dental treatments. Nanodiamonds are much smaller than those traditionally used in jewelry.

Currently, standard bone repair operations include inserting a sponge surgically to administer proteins that promote bone growth.  This new study, led by Dr. Dean Ho, may have uncovered is an easier way to deliver these proteins. Nanodiamonds, which are invisible to the human eye, bind rapidly to the materials needed for bone growth. This process can be done through injection or an oral rinse, rather than surgery.

“This discovery serves as a foundation for the future of nanotechnology in dentistry, orthopedics and other domains in medicine,” said No-Hee Park, dean of the School of Dentistry. “Dr. Ho and his team have demonstrated the enormous potential of the nanodiamonds toward improving patient care. He is a pioneer in his field.”

Results from the study will most likely pave the way for more study. Either way, stay tuned to find out how diamonds are playing a role in oral health care.

Read the full article from UCLA’s newsroom here: http://newsroom.ucla.edu/portal/ucla/nanodiamond-encrusted-teeth-248066.aspx

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