Jay P. Malmquist, DMD
5 Things You Might Not Know About Oral Cancer
Oral cancer consists of any head and neck cancer (excluding brain cancers – which is its own category). The death rate of oral cancer is unfortunately very high because people find out about oral cancer too late. This is why it is important to practice regular self-examinations in order to be proactive and seek treatment early.
1. 450,000 new oral cancer cases are discovered worldwide each year
While this number is only an estimate, it shows how many people are being affected by oral cancer and why this topic should be taken seriously.
2. HPV is a leading cause of oral cancer
There are many strains of HPV, but HPV-16 in particular has a strong connection to oral cancer. Most HPV strains cause warts or cervical cancer and some have a small connection to oral cancer. For people with HPV, it is important to practice regular oral self-exams in order to be proactive about oral cancer.
3. Oral cancer affects more men than women
Oral cancer affects men over women on a 2:1 ratio. This correlation may be due to men smoking and drinking more than women, although studies have shown oral cancer among women is on the rise. No matter your gender – practice clean oral health practices.
4. Alcohol and tobacco are huge risk factors
These two risk factors are considered lifestyle risk factors. When you think of smoking heavily, your first thought probably is lung cancer. However, that is not the only cancer that smoking causes, as roughly 80% of people with oral cancer are heavy smokers. Alcohol is another huge risk factor as 70% of oral cancer patients are heavy drinkers.
5. If oral cancer is discovered early enough, the cure rate is around 90%
The biggest concern about oral cancer is that it is not discovered soon enough. That is why it is important not to overlook any suspicious bumps that appear in your mouth, and to give your oral surgeon a call as soon as you see it.
Head and neck cancers are not usually discovered soon enough. Make sure you are practicing regular self-examinations, and contact our office today at Portland Office Phone Number 503-292-8824 for an oral cancer screening!
The Most Common Types of Bone Grafting
Bone grafting has become so common, most patients have encountered the term at least once before entering our office. But delving deeper into some of the additional types of bone grafting will give you a better appreciation of this amazing procedure.
What is Bone Grafting?
Bone grafting is the process of using natural or synthetic materials to encourage your body to grow new bone. Your jawbone requires regular stimulation from the activities of teeth to maintain its shape. When a tooth is extracted, the jawbone immediately begins to lose mass. In oral surgery, we use bone grafting to build up the jawbone so that we can place a dental implant.
Types of Bone Grafting:
• Socket Preservation: After tooth extraction, the empty socket is filled with bone grafting material to preserve the bone in the site for tooth replacement in the future.
• Sinus Lift: The sinuses lie above the upper jawbone and are filled with air. If the upper jawbone has receded, we lift the sinus membrane and fill the space underneath it with grafting material to bulk up the bone for upper implants.
• Ridge Augmentation: As with socket preservation, ridge augmentation involves the filling the site of an extracted tooth, however, bone loss has already occurred in this case as the extraction was done months or years before.
• Nerve Repositioning: The nerve that gives feeling to the bottom lip and chin is known as the inferior alveolar nerve. Sometimes this nerve must be relocated in order to place a lower jaw implant. The nerve is moved, and the pockets left behind are filled with bone grafting material to prepare for a dental implant.
If you have been told you need bone grafting and aren’t sure what to expect, please give us a call at Portland Office Phone Number 503-292-8824.
New Trends In Dental Implants
A trending topic right now seems to be the decision to opt for “mini-dental implants” instead of more traditional ones. Below we are going to take a look inside the trend, and lay out some of the benefits and drawbacks so that you can get a better understanding of this exciting trend in dentistry.
- Mini dental implants are usually less expensive than traditional ones, sometimes costing only 1/3 that of regular implants. They take less time to place and are smaller and less invasive, and can be used in small spaces or for those with inadequate bone mass.
- With mini dentures, smaller dentures can be used, leading to a better tasting experience for the palate than a traditional denture would provide.
- Mini implants can be placed with minimal recovery time, and usually require very little to no bone grafting.
Because this is still a fairly new procedure, there are a few downsides. For one, there aren’t enough studies out there on the longevity of these implants, so we don’t know how they hold up over time. A study published in the International Journal of Implant Dentistry in 2016 revealed that traditional dental implant placement has a proven survival rate of 95% or greater. The analysis collected data from over 10,000 implants from 3,095 patients, across three separate private practices over the course of 20 years. For mini dental implants, there isn’t yet enough data to conclude a proper survival rate.
Another concern is that because this is such a new trend there is not as much information or regulation out there. Some practices with claims such as “Dentures-in-a-day” might not do a proper consultation, skipping important steps such as a 3D scan to make sure that you are a good candidate for the procedure.
While it may be some time before this method is perfected and adopted, it is also exciting to see the advancements changing people’s lives in the dental industry every day. Check in with Malmquist Oral and Maxillofacial Surgery to find out what tooth replacement options may be right for you!
How to Take Care of Your Dental Implant
Cleaning and taking care of your implant is just as important as cleaning your natural teeth. Here are some things you should know about caring for your implant.
Your implant and your natural teeth are similar because they both rely on healthy tissue for support and both can build up plaque. It’s important to remove that plaque because it can develop into an infection. If the infection isn’t properly treated, it can result in a loss of bone around the implant which could progress to the loss of the implant itself.
It’s important to get your teeth cleaned on a regular basis so your dental hygienist can get that biofilm off your teeth and keep your teeth infection-free. As always, you should be brushing your teeth and flossing twice a day. Never use your teeth, especially your implant as “scissors” to open anything.
Dental implants are the closest thing you can get to real and natural teeth. They don’t require any special products or treatment. Just a simple brush and floss will do the job. They are also long lasting. If they are properly cared for, they can last a lifetime, avoiding any further dental work down the road.
With a dental implant, you can still enjoy all your favorite foods. It will not loosen or fall out if you are chewing something hard.
Overall, dental implants are meant to make life better and easier, not to add issues or interrupt your life. You don’t have to go out of your way to take care of them – a simple brush and floss will ensure that they improve your overall quality of life for many years to come.
If you think a may be right for you, call Malmquist Oral and Maxillofacial Surgery at 503-292-8824 to schedule a consultation with us.
Dental Implants: The Recovery
The recovery time following dental implant surgery tends to vary, but is usually based on the amount of teeth being implanted, whether or not a bone graft was needed and the individual and how well they manage their recovery. Luckily, the science and technology behind dental implants has improved drastically over the last few years, improving post-surgery pain and comfort for patients.
The patient requiring the least amount of recovery time would be one who had a standard, single dental implant placed with no bone grafting. With a simple procedure like this one, there is very little discomfort or pain after the surgery. Mild bruising and soreness can occur, but is typically manageable with over the counter pain relievers. In more severe implant cases, such as those where multiple teeth are implanted or severe bone grafting needed in order to accomplish the implant, the recovery time tends to be longer and the discomfort can be more intense.
In any cases, it is important to keep your mouth clean after surgery, which can be done by rinsing your mouth gently with salt water beginning the day after surgery. You may begin brushing your teeth the night after the surgery, but make sure to keep it light around the surgery area as to not disrupt the healing in that area. It is also important to remember that in the week following your surgery, there should be no smoking and no sucking through a straw, as this can seriously inhibit your healing process. It is important to stick to a diet primarily consisting of soft foods for the first 7-10 days following your surgery before beginning to return to your normal diet.
As you can see, the recovery process after receiving a dental implant is fairly predictable and comfortable. It is important to follow the instructions that we give you at Malmquist Oral and Maxillofacial Surgery, and to always remember that if you have any questions or concerns regarding a procedure or following your surgery, you can always give us a call at Portland Office Phone Number 503-292-8824.
Autograft vs. Allograft
What is a Bone Graft?
So, you were recently told by your doctor that you need a bone graft, but you aren’t quite sure what that means.
A bone graft is a surgical procedure that is used to fix bones or joints that were damaged by trauma, and it is also used to replace bone that is missing to provide structural stability around the body, including the jawbone. There are many types of bone grafts we can use to grow bone – the two most common are autografts and allografts.
What is a Autograft?
An autograft is a bone or tissue that is transferred from one spot to another on the patient’s body. It is often thought of as the “gold standard” in bone grafting because of its reliability. Its high success rate is due to the fact that it is living tissue and thus its cells are kept intact.
What is a Allograft?
An allograft is a bone or tissue that is transplanted from one person to another. They typically come from a donor, or cadaver bone. The allograft is safe, ready to use and available in large amounts. The main advantage of an allograft is that it requires one less procedure than the autograft, which must first be taken from the patient. Surgical time is minimized and the recovery can be quicker. The allograft comes from a reputable and reliable tissue bank.
Knowing which bone-grafting option you will need can be confusing, but we are here to answer any questions you may have. Please schedule a bone grafting consultation with us by calling Portland Office Phone Number 503-292-8824. We will perform a thorough evaluation of your oral health. After our evaluation, we will recommend what bone graft is best for you. We are happy to discuss your options and answer any questions you may have. We want you feeling confident with our choice and worry free.
When you hear this word in our office, it is most likely that we are talking about your wisdom teeth. And while we know that it may sound scary to have “impacted wisdom teeth”, we want you to know that, actually, it is very common.
What are impacted wisdom teeth?
Throughout evolutionary history, human mouths (jaws) have become increasingly smaller. While the jaws have gotten smaller, the amount of teeth we have has not. So now we have the same amount of teeth squeezing into a smaller space. Because wisdom teeth are the last to erupt, they often become impacted – that is, blocked by the other teeth around them. Often they are growing in sideways or unable to erupt through the gums at all due to crowding.
Why do wisdom teeth need removal?
The inability to erupt properly means that wisdom teeth can cause a lot of pain and even become infected down the road. This is the main reason that we recommend the removal of all third molars (another name for wisdom teeth). The reason that we remove them during the teen years is that the bone is still soft and recovery from the surgery is taken by the patient much better at this age. If we were to wait, your teeth may become infected, your bite crooked, and it may be too late at some point for us to take them out.
Types of Impaction:
- Vertical Impaction – In this case, the tooth is unable to break through the gum line. Vertical impaction is very common.
- Mesioangular Impaction – Angled toward the front of the mouth, the tooth is probably pushing on its neighbor, causing pain and crowding. This type of impaction is also very common.
- Distoangular Impaction – This tooth is angled toward the rear of the mouth, it is uncommon.
- Horizontal Impaction – In this case, the tooth is a complete 90 degrees from where it should be, and is likely growing into the roots of its neighboring tooth. This is very rare.
What is the removal procedure like?
You will be completely pain-free during the surgery, which takes just about an hour. You will also be sent home with instructions for pain management, eating and rest orders.
What is recovery like?
You will recover comfortably at home. You can start drinking liquids and soft foods as soon as you feel ready, but should avoid crunchy foods, extra hot or cold items, and straws (NO STRAWS!). You can expect to resume some of your normal activities a few days post-operation.
If you have any questions about wisdom teeth removal or aren’t sure if you even need the procedure, give us a call at Portland Office Phone Number 503-292-8824!
Tooth Extraction – Managing Pain
The 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 Portland Office Phone Number 503-292-8824
Preserving your Jaw after Extraction: Socket Preservation
Socket preservation is a procedure we will sometimes recommend when you are having a tooth extracted. The bones that hold your teeth require frequent use to maintain their size and shape, otherwise they start to recede as they are no longer needed.
When a tooth is extracted, it leaves behind a hole (or “socket”) in the alveolar ridge bone, making it vulnerable to shrinkage. In fact, some studies show that bone loss can be 50% in the first 12 months after extraction.
You may be wondering, “Why does bone loss matter if I don’t have a tooth there anyway?” Unfortunately, without teeth and adequate bone structure, several unwanted oral health problems may occur:
- Aesthetics: Without adequate bone structure and teeth, your smile starts to cave in in that area, causing undesirable aesthetic consequences. Your skin may begin to look shriveled over time and your smile will be unbalanced and unnatural.
- Alignment Issues: Your teeth are always moving, particularly into open spaces. A hole on one side of your smile can lead to a severe shift of your teeth over time, affecting your smile and subsequently requiring orthodontic treatment.
- Implant Complications: The damaged and recessed bone often ensures complications if you plan on getting a dental implant to replace the extracted tooth in the future.
This is where socket preservation comes in. Typically done at the end of your extraction procedure, we place bone-grafting material into the socket and a collagen membrane on top to encourage bone growth in the area. Because the procedure can be done at the same time as your extraction, no additional anesthesia or appointments are necessary.
If you are facing extraction, call us at Portland Office Phone Number 503-292-8824 to see if socket preservation is an option for you – it could save your smile!
Immunotherapy and Oral Cancer
You may have heard: Immunotherapy is proving to be very promising in the treatment of a variety of cancers, in particular lung cancer and advanced melanoma. However, immunotherapy has not found its way (yet!) into the treatment regimen for head and neck cancers.
What is immunotherapy?
Immunotherapy is the process of enlisting the patient’s own immune system in the fight against cancer cells. Several drugs have been used successfully to aid in the treatment of advanced lung cancers and melanoma, giving patients a longer prognosis in many cases.
Cancer Cells are Tricky
Cancer cells are notoriously sneaky – their ability to hide from immune cells is one of the reasons that cancer is so hard to treat. This is where “checkpoint inhibitors”, one of the most common classes of immunotherapy drugs in cancer treatment, come in. These drugs help to block the activation of proteins that help cancer cells hide from immune cells.
The Connection with Oral Cancer
Recurring head and neck cancers are very difficult to treat. Often they are resistant to the best chemotherapy drugs, so the hope has always been that immunotherapy drugs may some day step in to assist with the oral pathology fight. A recent trial in the UK has shown that the day may be coming sooner than we thought! The trial proved successful in extending prognosis for many of the patients.
Reduced Side Effects
The research also noted that side effects were reduced to give patients a better quality of life during treatment.
More Testing Needed
While more research is needed before the drugs receive FDA approval for the treatment of oral cancer, the good news is that because these drugs are already approved and on the market for other cancers, the application process for use in oral cancers will be quicker (and smoother) than it would be for a new drug.
At Malmquist Oral and Maxillofacial Surgery, our commitment to your care, comfort, health and safety is evident from the minute you walk through our door. Call us at Portland Office Phone Number 503-292-8824 for more information about oral cancer.