Jay P. Malmquist, DMD

Orthognathic surgery is a procedure, or set of procedures, that make corrections to the jaw. The jaw serves many functions. It isn’t just for chewing. A healthy jaw also plays an important role in your speech, ability to sleep well, as well as maintain a proper bite, airflow, and facial symmetry.

Your jaw can be misaligned for a number of reasons. Perhaps you suffered an injury that wasn’t corrected properly. Maybe things just grew that way. It may very well be that a slight misalignment is no issue, but it’s worth giving us a call to find out just how severe your misalignment is, and what it means for your health.

Reasons to ask about jaw surgery:

Unexplained Pain
Sometimes, unexplained pain elsewhere in the body is caused by the activities of your jaws. Your headaches and even neck pain may be the result of excessive pressure in your jaw due to grinding or bite issues.

Air Flow
The position of your jaw can also restrict air flow while you sleep. Misaligned jaws are a common cause of sleep apnea. It could very well be that your fatigue and stamina issues stem from a misaligned jaw.

Mechanical Problems
If you have trouble chewing, meeting your lips together or can see a visible imbalance in your appearance, it may be that you have jaw misalignment issues that can be corrected with surgery. It is also worth noting that a great deal of jaw issues cannot be detected by looking in the mirror, but we think it’s a good place to start.

A Common Treatment Plan:

Your treatment plan will depend on your needs, but for a major jaw correction we often start with braces to move teeth into a better position, and then surgically correct the position of your jaw. This happens after a consensus is made between your family dentist, a maxillofacial surgeon an orthodontist and yourself.

Surgery is done under anesthesia, so you won’t feel a thing while the procedure occurs.

Afterward, you’ll be given a schedule to modify your diet, activity, and be given medication so as to heal as soon as possible

Contact us for a consultation to see if corrective jaw surgery is for you!

Oral cancer is serious business. The good news is that you can do something about it. Regular self-examinations may help you pick up on warning signs in time to act on them. Oral health professionals are experts on mouths, but the only expert on you is YOU. If you notice something strange going on in your mouth, contacting a professional at our office is your best mode of action.

The first and most important thing to remember is oral cancer is often painless! The second rule to remember is that if you aren’t sure, ask! Its better to ask now and be sure than to wish you had asked. There are no dumb questions when it comes to looking for oral cancer. And, most importantly: any suspicious area that doesn’t resolve on its own in 14 days should be checked out ASAP.

The key to eliminating oral cancer is to act on it early. Here are some things to check regularly.

Your Tongue
Look for lumps and bumps on the upper and lower surfaces of your tongue. Feel around for odd textures, bumps, discoloration or swelling. Place the tip of your tongue on the roof of your mouth to peek underneath. Don’t limit your search to the red flags above. Use your fingers and your vision.

Your Cheeks
Gently feel your cheeks for bumps and swelling. You can do this by placing your finger on the interior and your thumb outside your cheek. Lightly squeeze and feel around for anomalies.

Your Lips
Take a good look at the interior of your lips with a hand mirror. Keep an eye out for the same signs. Lips are harder to be sure about because they are constantly drying, wetting, and being scraped as we eat and speak. Nonetheless, lips are prone to cancer given that they re always exposed to sunlight. Better safe than sorry.

Your Head/Neck Area
Closely examine your head and neck for lumps and protrusions. A bump or lack of uniformity is absolutely worth checking out. Ask us at your next visit to check out your throat too. Keep an eye out for sensitivity and soreness.

With oral cancer, the key is to keep your eye out for anything out of the ordinary. Anything that seems strange is worth noting and calling our office about.

Call us today for a check up!

Dental implants are becoming more and more popular these days, and we can see why. The ability to replace a missing tooth with a brand new one is an attractive concept.

We know that people often have questions about implants, so we have put together this page to answer those common questions:

What is a dental implant?

Implants are artificial teeth that function exactly like your natural teeth. We take a titanium screw, attach it to your jaw, allow the jaw to grow around the screw, and then fit the new tooth in right where the old one used to be. It will feel exactly like your old tooth used to when you had it.

How quick is the procedure?

It depends on just how strong and healthy your jaw is. Your jaw may very well be ready to receive the new tooth quickly, but it may also take time to grow around the screw. If your jaw is weak, we can also transplant bone from other parts of your body first, via another procedure called “bone grafting”, to grow a fresh, strong base where the screw can be inserted. If that is the case, the whole process takes more time, but again, it depends on your case.

Does it hurt?

No. Medications and anesthesia are available to reduce or eliminate pain. You shouldn’t feel a thing.

Since it’s an artificial tooth, do I need to care for it as if it were alive?

You should clean and maintain your implant exactly like you do with your living teeth. Though the implant isn’t going to die, it can still allow bacteria to build up, like your other teeth do. Clean all of your teeth with care, and they should all stay healthy.

How long do they last?

If your implant is taken good care of, it should last a long, long time. Perhaps 40 years and sometimes even a lifetime!

What should I eat after the procedure?

Eat soft food. We will help you decide on a diet that works for you depending on the specifics of your case and treatment.

Have more questions? Call us! We would be glad to set up an evaluation.

Bone grafting is something of a miracle. Although you only get one set of bones, it’s actually possible to convince your body to repair itself with new bone material where you need it most. We aren’t talking about growing a whole femur. We’re talking about growing just enough bone material to strengthen weak spots in your jaw.

Why would I ever need this?
Let’s say you need a dental implant. You’re sick of that hole in your mouth where one of your teeth used to be, and you’re ready for a shiny new tooth to fill the gap. The problem is, your bone just isn’t strong enough to support the implant. Maybe you have periodontal disease, and the jaw bone is just too weak. Bone grafting may be necessary.

How does it work?
Simply put, bone grafting is the process of taking a little bone material from another site in your body and placing it where it is most needed. The healthy bone then fuses with the weak bone and encourages your body to grow more bone in the site, rebuilding the area to the point where it can support an implant.

There are a few ways to do this.
Sophisticated sounding terms to impress your friends:

• Autogenous bone graft: Bone is removed from another site in your body and transplanted to where you need it. If you need just a little bone, it can be taken from another site in your mouth. But if there is not enough good material in your mouth, or you need a sizable amount, it can be taken from your hip, or your shin.
• Allograft: Synthetic bone can be grown in a lab, or taken from a cadaver bone. This is a perfectly safe, proven procedure, though your best bet is always your own bone material. Your body knows there’s just no place like home.
• Xenograft: Cow bone. Yes. Your body will accept cow bone. In this scenario, no secondary donor site is needed, so it may be a great option if you are uncomfortable with having bone taken from another site in your body. This is a perfectly safe procedure. Your jaw can be beefed up with bovine bone.

No online article will let you know for sure whether or not you need bone grafting, but it is good to know something about it. Give us a call and come on down for a consultation, and we’ll let you know exactly what we think the best option is for you.

It seems like something out of a science fiction movie, but with our help, you can easily re-grow bone to treat many common disorders in the mouth and make it dental-implant ready! Bone grafting is a common procedure done right in our office. Here is a simple explanation of this effective treatment option.

Reasons for Bone Grafting. There are many different reasons that a person loses bone support in the jaw. Sometimes it is due to injury, sometimes it because of missing teeth, and other times it is a due to a developmental defect or periodontitis. Bone graft surgery, also called regenerative surgery, is used to replace bone and soft tissue by actually stimulating the body’s natural ability to re-grow the lost tissue.   If your jawbone is inadequate to support dental implants, bone grafting can be used to build a sturdy foundation for implant-supported teeth.

It’s A Natural Process. With bone grafting surgery, a piece of bone is removed from another area of your jaw or your body, often the hip, and is transplanted into your jawbone. Sometimes we may use donor or synthetic graft material. Your body uses the implanted bone graft material as a frame on which it can grow new bone. Over time and with your body’s own healing mechanisms, the grafted bone fuses and becomes an integrated part of your existing bone. Bone grafting is a safe and very successful procedure that can be done in the office under local anesthesia. After the procedure, you will be given antibiotics and pain medication if needed. Swelling can be treated with ice packs applied to your face. Most patients proceed with their normal life the next day. Be sure to follow medication instructions and keep your mouth as clean as possible while you heal.

Healing Times. Healing time following bone grafting depends on the amount of bone loss and the location of the graft area. Maintaining a healthy amount of bone tissue around your teeth is crucial to keeping up your oral health. We are more than happy to explain different materials and techniques that can be used for an optimal outcome.

Bone grafting allows your body to rebuild itself. It can be a great way to restore your natural jaw line and smile. Let us help you decide if bone grafting is the right procedure for you!

Was this word the invention of an evil doctor who loves long and complicated words? No! Osseointegration actually derives from the Greek osteon, bone and the Latin integrare, to make whole. It’s a physical process that was first observed by Swedish researchers in the 1960’s and refers to the functional connection between a titanium implant and living bone. Simply put, without osseointegration, dental implants wouldn’t work!

Osseointegration is a natural process: When the titanium dental implant connects to bone cells, it is locked into the jawbone, forming a solid bond. While the process is natural, the implementation isn’t simple. Implant healing times and initial stability depend on implant characteristics and to a large extent on your doctor! We have ample experience in placing dental implants and therefore can ensure that you receive the best care and outcome when it comes to implant surgery and the healing process.

The first evidence of the bone bonding with the implant occurs after a few weeks, while a more robust connection progresses over the next months or years. The osseointegration process will make the implant resistant to external shocks over time, but it can still be damaged from trauma or poor care.

The benefits of dental implants can’t be overstated! Not only do they give you a fully functioning bite back, they also prevent your jawbone from deteriorating and protect your facial profile.

Give us a call if you have questions about the dental implant process!

Injuries to the face and mouth are emotionally upsetting as well as physically damaging. It’s extremely important to have medical and dental care by experts who know how to address the psychological, medical, and aesthetic elements of recovery. This blog will cover the most common causes of facial trauma and the types of injures that may occur. As with most injuries, prevention is the best medicine, so we will cover tips in avoiding facial trauma all together!

Most Common Causes of Facial Trauma: There are many ways in which the face can be damaged. Accidents, falls, automobile crashes, work related injuries, and interpersonal violence are among the most common causes for adults. For children, sports related injuries are the leading cause. Children who participate in contact sports, cheerleading, and gymnastics are especially at risk, especially for dental trauma. Dental trauma accounts for 17% of injuries to the body for children, according to the American Dental Association, compared to 5% across all ages. It is most frequently observed in males compared to females, and usually involves the front teeth.

Types of Injuries: Every year about 3 million people are treated for facial trauma according to the American Association of Oral and Maxillofacial Surgeons. Soft tissue trauma includes any cuts to the face or gums. Avulsed, or knocked out teeth are another type of injury, and must be dealt with immediately to increase the chances for reimplantation. Bone injuries, such as fractured jaws, cheekbones, and noses can also occur as well as damage to the nerves in the eyes, face and salivary glands. It is extremely important to have facial trauma assessed and treated by an expert in facial trauma. Besides the aesthetic reasons, serious health complications can occur, even from a small amount of damage. Depending on the location of the injury, speech, swallowing, and breathing can be affected. For dental injury, teeth that are loose in their sockets can make eating difficult and cause speech impediments. Chipped, broken, or misaligned teeth can cause TMJ and other functional problems, in addition to the loss of confidence in your appearance.

What You Can Do to Prevent Injuries: Using a mouthguard during sports or other high-risk activities is the most effective way to prevent injury. Studies in high-risk populations for facial trauma show relatively low compliance in using mouthguards. We can also recommend helmets, face shields, and protective eyewear that can further reduce your risks. The spring season seems to bring an increase of children to the emergency room as kids are eager to get on their bicycles, skateboards, and swing sets. As a parent, educate your child in safety measures and supervise their activity.

When facial trauma does happen, quick action is important. Please call us as soon as possible so we can best advise and support you in your recovery. Accidents happen, and when they do, we want to help!

Sometimes jaw problems may require more than orthodontic treatment. Jaw surgery, also known as orthognathic (or-thog-NATH-ik) surgery, can be a great choice for moderate to severe jaw issues. Oral and Maxillofacial Surgeons (OMS) are specially trained in orthognathic surgery that can dramatically improve chewing, speaking, breathing, and in the process enhance a patient’s appearance. If you are considering orthognathic surgery, here are some important things to know.

Why You May Need It. Most conditions that require corrective surgery are the result of abnormal growth of the jaws as they develop. These conditions are often inherited. Other less common causes are facial injury or arthritis of the jaw joints.

Orthognathic surgery may be indicated for the following conditions:

-Difficulty biting, chewing or swallowing food

-Excessive wear or breakdown of teeth

-Chronic jaw or jaw joint pain caused by TMJ (temporomandibular joint disorder) or other jaw problems

-Improve “gummy” smiles, where the lips don’t fully close and show large areas of the gums or “toothless” smiles, where the lips cover all of the teeth

-Facial imbalance, including underbites, overbites, crossbites, and deficient chins

-Sleep apnea

Treatment Team. While we will plan and perform the actual surgery, we will also be working with your dentist and orthodontist for the full course of treatment. Most treatment includes braces for 9 to 18 months before surgery to level and align your teeth. After your jaw heals from surgery, which typically takes about 6 weeks, your orthodontist will finish your alignment and remove the braces. Depending on the severity of your jaw problem, the entire treatment process can take from 12 to 24 months. We know that this is a long-term commitment and we will do our best to minimize the length of treatment and provide you with the best estimates of what will be required.

What to Expect. Jaw surgery can be performed on the upper jaw, lower jaw or both. It is best to perform the surgery after growth stops, usually ages 13 to 15 for females and 16 to 18 for males. Jaw surgery usually can be performed entirely inside your mouth, so no facial scars show. Once your jaws are properly aligned, screws and bone plates secure the bones into their new position. In some cases, extra bone may be added to the jaw. In this case, we transfer the bone from your hip, leg or rib and secure it with temporary wires.

Surgery can take place in an in-patient or outpatient setting, depending on the procedure required. Facial swelling, while variable, is common and increases for a couple of days following surgery before it subsides. More subtle changes in your appearance will continue for up to a year. For this reason, our students generally choose to have the surgery during school vacations. For adults, one to three weeks is usually required before returning to work.

Jaw surgery can enhance your comfort, appearance, and improve your overall health. We are here to answer any questions you have. Please make an appointment for a consultation so we can review the potential of this life changing treatment with you!

It’s estimated that 125 million Americans are missing at least one tooth. If you are one of them, you may be considering dental implants for tooth replacement. We think it’s important for you to know what factors make a person a good candidate for such a procedure. Here are a few things to consider.

Most People Are Good Candidates. Dental implants can replace one, several, or all of your teeth. They can be used in place of bridges or dentures. Good candidates have healthy gums and are old enough so that their jawbone has stopped growing. You should also have enough bone to support and anchor the implants. Even if you have lost bone in your jaw, however, you may still be a good candidate for implants. In fact, dental implants may be recommended to prevent further bone loss. In these situations, bone can actually be rebuilt with grafting procedures as part of the implant process.

Evaluation. Successful implantation starts with a thorough evaluation of your jaw, teeth, mouth and overall health. You will receive a mouth X-ray and possibly a Computed Tomography (CT) scan. This will help us identify areas of bone loss and carefully see the shape of your sinuses and nerve location to make accurate assessments for your treatment. We will also do a thorough medical evaluation, as your overall health and history plays a big role in how well your implant will heal and fuse to the bone.

People At Risk of Poor Outcomes. Uncontrolled diabetes, cancer, radiation to the jaws, smoking, alcoholism, or uncontrolled gum disease are all risk factors that can adversely affect your outcome. You may still be a good candidate with one of these diseases, but we’ll want to thoroughly assess your situation and work with you and your doctor to increase your overall health and functioning. People who take certain medications, such as steroids or drugs that suppress the immune system may not be suitable candidates, either. And people with certain habits, such as people who severely grind or clench their teeth may put too much pressure on the implants, causing long term damage.

Overall, dental implants have a very high rate of success and patients tell us how happy they are with the outcome. If you are considering implants, we can complete a careful examination to determine what options are best suited for you. Call us today to make that appointment!

When compared to the costs of other tooth replacement options, boy do dental implants seem expensive! Yet you may be surprised to learn that, in the long run, dental implants can be more affordable than their traditional counterparts. Understanding this procedure and the factors that determine the costs can help you decide if dental implants are a good investment for you!

What is a Dental Implant? A dental implant is a permanent replacement for lost teeth. It is made of an artificial tooth firmly held in place by a tooth root made of titanium (which is biocompatible) that is surgically placed into your jaw. Dental implants help stabilize the jaw and the bone around it to avoid future bone loss and maintain the shape of your jaw. They never have to be removed and feel more natural and comfortable than dentures. And unlike bridges or crowns, which are cemented in, the chances of slippage or shifting are eliminated. With implants, talking and eating become worry free.

Steps In a Dental Implant Procedure. We will first use extensive imaging to determine bone health, height, and thickness to assess your bone and teeth structure carefully. The surgery itself is done in our office in separate stages. First, the implant is surgically placed into your jawbone, completely hidden within your gum tissue. Once the implant has integrated into your bone, a healing process of about 4 to 6 months, the next stage is the placement of the abutment, or the post that penetrates the gum and will connect the replacement tooth to the implant. The final stage involves attaching your artificial tooth (made from impressions of your natural tooth) to the abutment. If more than one tooth is being replaced, a removable bridge is used, as it is more affordable than implanting each tooth separately. For a bridge, it takes only one implant on either side to span an area holding several teeth. The bridge snaps into place for a more permanent and natural fit than dentures.

Factors That Affect the Cost. While dental implant surgery is a safe and routine option, it is a complex procedure that takes time and expertise to be done effectively. There are many factors that will influence the final costs including what X-ray and CT scans are necessary to evaluate and assess the implant area and the brand and material of the post, abutment and artificial teeth. However, the biggest cost factor is the complexity of the surgery itself. For example, how many teeth are we replacing and what is the location? Will additional procedures, such as bone grafting or sinus elevation be required? We do our best to make sure that your estimate includes all of the possible costs of each of the steps of your procedure.

While dental implants may seem expensive, they are often more affordable in the long run than traditional restoration methods such as crowns and bridges, which are more vulnerable to damage and usually require repairs or replacement every few years.

Dental implants are known to have a 95% success rate when completed by professionals with the right experience and training, such as us! Because dental implants offer a permanent solution, are natural and comfortable, and require little maintenance, they are a cost effective choice for most of our patients.