Oral & Maxillofacial Surgery of Central New Jersey

When Should I Start Getting Botox?

'students holding books'BOTOX® can sometimes be a sensitive subject, particularly among the younger crowd. Most people associate BOTOX® with people 40 years and older, who are beginning to notice more wrinkles. But middle age is not the only time during which a person can receive BOTOX® treatment. Many doctors recommend that patients get BOTOX® at a younger age not only to remove wrinkles, but also to prevent them in the future.

There are benefits to getting BOTOX® done at any age, so what is the right age for you?

BOTOX® in your 20s: Having BOTOX® in your twenties doesn’t mean that you are full of wrinkles and facial lines already. Rather, it is done as a preventative measure. Doctors have begun recommending that people who are open to getting BOTOX® later in life should start in their mid to late 20s in order to prevent wrinkles from occurring in the future. This works by suspending movement of the muscles in the face that cause wrinkling. Consistent upkeep on your face will help lessen and decrease the likelihood of having significant wrinkles when you are older.

BOTOX® in your 30s: This decade is the time when wrinkles and facial lines can start becoming more noticeable on your face. Getting BOTOX® done on a regular basis throughout your thirties can have a significant improvement on the way your face looks and feels. It is critical to have BOTOX® done in your 30s in order to not only reduce the severity of future wrinkles, but to keep your face looking young and fresh.

BOTOX® in your 40s and on: Using BOTOX® regularly throughout your forties and beyond can definitely be beneficial to how your skin looks, but unfortunately you will not receive the same results as if you had started in your 30s. Starting BOTOX® at this stage in life can decrease the significance of your wrinkles, but it might take more facial work than just BOTOX® in order to get the results which you really want.

If you have any more questions about BOTOX® and what age is right for you to start getting treatments, feel free to contact us today!

Impacted

'impacted wisdom tooth'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 Princeton Junction Office Phone Number 609-716-4600!

3D Printers and Bone Grafting

'3D printed bone grafts'There is exciting news in bone grafting technology that will hopefully find its way into the oral surgeon’s office over the next decade! Researchers have been able to create a synthetic bone material using 3D printers that may be better than what is being used now.

3D printers create three-dimensional objects out of a variety of materials using a computer as a precise guide. Although the concept has been in the news a lot recently, the practice actually dates back to before the 21st century. In fact, 3d printing’s roots go back to the early 1980s. Since then, everything from jewelry to synthetic human organs has been printed, much to the amazement of modern society!

And now, surgeons have successfully implanted the 3D-printed synthetic bone grafting material into animals with bone defects. This “hyperelastic bone” was made using just the right combination of bioactive materials and polymers to make a material that could be layered while still wet, allowing for better adherence between layers.

Here are some of the expected benefits of this new material:

  • Very elastic, allowing for cutting without crumbling, which can be a problem with current grafting materials.
  • Blood vessels move in quickly because the material is porous.
  • Biodegradable as the body replaces it with genuine tissue.
  • Doesn’t dry out right away.
  • So far the animals haven’t rejected the implant, which could mean less complications for humans as well.
  • Could be a great option for children since it will grow with them.

While human trials are potentially five or more years away, the news is very exciting for the surgical community, and we are can’t wait to see what benefits this will bring to our patients.

To find out more about bone grafting in general or to set up a consultation with our office, please call us at Princeton Junction Office Phone Number 609-716-4600.

Immunotherapy and Oral Cancer

Yo'woman thinking about oral cancer'u 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 cancer 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 Oral & Maxillofacial Surgery of Central New Jersey, our commitment to your care, comfort, health and safety is evident from the minute you walk through our door. Call us at Princeton Junction Office Phone Number 609-716-4600 for more information about oral cancer.

Preserving your Jaw after Extraction: Socket Preservation

'x-ray of man with jaw pain'If you come to see us for an extraction, you may hear us talking about “socket preservation” or ”ridge augmentation”, and you might be wondering, what is that?

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 Princeton Junction Office Phone Number 609-716-4600 to see if socket preservation is an option for you – it could save your smile!

Oral & Oropharyngeal Cancers

Worldwide, over 550,000 new cases of Oral, Head and Neck cancer are diagnosed each year.

Oropharyngeal cancer is slightly different from oral cancer. Oropharyngeal cancers are related to HPV (Human papilloma virus) and usually occur in the tonsils or at the base of the tongue, while oral cancers are in the mouth and usually associated with tobacco use.

The Oral Cavity
The oral cavity includes the lips, the inside lining of the lips and cheeks, the teeth, the gums, the front two-thirds of the tongue, the floor of the mouth below the tongue, and the bony roof of the mouth – also known as the hard palate.

The Oropharynx
Behind the wisdom teeth is considered the oropharynx, which is part of the throat just behind the mouth. It also includes the base of the tongue, the soft palate (back of the mouth), the tonsils, and the side and back wall of the throat.

Categories
Oral and Oropharyngeal cancers are sorted into 3 categories: Benign (non-cancerous), harmless growths that may develop into cancer, and cancerous tumors. This is why regular check-ups with your dental professional are key to your overall well-being.

The Team Involved
The treatment of head and neck cancers does not involve just your dental team, the assistance of many different professionals contributes is required. There may be surgeons, radiation oncologists, medical oncologists, dentists, nutritionists, and speech therapists all involved in your treatment.

Oral cancers are found as late stage three and four diseases about 66% of the time.
It is very important for you to check yourself at home as well as visiting your dentist.

Call Oral & Maxillofacial Surgery of Central New Jersey to schedule your routine dental check up and oral cancer screening today 609-716-4600

Little, Medium, Big Bone Grafts!

'tooth with surrounding bone'Bone grafting is a straightforward procedure that is immensely beneficial for numerous reasons. In the instance of a missing tooth (or teeth), the jawbone can begin to slowly degrade. The jawbone holds teeth in place, and once a tooth is no longer present, the bone doesn’t have anything to support. There are different types of bone grafts:

Little Bone Graft

In the case of a simple, single lost tooth, the ideal course of action is to not lose excess bone. In this process, sterile, demineralized human bone granules are packed into the tooth socket immediately after tooth extraction. This procedure is very simple, and does not add anything to your recovery time. Over the next several weeks, your own bone will fill the tooth socket and preserve the bone height enough for you to have the area restored.

Medium Bone Grafts

If a tooth was removed a long time ago, there is likely to already be some bone loss impeding the restoration of the area. In this case, the area of the missing tooth is opened with a small incision, the bone surface is prepared, and demineralized bone graft granules are used to build up the area. Many surgeons prefer to use a little bit of the patient’s own bone in this procedure in order to ensure the best results possible. If your own bone is used, your surgeon will take it from another area of the jaw bone, usually near the wisdom tooth area, shaving off tiny granules and combining them with the demineralized bone. The bone graft will heal and integrate with the surrounding bone tissue. This type of graft can be used for one or multiple areas of missing teeth.

Big Bone Graft

Patients who have many missing teeth and who have been missing many teeth for many years, have often experienced advanced bone loss. In those who wear dentures, the lower jaw bone often recedes so severely that they can no longer wear them. Extensive bone grafting is necessary in order to consider restorative methods. A combination of demineralized, sterile human bone and the patient’s own bone is used to restore the jaw bone, creating enough width and height to consider dental implants. The patient’s bone is supplied by another part of the jaw, hip, or tibia. Bone granules are also used to enhance and strengthen the graft.

Bone grafting is a surgical procedure that takes time. However, it plays an essential role in making new teeth possible, and will ultimately be a positive process! For more information, call 609-716-4600 today for a consultation with Oral & Maxillofacial Surgery of Central New Jersey.

Dental Implant Success

What do you use your teeth for? Eating, drinking, speaking, laughing, the list goes on! How are these affected when you have tooth loss?

'dental implant between teeth'If you have missing teeth, you could be missing a lot! A very reliable and safe method for replacing teeth is dental implants.

Dental implants permanently attach prosthetic teeth to small posts or “roots” that are embedded in the jaw. These posts are made of titanium, and securely fuse to the jaw bone, this helps restore the full functionality of previously missing teeth.

Dental implants not only effectively and reliably replace missing teeth, but also help prevent the loss of jawbone density, restore the support of facial structures, and provide you with the support you need to effectively use your teeth.

The procedure for dental implants can be a quick and easy, and in some cases, can be done in a single day. Your implants become part of you, so they eliminate the discomfort of removable dentures. They also prevent the embarrassment of removing dentures at every snack or meal, as well as the need for denture adhesives.

Sliding dentures can make chewing difficult. Dental implants function like your own teeth, allowing you to eat your favorite foods with confidence and without pain. Nearby teeth are not altered in order to support a dental implant, thus more of your own teeth are left intact, improving oral health in the long-term as well as your oral hygiene.

Dental implants are very durable, lasting several years, and if they are in good care, can last a lifetime.

Don’t miss out with missing teeth, get your smile back and feel better about yourself!

Here at Oral & Maxillofacial Surgery of Central New Jersey we specialize in dental implants, so give us a call today at Princeton Junction Office Phone Number 609-716-4600 to discuss your future implant success!

Wisdom Tooth Removal – Aftercare

'woman smiling after wisdom teeth removal'

Having your impacted wisdom teeth removed is a serious surgical procedure, and post-operative care is extremely important! Read on for instructions on how to care for your sore mouth, and how to minimize unnecessary pain and complications.

Immediately Following Surgery

Keep a firm, yet gentle, bite on the gauze packs that have been placed in your mouth to keep them in place. You can remove them after an hour if the bleeding is controlled. If the surgical area continues to bleed, place new gauze for another 30 to 45 minutes.

Be careful!

Do not:
• Rinse vigorously
• Probe the area
• Smoke (hopefully you don’t!!)
• Participate in strenuous activities
You can:
• Brush gently (but not the area)
• Begin saltwater rinses 24 hours after surgery (mix 1 tbs of salt with 1 cup of water). Make sure to swish gently. These rinses should be done 2-3 times a day, especially after eating.

Enjoy some down-time!

Keep activity level to a minimum! Enjoy a day of couch or bed-rest, as being active could result in increased bleeding. Avoid exercise for 3-4 days, and when you do begin exercising again, keep in mind your caloric intake has been reduced so you may feel weaker.

Bleeding

As you’ve just had surgery, some bleeding will occur and it’s not uncommon to ooze blood for 24-48 hours after your procedure. REMEMBER-the blood you see is actually a little blood mixed with saliva, so don’t panic!
If excessive bleeding persists:
1. Try repositioning the packs. They may not be putting enough pressure on the site.
2. Sit upright and avoid physical activity.
3. Use an ice pack and bite on gauze for one hour.
4. You can also try biting on a moistened tea bag for 30 minutes (the tannic acid in tea promotes blood clotting).
5. If bleeding persists, please call our office at 609-716-4600.

Pain

Unfortunately, some pain is to be expected after surgery. Try not to let the anesthetic wear off before taking your prescribed pain medication. Dr. Bradley, Dr. Sasportas or Dr. Jaffery will have discussed a plan to manage your pain, make sure you follow these instructions.

Diet

Eat nourishing food that takes little effort.
Avoid:
• Extremely hot foods
• Straws (for the first few days)
• Chewing (until tongue sensation has returned)
• Smaller foods that can become stuck in the socket area
• Skipping meals—while eating may seem like a lot of work, you need your nourishment to be able to heal and feel better!

Day 2 and 3 Following Surgery

Swelling

Swelling is a completely normal occurrence. Keep in mind, swelling will usually be at it’s worst in the 2-3 days after surgery. You can minimize swelling by applying a cold compress (covered with a towel) firmly to the cheek next to the surgical area. Apply the pack with 20 minutes on, and 20 minutes off for the first 24-48 hours. Also make sure to take the medication prescribed by Drs. Bradley, Sasportas or Jaffery. This helps with pain and swelling.

Keeping your mouth clean

Keeping your mouth clean is very important! Continue saltwater rinses as often as you’d like, but at least 2-3 times a day. Begin your normal oral hygiene (remember to brush softly and don’t do anything that hurts)!

Healing

Everyone heals differently, but your timeline should look similar to this:
1. Day 1-2 will be the most uncomfortable and you will experience some swelling.
2. Day 3 you should be more comfortable and while still swollen, you should be able to begin a more substantial diet.
3. Day 4 and on you should see a gradual and steady improvement.

Other Normal Things

• Discoloration. Bruising is a normal post-operative occurrence you may notice 2-3 days after surgery.
• Stiff jaw muscles. You may find it difficult to open your mouth wide in the days following your surgery. This is normal and usually resolves itself within a week after surgery. Stretching these muscles may help to speed up recovery.
Since no two mouths are alike, do not take advice from friends (even well-intended advice could cause a healing set-back). The advice given to you from Drs. Bradley, Sasportas or Jaffery and the Oral & Maxillofacial Surgery of Central New Jersey team are tailored to fit your needs. Please call us at 609-716-4600 if you have any questions or concerns about your recovery. Happy healing!

Types of Jaw Surgery

'side profile of man'

Your jaw consists of two parts; the maxilla or upper jaw and the mandible or lower jaw . Sometimes these are misaligned and need to be put back into place for bite reasons, or for aesthetic purposes. Corrective jaw surgery straightens or aligns the jaw, and is often referred to as “orthognathic” surgery; “orthos” meaning to straighten and “gnathic” relating to the jaw.

There are a few different types of jaw surgery, depending on which part of your jaw requires correcting;

Maxillary Osteotomy (Upper Jaw)
This type of surgery corrects a significantly receded upper jaw, cross bite, or when you have too many or too few teeth showing. It also can adjust an open bite.

Mandibular Osteotomy (Lower Jaw)
This surgery corrects a significantly receded lower jaw. The surgeon moves the jawbone forwards or backwards depending on the best adjustment and bite alignment.

Genioplasty (Chin)
A deficient chin often accompanies a severely receded lower jaw. Typically, surgeons can alter the jaw and restructure the chin during the same surgery.

Once your jaw is aligned, tiny screws and plates hold the bone into position. These screws and plates are osseo integrated and are specially formulated to be compatible with your body. They become integrated with your bone over time and do not have to be taken out.

Extra bone can also be added to your jaw if there is insufficient bone. This can be grafted from your hip, leg, or rib.

Often these types of jaw surgeries are performed entirely inside the mouth without any evidence on the skin surface as to what procedure has been performed. There are no facial scars on the chin, jaw or around the mouth.

Often with extensive jaw surgery, the process is carried out after you have had braces, so your teeth are aligned and ready for your jaw to be moved. Braces are placed anywhere from 9 to 18 months before jaw surgery.

Jaw surgery can take up to 2 years to complete, but the results are for life! Know your jaw facts; Talk to us today to discuss your options!