dr. barrett

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 806-792-6291.

Pain

Unfortunately, some pain is to be expected after surgery. Try not to let the anesthetic wear off before taking your prescribed pain medication. Drs. Barrett or Higley 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. Barrett or Higley. 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. Barrett or Higley and the West Texas Oral Facial Surgery team are tailored to fit your needs. Please call us at 806-792-6291 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!

Pre-Implant Bone Augmentation

'man lifting weights'

We are all unique, and so is your mouth! Sometimes, your jaw needs to be beefed up a little, and we’re not talking a hefty workout at the gym.
You may have lost teeth due to gum disease which has resulted in bone loss, or you could just have been “born that way” and need a little help expanding!

Don’t let life get you down! We’ve got these options for you;

Sinus Lift or Sinus augmentation:
A sinus lift is often performed on people who have lost teeth in their upper jaw or are lacking adequate bone density. This procedure adds bone between your jaw and the maxillary sinuses (which are on either side of your nose), the area of your molars and premolars. To make room for the bone, the sinus membrane has to be moved upward, or “lifted.”
The new bone means implants can be placed. This procedure does not affect speech, intonation or cause sinus problems.
Sometimes this procedure is required in the alveolar ridge. The alveolar ridge is the part of the gums immediately behind the upper front teeth. Alveolar ridges contain the sockets, or alveoli, of the teeth. You can feel it on the upper palate if you say words like “tight”, “dawn” because the consonants are made with the tongue tip or blade reaching for this alveolar ridge.

Ridge Expansion or modification: If your jaw isn’t wide enough to support dental implants, bone graft material can be added to a small ridge, or space that is created along the the jaw. Malformation in the lower jaw can result in not enough bone to place dental implants and it can also cause an unattractive indentation in the jaw line near the missing teeth that may be difficult to clean and maintain.

During ridge expansion, the bony ridge of the jaw is increased and bone graft material is inserted and allowed to heal before placing the implant.
Ridge modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come. It can enhance your restorative success both aesthetically and functionally.

Whether you require a lift or expansion, the bone usually will be allowed to develop for about four to 12 months before implants can be placed. However, in some cases, the implant can be placed at the same time the ridge is modified.

What are you waiting for? Ask us today what your implant options can be!

Pediatric Facial Trauma

'child holding soccer ball in front of face'

We’ve all had our share of trips, bumps, and even broken bones in our childhood years! (If you haven’t, then you’re very lucky!)
As the saying goes, children are very resilient, and this is actually due to their biology. Children have “bendy bones” which are more likely to bend and crack under pressure rather than break.
The term is referred to as greenstick fractures; similar to when a green branch of a tree bends and cracks, but doesn’t break off.

Considering how much energy children have, pediatric facial trauma is actually very rare! Of all facial trauma, only 15% is pediatric (0-18 years).

The maxillofacial region is related to a number of vital functions, such as vision, smell, eating, breathing and talking. It also plays a significant role in appearance.
When treating children’s maxillofacial injuries, we take into consideration the difference anatomically between adults and children. Facial trauma can range between minor injury to disfigurement that lasts a lifetime if not treated correctly.

Children have much more flexibility in their facial bones, as well as smaller sinuses, multiple fat pads and unerupted teeth. In adolescents an increase in risk-taking behavior and the reduction of parental supervision results in an increase in facial fractures. Contact sports, physical play, riding bicycles, and even road traffic accidents all contribute to pediatric facial trauma.

A full treatment plan is always taken into consideration when we deal with facial trauma. The age of the patient, anatomic site of the trauma, complexity of the injury and how long since the injury occurred is taken into account. Ideally, don’t put off your incident for more than 4 days! This is prime healing time, and if any longer, could extend the healing and complicate the treatment process.

This is why it is very important to always wear protective gear! Remember to always have your children wear seatbelts, and invest in booster or car seats so your children can receive the full protection of seatbelt coverage.
During play, remember shin guards, mouth guards and helmets! Especially when riding a bike!

Play it safe, and if life throws a curve ball (at your face!) give West Texas Oral Facial Surgery a call at West Texas Oral Facial Surgery Phone Number 806-792-6291

Oral Cancer and Hepatitis C

'Oral Cancer' 'Hepatitis C'

The Journal of the National Cancer Institute (JNCI) recently found that individuals infected with the hepatitis C virus are two to five times more likely to develop head and neck cancers. The JNCI study found that the risk for hepatitis C patients of developing head and neck cancers more than doubled for oral cavity and oropharynx cancers, and increased nearly five times for larynx cancers. As well, patients that are hepatitis C virus-positive were also more likely to test positive for human papillomavirus (HPV).

The question remains, how does hepatitis C virus increase oral cancer risk?

The JNCI research found that patients infected with the hepatitis C virus had a higher odd ratio of having cancer of the oral cavity, oropharynx, or larynx than those without hepatitis C virus infection. Enhanced replication of hepatitis C virus in oropharyngeal tissues may in fact contribute to chronic inflammation, ultimately prompting cancer development. Human papillomavirus is known to suppress local immune response, which may accelerate the production of hepatitis C virus in oropharyngeal cells. The JNCI notes that human papillomavirus and hepatitis C virus may play a “synergistic role” in the development of oropharyngeal cancers by stimulating loss or destruction of tumor suppressor proteins p53 and retinoblastoma protein.

The JNCI notes that one of the study’s limitations is that it didn’t include individuals with hepatitis C virus who didn’t have oral cancer. All and all, it is important to take away from The Journal of the National Cancer Institute’s study that it is important to educate Hepatology (study of liver, gallbladder and pancreas health) and infectious disease specialists. These doctors who treat patients with hepatitis C virus need to understand that the hepatitis C virus not only drastically affect liver health, but it’s also a systemic infection that can drastically affect oral health.

Your oral health is important to us. If you suspect that your oral health is at risk, give West Texas Oral Facial Surgery a call today and schedule an oral cancer screening!

Eating After Wisdom Tooth Extraction

'woman in pain from wisdom teeth'

When it comes to getting your wisdom teeth pulled, you may be stressing about the long list of foods you can’t eat. Don’t worry – you won’t starve! We want your recovery to be as quick and painless as possible, so keep reading for an easy-to-follow guide to eating after your wisdom tooth removal!

DONT’S

  • Remember not to drink from a straw during your recovery. Using a straw could rip out your stitches or blood clots, causing dry socket.
  • The bubbles in carbonated drinks can also cause dry socket by loosening blood clots, so it’s best to avoid sodas.
  • Don’t eat crunchy foods like nuts, chips, and popcorn because they are hard to chew and can easily get stuck in your extraction sites.
  • Avoiding acidic foods and beverages can keep you from experiencing pain and stinging.

 

DO’S

  • Any liquids are fair game, like soups and broths. Lukewarm beverages are best, because you may experience temperature sensitivity.
  • Yogurt, pudding, applesauce and Jell-O are some go-to recovery foods: no chewing involved! Stick to these post-extraction staples for the first 24 hours after your surgery before moving on to soft foods that require chewing.
  • Mashed potatoes are great for the first few days because you can flavor them with gravy, butter, garlic, sour cream, cheese, the list goes on. Soft, starchy and filling, you won’t feel like you’re missing out on solid foods with these!
  • When you’re ready to move on to chewable foods, eggs are soft and can be eaten with just about anything.
  • You can even eat pancakes! They’re light, fluffy, and easy on your extraction sites (Tip: you can make breads even easier to chew by letting them sit in your mouth for a few seconds and softening them with your saliva).
  • Pasta is totally doable if you prepare it right. Macaroni and cheese is perfect because you can swallow the tiny noodles whole or chew them with your front teeth. You can also overcook your pasta noodles to make sure they are soft and easy to chew.

Your wisdom tooth extraction will be over with before you know it, and as long as you avoid difficult-to-chew foods you’ll be on your way to a speedy recovery!

How Many Wisdom Teeth Do You Have?

How Many Wisdom Teeth Do You Have?

Wisdom tooth removal has become somewhat of a rite of passage – puffy-cheeked post-extraction photos, a diet of Jell-O and mashed potatoes. But not everyone gets their wisdom teeth taken out. In fact, not everyone has wisdom teeth at all! Have you ever wondered why some people have four wisdom teeth while others have fewer or even none? We’ve got the facts behind how many wisdom teeth people have and why! 'drawing of wisdom tooth'

Why do we have wisdom teeth?

Third molars, or wisdom teeth, were once very useful to our ancestors. Because prehistoric man’s diet of hard-to-chew plants and uncooked meat required powerful chewing muscles, our ancestors’ jaws were large enough to fit 32 teeth, not just 28. Now that humans have evolved a better means of chewing and digesting our food, we no longer have large jaws, so we simply have no need or no room for wisdom teeth. Many scientists believe humans are currently evolving third molar hypodontia, or the lack of wisdom teeth, due to their inability to develop in the first place.

How many people have wisdom teeth?

About 20-25% of the human population is born with 1 to 3 wisdom teeth, and 35% is born without any wisdom teeth at all.

Why do some people have wisdom teeth and some don’t?

There are a few reasons why scientists believe that not everyone develops wisdom teeth:

  1. Genetics: Some evidence suggests that a genetic mutation occurred hundreds of thousands of years ago, causing some people to be born without wisdom teeth.
  2. Environment: Percentages of people who develop wisdom teeth varies from culture to culture. Certain ethnic groups are known for low percentages of wisdom teeth development, while others are known for high percentages. Environmental factors during dental development are also a possible explanation.

Will wisdom teeth become obsolete?

With the number of people lacking wisdom teeth steadily growing, it’s possible that we could someday completely evolve to not develop wisdom teeth at all. Scientists have experimented with chemically preventing the development of wisdom teeth.  Researchers have found that children ages 2-6 that are given local anesthesia for dental work have a higher chance of not developing wisdom teeth later on. Maybe in the future, simple injections at a young age will keep all of us from having to go through wisdom tooth extraction!

Smile Emergency: Facial Trauma and Cosmetic Dentistry

Accidents happen! Facial trauma can occur anywhere from sporting events and motor vehicle accidents, to work or home. Something as simple as an accidental fall could leave you with severely damaged teeth – but there’s no need to worry! Oral surgery and cosmetic dentistry offer a world of solutions for traumatic tooth injuries. Take a look at some common tooth injuries and available treatment options! 'woman smiling after surgery'

 

Tooth Injury:

Broken blood vessels in the tooth’s pulp can cause tooth discoloration. Tooth trauma causes blood to leak into the dentin layer and become visible through the enamel.

Treatment

Veneers are porcelain shells that are bonded to the front of teeth to improve appearance. They’re designed to match the color of your natural teeth, making them a perfect solution for treating discoloration – chipped teeth, too! Veneers are durable and, if properly cared for, will only have to be replaced after 10-20 years of use.

Whitening is another treatment for trauma-induced discoloration. There are a variety of whitening options to restore your tooth’s natural color, from at-home whitening treatments to in-office bleaching.

 

Tooth Injury:

Chipped and fractured teeth are among the most common results of sports injuries and falls.

Treatment

As mentioned above, veneers don’t just treat tooth discoloration – they also fix chips and fractures. However, they’re not always necessary. Bonding is sometimes all it takes to fix minor chips. During a bonding treatment, we etch the surface of the tooth and place a plastic, tooth-colored resin with a bonding liquid to replace any missing tooth fragments.

Crowns are porcelain caps that are secured over damaged teeth and cemented in place to restore appearance and function. They also correct tooth decay and fractured fillings, stabilizing teeth after root canal therapy. Porcelain crowns resemble natural teeth and can last anywhere between 5 and 15 years.

 

Tooth Injury:

Avulsed (knocked out) teeth need to be replaced to maintain your jawbone health. Without teeth to support, the jawbone deteriorates from underuse.

Treatment

In some cases, the missing tooth can be reattached. However, this isn’t always an option. Dental implants are artificial teeth that are secured in the gum with a metal screw and serve as placeholders for missing teeth. They look just like real teeth and are equally functional.

 

Give us a call if you want to transform your smile emergency. We are more than happy to discuss treatment options and get you back on track after your facial injury!

The Benefits of Jaw Surgery

As doctors, we always weigh the risks and benefits of any procedure or medication therapy. One of the most significant procedures that we perform in our office is orthognathic surgery, more commonly known as “jaw surgery”. 'man holding jaw in pain'

Orthognathic surgery has the ability to enhance a patient’s life, giving him or her the comfort needed to eat properly and, often, the freedom from pain. Because the decision to have jaw surgery is such a serious one, we would like to take a moment to look at the positive side of the procedure in this blog, focusing on the benefits of orthognathic surgery:

  • Pain Relief – There are several reasons that a person may experience jaw pain bad enough to warrant orthognathic surgery. They may have unnecessarily been causing excessive wear and tear in the joints over many years and living with constant inflammation. Correcting the alignment of the jaws through surgery is sometimes the only way to set the jaw back on the correct path, reducing strain and therefore pain. Another common scenario occurs with injury to the jaw, often from trauma caused by car and sports accidents. If the jaw is knocked too far out of place or suffers significant trauma, it may not heal on its own and may require resetting through a surgical procedure. These two situations represent occasions where the benefits of orthognathic surgery far outweigh the risks.
  • Regular Eating Patterns – A misaligned jaw can make it difficult to chew and swallow, particularly if your teeth do not line up correctly. Often, braces are not enough to correct the alignment issues with the teeth and the jaw itself must be altered. Sometimes, patients don’t even know that they are working too hard to chew because they are used to it always having been that way. Once their bite is corrected through surgery, they are pleasantly surprised to find a significant enhancement in their quality of life.
  • Better Overall Health – The health of your body starts in your mouth. Proper nutrition is key to everything from longevity to happiness. Whether your jaws are misaligned from injury or genetics – if your bite is significantly affected, your nutritional habits may be as well, and orthognathic surgery may be the best option for getting your health back on track.

Orthognathic Surgery: The Post-Surgery Diet

Orthognathic surgery, commonly referred to as “jaw surgery,” is used to correct a wide range of both minor and major skeletal and dental irregularities, often the misalignment of the jaws and teeth. Patients looking at undergoing orthognathic surgery are often faced with an extensive recovery period, as well as a restricted diet in the beginning of their recovery process. Post-surgery patients are discouraged from chewing to allow the bone to heal and stabilize. Due to the fact that adequate healing can take up to 8-12 weeks, patients will initially be on the “swallowing diet” for a number of weeks. 'peanut butter and banana smoothie'

When it comes to the “swallowing diet,” the name of the game is high calorie, high protein, and low volume. Facing a large volume of liquid each meal that meets both the necessary caloric and protein needs can be overwhelming. Consuming enough calories, as well as enough protein is a necessity to heal in a timely manner. In order to get adequate volume of fluid and nutrition daily, it may require you to eat smaller meals 5-6 times per day, rather than the usual 3 times per day.

Patients who are well prepared for their surgery often have a smoother recovery. Here is an example of smoothie recipe a patient can consume following orthognathic surgery:

Peanut Butter Banana Smoothie

  • 2 chilled bananas, broken into chunks
  • 2 cups milk
  • 1/2 cup peanut butter
  • 2 cups ice cubs
  • 2 tablespoons honey, or to taste

Place bananas, milk, peanut butter, honey, and ice cubes in a blender; blend until smooth, about 30 seconds.

Though patients are faced with a restricted diet post-surgery, it is important to remember to try and maintain a balanced diet. In particular, foods rich in vitamins A and C. According to the Academy of General Dentistry (AGD), plenty of vitamin C is one way post-surgery patients ensure a timely recovery!