4175 N Hanson Ct, Ste #200, Bowie, MD 20716 301-383-9883

Oral Surgeon Bowie, MD

Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There will usually be a metal or rubber chain protruding through the gums and attached to the arch wire of your braces. Please take care to avoid heavy contact with the chain during eating or brushing. It is not uncommon for the chain to become loose or detached from the tooth. If this happens please keep the chain and bracket handy and call our office immediately.

SUTURES

Usually there will be sutures (stitches) placed to reapproximate the gingiva at the surgical sites. The sutures we place are usually resorbable and do not need to be removed. Please avoid tampering with the sutures, allow 7-10 days for sutures to dissolve. Occasionally sutures may break and fall out sooner than anticipated, this is not cause for alarm simply keep the area clean, healing typically progresses as normal.

BLEEDING

Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding can be controlled by biting on a moistened gauze pad placed under pressure directly over the bleeding wound for 30 to 60 minutes. If bleeding continues profusely, please call for further instructions. Avoid the use of straws for 2-3 days.

SWELLING

Swelling is a normal occurrence after surgery. To minimize swelling apply an icepack, or towel filled with ice, on the face in the area of surgery. Apply the ice 20 mins on and 20 mins off at a time, as much as possible, for the first 24 hours.

DIET

Drink plenty of fluids. Avoid hot liquids or hard foods. Soft food and liquids should be eaten on the day of surgery and for 2-3 days. Return to a normal diet as soon as possible unless otherwise directed.

PAIN

  • You should begin taking pain medication as soon as possible prior to the local anesthetic wearing off which typically occurs 2-3 hrs after the procedure. For mild or moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every 3-4 hours not to exceed the max daily dose written on the bottle. Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen bought over the counter comes in 200 mg tablets: up to 4 tablets may be taken at a time, four times daily, not to exceed the max daily dose written on the bottle. Consult our office for additional recommendations.
  • For severe pain, you may be prescribed stronger medications. These medications should be taken as directed. Do not take any medication if you are allergic to it or similar medicines, or have been instructed by your doctor not to take it. Do not drive an automobile or work around machinery and avoid alcoholic beverages while taking narcotic pain medications. Pain or discomfort following surgery should subside gradually. If pain persists, it may require attention and you should call our office.

ANTIBIOTICS

Antibiotics are sometimes necessary after exposure of an impacted tooth, especially when bone is removed or the tooth is luxated (loosened). If prescribed, antibiotics should be taken as directed to help prevent infection.

ORAL HYGIENE

  • Good oral hygiene is essential to good healing especially since braces attract debris and bacteria. The night of surgery no rinsing or brushing should be done. The day after surgery, the prescribed oral rinse should be used twice daily; after breakfast and before bed. Be sure to rinse for at least 30 seconds then spit it out. Warm salt water rinses (one teaspoon of salt in a cup of warm water) should be used at least 3 times a day as well, especially after meals. Brush your teeth along with the braces well. Be gentle initially while brushing the surgical areas and be sure to use a soft bristle brush and avoid excessive contact to the protruding chain.

ACTIVITY

  • Keep physical activities to a minimum immediately following surgery. If you exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking in normal nourishment. This may weaken you and further limit your ability to exercise.

SMOKING

  • Smoking not only disturbs and delays the normal wound healing but it also increases risk of excessive post surgical bleeding as well as infection hence should be avoided for 3-4 days after surgery.

Oral Surgeon Bowie, MD

TEETH-IN-AN-HOUR™ is a revolutionary concept providing patients with fully functioning teeth on dental implants in a single procedure that takes about an hour. This technology was developed by Nobel Biocare and utilizes collaboration between both the restorative doctor and the oral surgeon. This merging of knowledge and experience achieves not only increased safety, but also a more precise implant placement. In addition, the fabrication of a final prosthesis is completed prior to the surgery. The computer-guided implant surgery is done in an arthroscopic fashion without requiring any flap reflection. This benefits the patient in that there is less postoperative discomfort, less swelling, and less bruising. Patients can often resume their normal activities the next day.

The process begins when a CT scan is taken of the patient’s jaw bone. This CT scan allows for the generation of a three-dimensional model of the jaw bone that can then be used with virtual software to plan the implant placement without the presence of the patient. The results are a more accurate implant placement and less chair time for the patient.

Oral Surgeon Bowie, MD

An Implant Supported Overdenture is a contemporary restoration that has revolutionized the way surgeons and dentists think of replacing a full set of teeth. Standard dentures are unsecured prostheses with inherent limitations. Most often, dentures are painful, inconvenient and unstable. Such dentures can make chewing foods difficult, limiting the foods that you once enjoyed. Modern dentistry can help with implant supported dentures.

  • The Implant Supported Overdenture treatment concept replaces your missing teeth with a full dental bridge supported by dental implants. Fewer implants are needed and overall treatment time and cost is reduced. An Implant Supported Overdenture solution also ensures greater stability in the bone, reducing the need for bone graft surgery to increase bone volume. Implant-supported overdentures stay connected with bar and clip attachment methods or use a variety of abutment-based attachments (ball, magnets, and resilient stud attachments such as Locators). The most appropriate attachment system for your individual needs relates to a variety of factors that is determined early in the treatment.Typically, a temporary set of teeth can be placed on the same day of surgery. The temporary teeth allow you to lead a normal life immediately after surgery. After a short healing period, your dentist will place the final bridge. Your quality of life is improved, and you can start enjoying your favorite foods again with renewed confidence.

IMPLANT SUPPORTED OVERDENTURES OFFER YOU MANY ADVANTAGES:

  • A cost effective solution. When compared to some other implant supported restoration methods, your new replacement teeth require fewer implants for each jaw. With fewer implants required, the cost is lowered.
  • Reduced need for bone grafting. The special angled placement of two of the implants ensures a secure and stable anchorage for the replaced arch, often making bone grafting unnecessary.
  • Faster treatment and healing time. Your replacement arch can be attached to your implants immediately after insertion.

Scientifically proven and documented. Implant Supported Overdentures have had good clinical outcomes from decade long studies with favorable results.

Oral Surgeon Bowie, MD

DO I HAVE ENOUGH BONE?

  • After tooth extraction, if the walls of the socket are very thick, they will usually fill naturally with bone in two to three months. However, when the walls of your socket are very thin (such as in your upper and lower front teeth), this type of healing will not be as predictable. In these situations, a bone graft is often placed at the time of tooth extraction to help your body fill in the empty socket with bone. This step will maintain the width and volume of bone you will need for implant placement several months later.
  • There may be inadequate bone for implant placement if your tooth was removed many years ago and your bony ridge is extremely thin. In this case, a bone graft can be placed next to the thin bone and allowed to heal for up to six months. After the graft has fused to your pre-existing bone, the ridge will be re-entered and the implant placed. Bone grafting is usually a relatively comfortable office procedure. Many different bone-grafting materials are available, including using your own bone.
  • You may also need bone grafting if the sinus cavities in your upper jaw are very large, or very low, and extend into the tooth-bearing areas. This often occurs when teeth in the back of a person’s upper jaw have been removed many years before, and the amount of bone available for implant placement is limited. A “sinus grafting procedure” is then required. Most often, it is performed in the office with local anesthesia and perhaps sedation. During this procedure, the membrane that lines the sinus will be located and elevated. Bone will then be added to restore the bone height and ensure that dental implants of an adequate length can be placed. This procedure often can be performed at the time of implant placement providing bone height is adequate.

Oral Surgeon Bowie, MD

Although many patients have no problem wearing an upper denture, some people find it difficult to wear and eat with lower dentures. Several implant-supported replacement options are available if you are missing all of your lower teeth.

Ball Attachment Denture

One option is to have two implants placed in your lower jaw and a denture made that snaps onto these implants. This option allows your lower denture to be more stable while chewing than without implants. However, there will still be movement of your lower denture, and sore spots will occur if any food particles, especially seeds, are caught under it. As with all removable replacement teeth, you still will need periodic appointments for denture adjustment.

Bar Attachment Denture

Another option involves placing four to six implants, depending on your jaw size or shape, into your lower jaw. After healing is complete, the implants are connected with a custom-made support bar. Your denture will be made with special internal retention clips that attach onto the support bar, enabling the denture to snap firmly into place. This is called an “overdenture.” The advantage of this option is that it is much more stable than the first option and allows very little denture movement. Your denture is still removable for easy cleaning and maintenance.

Screw Retained Denture

A third option involves placing five or more implants in your jaw and attaching a permanent denture. Your denture is held in place by screws or clasps that secure it to the support posts or bar. It doesn’t touch the gum tissue, which allows you to clean under the denture without removing it. This denture will replace all your missing lower teeth and will not be removed except at maintenance visits. Although cleaning under your denture without removing it is more
time consuming and requires more dexterity, many patients who want a permanent denture prefer this option.

Individual Implants

The final option is to have all your teeth individually replaced so that they will appear to be growing out of your gum tissue and will most closely resemble the appearance of your natural teeth. This option usually requires eight or more implants. Separate abutments or support posts for each one of these implants will be made and crowns for each missing tooth will be placed.

The teeth are often joined together. Overall, this is the most costly option, because it requires the most implants and individual replacement tooth fabrication. Your replacement options may also be limited by the current size and shape of your jawbone.

WHAT IF I’M MISSING ALL OF MY UPPER TEETH?

A similar range of treatment options is also available for your upper jaw. However, because the bone is not as hard as that in the lower jaw, people often need more implants to support their new replacement teeth. Depending upon the number of implants to be placed, it may be possible to eliminate the need for covering the roof of your mouth with a complete denture. This option allows you to fully taste your food and gives you a better sense of its temperature.

Your denture will feel more natural. You have the option of a removable or fixed denture. Sinus grafting may be performed in the upper jaw to replace bone height strength and support prior to implant placement.

Coming Soon !

Oral Surgeon Bowie, MD

Your teeth affect your whole body. When they’re healthy, you’re healthier too. A missing tooth can affect your bite, speech and eating choices. As you rely more on your remaining teeth, you increase the chance they will wear out prematurely, or be damaged or lost. You may also experience headaches and/or jaw pain. Missing teeth also cause other teeth to shift and some patients develop parafunctional habits such as grinding or clenching as a result of disharmony caused by the missing teeth. Who would want their appearance and health to deteriorate? That’s the natural consequence of missing teeth – the jaw literally melts away. Generally, people will lose 25% of their supporting jawbone structure within the first year after tooth loss. Dental implants are more easily and predictably placed when teeth are first extracted or lost because bone replacement becomes more complex as time passes. The great news? Implants act just like your natural teeth. They safeguard and preserve your bone structure, oral health and appearance. Your regular dentist and the oral surgeon will provide you with options so that you can make the most informed decision concerning tooth replacement.

TOOTH REPLACEMENT OPTIONS

  • You can select from a number of different options to replace your missing teeth – from removable such as dentures to long-lasting permanent solutions such as a fixed dental bridge or dental implants.
  • A good candidate is anyone missing one or more teeth, or who is unhappy with their dentures. Age is not a factor. However, smoking, diseases such as diabetes, and radiation therapy to the area, have been shown to lower the success rate of implant placement.  X-rays of your jaw will be taken to evaluate whether they will accommodate implants. Detailed x-rays may also be required to determine if other tests or procedures are needed to place implants properly.

WHY SELECT DENTAL IMPLANTS OVER MORE TRADITIONAL TYPES OF RESTORATIONS?

There are several reasons: A dental bridge can sacrifice the structure of surrounding good teeth to bridge the space of the missing tooth/teeth. In addition, removing a denture or a “partial” at night may be inconvenient, not to mention loose fitting dentures that slip can be uncomfortable and rather embarrassing.

Oral Surgeon Bowie, MD

WHAT ARE DENTAL IMPLANTS?

  • A natural tooth consists of a root and a crown. If you compare natural teeth to implant-supported replacement teeth, you’ll see they have the same basic parts. Both have a crown (the visible part used to chew food). Both have a root that holds the tooth securely under the gum and is anchored into the jaw. The difference is that the implant is made of titanium – the same time-tested material used by surgeons for artificial joints. When you lose a tooth, you lose both the root and the crown. To replace the tooth, the surgeon first replaces the root with a small dental implant.
  • Time is allowed for bone to heal and grow around the dental implant. The bone bonds with the titanium, creating a strong foundation for artificial teeth. A support post (abutment) is then placed on the implant and a new replacement tooth (crown) is placed on top of the abutment. In many cases a temporary replacement tooth can be attached to the implant immediately after it is placed. If all of your teeth are missing, a variety of treatment options are available to support the replacement teeth.

ADVANCES IN IMPLANT TECHNOLOGY

Using the most recent advances in dental implant technology, Dr. Egolum is able to place single stage implants. These implants do not require a second procedure to uncover them, but do require a minimum of six weeks of healing time before artificial teeth are placed. There are even situations where the implant can be placed at the same time as the tooth extraction – further minimizing your number of surgical procedures. Dr. Egolum also utilizes cone beam CT imaging and surgical guides to plan and place your dental implants to improve accuracy and success of the implants. Dental implant placement is a team effort between an oral surgeon and your general dentist. Dr. Egolum performs the actual implant placement surgery, initial tooth extractions, and bone grafting if necessary. Your regular dentist fits and makes the permanent prosthesis. Your regular dentist will also make any temporary prosthesis needed during the implant process.

Oral Surgeon Bowie, MD

A small amount of bleeding is to be expected multiple extractions. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 – 45 minutes. If bleeding continues, bite on a moistened black tea bag for 30 minutes. The tannic acid in the black tea helps to form a clot by contracting blood vessels. If bleeding persists, call our office immediately. If you were instructed to wear an immediate denture/ prosthesis after extractions please do not remove the immediate denture unless the bleeding is severe. Expect some oozing around the sides of the denture.

Use ice packs (externally) on the cheek near the surgical site. Apply ice for the first 24 hours only. Starting the following day you may use a warm wet rag against the face to help further minimize discomfort and swelling.

For mild discomfort you may use Tylenol, or any similar medication; two tablets every 3-4 hours. Two to four tablets of Ibuprofen (Advil or Motrin) can be taken every 6 hours. Care should be taken not to exceed the daily max dose indicated on the bottle.

For severe pain, use the prescriptions given to you. If the pain does not begin to subside after 3 days, or increases after 3 days, please call our office. If an antibiotic has been prescribed, please take as prescribed till completed. If you are allergic to any medication please do not take it, if allergy develops unexpectedly please stop medications and call our office immediately.

Drink plenty of fluids. If many teeth have been extracted, the volume lost at this time needs to be replaced. Drink at least six glasses of liquid the first day.

Do not rinse your mouth or brush your other teeth for the first day, or while there is bleeding. After the first day, use a warm salt water rinse following meals to flush out particles of food and debris that may lodge in the operated area. (One teaspoon of salt in one glass of warm water). If you were instructed to wear a denture, you way remove it after 48 hrs. Please rinse the denture and clean it with an antibacterial solution at which point it can be replaced, this is to be done 3-4 times a day especially after meals starting 48 hrs after surgery.

Restrict your diet to liquids and soft foods that are comfortable for you to eat. As the wounds heal, you will be able to resume your normal diet.

The removal of many teeth at one time is quite different from the extraction of just one or two teeth. Because the bone typically must be shaved and smoothed for patient comfort and optimal healing. The following conditions may occur, all of which are considered normal:

  • The area operated on will usually swell, reaching a maximum in two days. Swelling and discoloration around the eyes may occur. The application of a moist warm towel will help eliminate the discoloration. The towel should be applied continuously for as long as is tolerable, beginning 48 hours after surgery. ( Remember: ice packs are used for the first 24 hours only).
  • A sore throat may develop. The muscles of the throat are near the extraction sites. Swelling into the throat muscles can cause pain. This is sometimes normal and should subside in 2-3 days.
  • If the corners of the mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment like Vaseline. There may be a slight elevation of temperature for 24-48 hours. If your temperature continues to rise, notify our office.

If immediate dentures have been inserted, sore spots may develop. In most cases, your dentist will see you within 24-48 hours after surgery to make the necessary adjustments and relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process. Please call our office if severe soreness or tenderness develops.

Oral Surgeon Bowie, MD

JAW JOINT DISORDERS | JAW PAIN

TMJ (temporomandibular joint) disorders are a family of problems related to your jaw joint . If you have had symptoms like pain or a “clicking” sound, you’ll be glad to know that these problems are more easily diagnosed and treated than they were in the past. These symptoms occur when the joints of the jaw and the chewing muscles do not work together correctly. TMJ stands for temporomandibular joint, which is the name for each joint (right and left) that connects your jaw to your skull. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.

No one treatment can resolve TMJ disorders completely and treatment takes time to become effective. Dr. Egolum can help you have a healthier, more comfortable jaw.

TROUBLE WITH YOUR JAW?

TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disk, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, clicking, or grating noise when you open your mouth, or trouble opening your mouth wide.

DO YOU HAVE A TMJ DISORDER?

  • Are you aware of grinding or clenching your teeth?
  • Do you wake up with sore, stiff muscles around your jaws?
  • Do you have frequent headaches or neck aches?
  • Does the pain get worse when you clench your teeth?
  • Does stress make your clenching and pain worse?
  • Does your jaw click, pop, grate, catch, or lock when you open your mouth?
  • Is it difficult or painful to open your mouth, eat, or yawn?
  • Have you ever injured your neck, head, or jaws?
  • Have you had problems (such as arthritis) with other joints?
  • Do you have teeth that no longer touch when you bite?
  • Do your teeth meet differently from time to time?
  • Is it hard to use your front teeth to bite or tear food?
  • Are your teeth sensitive, loose, broken or worn?

The more times you answered “yes”, the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.

TREATMENT

There are various treatment options that Dr. Egolum can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Dr. Egolum will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care combined with professional care.

The initial goals are to relieve the muscle spasms and joint pain. This is usually accomplished with a pain reliever, anti-inflammatory, or muscle relaxant. Steroids can be injected directly into the joints to reduce pain and inflammation. Self-care treatments can often be effective as well and include:

  • Resting your jaw
  • Keeping your teeth apart when you are not swallowing or eating
  • Eating soft foods
  • Applying ice and heat
  • Exercising your jaw
  • Practicing good posture

Stress management techniques such as biofeedback or physical therapy may also be recommended, as well as a temporary, clear plastic appliance known as a splint. A splint (or night guard) fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. There are different types of appliances used for different purposes. A night guard helps you stop clenching or grinding your teeth and reduces muscle tension at night. It also helps to protect the cartilage and joint surfaces. An anterior positioning appliance moves your jaw forward, relieves pressure on parts of your jaw, and aids in disk repositioning. It may be worn 23 hours/day to help your jaw heal. An orthotic stabilization appliance is worn 23 hours/day, or just at night, to move your jaw into proper position.

Appliances also help protect tooth wear.

WHAT ABOUT BITE CORRECTION OR SURGERY?

If your TMJ disorder has caused problems with how your teeth fit together you may need treatment such as bite adjustment (equilibration), orthodontics with or without jaw reconstruction, or restorative dental work. Surgical options, such as arthroscopy and open joint repair restructuring, are sometimes needed, but are reserved for severe cases. Dr. Egolum does not consider TMJ surgery unless the jaw can’t open, is dislocated and non-reducible, has severe degeneration, or the patient has undergone appliance treatment unsuccessfully.

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