Inland Institute Oral and Maxillo-Facial Surgery

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 incudes 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.

oropharyngeal cancer cells

The Orpharynx
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 David H. Gilbert DDS, MS, MBA, FACS to schedule your routine dental check up and oral cancer screening today.

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? 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 implant

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 David H. Gilbert DDS, MS, MBA, FACS we specialize in dental implants, so give us a call today at Inland Institute - Oral & Maxillofacial Surgery Phone Number 909-982-8888 to discuss your future implant success!

How are wisdom teeth removed?

Don’t be worried about your wisdom tooth extraction, let us outline the whole process for you:

Treatment Development
During late adolescence, wisdom teeth start to appear and occasionally are accompanied by oral pain, as well as an increased risk of dental issues such as pericoronitis, gum disease, and tooth decay. Through evaluation, your oral surgeon will determine the number of wisdom teeth present, as well as how they are developing in relation to the rest of your teeth. Using advanced imaging technology, an oral surgeon will discover if the teeth are partially or fully impacted, and then will create a strategic treatment plan in order to remove the teeth and ensure successful recovery.

Preparation
Although sedation is not always necessary, many patients have found anesthesia to be helpful in relaxation and reducing pain during the procedure. If sedation is chosen, there are certain preparations that must be made: patients must enlist the help of family or friends to bring them back home after their surgery.

impacted wisdom tooth diagram

The Procedure
Local anesthesia is applied to the area. Then, a surgical tool is used to reveal the bone and tooth. After the tooth is clearly visible, it is removed. Once the tooth is extracted, the gums and bone are left to heal.

Healing
Following the procedure, there may be some swelling in the tissue and cheeks near the treatment site. To promote a successful recovery, patients should avoid strenuous activity, smoking, and eating hard foods. Patients should not touch the treatment area with their tongue, or use straws, as this could potentially dislodge the developing blood clots and expose the area to food and bacteria.

Wisdom tooth extraction can be an uncomplicated procedure that ultimately will protect your long-term oral health. For more information about wisdom tooth extraction, schedule your consultation at David H. Gilbert DDS, MS, MBA, FACS today!

BOTOX Cosmetic: “The Lunchtime Procedure”

BOTOX injection time is quick; most visits only require about 10 minutes. You can schedule it during your lunch hour.

The process of aging and repeated contractions from frowning and squinting causes changes in the face, smile and even muscle movement. Skin is also affected by the elements of weather and lifestyle and sun damage plays a major role in the aging process. These processes create unwanted lines and creases in the skin.

By temporarily blocking the nerve impulses to the muscle, BOTOX injections will relax the muscles. That reduces muscle activity, temporarily smoothing out those unwanted lines.

BOXTOX before and after

Where can BOTOX help?

  • Erase those pesky frown lines between your eyebrows with injections of BOTOX into the forehead; years will be removed off your appearance.
  • To correct crow’s feet, injections are placed in the muscle around the eye causing a reduction in activity and lessening the appearance of the fine lines.

Precisely placed injections by a physician with medical expertise in facial anatomy like Dr. Gilbert will ensure full ability to smile normally and still show emotional expressions.

What to expect after being treated with BOTOX injections:

  • Recovery is minimal and you can resume your day once treatment is finished.
  • Noticeable results may been seen within 24-48 hours after being treated on frown lines, even the moderate to severe cases of frown lines. In general, most results are apparent by the 5th day.
  • You will be able to wear sunscreen and makeup after your appointment.
  • It is recommended to stay out of the sun for a few days, allowing the treated areas to heal.
  • Results typically last 3-4 months and in some cases even up to 6 months, depending on area treated, physical characteristics and style of living.
  • If you discontinue treatment, the treated areas will ultimately return to the way they were before treatment was started.

Call David H. Gilbert DDS, MS, MBA, FACS to find out if BOTOX is right for you!

5 Botox Myths

Since its FDA approval in 2000, Botox™ has become one of the the safest, effective, and well-known procedures in the world. Despite its popularity however, Botox™ has many misconceptions. Here are 5 myths about Botox™ —busted.

Myth #1: The best time to get Botox™ is when wrinkles and lines appear.

Fact: Actually, Botox™ is being used more and more frequently as a preventative treatment. It’s much more difficult to smooth lines that have been etched into the skin.

woman surprised with no wrinkle lines

Myth #2: If you stop getting Botox™, your wrinkles will get worse.

Fact: Actually, they’ll just go back to the way they were before. Botox can prevent your lines from worsening, and when you decide to stop Botox, you will just resume the normal development and deepening of wrinkles.

Myth #3: You are never too young for Botox™.

Fact: There is some truth to this.  Botox™ should definitely be used as a preventative method for people of most ages, starting in their 20s–but if you’re a teenager, you’re probably not quite ready for cosmetic procedures.

Myth #4:  Botox™ is only for wrinkles.

Fact: Actually, Botox™ has many other uses!  Botox™ injections can treat migraines by reducing muscle tension, can treat excessive sweating by temporarily blocking sweat glands, and even shrink swollen prostate glands!  Botox™ is not just cosmetic.

Myth #5: Botox is only for women.

Fact: Now that’s just plain wrong– Botox™ is for everyone! At any age, with any gender, you should be able to look the way you want to. Although Botox™ is traditionally seen as a product for women, more and more men are turning to Botox™ as a non-invasive, simple, and effective way to rejuvenate a youthful appearance.

Pre-Implant Bone Augmentation

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;

man lifting weights

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.

Dental Implants 101

Whether you are missing a tooth, or at risk of losing many, dental implants may be a great solution   for you. Dental implants are an increasingly popular fix for missing or dying teeth, and have many benefits.

What is a Dental Implant?

Dental implants are high tech teeth. The root of your current tooth is removed, and replaced with a screw attached to a ‘cap’ that looks identical to a natural tooth. Many people report higher confidence and comfort after receiving their new tooth.

Dental Implants 101

What’s so Great About Them?

The cool thing about implants is that if taken care of, they can last for life. Usually all that needs to be replaced, if anything, is the cap. The other great thing about implants is that they can’t die like natural teeth. You still have to clean and maintain them like your other teeth, but no roots are any longer at risk of causing that tooth to fail. In addition to that, many implants can last a lifetime!

What is the Surgical Process Like?

The process is done either all at once, or in steps. This depends on the recommendations for your particular case. The first step is to remove the root of your natural tooth, and place the implant in its place. If there is not enough bone to place the implant, we may encourage you to have bone grafting first. The gum is then stitched closed and allowed to heal. This can take five to six months. The next step is to reopen the gum and place an abutment on the implant, along with a temporary crown so you can heal while the permanent crown is made for you. You then return to get your permanent crown attached in a few weeks. In other cases, all of these steps can be done in a single visit, but it depends on your specific case.

If you have any questions, please call our office for more information, we would be glad to help!

Types of Jaw Surgery

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;

man side profile

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!

Learning the Lingo – Dental Implants

Dental implants are a safe and effective replacement for a missing tooth or teeth. The implant is placed in your jawbone and integrates with your natural bone. This implant then forms a stable, sturdy base for your new teeth.

What They Are

Implant: The implant itself is a rod that is screwed into the jawbone.

Abutment: This is the connection between the implant and the crown.

Crown: A tooth shaped cap that is attached to the abutment. It is the part of the tooth that is visible above the gum line.

dental implant

What They’re Made Of

Titanium: Most implants are typically made of titanium, a biocompatible metal.

Zirconia: Often used for crowns and bridges and can be used as a metal-free option. Zirconia is biocompatible just like titanium.

Where They Go

Endosteal Implants: Placed in the jawbone. These implants are typically shaped like small screws, cylinders or plates, and they are the most commonly used.

Subperiosteal Implants: Placed under the gum, but on or above the jawbone. These implants are mostly for people with smaller jaws or shallow jawbones.

What Happens To Them

Osseointegration: Creates strength and durability by fusing directly to the bone and is bio-compatible. Bone cells attach themselves directly to the titanium/zirconium surface, essentially locking the implant into the jaw bone. Osseointegrated implants can then be used to support prosthetic tooth replacements of various designs and functionality. Anything from a single tooth, to all teeth in the upper and lower jaws. The teeth/crowns are usually made to match the enamel color of the existing teeth to create a natural appearance.

Bone augmentation: Some people do not have enough healthy bone to support dental implants, so bone must be built. Procedures can include bone-grafting which means adding bone to the jaw.

Talk to us today at David H. Gilbert DDS, MS, MBA, FACS at Inland Institute - Oral & Maxillofacial Surgery Phone Number 909-982-8888 to discuss your options with an implant specialist!

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.

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.

Peanut Butter Banana Smoothie

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!

Call David H. Gilbert DDS, MS, MBA, FACS for more after orthognathic surgery care at Inland Institute - Oral & Maxillofacial Surgery Phone Number 909-982-8888!