Posts for tag: oral surgery
One in 700 babies are born each year with a cleft lip, a cleft palate or both. Besides its devastating emotional and social impact, this common birth defect can also jeopardize a child's long-term health. Fortunately, incredible progress has occurred in the last half century repairing cleft defects. Today's children with these birth defects often enter adulthood with a normal appearance and better overall health.
A cleft is a gap in the mouth or face that typically forms during early pregnancy. It often affects the upper lip, the soft and hard palates, the nose or (rarely) the cheek and eye areas. Clefts can form in one or more structures, on one side of the face or on both. Why they form isn't fully understood, but they seem connected to a mother's vitamin deficiencies or to mother-fetus exposure to toxic substances or infections.
Before the 1950s there was little that could be done to repair clefts. That changed with a monumental discovery by Dr. Ralph Millard, a U.S. Navy surgeon stationed in Korea: Reviewing cleft photos, Dr. Millard realized the “missing” tissue wasn't missing—only misplaced. He developed the first technique to utilize this misplaced tissue to repair the cleft.
Today, skilled surgical teams have improved on Dr. Millard's efforts to not only repair the clefts but also restore balance and symmetry to the face. These teams are composed of various oral and dental specialties, including general dentists who care for the patient's teeth and prevent disease during the long repair process.
Cleft repairs are usually done in stages, beginning with initial lip repair around 3-6 months of age and, if necessary, palate repair around 6-12 months. Depending on the nature and degree of the cleft, subsequent surgeries might be needed throughout childhood to “polish” the original repairs, as well as cosmetic dental work like implants, crowns or bridgework.
In addition to the surgical team's skill and artistry, cleft repair also requires courage, strength and perseverance from patients and their parents, and support from extended family and friends. The end result, though, can be truly amazing and well worth the challenging road to get there.
If you would like more information on repairing cleft birth defects, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Cleft Lip & Cleft Palate.”
Every year, thousands of children are born with a cleft palate, cleft lip or a combination of both. The advocacy group AmeriFace promotes the month of July as National Cleft & Craniofacial Awareness & Prevention Month to call attention to this potentially disfiguring defect—and to highlight treatments offered by dentists that can change the destiny of a child with a cleft defect.
Simply put, a cleft is a gap or opening in the palate (roof of the mouth) and/or upper lip. Cleft lips and palates result when structures that are forming in an unborn baby’s mouth and face don’t fuse together as they should during pregnancy. They can occur on either one side or on both sides of the face, in partial form (with some connecting tissue present) or completely open.
Clefts can cause severe disfigurement in a child, which may lead to a diminished self-image and disruption in relationships with others. A cleft can also compromise other aspects of a child’s health and life, including dental health, nutrition, respiratory function and speech development.
Doctors don’t always know why a particular baby is born with a cleft lip or palate, but clefts are thought to result from a combination of factors. Genetics most certainly plays a role, but there appear to be other influencing factors during pregnancy like nutritional deficiencies and fetal exposure to alcohol, radiation or toxic chemicals. In addition, having poorly controlled diabetes or being obese during pregnancy may increase the risk of the baby being born with cleft lip or cleft palate.
Managing known health conditions as well as striving for better prenatal nutrition and protection from environmental hazards may reduce the risks for cleft formation, even so, clefts do form. When they do, we can often effectively correct them, thanks to surgical procedures first developed by a military surgeon stationed in Korea in 1950.
While analyzing photos of cleft patients, Dr. Ralph Millard realized the tissue needed to repair a cleft was already present, but in a distorted form. He then experimented with surgical techniques that released the tissue so that it could be moved and fashioned into a normal appearance.
Dr. Millard’s original techniques remain the basis for today’s advanced procedures. Correction of a cleft lip or palate typically requires a series of procedures which can span the child’s developmental years. The first surgery usually occurs around 3-6 months of age, followed by later procedures to refine the earlier work. This process usually requires a team of dental specialists that includes oral surgeons, orthodontists and general dentists.
The road to restoration from a cleft birth defect can be a long one for children and their families, but the treatment methods developed over the last several decades can truly give them the gift of a normal life.
If you would like more information about cleft repair and other oral surgical procedures, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Cleft Lip & Cleft Palate: Common Birth Defects That Can Be Repaired Beautifully by Skilled Surgeons.”
One of the most common and anguish-filled birth defects is a cleft lip or palate (roof of the mouth). Not only do clefts disrupt the normality of a child’s facial appearance, they can also lead to problems with chewing, speech and the long-term health of teeth and gums.
A cleft is a tissue gap that occurs during fetal development, usually in the first trimester, in which parts of the baby’s face fail to unite. Why this occurs is not fully understood, but vitamin imbalances in the mother, exposure to radiation or other toxic environments, or infections are all believed to play a role.
Facial clefts are classified as either incomplete, in which there is some but not full tissue fusion, or complete, with no fusion at all. A cleft can be unilateral, affecting only one side of the face, or bi-lateral, affecting both sides. During infancy a cleft can adversely affect a child’s ability to nurse, and it sometimes disrupts breathing. As the child grows, speech patterns may be severely disrupted and their teeth and bite may not develop properly.
Fortunately, there have been dramatic advances in cleft repair over the past sixty years. It’s actually a process that can span a child’s entire developmental years and involve the expertise of a number of surgical and dental specialists. For a cleft lip, the initial surgical repair to realign and join the separated tissues usually occurs around three to six months of age; repair of a cleft palate (where the gap extends into the roof of the mouth) between 6 and 12 months.
Subsequent procedures may be needed in later years to refine earlier results and to accommodate the mouth’s continuing growth. At some point the treatment focus shifts to cosmetic enhancement (which can include implants, crown or bridgework) and periodontal health, to ensure gum tissues that support teeth and gums aren’t compromised by the effects of the cleft or its treatment.
At the end of this long process, something of a miracle may seem to occur: a young person’s once disfigured mouth transforms into a beautiful smile. It’s a chance for them to gain a normal life — and a new lease on physical, emotional and oral health.
The proliferation of drugs to treat all manner of diseases and conditions has heightened concerns not only about general side effects, but also how a particular drug may affect treatments for other conditions. There are indications, for example, that drugs classified as blood thinners could cause complications for patients undergoing oral surgery.
Blood thinners like Warfarin are typically prescribed to patients with artificial heart valves or who are at significant risk for stroke, heart attack, or the formation of clots that could potentially damage the heart and lungs. The drug reduces the coagulation (clotting) mechanism in blood; aspirin taken regularly should also be considered a blood thinner.
As with any invasive procedure, blood thinners can complicate oral surgery. Blood doesn’t clot normally and so bleeding during a procedure is more difficult to stop. This doesn’t necessarily mean the surgery can’t be performed. For one thing, many oral procedures like tooth removal involve little trauma to tissues and bleeding in the hands of a careful and experienced surgeon. The surgeon can also use hemostatic agents during surgery that will stabilize blood clotting, as well as suturing the incision in such a way as to reduce bleeding from surface capillaries. In the case of a tooth extraction, a bone graft placed within the empty socket not only reduces bone loss from a missing tooth, but can also enhance bleeding control.
In consultation with your medical doctor, it’s also possible to temporarily stop or reduce your medication dosage in anticipation of a pending oral surgery. While it may not be safe to stop the drug altogether, a reduced dosage can ease the anti-coagulant effect and reduce any complications from bleeding that might occur during the surgery. You can then resume normal dosage soon after the procedure.
During your pre-op examination, it’s important to let your surgeon know about any drugs you are currently taking, including over-the-counter drugs like aspirin. The oral surgeon will then be able to take the necessary steps, including working with your medical doctor, to ensure your surgical procedure is safe and uneventful.
If you would like more information on oral surgery precautions while taking blood thinners and other medication, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Oral Surgery & Blood Thinners.”
During most of your life, your dental healthcare will be mainly provided by your general dentist. Sometimes, though, certain situations and conditions call for the skills of a dental specialist. One such specialist is an oral surgeon.
An oral surgeon is a dentist who has undertaken further training and residencies in the practice of oral surgical procedures and treatments. They are especially distinguished by surgical procedures that may require advanced forms of anesthesia.
The field of oral surgery touches on a wide array of conditions. They are adept at tooth extractions, especially difficult cases like impacted teeth, and surgical procedures that correct issues involving the underlying bone of the jaw. They perform procedures as part of treatment for diseases of the jaws or facial region (including biopsies, and the removal and treatment of oral cancers), reconstructive surgeries of the mouth and jaw following disease or injury, and orthognathic surgeries that correct malocclusions (bad bites) caused by the size of the jaw and its placement with the skull.
Oral surgeons also provide treatments in the area of pain management like temporo-mandibular disorder (TMD), a group of conditions involving the joint that connects the lower jaw with the skull. Because of their background training in oropharyngeal (pertaining to the back of the mouth and the throat) physiology, many oral surgeons have received further training in the diagnosis and treatment of obstructive sleep apnea (OSA). They also play an important role in cosmetic dentistry, as with the surgical placement of dental implants.
All in all, these professionals are an important part of your dental healthcare team. Along with your general dentist and other oral specialists, they’re committed to helping you gain the highest degree of dental health possible, as well as a vibrant, healthy smile.
If you would like more information on the role of oral surgeons, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Why Consult an Oral Surgeon?”