Oral Cancer is on the Rise

Oral and oropharyngeal cancer is on the rise. Symptoms of this cancer can present as canker sores or an infection that doesn’t want to heal.

Risk factors for oral cancer include:

  • Smoking
  • Excessive alcohol use
  • Exposure to HPV (the human papilloma virus)

Oral cancer is divided into two categories:

  • Oral cancer affects the lips, cheek lining, gums, front of the tongue, and the hard part of the roof of the mouth
  • Pharyngeal cancer affects the throat, soft part of the roof of the mouth, the throat and the back and base of the tongue


Early detection will allow for more treatment options that lead to complete recovery. During regular and routine dental visits, a dentist or a hygienist will screen patients and can typically identify the more commons symptoms.

The most common symptoms of oral cancer are:

  • A sore that will not heal or go away
  • Pain in the mouth that will not go away
  • White or red patches on the lining of the mouth, tongue, tonsil, or gums
  • Lumps or a thick, rough spot
  • Difficulty chewing, swallowing and moving tongue and jaw


If a dentist suspects oral or oropharyngeal cancer, he/she can perform a biopsy or will refer the patient to an oral surgeon for further testing.

The American Association of Oral and Maxillofacial Surgeons also recommend that patients perform a self-check each month.

Click on the following link for more information about oral cancer detection, risk factors and cancer facts: https://myoms.org/procedures/head-neck-and-oral-cancer.

American Association of Oral & Maxillofacial Surgeons

ABOMSAs board-certified oral surgeons, each Northwest Oral & Maxillofacial Surgeon is a member of the AAOMS, the American Association of Oral & Maxillofacial Surgeons.  This organization provides educational, research and advocacy support for our dental specialty. As members, we comply with rigorous continuing education requirements and periodic office examinations to ensure that we meet stringent national standards.

While we always try to answer all of our patients’ questions during an exam, we are aware that patients are hungry for as much information as possible. In response to this need, the AAOMS hosts an excellent website for the public, myOMS.org.

myOMS.org is a valuable resource for additional information that is extremely easy to use! We recommend that you access this site if you have questions about conditions and treatments of the face, mouth or jaw.

Check out the website if you are simply trying to make an educated decision about oral surgery. The content on the site is unbiased, valuable and vital. You will find videos, news, illustrations and brochures to explain the procedures performed by oral and maxillofacial surgeons. If you live outside of the communities that we serve, we recommend that you locate an oral surgeon by using the “Find a Surgeon” search function.

As always, please contact us if you have questions we can answer for you, texasoralsurgery.com.

What is an OMS?

Have you ever wondered what the rest of the name you sometimes see for your oral surgeon means?  What is an oral and maxillofacial surgeon?  Many people are confused by the word “maxillofacial” which simply means of, or relating to, the jaws and face.

According to the American Association of Oral & Maxillofacial Surgeons, “Oral and maxillofacial surgeons are the only dental specialists recognized by the American Dental Association who are surgically trained in a hospital-based residency program for a minimum of four years.”  This training focuses on the bone, skin, and muscle of the face, mouth and jaw and follows years of undergraduate and dental school education. Following the four – six year residency program, the surgeon must prepare for, and pass, extremely rigorous written and oral examinations in order to become a board-certified specialist.

While you may typically associate an OMS with wisdom teeth extractions, oral surgeons are trained to perform intricate and complex surgeries such as the correction of cleft palates, and the rebuilding of jaws, cheeks, eye sockets and foreheads.  In addition, oral surgeons are experts in the preservation of jawbones with the use of bone grafting and dental implants.

For a quick summary (and a lesson on how to pronounce “maxillofacial,”) take one minute to watch the What is an OMS? video on MyOMS.org.

For more information about the surgeons at Northwest Oral & Maxillofacial Surgery, visit texasoralsurgery.com.

So, whatever name you chose to call us, we are honored that you have chosen a real, board-certified surgeon for your surgical care needs.

What is an OMS? from AAOMS.org on Vimeo.


Should I Have Oral Surgery in My Dentist’s Office?

Oral surgery equipment imageRecently a neighbor and I were discussing dentistry. After all, I am an oral surgeon and everyone wants to talk to me about their dental issues. I am happy to oblige, and I offer suggestions and advice when appropriate. On this particular occasion, my neighbor asked me about using an oral surgeon at his dentist’s office. He needs several teeth extracted and replaced with dental implants for future restoration. His general dentist offered to have his itinerant oral surgeon take care of him.

An itinerant oral surgeon is one who travels from office to office performing oral surgical procedures. The beauty of using an itinerant surgeon is the convenience for the patient as the oral surgeon basically comes to the patient. There isn’t any need for the patient to fill out additional paperwork or become familiar with a new office location and staff. Undoubtedly, there are benefits to convenience. But, should convenience be the priority when it comes to your health, safety and success of a procedure?

Itinerant oral surgeons have become more prevalent is the last decade. There is a financial incentive for a general dentist to host an itinerant surgeon in his/her office. Referring patients “out” to a specialist does not come with any financial benefits for the dentist. As a matter of fact, it is against Texas State Board of Dental Examiners rules and regulations to fee split or reap any financial rewards for referring to specialists. The benefit of referring to specialists comes with the knowledge and subsequent evidence that a patient was well cared for by a trained and experienced dental specialist.

My neighbor may have gotten more information about itinerant surgeons than he expected! In summary, I told him the following:

  • Oral surgery and the administration of IV anesthesia is serious business. A board-certified oral surgeon is the optimal specialist for multiple teeth extractions and dental implant placement.
  • A board-certified oral surgeon is trained in a hospital setting for four to six years after graduating from dental school. He/she received intense training and experience in the safe administration of IV anesthesia. In addition, oral and maxillofacial surgeons are ACLS (Advanced Cardiovascular Life Support) and PALS (Pediatric Advanced Life Support) certified annually.
  • Too often, the “oral surgeon” who travels is really just a dentist who performs oral surgery. He or she does not have the education and training that a board-certified oral surgeon possesses.
  • An oral surgery office is the best place to have oral surgery. Each office undergoes an Office Anesthesia Evaluation (OAE), a program designed by the American Association of Oral & Maxillofacial Surgeons to assure the public that the surgeon, the staff and the facility are equipped for the successful use of anesthesia. The OAE includes evaluation and inspection of the facility, emergency equipment and emergency medicines. It requires successful demonstration of emergency management procedures by the surgeon and the staff, and subsequent critique and discussion of the demonstration. Dental offices are not required to undergo an Office Anesthesia Evaluation.
  • At the oral surgeon’s office, a surgeon employs a well-trained staff of surgical assistants who are experienced and certified to assist in surgery. Dental assistants in a general dentist office do not have the experience or training that is required for safe oral surgery.
  • The opportunity for an adequate consultation with the itinerant oral surgeon prior to a procedure is either nonexistent or minimal. Questions can go unanswered and the opportunity to do a “background check” of the surgeon might be missed.
  • If complications arise following surgery, patients will likely be unable to follow up with the itinerant surgeon in a timely fashion. As an itinerant, his/her ability to establish a solid relationship with a patient is limited and may prove to be unsatisfactory for the patient.
  • Finally, I mentioned to my neighbor that safety in the dental offices is a valid concern. It is common to frequently hear reports on the news and internet about patients that have either become severely injured or have died as a result of inadequate dental practices.


I recommended to my neighbor that he forego using the itinerant surgeon and request a referral to a board-certified oral surgeon who practices in a permanent location. Reputable dentists have a list of trusted specialists to whom they refer. And, a quick search on the internet will show that oral and maxillofacial surgery offices are numerous and conveniently located in most metropolitan areas.

I appreciated the opportunity to discuss this topic with my neighbor. It’s important for patients to evaluate a treatment plan and to question why it is being prescribed. In the case of employing an itinerant surgeon, I suggest figuring out who is really benefitting — patient or dentist?


  1. James Clark, a Diplomate of the American Board of Oral and Maxillofacial Surgeons, has been practicing the full scope of oral and maxillofacial surgery for over 30 years. For more information about Dr. Clark and his colleagues as Northwest Oral & Maxillofacial Surgery, please visit texasoralsurgery.com.


Which Dental Specialist Should I See?

Oral Surgeon? Periodontist? Prosthodontist? Endodontist? Orthodontist? Pediatric Dentist? How do you know which dental specialist to see? Check out this helpful infographic to find out.

Be Your Own Healthcare Advocate

Whether you are preparing for an elective surgical procedure or an intense round of chemotherapy, it is important to be an advocate in your own healthcare.

1. Be prepared for your visit with your physician:

a. Know your medical background including previous illnesses, diagnoses, and surgeries.
b. Provide a list of current medications, physicians and treatments.
c. Bring insurance information and ID to your appointment.

2. Avoid costly and unexpected medical expenses by understanding your health insurance benefits including:

a. What are your deductibles, co-pays, maximum benefits and maximum out-of-pocket amounts?
b. Is your physician an in-network or out-of-network provider?
c. Is the hospital an in-network or out-of-network facility?

3. Invite a friend or family member to your doctor’s appointment if you feel like you need a second set of eyes and ears. Ask your companion to take notes. Later you can later discuss what was covered in the appointment.

4. Be assertive. Ask questions. It is not disrespectful to question your doctor about a diagnosis or a treatment plan.

5. Stand up for yourself. If you don’t agree with a treatment plan, say so. Ask for other options.

6. Educate yourself about your diagnosis and treatment plan. There are many credible books, articles and reputable websites on the internet. Avoid chat rooms, forums and other untrustworthy sites where opinions exceed facts.

7. Seek second or third opinions.

8. Acknowledge your intuition. If your gut is telling you that something isn’t quite right, then make a change in your doctor and/or treatment plan. You should feel 100% comfortable with your doctor, the staff, and the prescribed course of action.

9. Review the medical bills. Don’t assume that your health insurance is paying its part or that the doctor’s office hasn’t charged you in error. Communicate with the office is you see something that isn’t correct.

It is your health. Take charge of it. Gain the knowledge and confidence that will empower you to make the best decisions for your health.

For more helpful tips and information, visit our Patient Resources page.

Effective Alternative for Post-Surgical Pain Management

When prescribed and administered appropriately, opioid analgesic drugs can be used to effectively treat post-oral surgical pain.  At Northwest Oral & Maxillofacial Surgery, our surgeons have historically exercised sound professional judgement and, in good faith, prescribed opioid drugs, such as hydrocodone, to manage such pain.  However, as with most medications, opioids have risks and side effects with a potential for misuse and addiction.

In response to the concern about the abuse and misuse of opioids prescribed for post-surgical pain management, Northwest Oral & Maxillofacial Surgery is pleased to offer an alternative, Exparel®.

Exparel® is a slow-release, non-narcotic, numbing medication.  It is administered at the time of surgery directly to the surgery site.  It will provide post-operative pain relief for up to three days.  By using Exparel®, patients may be able to eliminate or greatly reduce their need for narcotics such as hydrocodone following oral surgery. More than likely, a patient treated with Exparel® will be able to manage pain with over-the-counter medications such as acetaminophen or ibuprofen.

If you are concerned about exposing yourself or a love one to the potentially dangerous risk of narcotics, the doctors encourage you to ask about Exparel®.  For more information about Exparel®, visit www.exparel.com or contact your oral surgeon at Northwest Oral & Maxillofacial Surgery, www.texasoralsurgery.com.

Northwest Oral & Maxillofacial Surgery

Bone Graft and Dental Implants

Missing teeth should be replaced and the best option for replacing missing teeth is through the use of dental implants and restorative crowns, bridges or dentures. Dental implants provide the foundation for the most natural, stable and comfortable replacement solution.

When a patient loses a tooth, we recommend that it be replaced as soon as possible. By doing so, the risk of losing critical bone is minimized. For an implant to be successful, adequate bone is required.

When a tooth is missing, the constant biting force is no longer occurring which is crucial to keeping the jawbone healthy. Without this force, a patient’s jawbone will deteriorate and become too thin and soft to support a dental implant. In this case, a bone graft will be necessary.

A bone graft requires a surgical procedure to fill a void where bone is absent. In addition, a bone graft will encourage and facilitate bone regeneration. Some bone grafts are bigger than others.  The longer that teeth have been missing, the more bone loss will occur. With advanced bone loss, grafting will be more extensive and involved.

The surgeons at Northwest Oral & Maxillofacial Surgery are trained and experienced in bone grafting procedures. The materials that the surgeons place have been carefully chosen and patients are given the option of an autograft, an allograft or a xenograft:

Autograft: The use of a patient’s own bone to rebuild and prepare the jawbone for an implant. It typically involves taking bone from the patients jaw or chin and placing it where needed.

Allograft: Graft from human bone, typically from a cadaver. At Northwest Oral & Maxillofacial Surgery, we only obtain allograft materials from reputable tissue banks. The cadaveric bone has been treated and purified multiple times and is neutral to immune reactions. In addition, donors are screened for known diseases and are certified safe for use by the American Association of Tissue Banks.

Xenograft: Graft from animal bone, typically a bovine. Xenograft materials have been physically and chemically treated to be comparable to human bone graft material.

If you are considering a dental implant and require bone grafting, we encourage our friends, family and patients to use a qualified dental specialist, such as an oral surgeon, to coordinate a safe surgical procedure and beautiful restoration.  Please contact us today if you have questions or would like to schedule an appointment with one of our board-certified oral and maxillofacial surgeons.


Safe Administration of IV Anesthesia

At Northwest Oral & Maxillofacial Surgery, many of the surgical procedures prescribed require the use of IV anesthesia to sedate and relax, as well as relieve pain for our patients. The board-certified oral surgeons at Northwest Oral & Maxillofacial are uniquely qualified to administer anesthesia because of their extensive education, training and clinical experience.

Our surgeons have completed a four-year undergraduate degree, a four-year dental degree and an additional four or six-year oral and maxillofacial surgical residency. It is during the residency that oral surgeons are trained in a hospital setting, alongside anesthesiology residents, to evaluate patients pre-operatively, administer anesthesia, monitor vitals, recognize complications associated with anesthesia, and to respond accordingly. In addition, the NWOMS surgeons are BLS (Basic Life Support), PALS (Pediatric Advanced Life Support) and ACLS (Advanced Cardiac Life Support) certified on an annual basis. Our surgeons, Diplomates of the American Board of Oral Surgeons, maintain their board certification through ongoing continuing education, passing the American Board of Oral & Maxillofacial Surgery Recertification Examination every eight to ten years, and successfully completing an Office Anesthesia Evaluation every five years.

An Office Anesthesia Evaluation (OAE) is a program designed by the American Association of Oral & Maxillofacial Surgeons to assure the public that the surgeon, the staff and the facility are equipped for the successful use of anesthesia. The OAE includes evaluation and inspection of the facility, emergency equipment and emergency medicines. It requires successful demonstration of emergency management procedures by the surgeon and the staff, and subsequent critique and discussion of the demonstration. Lastly, OAE examiners may observe surgery and anesthesia during the rigorous certification process.

The surgical staff at Northwest Oral & Maxillofacial Surgery is trained to assist the surgeons in the safe and predictable administration of anesthesia. Each assistant is BLS (Basic Life Support) certified, engages in ongoing continuing education and has successfully completed DAANCE, the Dental Anesthesia Assistants National Certification Examination. Two surgical assistants are present in each surgery, one to assist the surgeon and one dedicated to the observation and monitoring of the patient’s vital signs.

Dr. Penelope Duke, MD, a board-certified anesthesiologist, serves as our Medical Director of Anesthesia Services for Northwest Oral & Maxillofacial Surgery. She is an integral part of our ongoing commitment to delivering safe, state-of-the-art anesthesia. Dr. Duke also administers and monitors anesthesia to our patients who require additional care because of underlying health conditions, age or other risk factors. To our knowledge, we are the only private practice with this extra measure in place to ensure that we are constantly examining our anesthesia practices including emergency protocols, staff training, and facility evaluations.

Oral & Maxillofacial Surgeons are the surgical specialists within the dental profession. Each day their focus is on the safe administration of IV anesthesia and successful surgical procedures.  When deciding how to proceed with a surgical treatment plan, the surgeons at Northwest Oral & Maxillofacial Surgery encourage patients to be an advocate in their care. Patients are encouraged to ask questions about their surgeon’s credentials and the safety of the office. Ultimately, the goal at NWOMS is to provide compassionate care in an environment specifically designed for the safest surgical experience.

Northwest Oral & Maxillofacial Surgery | texasoralsurgery.com