Dr. Zahid Lalani – Memorial Hermann The Woodlands Facial Trauma Team

Following a tragic event and traumatic injury, the proximity and availability of a trauma center can greatly affect patient outcome.  In the greater Houston area, there are currently two level I trauma centers – Memorial Hermann Red Duke Trauma Institute and Ben Taub Hospital. A level I trauma center provides total care for every aspect of the most serious injuries from prevention to rehabilitation.  The center is required to have in-house 24-hour trauma surgeons and a staff of specialists and sub specialists on call.   Many times critical patients will be transferred to a level I center from a level II, III or IV center or emergency room; thus, increasing the time lapsed before appropriate care is administered.

In response to the growing need for a higher-level trauma care in the communities north of the Texas Medical Center, Memorial Hermann The Woodlands Hospital, previously a level III trauma center, has begun providing services to patients as a level II trauma center since summer 2015. As a level II trauma center, Memorial Hermann The Woodlands Hospital will provide 24-hour immediate coverage by general surgeons as well as by specialists in orthopedics, neurosurgery, anesthesiology, emergency medicine, radiology and critical care.  In addition, there are sub-specialists on-call who are required to respond to an emergency within a stringent time frame.  The goal is to provide immediate and comprehensive care to trauma patients and reduce the burden on level I trauma centers.

The American College of Surgeons recommends that an Oral and Maxillofacial Surgeon be a member of a level I or II trauma team. Dr. Zahid Lalani, a board certified Oral and Maxillofacial Surgeon practicing with Northwest Oral & Maxillofacial Surgery, spearheaded the formation of the facial trauma team with Dr. Bryan Correa, a board certified plastic surgeon.  In addition, Dr. Lalani has assumed the responsibility of the on-call Oral and Maxillofacial Surgeon at Memorial Hermann The Woodlands Hospital providing treatment for all types of traumatic facial injuries.  “I am pleased to be a part of the expanded team of affiliated physicians covering facial trauma call at the hospital. Oral and maxillofacial surgeons are one of the most qualified specialists to handle serious and complex trauma to the face and jaw.  Treatment of facial trauma and reconstructing deformities is my passion. It makes a huge difference for patients when you help them get their identity back after an injury.” Dr. Lalani was elected a Fellow of the American Academy of Craniomaxillofacial Surgeons, having been nominated by his peers in the country for this honor.

For more information about trauma care at Memorial Hermann The Woodlands, visit trauma.memorialhermann.org.  For more information about Zahid Lalani, D.D.S., PhD, M.B.A., please visit texasoralsurgery.com.

A healthy smile should last a lifetime, but, well…. sometimes that smile needs a little help. For various reasons, many people end up with a missing tooth (or teeth). Not only can a missing tooth cause embarrassment, but it can also lead to long-term health issues. Fortunately, there are procedures, such as dental implants, that can bring back that beautiful smile.

Dental implants have a dramatic, positive affect on a patient’s life. Not only does the simple procedure brighten his or her appearance, it can also drastically improve their overall quality of life.

Unlike other dental procedures, an implant replaces the tooth root, not just the crown. The bone bonds to the implant, provides a solid foundation for chewing that looks natural. The implant is permanent and designed to last a lifetime.

In fact, there are many advantages of dental implants including:

Increased confidence – many people are self conscious when missing a tooth, but once it’s “fixed” their confidence and self esteem rises

Improved chewing ability – a dental implant attaches to the root, making chewing and biting easier. Patients can enjoy their favorite foods again!

Improved appearance – this simple, single procedure is one of the most dramatic ways to improve a person’s appearance

Keep surrounding teeth healthy – the teeth around the “missing” tooth won’t suffer

Easy to care for – implants are permanent, and require the same care as your regular teeth

Permanent – dental implants are permanent and designed to last a lifetime. Once implanted, you don’t have to think about them!

Improve long-term health – dental implants reduce the risk of periodontal disease and other oral infections. They also keep the jaw bone healthy (the jaw bone can actually shrink over time when teeth are missing!).

If you or someone you love is missing a tooth – or teeth – dental implants can make a huge difference in the overall quality of life. To learn more or for a consultation to determine if an implant is the right solution for you, contact Northwest Oral & Maxillofacial Surgery today.

Donations accepted through the end of June

The Woodlands, TX – 6.22.16 – Northwest Oral & Maxillofacial Surgery, the largest oral surgery practice in southeast Texas, has partnered with Interfaith of The Woodlands and coordinated a flood relief drive. Patients and employees are contributing food, personal care items, and cleaning supplies to Interfaith of The Woodlands who will distribute these necessities to residents who suffered losses during the recent flood events.

At Northwest Oral & Maxillofacial Surgery’s Sterling Ridge office, the donation bucket is overflowing.  According to Dr. Charles Repa, “We empty our bucket and it is filled up again before we know it! We are so grateful to our patients and employees who have been so generous.” The flood relief drive will continue at Northwest Oral & Maxillofacial Surgery through the end of the month. Anyone is welcome to drop off donations at any Northwest Oral Surgery office or at Interfaith of The Woodlands.

About Northwest Oral & Maxillofacial Surgery

Northwest Oral & Maxillofacial Surgery is an oral surgery practice of seven board certified oral surgeons conveniently located in six locations including Magnolia, Conroe, Spring, Huntsville and The Woodlands (Sterling Ridge and Technology Forest.) The surgeons specialize in wisdom teeth extractions, dental implant preparation and placement, bone grafting, and other oral and facial surgeries.

For more information contact Tracey Carlson at nwomsmarketing@aol.com or visit www.texasoralsurgery.com.

Does the presence of certain mouth bacteria indicate pancreatic cancer? While there is not an undeniable link, there is a strong suggestion that two types of bacteria in the oral microbiome are associated with pancreatic cancer. Similarly, these same two types of bacteria, porphyromonas gingivalis and aggregatibacter actinomycetemcomitans, are also linked to periodontitis, a serious gum infection that damages gums and can destroy the jawbone.

In 2015, pancreatic cancer was the cause of over 40,000 deaths in the United States. The symptoms often go undetected allowing the cancer to invade other vital organs such as the stomach, liver, or gallbladder.

Pancreatic cancer is seen more often in individuals that are:

• Between the ages of 60 – 80
• African American
• Men
• Obese

Diet, smoking, chronic pancreatitis and family history may also be indicators of the predisposition to develop pancreatic cancer.

To read more about pancreatic cancer and its association with oral bacteria, check out Oral Bacteria Linked to Pancreatic Cancer on DentistryIQ.com and Oral Bacteria May Signal Risk For Pancreatic Cancer on Colgate.com.

The surgeons at Northwest Oral & Maxillofacial Surgery are Diplomates of the American Board of Oral & Maxillofacial Surgery. They specialize in wisdom teeth extractions, dental implant preparation and placement, oral pathology, bone grafting, corrective jaw surgery and oral/facial trauma.  For more information about Northwest Oral & Maxillofacial Surgery, please visit texasoralsurgery.com.

Have you ever been diagnosed with a dental condition and been prescribed a treatment plan with which you were uncomfortable?  If so, did you seek a second opinion?  We certainly hope that you did.  Second opinions can confirm a diagnosis and provide the reassurance that you need to proceed with treatment.  Or, second opinions can offer alternative solutions that are more agreeable to you.  Nevertheless, in most cases, if you have doubts about a diagnosis, your intuition may be signaling that something just doesn’t seem right.  Trust your instincts and seek another opinion.

Why would you need a second opinion?  You might consider a second opinion if:

• Your diagnosis is serious in nature such as oral cancer, temporomandibular joint disorder, or periodontitis for example.
• You are seeing a new dentist and don’t have “history” with him/her.  You just have not gained the confidence with your new dentist quite yet.
• You feel like your dentist may being putting profit over your best interest and that he/she is suggesting treatments that are unnecessary and expensive.
• Your condition is one that should be treated by a specialist; but, your dentist is offering to treat it instead of referring you to an oral surgeon, periodontist, or endodontist for example.

Be honest with your dentist and tell him/her that you will be seeking a second opinion.  Chances are he or she will welcome this because it will confirm his original diagnosis.  Ask your dentist to make your records, test results and radiography available to you.  And, check with your insurance company because many plans will cover the cost of second opinions. We encourage you to be your own advocate and make the most informed decision about treatment.

Here’s a report from Jeremy Rogalski of KHOU that discusses just one of the many reasons we recommend seeking a second opinion.

All Northwest Oral & Maxillofacial Surgeons are board certified by the American Board of Oral & Maxillofacial Surgery; but why is that important?

The graphic below highlights what it means to be board certified and how it affects you, the patient.

Without a doubt, one of the most frequently asked dental-related questions is, “Should I have my wisdom teeth removed?” According the American Association of Oral and Maxillofacial Surgeons, it is recommended that all patients seek the advice of a board-certified oral surgeon and undergo a comprehensive clinical and imaging examination to determine the most appropriate treatment for wisdom teeth.  A complete exam will address the following:

• Are the wisdom teeth, or third molars, symptomatic? Is there pain or swelling associated with the teeth?
• Have the third molars erupted? Or, are they impacted?
• Is there evidence of disease?
• Does their position interfere with other teeth, nerves or sinuses?

In the presence of symptoms or disease, surgical removal is typically the prescribed treatment.  For those patients with asymptomatic and disease-free third molars, patients are encouraged to follow the advice of their oral & maxillofacial surgeon. He/she will outline and explain the risks associated with retaining third molars which include the future possibility of developing pathology (disease) and interference with the alignment of other teeth. Surgeons will caution that is more difficult and precarious to remove wisdom teeth as a patient ages.

While no one can accurately predict how wisdom teeth may or may not progress, patients can feel confident in their surgeon’s experience and expertise to help them decide how to manage third molars. For more information about wisdom teeth management, watch this video produced by the American Association of Oral & Maxillofacial Surgeons, or contact one of the board-certified oral surgeons at Northwest Oral & Maxillofacial Surgery to schedule a comprehensive consultation. Visit texasoralsurgery.com for more details.

Source: “Management of Third Molar Teeth.”  American Association of Oral & Maxillofacial Surgeons.  2016. 

Wisdom teeth removal is a common practice, and most dental professionals recommend that their patients have them taken out. After all, wisdom teeth are not necessary and can cause a number of problems, either as they first grow in or further down the line. Sometimes removing them right away is necessary, as in the case of impacted teeth or severe crowding. Other times they are taken out as a preventative measure to stop problems from developing in the future.

But is it always necessary?

Although it is usually recommended, there are cases when it is not necessary. We’ll discuss those instances in this post, but first let’s consider the top reasons people have wisdom teeth removed:

They Cause Crowding or Shifting – Wisdom teeth can cause crowding in your mouth, forcing your other teeth to shift. If you’ve had braces or previous orthodontic/dental work, this movement can undo the beautiful (and often expensive!) results.

Hard to Clean – Because they’re positioned so far in the back of the mouth, wisdom teeth are incredibly difficult hard to keep clean, even with electronic toothbrushes and regular flossing. This can lead to bacteria growth, cavities and gum disease over time.

Impacted Teeth – When wisdom teeth are blocked and can’t come in properly they remain underneath the gums, often growing sideways or at an angle. Or they may be partially exposed, again leaving the area susceptible to cavities and other infections.

Other Complications – Sometimes other complications occur, such as fluid-filled growths (cysts) that damage the teeth, bone and nerves. Some people experience jaw or even sinus issues related to wisdom teeth. Others report uncomfortable, constant pain in the area.

However, despite the fact that there are many compelling reasons to have wisdom teeth removed, doing so is not always a given. There are times when it is not necessary, and some lucky people can keep wisdom teeth their entire life with no problems.

If your wisdom teeth:

• Are healthy and clean
• Positioned correctly (aligned with your other teeth)
• Not impacted
• Don’t cause crowding in your mouth
• Don’t cause pain

You may be one of the few that doesn’t need to have them removed.

However, even if you meet the above criteria and decide to keep you wisdom teeth, remember that you are making a lifelong commitment. It is critical that you clean your teeth thoroughly (brushing, flossing) and maintaining regular dental checkups for cleanings, x-rays and consultations.

Many people subscribe to the “better safe than sorry” philosophy when it comes to wisdom teeth removal. There are a lot of things that can go wrong in the future, and since it’s impossible to predict many choose to have them removed as a preventative measure. It’s also important to keep in mind that they are much easier to remove when a patient is younger. As we age, the bones in our mouth actually get harder, making the teeth tougher to remove and leading to a longer recovery time.

As with any procedure, it’s important discuss wisdom teeth removal with your dental professional(s). They can explain the pros and cons and discuss your specific case. Together, you can decide what is best for you now and in the future. And of course, the ultimate decision about your personal health is yours.

If you want more information on wisdom teeth removal visit our website at texasoralsurgery.com or contact us here to schedule a consultation.

It is generally recommended that children and adults visit their general dentist twice a year for routine check-ups and cleanings.  As a part of these visits, x-rays are often required annually for the identification and diagnosis of dental conditions.  And, while I believe that the benefits of x-rays far outweigh the risks, concern about the amount of radiation from dental x-rays remains one the most common questions in dentistry.

Panoramic x-ray

The most prescribed dental x-rays are:

• Bite-wing x-rays which focus on the upper and lower back teeth and check for decay between teeth,
• Periapical x-rays which show the entire length of a tooth from crown to root and is used to look at the health of the bone that supports the teeth and to detect abscesses, cysts, tumors and impacted teeth,
• 

  Bite-wing x-ray

  Occlusal x-rays which show nearly the full arch of teeth in either the upper or lower jaw. These x-rays are used to detect extra teeth, teeth that have not yet broken through, jaw fractures, cleft palate, unusual growths or foreign objects,

• Panoramic x-rays which are a two-dimensional tomographic exam that show the entire mouth in a single image including teeth, jaws, and surrounding tissue,
• Cone beam CT (computed topography) Scan which is a three-dimensional image of the teeth, soft tissues, nerve pathways and bone in a single scan. Commonly used by oral surgeons and orthodontists, the images from a cone beam CT allow for better treatment planning and placement of dental implants.

So, how much radiation are you exposed to during an x-ray?

Radiation is measured in sieverts which indicates the health effect of low levels of ionizing radiation on the human body.  Since a Sievert is a very large dose, most measurements are done in millisieverts.

A large amount of radiation can cause tissue damage and increase the risk of developing cancer later in life.  The average American is exposed to 3mSv of naturally occurring radiation during the course of a year.  This naturally occurring radiation, or background radiation, originates from radioactive materials in the environment, radon gas in homes and cosmic rays from outer space.

While x-rays, radiography, contribute to the overall radiation exposure for a patient, it is well-documented that the amount of radiation exposure for dental x-rays is very small compared to other radiography.  It is always best to weigh the benefits and risks of any medical or dental procedure, but x-rays are an invaluable tool for your dentist or specialist when diagnosing dental conditions.  Together with your practitioner’s best professional judgement, you can decide whether or not an x-ray or computed tomography (CT) is right for you.

Dr. M. James Clark is a board-certified oral surgeon at Northwest Oral & Maxillofacial Surgery.  For more information about Dr. Clark and his colleagues, please visit texasoralsurgery.com.  Dr. Clark is located at 4185 Technology Forest in The Woodlands and can be reached at 281-367-2001.

Wisdom teeth are the very last four molars on each side of the upper and lower jaw. They are also the last teeth to come in, usually appearing in patients between the ages of 16-20.  Chances are, the first thing that pops into your head when you hear wisdom teeth is “removal.” Because your wisdom teeth are the last teeth to come in, there is little or no room for them. They can be impacted or trapped under the gum by other teeth or bone, or they can also come in at the wrong angle and shift your other teeth.  For most people, their jawbone just does not have room enough for more teeth. Consequently, most people tend to have their wisdom teeth removed.   Your dentist or orthodontist will refer you to a board-certified oral surgeon for extraction.

How are wisdom teeth removed?

With the use of IV anesthesia administered by a board-certified oral surgeon, a patient will be sedated.  However, if a patient prefers to be awake during the procedure, then the surgeon can simply numb the mouth with a local anesthetic.  The tooth extraction will take 30-45 minutes.  In the removal process, gum tissue will be opened up.  Any bone that is covering the tooth will be removed.  The wisdom tooth can then be extracted in whole or in smaller pieces.  Most patients opt to have all four wisdom teeth removed in one surgical procedure.  Following surgery, patients will spend about another hour in a recovery suite prior to heading home.

Recovery

Typical recovery involves swelling, mild bleeding and discomfort for approximately three days. Your surgeon will write a prescription to help with any pain or swelling.  Ice packs and cold presses will help, too. Applying steamed towels or moist heat packs to the outer jaw can alleviate soreness. Eat only soft foods for the first few days and drink plenty of fluids. Starting on the second day of recovery you can brush your teeth just make sure to avoid the back until it is fully healed.  During the recovery period, your surgeon will recommend that you refrain from strenuous physical activity.

Complications

The most common complication of wisdom teeth surgery is the development of very painful dry socket which occurs when the protective blood clot over the site of surgery is lost or dislodged.  To avoid dry socket, do not drink from a straw or smoke.  Sucking is the culprit.  If you develop a dry socket, contact your oral surgeon.  He will pack the site with medicated packing which will alleviate the pain.

For more information about wisdom teeth, visit texasoralsurgery.com.