It’s hard to believe, but the lazy days of summer are drawing to an end, and soon the school bells will be ringing.  For many students in our area, back-to-school means back-to-practice.

According to Dr. M. James Clark, a board-certified oral surgeon with Northwest Oral & Maxillofacial Surgery, “We see about a dozen students each year that experience facial trauma during sports practice and games.”   Although not all sports-related injuries can be avoided, there are some steps that players can take to minimize their risks.

“Wear a helmet!” says Dr. Clark.  Whether you play football, baseball, or lacrosse, wearing a helmet is the best way to prevent a serious injury.  New innovations in helmet technology make them comfortable and effective in protecting the players’ maxillofacial area.  In addition to a helmet, Dr. Clark recommends that players wear a mouth guard that will protect players against loss of teeth or injuries to the jaw.   New designs of mouth guards are lightweight, easy to wear and provide excellent protection for the teeth, gums and lips.

In the unfortunate event that a player suffers an injury to his/her face or jaw during practice or a game, call 911 if the player is unconscious, disoriented, nauseated, dizzy or incapacitated.  If the injuries are not this severe but still require immediate attention, it is advised to take the player to nearest emergency room.  While at the hospital, request a consultation with an
oral & maxillofacial surgeon, the most qualified specialist to deal with trauma to the face and mouth.  The surgeon will be able to diagnose and treat fractures that involve the upper or lower jaw, cheekbones and eye sockets.  The oral & maxillofacial surgeon will also examine and treat the player for injuries to facial nerves, salivary glands and salivary ducts.   Timely attention to facial injuries will result in the most favorable outcome both aesthetically and functionally.

“Play hard, but be smart,” says Dr. Clark.  “Pack your safety gear!  And, on your way to practice, wear your seat belt in the car.  You can’t be too safe.

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.

We all are aware of what an important role our dentist plays in our overall oral health.  He or she  is your “go-to” clinician for routine procedures that include teeth cleanings, cavity fillings, sealants, crowns and other restorations.  To become a dentist, each has completed a post-graduate, four-year doctorate degree in dentistry.  For procedures outside the scope of their  training, a dentist will generally refer patients and coordinate treatment with a specialist.

For nearly 35 years, I have been a specialist, more specifically, an oral surgeon.  After five years of post-graduate education, I graduated from The University of Texas Health Science Center.  In 1983, I joined Northwest Oral & Maxillofacial Surgery, earned my board-certification, and pursued my commitment to providing the best oral surgical care for my patients.  I can honestly tell you that I think I have seen it all.  I’ve seen patients in my office who have had remarkable dental work, including beautiful restorations and perfectly aligned teeth.   And, on the flip side, I have seen some very scary conditions as a result of inadequate dental care.  Unfortunately, these abominable dental cases are usually a result of patients trusting their care to general dentists who have become known as “super-generalists,” or super-general dentists.

Have you encountered a super-general dentist?  His or her office promotes itself as capable of handling all dental issues for the sake of time and convenience.  Before you agree to allow your general dentist to perform procedures, find out a few things:

• Does your general dentist rightfully possess the necessary qualifications to perform the prescribed procedure?
• Has your general dentist had post-graduate training to perform the procedure?
• Is there a specialist in your community that specializes in the procedure that has been prescribed?
• Does your general dentist have the right equipment and trained staff to perform the procedure?
• Has your dentist enrolled in legitimate continuing education courses?
• What is the motivation behind offering procedures beyond his or her training?

If you are not comfortable with the answers to the questions above, there are many dental specialists that are properly trained and prepared to treat you:

•  Oral Surgeon: Experts in mouth, face and jaw surgery
•  Periodontist:  Experts in treating periodontal disease (gums)
•  Orthodontist: Experts in the treatment of improper bite and crooked teeth
•  Pediatric Dentist:  Experts dedicated to the oral health of children from infancy through 16 years old
• Prosthodontist:  Experts in the esthetic restoration and replacement of teeth

When your general dentist refers you to a specialist, you can feel confident that he or she has your best interest at heart.  He acknowledges the limitations of his training and appreciates the expertise of a specialist.  So, before agreeing to advanced dental procedures in your general dentist’s office, consider consulting with a specialist.  Beware of the dentists that claim to do it all.  As an oral surgeon, I want all of my patients, family and neighbors to have the best treatment possible.  Seek second opinions and seek specialists.  And, if you have any doubts, feel free to contact me directly at referral@nwoms.net.

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Dr. M. James Clark is a board-certified oral surgeon specializing in wisdom teeth extractions, implant dentistry and the treatment of other conditions of the mouth, face and jaw.  Dr. Clark practices at the Technology Forest office of Northwest Oral & Maxillofacial Surgery.

THE WOODLANDS, Texas – The Connecticut Mission of Mercy organizes a two-day clinic annually that provides free dental care to the underserved, the working poor and uninsured who are those that would otherwise go without dental care. Dr. Zahid Lalani, a board-certified oral surgeon, proudly volunteered in March 2015 at the two-day dental clinic.

“It was an overwhelming experience,” said Dr. Zahid Lalani. “The sheer number of people waiting for dental care, the gratitude that they showed and the enthusiasm of all the volunteers and dental professionals was incredible.”

While a MBA candidate at Yale University, Dr. Lalani was introduced to the outreach program and its tremendous impact on the community by Dr. Suzanne Lagarde, his friend and classmate at Yale University School of Management. Dr. Lagarde, a gastroenterologist by training, has been in charge of the medical triage at the clinic for the past 8 years. Dr. Lalani committed to her that he would volunteer as an oral surgeon at the clinic every year after they finished school in 2014.

Oral health is inseparable from general health. It can affect a person’s self-esteem, compromise his or her ability to work, attend school and lead a normal life. The Connecticut Foundation for Dental Outreach, in collaboration with the Connecticut State Dental Association, held the state’s first Mission of Mercy project in 2008. Every year the Connecticut Mission of Mercy project holds the two-day dental clinic in a different location throughout the state. This year, the dental clinic was held in Danbury, Connecticut. Despite the bitter cold and snow, a total of 1,997 patients were treated by 1,321 volunteers. It was truly a success!

“Volunteering at The Connecticut Mission of Mercy was one of the most fulfilling and humbling experiences in my life. I plan to return each year to serve those in need and to deliver on a promise to a friend,” stated Dr. Lalani.

Dr. Zahid Lalani, a board-certified oral surgeon, practices the full scope of his specialty at the Louetta office of Northwest Oral & Maxillofacial Surgery.

THE WOODLANDS, Texas – As a proud mother of a son who is a recovering drug addict, Julie Peterson reflects daily on her own journey with James. “Looking back now I can see the warning signs clearly,” stated Julie. “But while I was in the midst of it all, I didn’t want to acknowledge what I feared most.“Julie was in a state of denial about her son’s grim circumstances.

Julie divorced James’ father after four years of marriage. Drugs, alcohol and physical abuse were the motivating factors behind the divorce; yet, Julie struggled with overwhelming guilt about removing James’ father from his life. Nevertheless, she was determined to break the cycle of addiction and abuse. Julie felt it was her responsibility to “break the chain” and to keep her son from following the same destructive path as his father.

Julie brought James into Northwest Oral & Maxillofacial Surgery last week for his scheduled oral surgery with Dr. Clark. While she waited, Julie had a chance to talk about James’ descent into the world of drugs. What were the warning signs, and what would she tell parents of pre-teens and teenagers about drug abuse?

Warning Signs

James displayed increased and more dramatic mood swings. “He was more violent and physical with his outbursts. He would hit walls and appear as though he was losing control,” said Julie.

His grades were inconsistent and generally falling. Although James would have periods of doing well in school, Julie noticed that the trend was toward performing poorly in academics.

His friendships and relationships with good kids faded. He gravitated towards individuals that would get into trouble. Julie remarks that it was not the bad influence of others, but James’ own desire to gravitate towards drug abuse that ultimately led to his demise.

Without a doubt, James is a good kid with a good heart. But when drugs were involved, he was manipulative. He would use whatever means it took to get what he wanted. At times, Julie suspected James would behave well so that he would be commended for good behavior. Upon release from being grounded, James would return to old habits. “It was always disappointing because I wanted to believe that his motivation was honorable, and that he was ready to walk the straight and narrow.”

Julie found physical evidence of drugs including marijuana, measuring scales, -rolling papers, matches, and burn marks on furniture, carpet, counters, and closet shelves.

James attempted to mask odors. In one instance, she found empty toilet paper rolls stuffed with fabric softener sheets inside hidden in James’ closet. Unusual use of air fresheners, body sprays, mouthwash and chewing gum were signs that James’ was using.

Physical changes including weight loss, lack of grooming, increase in facial blemishes including acne, glazed eyes and a gaunt face were undeniable signs that James was abusing drugs.

According to Dr. M. James Clark of Northwest Oral & Maxillofacial Surgery and Dr. Parke of Parke Rogers Dentistry, there are many warning signs related to dental health that parents should heed:

• Rapid tooth decay in teenagers that can’t be attributed to soft drinks or candy is likely attributed to a combination of dry mouth caused by the drugs and long periods of poor oral hygiene.
• A pattern of tooth decay on the front of the teeth and between the teeth
• Bad breath
• Grinding and clenching teeth resulting in a squared off appearance
• Swollen and bleeding gums, open sores on gums

In James’ case, rapid tooth decay and poor dental hygiene ultimately necessitated his need for oral surgery and restorative dentistry.

Advice to Parents

When asked about how she would counsel parents about children and drug abuse, Julie recommends prayer! “Pray without ceasing,” exclaimed Julie. “Be in constant communication with God and relinquish control to him.” Other advice that Julie offers is to really engage with your children, be “in the moment,” and listen to them. “Put your phones and computers down and get involved. And, lastly, stand firm with your spouse and provide a united and loving front.” In Julie and James’ situation, Julie struggled with the tough love approach used by her husband, James’ stepfather. “ I wanted to protect James. I undermined my husband’s authority which just caused more confusion and chaos.”

Today James is about to enter the final phase of a drug recovery program called Teen and Adult Challenge. The final phase includes moving to Brenham, becoming employed, enjoying some freedom, and continuing his journey in faith. James said, “I am following God’s lead to do whatever he wants me do.” James and his family are proud of his progress and are looking forward to the future.

James came to Northwest Oral & Maxillofacial Surgery through NWOMS’ partnership with Interfaith Community Clinic and Dr. Stephanie Parke of Parke & Rogers Dentistry. James has been suffering from many of the dental issues that drug abusers experience. Dr. Parke has provided comprehensive dental treatment including fillings, crowns and hygiene therapy, while Dr. Clark has provided extractions of diseased teeth and wisdom teeth. Dr. Clark will replace the missing teeth with dental implants that Dr. Parke will restore with crowns. “We are so happy to provide these dental services to James and are so appreciative of his mom’s commitment to getting him to his scheduled appointments,” said Dr. Clark. “We are half-way there!”

As 2015 approached, many us of eagerly accepted the challenges of adopting optimistic and rigorous New Year’s resolutions.   Unfortunately, almost three months into the new year, about 90% of our New Year’s resolutions have fallen by the wayside.  How are your New Year’s resolutions coming along?  Maybe it’s time to hit the refresh button.  After all, spring is the season of renewal, rebirth and growth.   Many of the resolutions that we make each year are related to our health – weight loss, fitness, and healthy living –  and it is never too late to improve in all three of these areas.

A weight loss plan should begin with your physician.  Have a check-up to make sure that you are healthy enough to begin such a program.  Set realistic expectations.   Choose a weight loss plan that suits you.   There are so many from which to choose.  Weight Watchers, Jenny Craig and The Biggest Loser Diet rank among the top diets for weight loss.  For more information about the most popular diets, click on the link:  http://health.usnews.com/best-diet.

When it comes to fitness, it isn’t necessary to start out running a marathon.  Again, set realistic goals.  With springtime’s warmer weather and longer days, a brisk walk around your neighborhood is a good place to start.  Consider biking, swimming or joining a fitness class or sports team.  Grab a friend, too.  It’s all about getting up and moving around.   And, to make it fun, consider one of the new high-tech fitness trackers that will help you stay motivated and improve your health by tracking activity, exercise, weight and sleep.

Without a doubt, healthier living includes a good diet and exercise.  But, it includes so much more.  Make sure you are getting enough sleep.  Sleep deprivation can lead to decreased performance at school and work, impaired memory and a poor quality of life. The importance of adequate sleep cannot be overstated!  Also, try to spend time with loved ones each day.  Studies have shown that spending time with family and friends can decrease loneliness, reduce stress levels and also help you with achieving your healthy living goals.  Finally, think happy and positive thoughts.  Meditate quietly each morning or read encouraging scripture.  You will be prepared to face the day ahead.

So as we spring forward, resolve to recommit.  Pick one or two of your most important resolutions and approach them in small steps that can eventually turn into habits.  And, if you “fall off the wagon,” give yourself a break.  The good news is that tomorrow is a new day with a fresh beginning!

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Dr. M. James Clark is a board-certified oral surgeon, practicing at the Technology Forest office of Northwest Oral & Maxillofacial Surgery.  If you have any questions regarding oral health or oral surgery, please contact Dr. Clark at referral@nwoms.net.

Last week a tragic story began circulating in the media about a woman who died during dental surgery.  Dr. Rashmi Patel, a general dentist in Suffield, Connecticut has been charged with criminally negligent homicide and tampering with evidence.  Patient Judith Gan was undergoing treatment to have 20 teeth extracted and dental implants placed while under conscious sedation.

While I do not have all of the facts, I believe that it is safe to say that this tragic death could have been prevented, and that poor judgment on Dr. Patel’s part is to blame.  First of all, according to the article, Mrs. Gan had underlying medical conditions that were not adequately addressed.  She had suffered a heart attack and two strokes within the last two years.  In addition, she was prescribed and taking medications that would affect the effectiveness and safety of conscious sedation.  There are inherent risks in all dental procedures and anesthesia; even more so when administered by individuals not adequately trained to do so.  Patients that present these medical conditions within my practice are typically sedated by our board-certified anesthesiologist, Dr. Penelope Duke.  If medical conditions are more serious, surgery is better suited for our local hospital where I, as a board-certified oral surgeon, have privileges.

It is my opinion that Dr. Patel failed to recognize the risks associate with patient Gan.  While the treatment plan should be acceptable for a healthy individual, it proved to be risky for her.  Dr. Patel should have been trusted to identify her dental problems and fix the ones for which he is trained. He should also be trusted to refer the patient to a specialist who has the training and experience in physical diagnosis, the administration of IV anesthesia, and emergency care if required.

I question why Mrs. Gan would allow the dentist to perform this surgery given her medical conditions and her dentist’s lack of training and experience.  It could be a case of misplaced trust.  Or, perhaps she was working within the confines of her personal finances and dental insurance.  It could have made sense to her financially to just get it all done in one procedure.  Sadly, we may never know why she and her family chose to proceed with surgery and Dr. Patel.  But, it is my hope that consumers may learn from the tragic mistakes of others.

Fortunately, the majority of us living in and around The Woodlands are fortunate to have access to excellent medical and dental providers.  And, for the most part, we have insurance that allows us to make healthcare decisions that are in our best interest.  Nevertheless, it never hurts to repeat the following when it comes to your health:

• Get a second professional opinion
• Make sure you understand your provider’s qualifications, credentials, licenses, certifications, training and experience.
• If the treatment plan doesn’t seem right, it probably isn’t.  Ask questions.
• Report to your provider ALL medical conditions and medications. Don’t leave any information out.
• If your surgeon requires a medical clearance, it shows that he/she is making sure that you are capable of undergoing surgery.  He is treating you as a whole patient.  Be glad that he/she is taking this step.  It is in your best interest.

If you have any questions about any dental procedures or surgeries, feel free to contact me.  My email address is referral@nwoms.net.  I will be happy to help you.  If you would like to read the article related to this blog, please visit: http://www.foxnews.com/health/2015/02/18/dentist-charged-in-death-patient-getting-20-teeth-pulled/

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Dr. M. James Clark is a board-certified oral surgeon specializing in wisdom teeth extractions, implant dentistry and the treatment of other conditions of the mouth, face and jaw.  Dr. Clark practices at the Technology Forest office of Northwest Oral & Maxillofacial Surgery.

The first dental implant, an artificial tooth root that holds a replacement tooth, bridge or denture, was introduced to the United States back in the 1970’s.  At the time, there was only one dental implant, the Branemark Implant System.  It remains the model for today’s modern implant.  The idea was conceived by a Swedish orthopedic surgeon, Dr. Per-Ingvar Branemark, while working with titanium metal chamber to study bone healing.   He found that titanium could fuse to bone, also known as osseointegration, which makes a titanium dental implant successful.

Upon introduction to the marketplace, Branemark only sold dental implants to the best oral surgeons.  The company did not allow other dental professionals to place their implants.  Unfortunately, today there are no restrictions, implied or otherwise, regarding who can buy and place dental implants.  And, today there are hundreds of companies manufacturing dental implants and thousands of dental providers who place them.  As with most products and providers, the quality of each will vary.  Placing dental implants is a surgical procedure and should be handled by a board-certified surgeon, specifically an oral surgeon or periodontist. Specialists have the proper surgical training and understanding of implants that lead to a successful completion of a treatment plan.  The success rate of dental implants placed by board-certified oral surgeons is 98%.

Your dentist is uniquely qualified to restore your tooth with a crown, bridge or a denture; and, while working cooperatively with your oral surgeon, a patient can expect a seamless treatment plan.  Unfortunately, many general dentists are opting to place implants these days.  The failure rate for these implants is approximately 20%.  There is too much time and money involved with dental implants to run the risk of failure.   Consider the reasons that your dentist may offer to place your implant.

I encourage each patient to consider the unique specialties, training, and experience of each dental provider involved in your case.  As a general rule, there are very few doctors that can successfully provide all of the services needed.   The interdisciplinary approach is clearly the best way to ensure a quality and long-lasting result.

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Dr. M. James Clark is a board-certified oral surgeon specializing in wisdom teeth extractions, implant dentistry and the treatment of other conditions of the mouth, face and jaw.  Dr. Clark practices at the Technology Forest office of Northwest Oral & Maxillofacial Surgery.  For questions about oral surgery, feel free to email Dr. Clark at referral@nwoms.net.

Have you ever wondered why your third set of molars is called wisdom teeth when there is absolutely nothing wise about them?  They are called wisdom teeth because these teeth generally appear during the late teens or early twenties, which has ironically been referred to as the “age of wisdom.”

So, if your third molars are not causing you any problems, then should you have them removed?  The answer is yes.  It is very unlikely that these teeth will be a valuable asset to your mouth.  On the contrary, wisdom teeth typically cause many problems including:

• Jaw pain
• Misalignment of surrounding teeth
• Infection
• Pain
• Swelling
• Tooth decay
• Gum disease

I advise removal of wisdom teeth prior to problems developing.  Extraction is easier and much safer in younger people when roots are not fully developed and the bone is less dense.  Recovery and healing time increases incrementally with age.  Following wisdom teeth surgery, it will generally take about seven to ten days to recover for a younger person.  It is important to consider your school, athletic and/or musical schedules when scheduling surgery.

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For more information about wisdom teeth, please call Dr. M. James Clark at the Technology Forest office of Northwest Oral & Maxillofacial Surgery.  Dr. Clark and his colleagues at Northwest Oral & Maxillofacial Surgery are board-certified oral surgeons practicing in The Woodlands, Conroe, Spring, Magnolia and Huntsville.

Are you considering a dental implant to replace a missing tooth or teeth?  According to most dental professionals, an implant is the best option to permanently restore function and aesthetics.  It is a replacement for the tooth root that supports the bone and the crown to provide a natural-looking tooth.

Where to Start?

Once you have decided on an implant, where do you begin treatment?  To start with, it is important to consult with your general dentist.  In most cases, your general dentist will confirm that a dental implant is needed, and he/she will refer you to a board-certified oral surgeon.  Your oral surgeon will consult with you and provide a treatment plan that will include your general dentist.  See below for a delineation of responsibilities:

Why is it best to use two dental professionals? 

A general dentist is a trained in many aspects of dentistry including restorative dentistry.  He/she is extremely capable of restoring the beautiful smile or basic functions that you are seeking.  On the other hand, a board-certified oral surgeon is specifically trained to extract teeth, place dental implants, and administer anesthesia.

The failure rate of implants placed by surgeons is less than 1%; whereas, the failure rate of implants placed by other dental professionals is 18%.  The cost to use both  a general dentist and a surgeon is not more expensive as a general rule.  Each provider is uniquely qualified to successfully complete your treatment plan.

As you continue to contemplate implant dentistry, do your research.  Make sure that your general dentist and oral surgeon are qualified and trained to provide the treatment that you need.  Get second opinions if you feel that is necessary.  This is your mouth, money and time.  The results will be worth it!

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Dr. M. James Clark is a board-certified oral surgeon, practicing at the Technology Forest office of Northwest Oral & Maxillofacial Surgery.  Questions for Dr. Clark can be submitted to referral@nwoms.net.   He will be happy to answer your dental implant questions and refer you to general dentist, if necessary.

So you are missing a tooth? Or, maybe you are you missing several teeth. Either way, missing one or more teeth can be a big problem. Not only does it look unattractive, missing teeth hinder proper eating, drinking, and speaking. Chances are you will want to replace the tooth as quickly as possible. As an oral surgeon, I am often asked, “What is the best option for tooth replacement?” There are two acceptable treatments: dental bridges and dental implants.

What is a dental bridge?

A dental bridge is a frame on which two crowns and a false tooth are attached. The benefits of getting a bridge include slightly less initial expense and possibly fewer dental appointments. Many patients are pleased with the outcome. However, in order to attach a dental bridge to the adjacent teeth, your dentist will have to grind down the healthy adjacent teeth and add crowns to secure the bridge. By doing this, your anchor teeth will become susceptible to decay, plaque accumulation, and periodontal disease  causing possible future failure of the bridge. Also, the false tooth on top of the bridge sits above the gum. It doesn’t replace the root. Because of the lack of normal chewing forces, bone loss will occur. Although a dental bridge is slightly less expensive initially, its lifespan is between five and ten years. A replacement bridge will be inevitable.

What is a dental implant?

Dental implants are currently considered the best way to replace missing teeth. A dental implant is placed in the jaw to replace the missing tooth root. It acts as a base for a crown, a bridge or an entire dental prosthesis. It is the closest imitation of a real tooth. Among the many benefits of implants, one very important one is bone preservation. Without the chewing forces to the jaw, a patient will experience bone loss and ultimately lose his/her facial structure. Unlike with bridges, the adjacent teeth are left intact. There is no need to grind down adjacent teeth in order to adhere a crown and bridge. And most importantly, dental implants look and feel natural and comfortable.

Initially, a dental implant will be more expensive than a dental bridge. However, it is has been shown in many studies that an implant can last a lifetime. And, as dental implants become a more widely accepted solution, some insurance plans will cover a portion of the cost. (Check with your specific plan for more details.)

The bottom line is that you should replace your missing tooth. Whether you opt for a dental bridge for the sake of time and expense, or dental implant for the longevity and durability, it is my recommendation to do your research to find out what’s best for you. And, employ both your restorative (general) dentist and board-certified oral surgeon to complete your treatment plan. Without a doubt, this interdisciplinary approach will give you the best results.

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Dr. M. James Clark is a board-certified oral surgeon specializing in wisdom teeth extractions, implant dentistry and the treatment of other conditions of the mouth, face and jaw.  Dr. Clark practices at the Technology Forest office of Northwest Oral & Maxillofacial Surgery.