Facial Trauma and Reconstructive Surgery

This section is dedicated to the latest information on oral health topics, culled from authoritative sources such as the American Dental Association.

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Heart Disease

Poor dental hygiene can cause a host of problems outside your mouth-including your heart. Medical research has uncovered a definitive link between heart disease and certain kinds of oral infections such as periodontal disease. Some have even suggested that gum disease may be as dangerous as or more dangerous than other factors such as tobacco use. A condition called chronic periodontitis, or persistent gum disease, has been linked to cardiovascular problems by medical researchers.

In short, infections and harmful bacteria in your mouth can spread through the bloodstream to your liver, which produces harmful proteins that can lead to systemic cardiac problems. That's why it is critical to practice good oral hygiene to keep infections at bay-this includes a daily regimen of brushing, flossing and rinsing.


Antibiotic Prophylaxis

In some cases, patients with compromised immune systems or who fear an infection from a dental procedure may take antibiotics before visiting the dentist.

It is possible for bacteria from your mouth to enter your bloodstream during a dental procedure in which tissues are cut or bleeding occurs. A healthy immune system will normally fight such bacteria before they result in an infection. However, certain cardiovascular conditions in patients with weakened hearts could be at risk for an infection or heart muscle inflammation (bacterial endocarditis) resulting from a dental procedure.

Patients with heart conditions (including weakened heart valves) are strongly advised to inform our office before undergoing any dental procedure. The proper antibiotic will prevent any unnecessary complications.


Dentistry Health Care That Works: Tobacco

The American Dental Association has long been a leader in the battle against tobacco-related disease, working to educate the public about the dangers inherent in tobacco use and encouraging dentists to help their patients break the cycle of addiction. The Association has continually strengthened and updated its tobacco policies as new scientific information has become available.

Smoking and Implants

Recent studies have shown that there is a direct link between oral tissue and bones loss and smoking. Tooth loss and edentulism are more common in smokers than in non-smokers. In addition, people who smoke are more likely to develop severe periodontal disease.

The formation of deep mucosal pockets with inflammation of the peri-implant mucosa around dental implants is called peri-implantitis. Smokers treated with dental implants have a greater risk of developing peri-implantitis. This condition can lead to increased resorption of peri-implant bone. If left untreated, peri-implantitis can lead to implant failure. In a recent international study, smokers showed a higher score in bleeding index with greater peri-implant pocket depth and radiographically discernible bone resorption around the implant, particularly in the maxilla.

Many studies have shown that smoking can lead to higher rates of dental implant failure. In general, smoking cessation usually leads to improved periodontal health and a patient’s chance for successful implant acceptance.


External Links

Dental injury.When you were a youngster, did you ever get a black eye, chip a tooth or bruise your cheek? If so, you may have experienced a case (let's hope, a mild one!) of facial trauma. In many situations, however, facial trauma can be severe. Among its major causes are auto accidents, sports injuries, work-related mishaps, falls, and acts of violence. When serious facial injury occurs, it's important that you receive immediate and comprehensive care. That's why oral and maxillofacial surgeons are on call at most emergency and trauma centers.

Facial trauma in general involves injuries to the soft- or hard-tissue structures of the face, mouth or jaws — including the teeth, the bones of the jaws and face, and the tissue of the skin and gums. It can also involve treatment of particular specialized regions, such as the area around the eyes, the salivary glands or facial nerves. Because facial injuries can affect not only a person's ability to carry on basic life functions (eating, vision, etc) but also his or her appearance, there is often a strong emotional component to treatment as well as a physical one. But after completing an extensive training program, oral and maxillofacial surgeons are capable of handling the full scope of facial injuries.

Treatments for Facial Injury

Some facial traumas are relatively minor. A common one occurs when a tooth is loosened or knocked out (avulsed). Many times, if treated immediately, the tooth can be successfully re-implanted in the jaw. If that isn't possible, placing a dental implant is often the most effective way to replace a missing tooth.

Another type of relatively common but more serious injury may involve a fracture of the facial bones, including the cheekbones, upper or lower jawbones, or the eye sockets. In principle, its treatment is essentially the same as that used for a broken arm: place the bones back in their proper position, and immobilize them. But since it isn't possible to put a cast on the face, different immobilization techniques are used. One method involves wiring the upper and lower jaws together to let them heal in the correct alignment; alternatively, plates and screws may be used to permanently reattach the bones.

Severe facial trauma is often a critical condition, since over 60% of these patients also have serious injuries in other parts of the body. In fact, many of the standard techniques used in trauma centers were developed by oral and maxillofacial surgeons during the wars in Korea, Vietnam, and the Middle East. Restoring breathing, controlling bleeding and checking for neurological damage are top priorities. After that, as much of the reconstructive surgery as possible is accomplished in one operation.

Preventing Facial Trauma

Athletic mouthguards.

What's the best treatment for facial trauma? Prevention. Always wearing seat belts, using proper helmets and protective gear when playing sports, and staying out of dangerous situations (like driving while impaired, tired or distracted) can go a long way toward keeping you safe. If you're engaging in athletic activities that carry any risk of facial injury, wear a properly fitted mouthguard — this small piece of protective equipment can save you a lot of potential harm.

But if you (or someone you care for) require a trip to the emergency room for a facial injury, be sure to ask for a consultation with an oral and maxillofacial surgeon, so that you get the best care and the most favorable outcome.

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