Dr. Keith Krueger

Orthognathic Surgery

woman smiling in dental chairWhat is orthognathic surgery?

Also known as corrective jaw surgery, patients undergo this procedure in order to correct a wide range of major and minor dental and skeletal irregularities. Jaw surgery is used to correct the misalignment of a person’s jaw or teeth, which will eventually improve breathing, chewing, and speaking. While a patient’s physical appearance may be altered just a bit with surgery, orthognathic surgery is mostly meant to correct functional problems.

What are some conditions that require orthognathic surgery?

There are quite a few conditions that indicate that you may need jaw surgery. Some of those include:

  • Sleep Apnea (breathing problems during sleep)
  • Protruding jaw
  • Open bite (someone who is unable to fully close their mouth)
  • Chronic mouth breathing and dry mouth
  • Difficult biting food or chewing
  • Difficulty swallowing
  • Chronic joint or jaw pain (TMJ)
  • Excessive wear on teeth

Evaluating Your Need For Jaw Surgery

We will work with your orthodontist and general dentist to evaluate your need for jaw surgery. In a great number of cases, patients need to have orthodontic work done before and after surgery. Jaw surgery is a lengthy and delicate process. In most cases, the whole process, including orthodontic work, will last 1-2 years. We will evaluate you thoroughly and realistically so that you may make the most informed decision possible.

How will I benefit from having jaw surgery?

Corrective jaw surgery will benefit you in numerous ways. After surgery, your jaw will be more aligned and balanced, and you will have more a far more functional and healthy jaw. While recovery may be lengthy, we will keep you comfortable along the way. With jaw surgery, patients can see an improvement in speech, eating, chewing and also breathing. Many patients see a positive change in their facial structures aw well after their jaw has been realigned.

To find out if you are a good candidate for corrective jaw surgery, please call us at West Office Phone Number 541-617-3993.

Dental Implants – The Recovery

recovery signThe recovery time following dental implant surgery tends to vary, but is usually based on the amount of teeth being implanted, whether or not a bone graft was needed and the individual and how well they manage their recovery. Luckily, the science and technology behind dental implants has improved drastically over the last few years, improving post-surgery pain and comfort for patients.

The patient requiring the least amount of recovery time would be one who had a standard, single dental implant placed with no bone grafting. With a simple procedure like this one, there is very little discomfort or pain after the surgery. Mild bruising and soreness can occur, but is typically manageable with over the counter pain relievers. In more severe implant cases, such as those where multiple teeth are implanted or severe bone grafting needed in order to accomplish the implant, the recovery time tends to be longer and the discomfort can be more intense.

In any cases, it is important to keep your mouth clean after surgery, which can be done by rinsing your mouth gently with salt water beginning the day after surgery. You may begin brushing your teeth the night after the surgery, but make sure to keep it light around the surgery area as to not disrupt the healing in that area. It is also important to remember that in the week following your surgery, there should be no smoking and no sucking through a straw, as this can seriously inhibit your healing process. It is important to stick to a diet primarily consisting of soft foods for the first 7-10 days following your surgery before beginning to return to your normal diet.

As you can see, the recovery process after receiving a dental implant is fairly predictable and comfortable. It is important to follow the instructions that we give you at Krueger & Lenox Oral and Maxillofacial Surgery, and to always remember that if you have any questions or concerns regarding a procedure or following your surgery, you can always give us a call at West Office Phone Number 541-617-3993.

Oral Cancer Among Men to Increase in 2017

man standing with arms crossedA recent study by the American Cancer Society reports that oral cancer cases in men is expected to increase in 2017 by 4%, while the rate of new cases among women stays the same year over year. “Oral Cancer”, which is a common way to refer to all head and neck cancers, involves cancer of the oral cavity, lips, tongue, pharynx and esophagus.

Unfortunately, oral cancers often go undetected until their later stages when they are more difficult to treat, giving them an even worse reputation than many other cancers.

Oral cancer is more likely in those who:

  • Drink Alcohol Excessively (more than 2 drinks a day for men and more than 1 drink a day for women)
  • Smoke or Chew Tobacco
  • Have HPV (certain strains of the HPV virus are known to cause oral and other cancers)

HPV and Oral Cancer
Along with the rise of HPV among men has come the rise of oral cancers as well. Unfortunately, it has now been estimated that half of U.S. men are infected with HPV. While most of these will not go on to develop cancer, certainly, these increases may continue to create a rise in head and neck cancers until the disease is brought under control.

What You Can Do
Prevention and detection are the most important things when it comes to the fight against oral cancer. With early detection, we can do better for survival rates and, as we have seen with general cancer cases, prevention in the form of abstaining from tobacco and drinking in moderation can reduce the number of cases over time. In order to protect yourself and your family and help us with survival rates, we urge you to see us for an oral cancer screening. It only takes a few minutes for us to examine you – and it could save your life.

For more information on oral cancer, call us at West Office Phone Number 541-617-3993 or visit oralcancerfoundation.org.

Autograft Vs. Allograft

woman smilingSo, you were recently told by your doctor that you need a bone graft, but you aren’t quite sure what that means.

A bone graft is a surgical procedure that is used to fix bones or joints that were damaged by trauma, and it is also used to replace bone that is missing to provide structural stability around the body, including the jawbone. There are many types of bone grafts we can use to grow bone – the two most common are autografts and allografts.

An autograft is a bone or tissue that is transferred from one spot to another on the patient’s body. It is often thought of as the “gold standard” in bone grafting because of its reliability. Its high success rate is due to the fact that it is living tissue and thus its cells are kept intact.

An allograft is a bone or tissue that is transplanted from one person to another. They typically come from a donor, or cadaver bone. The allograft is safe, ready to use and available in large amounts. The main advantage of an allograft is that it requires one less procedure than the autograft, which must first be taken from the patient. Surgical time is minimized and the recovery can be quicker. The allograft comes from a reputable and reliable tissue bank.

Knowing which bone-grafting option you will need can be confusing, but we are here to answer any questions you may have. Please schedule a bone grafting consultation with us by calling West Office Phone Number 541-617-3993. We will perform a thorough evaluation of your oral health. After our evaluation, we will recommend what bone graft is best for you. We are happy to discuss your options and answer any questions you may have. We want you feeling confident with our choice and worry free.

Tooth Extraction – Managing Pain

cartoon image of man kicking painThe Procedure Itself
Thanks to a wide variety of anesthesia choices available to us these days, you should feel no pain during your extraction.

After the Surgery

  • Over-the-Counter Medicines: Generally speaking, over the counter non-steroidal anti-inflammatory medications such as Ibuprofen are all that you will need following your surgery.
  • Staying On Top of Pain: It is very important to stay on a strict schedule of medication the first few days following your surgery. Getting behind on medication will result in more pain and may even make it difficult to catch up with pain control again.
  • Ice for Swelling: We want you to ice your cheeks for the first 24 hours following surgery, twenty minutes on and twenty minutes off alternating. Managing swelling can help greatly with pain management, and the act of icing may even feel good on its own.
  • Rest: Your body was expertly designed with high-tech systems in place to heal – but you have to give it the space and conditions to do so. Rest is one of the most important things you can do to help your body heal faster.
  • Salt Rinse the DAY AFTER Surgery: The day after surgery, you should rinse your mouth very gently with a mixture of one cup of warm water and ½ teaspoon of salt. You may do so up to 4 times a day. Designed to gently clean the wound site (but NOT dislodge the blood clot), some patients also feel that the warm water helps with pain relief.
  • Prescriptions: Most often, our patients do not require prescription pain medication post-op. However, in the case that we feel your case calls for such, please keep the following in mind:
    • Antibiotics – If we have ordered antibiotics for you, you must take them on schedule and for as long as we prescribe – Never stop antibiotic treatment prematurely without our specific orders.
    • Pain-Killers – In the event that you require prescription pain killers, please note that we are required to prescribe these sparingly and in accordance with certain laws, due to rising rates of substance abuse. You can help keep these drugs off the street by taking only what you need, and taking unused pills to a pharmacy for safe disposal – never “keep them around” in your cabinet for future use.

For more information, please visit our surgical instructions page and feel free to call us at West Office Phone Number 541-617-3993

Preserving Your Jaw after Extraction: Socket Preservation

skeleton with jaw bone highlightedIf you come to see us for an extraction, you may hear us talking about “socket preservation” or ”ridge augmentation”, and you might be wondering, what is that?

Socket preservation is a procedure we will sometimes recommend when you are having a tooth extracted. The bones that hold your teeth require frequent use to maintain their size and shape, otherwise they start to recede as they are no longer needed.

When a tooth is extracted, it leaves behind a hole (or “socket”) in the alveolar ridge bone, making it vulnerable to shrinkage. In fact, some studies show that bone loss can be 50% in the first 12 months after extraction.

You may be wondering, “Why does bone loss matter if I don’t have a tooth there anyway?” Unfortunately, without teeth and adequate bone structure, several unwanted oral health problems may occur:

  • Aesthetics: Without adequate bone structure and teeth, your smile starts to cave in in that area, causing undesirable aesthetic consequences. Your skin may begin to look shriveled over time and your smile will be unbalanced and unnatural.
  • Alignment Issues: Your teeth are always moving, particularly into open spaces. A hole on one side of your smile can lead to a severe shift of your teeth over time, affecting your smile and subsequently requiring orthodontic treatment.
  • Implant Complications: The damaged and recessed bone often ensures complications if you plan on getting a dental implant to replace the extracted tooth in the future.

This is where socket preservation comes in. Typically done at the end of your extraction procedure, we place bone-grafting material into the socket and a collagen membrane on top to encourage bone growth in the area. Because the procedure can be done at the same time as your extraction, no additional anesthesia or appointments are necessary.

If you are facing extraction, call us at West Office Phone Number 541-617-3993 to see if socket preservation is an option for you – it could save your smile!

Missing Teeth: More than Just a Gap In Your Smile

man smilingWhile it is true that the most obvious effect of missing teeth is a gap in your smile, missing teeth can cause other problems that you might not be immediately aware of. For example, did you know that for every missing tooth you have you lose 10 percent of your chewing ability? Read on to get a better idea of how a missing tooth can affect your life.

Surrounding Teeth
A missing tooth usually means more stress for the remaining teeth. In addition to that, if you are missing a tooth on the lower jaw, the opposing tooth on the top can grow longer to fill the gap in a process known as superuption or extrusion. This could lead to teeth tilting and move out of place by drifting into the space that was left by your missing tooth – a disaster for your beautiful smile!

Digestive Health
If you are missing teeth, you can’t enjoy all of the foods that you are used to eating – bad for your health and bad for your mood! Say goodbye to caramel apples, saltwater taffy, crunchy carrots and even gum. And because the variety in your diet is reduced when a tooth is missing, digestive problems are unfortunate yet common.

Decay and Hygiene Problems
The shifting of your teeth may cause new hygiene issues as it may be difficult to brush and floss like you normally would. This leaves your mouth more vulnerable to gum disease and tooth decay.

Facial Aesthetics
People with more than one missing tooth may also have issues with a collapsed bite which causes a loss of vertical dimension. This could make your face appear shorter, as the distance between the tip of your nose and your chin would decrease.

The good news is that you don’t have to suffer anymore! Dental implants can help you avoid all of the problems listed above and let you live your life normally again. It’s never too late for a dental implant, give us a call at West Office Phone Number 541-617-3993 to find out about this life-changing procedure.

Why do we have wisdom teeth anyway?

question mark above woman's headWisdom teeth were once an extremely valuable asset to our ancestors. When a typical diet consisted of chewy plants and uncooked meat, third molars (wisdom teeth), which fit easily into our ancestors’ larger jaws, were absolutely necessary. Wisdom teeth were the evolutionary answer to the need for chewing power to combat excessive wear.

Today, our diets are not as rough as those of our ancestors. With modern marvels like forks, spoons, and knives, as well as softer food, the need for wisdom teeth is virtually nonexistent. And yet, on average, about 65% of the human population is born with wisdom teeth which usually erupt between the ages 17 and 25.

Although wisdom teeth were incredibly advantageous for our ancestors, they pose a bit of a problem for the modern mouth. Humans have evolved to have smaller jaws, and so wisdom teeth are often either too big for the jaw or the jaws themselves are just too small. Either way, third molars crowd the mouth. Because of this lack of space, molars often grow sideways, only partially emerging from the gums, or actually get trapped inside the gums and jawbone.

These impacted wisdom teeth can be chronically contaminated with bacteria associated with infection, tooth decay, inflammation, and gum disease. And because they’re so far back in the mouth or trapped underneath gums, it’s difficult and sometimes impossible to keep them clean. Even when wisdom teeth come in fully, they are so far back in the mouth that it’s just too easy for food to get trapped, leading to plaque, cavities, and gum disease.

Although wisdom teeth were very important to our ancestors, nowadays, they pose a serious problem to oral health. Call Krueger & Lenox Oral and Maxillofacial Surgery to find out if your wisdom teeth are ready to come out!

How Are Wisdom Teeth Removed

impacted wisdom tooth diagram

Don’t be worried about your wisdom tooth extraction, let us outline the whole process for you:

Treatment Development
During late adolescence, wisdom teeth start to appear and occasionally are accompanied by oral pain, as well as an increased risk of dental issues such as pericoronitis, gum disease, and tooth decay. Through evaluation, your oral surgeon will determine the number of wisdom teeth present, as well as how they are developing in relation to the rest of your teeth. Using advanced imaging technology, an oral surgeon will discover if the teeth are partially or fully impacted, and then will create a strategic treatment plan in order to remove the teeth and ensure successful recovery.

Preparation
Although sedation is not always necessary, many patients have found anesthesia to be helpful in relaxation and reducing pain during the procedure. If sedation is chosen, there are certain preparations that must be made: patients must enlist the help of family or friends to bring them back home after their surgery.

The Procedure
Local anesthesia is applied to the area. Then, a surgical tool is used to reveal the bone and tooth. After the tooth is clearly visible, it is removed. Once the tooth is extracted, the gums and bone are left to heal.

Healing
Following the procedure, there may be some swelling in the tissue and cheeks near the treatment site. To promote a successful recovery, patients should avoid strenuous activity, smoking, and eating hard foods. Patients should not touch the treatment area with their tongue, or use straws, as this could potentially dislodge the developing blood clots and expose the area to food and bacteria.

Wisdom tooth extraction can be an uncomplicated procedure that ultimately will protect your long-term oral health. For more information about wisdom tooth extraction, schedule your consultation at Krueger & Lenox Oral and Maxillofacial Surgery today!

Little Medium Big Bone Grafts

bone graft, bone tissue

Bone grafting is a straightforward procedure that is immensely beneficial for numerous reasons. In the instance of a missing tooth (or teeth), the jaw bone can begin to slowly degrade. The jaw bone is holds teeth in place, and once a tooth is no longer present, the bone doesn’t have anything to support. There are different types of bone grafts, and depending on your situation. Outlined below are several different types of bone grafts:

Little Bone Graft

In the case of a simple, single lost tooth, the ideal course of action is to not lose excess bone. In this process, sterile, demineralized human bone granules are packed into the tooth socket immediately after tooth extraction. This procedure is very simple, and does not add anything to your recovery time. Over the next several weeks, your own bone will fill the tooth socket and preserve the bone height enough for you to have the area restored.

Medium Bone Grafts

If a tooth was removed a long time ago, there is likely to already be some bone loss impeding the restoration of the area. In this case, the area of the missing tooth is opened with a small incision, the bone surface is prepared, and demineralized bone graft granules are used to build up the area. Many surgeons prefer to use a little bit of the patient’s own bone in this procedure in order to ensure the best results possible. If your own bone is used, your surgeon will take it from another area of the jaw bone, usually near the wisdom tooth area, shaving off tiny granules and combining them with the demineralized bone. The bone graft will heal and integrate with the surrounding bone tissue. This type of graft can be used for one or multiple areas of missing teeth.

Big Bone Graft

Patients who have many missing teeth and who have been missing many teeth for many years, have often experienced advanced bone loss. In those who wear dentures, the lower jaw bone often recedes so severely that they can no longer wear them. Extensive bone grafting is necessary in order to consider restorative methods. A combination of demineralized, sterile human bone and the patient’s own bone is used to restore the jaw bone, creating enough width and height to consider dental implants. The patient’s bone is supplied by another part of the jaw, hip, or tibia. Bone granules are also used to enhance and strengthen the graft.

Bone grafting is a surgical procedure that takes time. However, it plays an essential role in making new teeth possible, and will ultimately be a positive process! For more information, call 541-617-3993 today for a consultation with Krueger & Lenox Oral and Maxillofacial Surgery