Dr. Keith Krueger

Dental Implant Recovery

dental implants

Dental implants, titanium posts that are placed within your jawbone, are an excellent option for restoring missing teeth. The process of getting dental implants typically takes a few appointments over the span of several months, and since the strength of dental implants comes from their fusion with the jawbone, proper healing from this surgery is absolutely essential. Here are some tips for a speedy and well-healed recovery!

Prepare

One of the best ways to promote a speedy recovery is to properly prepare for dental implant placement. Get ready for your procedure by:
● Getting plenty of sleep
● Avoiding smoking or drinking excessively
● Maintain your oral health! Brush twice a day and floss once a day!
● Arrange for someone to drive you to and from your procedure
● Plan to take some time off work so you can really focus on resting and recovering
● Pick up post-surgical prescriptions, gauze, cold compresses, and any other supplies
● Ask for a recovery timeline

Getting ready before your dental implant surgery can make a huge difference in the recovery afterwards!

Recovery Time Factors

Recovery time for the dental implants procedure depends on several factors. While each patient’s case is slightly different, these following factors are the main contributors to healing time:
● The number of implants: Having a single implant may take less recovery time than multiple implant placement.
● Whether or not you require preparatory procedures such as bone grafting
● Your oral and overall health: the healthier you are, the easier it will be for you to heal quickly.

Your oral surgeon will explain your unique estimated recovery time based on these and other factors at your initial consultation.

After Your Surgery

After the procedure, the healing process can be sped up through:
● Biting down on gauze to staunch the bleeding
● Avoiding any activity that could put pressure on your mouth
● Taking proper prescribed medication
● Eating soft foods and avoiding chewing near the treatment area
● Rinsing your mouth with warm saltwater between meals
● Using a cold compress to reduce swelling
● Gently retaining oral health routines like brushing and flossing

Following these guidelines, you will be able to heal comfortably and successfully!

To learn more about this treatment, or schedule a consultation, call 541-617-3993 and come see us at Krueger & Lenox Oral and Maxillofacial Surgery today!

Types of Jaw Surgery

man side profileYour jaw consists of two parts; the maxilla or upper jaw and the mandible or lower jaw . Sometimes these are misaligned and need to be put back into place for bite reasons, or for aesthetic purposes. Corrective jaw surgery straightens or aligns the jaw, and is often referred to as “orthognathic” surgery; “orthos” meaning to straighten and “gnathic” relating to the jaw.

There are a few different types of jaw surgery, depending on which part of your jaw requires correcting;

Maxillary Osteotomy (Upper Jaw)
This type of surgery corrects a significantly receded upper jaw, cross bite, or when you have too many or too few teeth showing. It also can adjust an open bite.

Mandibular Osteotomy (Lower Jaw)
This surgery corrects a significantly receded lower jaw. The surgeon moves the jawbone forwards or backwards depending on the best adjustment and bite alignment.

Genioplasty (Chin)
A deficient chin often accompanies a severely receded lower jaw. Typically, surgeons can alter the jaw and restructure the chin during the same surgery.

Once your jaw is aligned, tiny screws and plates hold the bone into position. These screws and plates are osseo integrated and are specially formulated to be compatible with your body. They become integrated with your bone over time and do not have to be taken out.

Extra bone can also be added to your jaw if there is insufficient bone. This can be grafted from your hip, leg, or rib.

Often these types of jaw surgeries are performed entirely inside the mouth without any evidence on the skin surface as to what procedure has been performed. There are no facial scars on the chin, jaw or around the mouth.

Often with extensive jaw surgery, the process is carried out after you have had braces, so your teeth are aligned and ready for your jaw to be moved. Braces are placed anywhere from 9 to 18 months before jaw surgery.

Jaw surgery can take up to 2 years to complete, but the results are for life! Know your jaw facts; Talk to us today to discuss your options!

Learning the Lingo – Dental Implants

dental implantsDental implants are a safe and effective replacement for a missing tooth or teeth. The implant is placed in your jawbone and integrates with your natural bone. This implant then forms a stable, sturdy base for your new teeth.

What They Are
Implant: The implant itself is a rod that is screwed into the jawbone.

Abutment: This is the connection between the implant and the crown.

Crown: A tooth shaped cap that is attached to the abutment. It is the part of the tooth that is visible above the gum line.

What They’re Made Of

Titanium: Most implants are typically made of titanium, a biocompatible metal.

Zirconia: Often used for crowns and bridges and can be used as a metal-free option. Zirconia is biocompatible just like titanium.

Where They Go

Endosteal Implants: Placed in the jawbone. These implants are typically shaped like small screws, cylinders or plates, and they are the most commonly used.

Subperiosteal Implants: Placed under the gum, but on or above the jawbone. These implants are mostly for people with smaller jaws or shallow jawbones.

Wisdom Tooth Removal – Aftercare

woman smiling after Wisdom Tooth RemovalHaving your impacted wisdom teeth removed is a serious surgical procedure, and post-operative care is extremely important! Read on for instructions on how to care for your sore mouth, and how to minimize unnecessary pain and complications.

Immediately Following Surgery

Keep a firm, yet gentle, bite on the gauze packs that have been placed in your mouth to keep them in place. You can remove them after an hour if the bleeding is controlled. If the surgical area continues to bleed, place new gauze for another 30 to 45 minutes.

Be careful!

Do not:
• Rinse vigorously
• Probe the area
• Smoke (hopefully you don’t!!)
• Participate in strenuous activities
You can:
• Brush gently (but not the area)
• Begin saltwater rinses 24 hours after surgery (mix 1 tbs of salt with 1 cup of water). Make sure to swish gently. These rinses should be done 2-3 times a day, especially after eating.

Enjoy some down-time!

Keep activity level to a minimum! Enjoy a day of couch or bed-rest, as being active could result in increased bleeding. Avoid exercise for 3-4 days, and when you do begin exercising again, keep in mind your caloric intake has been reduced so you may feel weaker.

Bleeding

As you’ve just had surgery, some bleeding will occur and it’s not uncommon to ooze blood for 24-48 hours after your procedure. REMEMBER-the blood you see is actually a little blood mixed with saliva, so don’t panic!
If excessive bleeding persists:
• Try repositioning the packs. They may not be putting enough pressure on the site.
• Sit upright and avoid physical activity.
• Use an ice pack and bite on gauze for one hour.
• You can also try biting on a moistened tea bag for 30 minutes (the tannic acid in tea promotes blood clotting).
• If bleeding persists, please call our office at 541-617-3993.

Pain

Unfortunately, some pain is to be expected after surgery. Try not to let the anesthetic wear off before taking your prescribed pain medication. Dr. Krueger, Dr. Lenox and Dr. Peterson will have discussed a plan to manage your pain, make sure you follow these instructions.

Diet

Eat nourishing food that takes little effort.
Avoid:
• Extremely hot foods
• Straws (for the first few days)
• Chewing (until tongue sensation has returned)
• Smaller foods that can become stuck in the socket area
• Skipping meals—while eating may seem like a lot of work, you need your nourishment to be able to heal and feel better!

Day 2 and 3 Following Surgery

Swelling

Swelling is a completely normal occurrence. Keep in mind, swelling will usually be at it’s worst in the 2-3 days after surgery. You can minimize swelling by applying a cold compress (covered with a towel) firmly to the cheek next to the surgical area. Apply the pack with 20 minutes on, and 20 minutes off for the first 24-48 hours. Also make sure to take the medication prescribed by Drs. Krueger, Lenox and Peterson. This helps with pain and swelling.

Keeping your mouth clean

Keeping your mouth clean is very important! Continue saltwater rinses as often as you’d like, but at least 2-3 times a day. Begin your normal oral hygiene (remember to brush softly and don’t do anything that hurts)!

Healing

Everyone heals differently, but your timeline should look similar to this:
• Day 1-2 will be the most uncomfortable and you will experience some swelling.
• Day 3 you should be more comfortable and while still swollen, you should be able to begin a more substantial diet.
• Day 4 and on you should see a gradual and steady improvement.

Other Normal Things

• Discoloration. Bruising is a normal post-operative occurrence you may notice 2-3 days after surgery.
• Stiff jaw muscles. You may find it difficult to open your mouth wide in the days following your surgery. This is normal and usually resolves itself within a week after surgery. Stretching these muscles may help to speed up recovery.
Since no two mouths are alike, do not take advice from friends (even well-intended advice could cause a healing set-back). The advice given to you from Drs. Krueger, Lenox and Peterson and the Krueger & Lenox Oral and Maxillofacial Surgery team are tailored to fit your needs. Please call us at 541-617-3993 if you have any questions or concerns about your recovery. Happy healing!

Pediatric Facial Trauma

kid hiding behind soccer ballWe’ve all had our share of trips, bumps, and even broken bones in our childhood years! (If you haven’t, then you’re very lucky!)
As the saying goes, children are very resilient, and this is actually due to their biology. Children have “bendy bones” which are more likely to bend and crack under pressure rather than break.
The term is referred to as greenstick fractures; similar to when a green branch of a tree bends and cracks, but doesn’t break off.

Considering how much energy children have, pediatric facial trauma is actually very rare! Of all facial trauma, only 15% is pediatric (0-18 years).

The maxillofacial region is related to a number of vital functions, such as vision, smell, eating, breathing and talking. It also plays a significant role in appearance.
When treating children’s maxillofacial injuries, we take into consideration the difference anatomically between adults and children. Facial trauma can range between minor injury to disfigurement that lasts a lifetime if not treated correctly.

Children have much more flexibility in their facial bones, as well as smaller sinuses, multiple fat pads and unerupted teeth. In adolescents an increase in risk-taking behavior and the reduction of parental supervision results in an increase in facial fractures. Contact sports, physical play, riding bicycles, and even road traffic accidents all contribute to pediatric facial trauma.

A full treatment plan is always taken into consideration when we deal with facial trauma. The age of the patient, anatomic site of the trauma, complexity of the injury and how long since the injury occurred is taken into account. Ideally, don’t put off your incident for more than 4 days! This is prime healing time, and if any longer, could extend the healing and complicate the treatment process.

Oral Cancer and Hepatitis C

Oral Cancer and Hepatitis CThe Journal of the National Cancer Institute (JNCI) recently found that individuals infected with the hepatitis C virus are two to five times more likely to develop head and neck cancers. The JNCI study found that the risk for hepatitis C patients of developing head and neck cancers more than doubled for oral cavity and oropharynx cancers, and increased nearly five times for larynx cancers. As well, patients that are hepatitis C virus-positive were also more likely to test positive for human papillomavirus (HPV).

The question remains, how does hepatitis C virus increase oral cancer risk?

The JNCI research found that patients infected with the hepatitis C virus had a higher odd ratio of having cancer of the oral cavity, oropharynx, or larynx than those without hepatitis C virus infection. Enhanced replication of hepatitis C virus in oropharyngeal tissues may in fact contribute to chronic inflammation, ultimately prompting cancer development. Human papillomavirus is known to suppress local immune response, which may accelerate the production of hepatitis C virus in oropharyngeal cells. The JNCI notes that human papillomavirus and hepatitis C virus may play a “synergistic role” in the development of oropharyngeal cancers by stimulating loss or destruction of tumor suppressor proteins p53 and retinoblastoma protein.

The JNCI notes that one of the study’s limitations is that it didn’t include individuals with hepatitis C virus who didn’t have oral cancer. All and all, it is important to take away from The Journal of the National Cancer Institute’s study that it is important to educate Hepatology (study of liver, gallbladder and pancreas health) and infectious disease specialists. These doctors who treat patients with hepatitis C virus need to understand that the hepatitis C virus not only drastically affect liver health, but it’s also a systemic infection that can drastically affect oral health.

Your oral health is important to us. If you suspect that your oral health is at risk, give Krueger & Lenox Oral and Maxillofacial Surgery a call today and schedule an oral cancer screening!

Eating After Wisdom Tooth Extraction

woman holding jaw in painWhen it comes to getting your wisdom teeth pulled, you may be stressing about the long list of foods you can’t eat. Don’t worry – you won’t starve! We want your recovery to be as quick and painless as possible, so keep reading for an easy-to-follow guide to eating after your wisdom tooth removal!

DONT’S

  • Remember not to drink from a straw during your recovery. Using a straw could rip out your stitches or blood clots, causing dry socket.
  • The bubbles in carbonated drinks can also cause dry socket by loosening blood clots, so it’s best to avoid sodas.
  • Don’t eat crunchy foods like nuts, chips, and popcorn because they are hard to chew and can easily get stuck in your extraction sites.
  • Avoiding acidic foods and beverages can keep you from experiencing pain and stinging.

 

DO’S

  • Any liquids are fair game, like soups and broths. Lukewarm beverages are best, because you may experience temperature sensitivity.
  • Yogurt, pudding, applesauce and Jell-O are some go-to recovery foods: no chewing involved! Stick to these post-extraction staples for the first 24 hours after your surgery before moving on to soft foods that require chewing.
  • Mashed potatoes are great for the first few days because you can flavor them with gravy, butter, garlic, sour cream, cheese, the list goes on. Soft, starchy and filling, you won’t feel like you’re missing out on solid foods with these!
  • When you’re ready to move on to chewable foods, eggs are soft and can be eaten with just about anything.
  • You can even eat pancakes! They’re light, fluffy, and easy on your extraction sites (Tip: you can make breads even easier to chew by letting them sit in your mouth for a few seconds and softening them with your saliva).
  • Pasta is totally doable if you prepare it right. Macaroni and cheese is perfect because you can swallow the tiny noodles whole or chew them with your front teeth. You can also overcook your pasta noodles to make sure they are soft and easy to chew.

Your wisdom tooth extraction will be over with before you know it, and as long as you avoid difficult-to-chew foods you’ll be on your way to a speedy recovery!

Dental Implants: High Tech Teeth

What are dental implants? Dental implants are replacement tooth roots that provide a foundation for both fixed and removable replacement teeth. Like roots, dental implants are secured within the jawbone and not visible once surgically placed.

Dental Implants High Tech TeethTeeth replacement is not new to dental technology. Early civilizations practiced teeth replacements; archaeologists have discovered skulls where teeth have been replaced by cast iron and sea shells. Despite their primitive methods, some of these implants were fused with bone like modern dental implants! However, unlike the ancient cast iron or sea shell implants, modern implants are composed of titanium. Titanium is lightweight, strong, and biocompatible.

According to the American Academy of Implant Dentistry (AAID), dental implants have the highest success rate of any implanted surgical device — 98%. Dental implants are available in several designs that meet individual needs: single tooth replacement, multiple tooth replacement, implant supported prosthesis (removable), and an implant stabilized denture. Aside from meeting individual needs, there are a few other advantages to having dental implants:

  • Improved appearance. Dental implants are designed to fuse with bone, and look and feel like your natural teeth.
  • Improved comfort. Because dental implants become an extension of your natural mouth, implants remove the discomfort associated with removable dentures.
  • Easier eating. Dental implants act as your natural teeth, allowing you to eat without the pain and discomfort that often accompany slipping of dentures.
  • Improved self-esteem. Dental implants give your best natural smiling, helping build self-confidence!
  • Improved oral health. Dental implants are the only proven way to prevent bone loss after the loss of natural teeth. The jawbone needs consistent chewing action to stimulate continual bone growth. Tooth/teeth replacement with dental implants offers a solution to prevent bone loss.
  • With proper care, consistent brushing, flossing and routine dental visits, dental implants can last 40-years to life.

If you are interested in dental implants, or have any questions regarding the procedure, call Krueger & Lenox Oral and Maxillofacial Surgery today at 541-617-3993!

Modern Options for Bone Grafting Technology

Bones, grafting, or any combination of the two are rarely the subject of casual conversation. Most of us, regardless of our profession, are happier discussing recent football scores, the price of gasoline, or the abnormally high number of Dunkin Donut franchise locations. Perhaps for it is for this very reason, however, that we should bring up this important topic–to raise awareness, maximize modern technology, and inform the public about the options offered in terms of dental implant surgery.

Modern staircaseBone grafting for dental implants is the process by which bone tissue is placed (grafted) into the mouth to act as a placeholder for tissue that has been lost. In the modern medical landscape this is a safe, painless, and routine process: indeed, more than two million bone-grafting operations occur worldwide each year, making bone the second most transplanted organ (after blood!).

As well as natural bone tissue, synthetic tissue is an alternative for patients seeking the best results. Structured as a ‘biodegradable scaffold’ that can be implanted within the body and trigger bone regeneration, this strong, flexible material has been compared to tire rubber! Dr. Karin Hing, author of the study and reader in Biomedical Materials at Queen Mary’s University of London Institute of Bioengineering stated that the challenge being tackled currently is the development of a graft that is as clever as bone. By mechanically evaluating the way bone adapts to its environment and reacts to chemical and physical components, progress is taking place in leaps and bounds.

What does this mean for the average person who just wants to be happy with their mouth? Comfortable outpatient procedures complete with local anesthesia or intravenous sedation make bone grafting a sensible and worry-free choice. Browse our procedures page for more information on maximizing your resources!

The Benefits of Jaw Surgery

As doctors, we always weigh the risks and benefits of any procedure or medication therapy. One of the most significant procedures that we perform in our office is orthognathic surgery, more commonly known as “jaw surgery.”

man holding jaw in painOrthognathic surgery has the ability to enhance a patient’s life, giving him or her the comfort needed to eat properly and, often, the freedom from pain. Because the decision to have jaw surgery is such a serious one, we would like to take a moment to look at the positive side of the procedure in this blog, focusing on the benefits of orthognathic surgery:

  • Pain Relief – There are several reasons that a person may experience jaw pain bad enough to warrant orthognathic surgery. They may have unnecessarily been causing excessive wear and tear in the joints over many years and living with constant inflammation. Correcting the alignment of the jaws through surgery is sometimes the only way to set the jaw back on the correct path, reducing strain and therefore pain. Another common scenario occurs with injury to the jaw, often from trauma caused by car and sports accidents. If the jaw is knocked too far out of place or suffers significant trauma, it may not heal on its own and may require resetting through a surgical procedure. These two situations represent occasions where the benefits of orthognathic surgery far outweigh the risks.
  • Regular Eating Patterns – A misaligned jaw can make it difficult to chew and swallow, particularly if your teeth do not line up correctly. Often, braces are not enough to correct the alignment issues with the teeth and the jaw itself must be altered. Sometimes, patients don’t even know that they are working too hard to chew because they are used to it always having been that way. Once their bite is corrected through surgery, they are pleasantly surprised to find a significant enhancement in their quality of life.
  • Better Overall Health – The health of your body starts in your mouth. Proper nutrition is key to everything from longevity to happiness. Whether your jaws are misaligned from injury or genetics – if your bite is significantly affected, your nutritional habits may be as well, and orthognathic surgery may be the best option for getting your health back on track.