Oral and Maxillofacial Surgeons: Frequently Asked Questions

Do you have questions about our office procedures or your treatment? We’ve provided some of our most common questions below, along with our answers.

What exactly is an Oral & Maxillofacial Surgeon?

Oral and Maxillofacial Surgeons (OMS) are specialists who treat conditions, injuries, and defects of the mouth, teeth, jaws, and face. Oral surgeons must complete an additional 4 to 6 years of comprehensive training program after they graduate from dental school. Many oral surgeons attend programs that enable them to attend medical school and obtain their medical degrees as well. Doctors Metz, Seidel and Orfanos have all completed their medical doctorates (MD). Read More

Why should I choose OMSH?

At OMSH, we strive to offer the highest standard of service and the best treatments available. You come first at our comfortable state-of-the-art facility. From your first phone call through your final follow-up visit, our team is more than happy to assist you with whatever you need. Read More

How does OMSH stand out from any other dental practice I can visit?

Our surgeons are specialists in oral and maxillofacial surgery. That means they have additional training and experience in procedures such as dental implants, extractions, wisdom tooth surgery, plastic surgery, facial rejuvenation and trauma surgery. This translates into easier and more comfortable dental care for you and your family. For example, we offer more sedation options than a general dentist. And, because we perform these procedures so frequently, we understand how to quickly work around any difficulties that might unexpectedly arise. With our knowledge and experience, you’ll spend less time in the dental chair and have a smoother recovery.

How do I determine if I am a candidate for dental implants?

Almost every person who is missing one or more teeth and is in good general health is a candidate for dental implant treatment. Working together with your primary care physician, we can optimize treatment for patients with diseases such as diabetes so that they are candidates for dental implants. The quality and quantity of available bone is an important factor in dental implant treatment. Oral Maxillofacial surgeons can, even with significant bone loss, perform extraordinary procedures that add bone or create new bone allow people who would not otherwise have been candidates for dental implants to have successful implant treatment.

What should I consider to decide if dental implants are right for me?

Dental implants are quite superior, for several reasons, to alternative methods for tooth replacement. First, dental implants preserve both the underlying bone and the actual structure of your face. Second, they also look, feel and function like natural teeth; so, they can improve both your nutrition and your digestion as opposed to alternative methods. Third, dental implants restore your mouth as closely as possible to its natural state; therefor, you don’t have to worry about them coming loose or falling out. Your self-esteem and self-confidence can be maintained or enhanced by the comfort and natural appearance of dental implants. Additionally, one of the most important reasons to consider dental implants is that they provide a strong foundation for your teeth. A dental implant replaces the part of your tooth that is visible in your mouth, the crown of a tooth; however, dental implants also replace natural tooth roots where teeth are missing. Replacing the tooth root as well as the visible part of the tooth is vital because natural tooth roots are embedded in bone. This provides the stable foundation necessary to bite and chew normally. There is a give-give relationship because at the same time as the bone holds tooth roots in place, the roots preserve the bone. Missing teeth and roots cause deterioration in the bone that supported those teeth and roots. This deterioration process is called bone resorption. Dental implants preserve the underlying bone because the bone forms a very strong bond to the implants; so, they serve virtually the same function as natural tooth roots. A strong foundation for biting, chewing, speaking, and appearance is the result.

Where can I learn more about dental implants?

Because we specialize in dental implants, we’ve included plenty of information on this subject on this website – just click here. Additionally, our dental implant coordinator is always happy to answer any questions you may have. You can also find further good information about dental implants at the website of the International College of Oral Implantologists.

Is age a factor in implant treatment?

Dental implants have roots back to the 1950’s, specifically as a solution for older patients who were missing teeth. Overall health and a desire to improve your quality of life are usually more important factors than a person’s age. In fact, we are quite experienced helping patients in their 90s have dental implant treatment without any problems.

Is it too late for a dental implant if my bone has already deteriorated?

If you have dentures or a partial already, you may be concerned that your bone has deteriorated – making it too late to consider dental implants. The good news is that technology now makes it possible to grow new bone or add bone to areas where the bone has melted away. The placement of dental implants can then be accomplished. Bone grafting procedures allow dental specialists to repair defects in the bone and even further, to place implants to improve appearance. Oral Maxillofacial surgeons can also use bone grafting techniques to make it possible for people with significant bone loss to have implants, thereby restoring function and integrity of facial structures. Sometimes it is even possible to graft bone and place implants at the same time; however, each person’s situation is unique. Unfortunately everyone is a candidate for bone grafting. If you wear dentures or a partial, you will do yourself a favor by talking to talk to a qualified, experienced surgeon. Determining whether you qualify for bone grafting and dental implant treatment can be a very big step in your life.

Is it true that dental implant treatment is painful?

Implant patients generally say that the implant procedure is not as traumatic as having their tooth extracted. Everyone tolerates pain differently, but most patients are comfortable simply taking Tylenol after the procedure.

What options do I have for anesthesia at OMSH?

As a specialty surgical practice, we can provide you with more options for sedation than a general dentist. We have specially trained staff, certified and/or licensed, who administer and monitor your vital signs during surgery. We offer everything from nitrous oxide to oral sedation to IV sedation. The type we use depends on the procedures you are having done, as well as your personal preferences. We’ll be happy to discuss patient comforts and your sedation options with you.

Should wisdom teeth be removed even if they are not causing any problems?

Wisdom teeth, sometimes referred to as third molars, can cause serious problems such as crowding and shifting other teeth, changing your bite, and contributing to loss of jawbone tissue. Wisdom teeth that are only partly erupted often trap food, causing decay and gum disease. Swelling and jaw pain are some of the most common early symptoms. The longer your wisdom teeth remain in your mouth, the more likely they are to cause harm, and the more difficult they are to remove. Because wisdom teeth erupt at different rates, a lot of damage can be done before you even begin to notice symptoms. We recommend calling us at the first sign of symptoms.

Do each of my missing teeth require an implant?

Each patient we see is different and we evaluate each patient individually to determine the number of implants required to support the replacement teeth that will best fit the patient’s functional and aesthetic needs. Usually, it is possible to replace all of the lower teeth with an implant-retained denture supported by 2-4 implants. Back molars take most of the brunt of chewing. When they are missing, some clinicians recommend replacing them with individual implants.

How do dental implants preserve the bone to which they are attached?

Dental implants serve as substitute natural tooth roots by stimulating the bone and preserving it. Since the bone forms a bond with the implant, a stable foundation for replacement teeth that look, feel, and function is provided, basically the same as natural teeth provide. Bone deterioration is prevented with implants, so the facial structures remain intact and do not collapse. Additionally, replacing missing teeth with implants prevents other problems associated with tooth loss (such as other teeth shifting into the spaces created by missing teeth and functional problems with the bite and jaw joints).

Is it true that dentures and partials accelerate the deterioration of facial structures?

A denture is a prosthesis which (like any other prosthesis) is designed to replace a missing body part. Because the jaws deteriorate and the face collapses when all teeth are missing, dentures are designed to replace missing teeth as well as the facial structures that have deteriorated. To achieve this, they must be fairly thick to compensate for the bone that has deteriorated away. As facial structures continue to collapse over time, dentures must be replaced or relined to be thicker in order to compensate for additional bone loss. Dentures accelerate bone loss because they press down on the gums and the underlying bone when one eats. This compresses the gums and bone; and, unfortunately, if you wear a denture, your bone will deteriorate faster. Additionally, your facial structure will collapse more quickly than if you do not wear a denture. A partial denture is also a prosthesis; but, it is designed to replace facial structures when just some of a person’s teeth are missing. A partial is held in place by metal clasps that hook onto adjacent teeth. A partial also accelerates bone loss as it presses down on the gums and the underlying bone as it functions. The hooks place pressure on adjacent teeth as the partial rocks back and forth; and, this causes the adjacent teeth to eventually loosen and come out. Then, more false teeth must be added to the partial and the pressure from the hooks shifts to other teeth causing them to become compromised. This process continues as long as the partial is used.

Is facial structure compromised by the loss of just one or a few teeth?

The bone in the front of your mouth is extremely thin. So, losing a front tooth usually makes the bone melt away rather quickly. This will cause the bone and gums to cave in; and, the defect that is visible when smiling tends to make people self-conscious about their appearance. When front teeth are replaced by a traditional bridge, the teeth on either side should look natural. But, as time goes by, the gums and bone above the false tooth collapse and leave the false tooth hanging and looking fake. As the bone deteriorates above the bridge, a visible gap often appears between the gums and the bridge. This problem is more obvious when more than one tooth is lost in the front of the mouth.

Is it common to remove healthy tooth structure?

When the teeth that will support the bridge are perfectly healthy, most dentists will not recommend a bridge. This is because it requires destroying healthy tooth structure that can never be replaced. The tooth structure that is removed to support an abutment crown is enamel, which is the hard protective surface of the tooth. Enamel is much more resistant to decay than the layer beneath it. The layer beneath is a softer, spongy material that decays fairly rapidly. When teeth are ground down in order to place a bridge, the tooth structure under the crown becomes more susceptible to decay, particularly since the cement that holds the bridge washes away over time and bacteria has a path to leak under the crown.

Is OMSH currently accepting new patients?

At OMSH, we are always accepting new patients for specialty care. There is no age limit – young or the young at heart, both are welcome in our practice.

Does OMSH accept referrals?

Absolutely! We work with many different dental and medical practices throughout the Houston area to provide for their patients in need of specialty care from an oral surgeon. Even if your general practitioner has given you the name of another provider, you may still contact our office on your own to see one of our doctors for your needs.

Does OMSH need me to have a referral from my doctor?

Here at OMSH, we do not require a written referral from your dental or medical doctor. Patients can initiate their own care if they have a situation that requires care from our group of doctors. Just call our Houston oral surgery office and any of our team members will help you find a convenient time for a consultation.

What do dental implants generally cost?

A dental implant is an investment in your health, appearance, and quality of life. A dental implant investment involves preserving the integrity of your facial structure as well as replacing missing teeth. Implant treatment cost depends on a number of factors, including the number of teeth being replaced, the type of implants, and the need for additional procedures that are necessary to achieve the best result. Each situation is unique; so, the only way to obtain an accurate cost for the implant treatment that is right for you is to have an examination and a consultation with a surgical specialist and a restorative dentist.

How expensive is the cost of implants compared to alternative treatments?

Many people make the mistake of assuming that dental implants are more expensive than traditional treatment. The fact is that in many cases implant treatment is more cost efficient in the long run. The two most common options when replacing a single missing tooth are the tooth-supported bridge and an implant-supported crown. The bridge often costs less initially; however, a bridge needs to be replaced every 5 to 10 years. Further, a bridge requires grinding down adjacent teeth to cement it into place. Such treatment generally causes permanent compromise to the long-term health of these teeth. And, perhaps most importantly, a bridge does not prevent bone loss. A traditional bridge commonly requires additional procedures. A few definite possibilities are replacing the bridge, having to re-treat the teeth that were ground down, or repairing a defect in the bone. Of course, any of these additional treatments could increase the cost of treatment significantly. Dental implants are substantially better long-term alternatives from a financial and health standpoint.

Are dental implants usually covered by dental insurance?

Yes. Insurance plans are more frequently covering dental implants because they are realizing that implants are a cost-effective treatment option in the long term. However, policies do differ and the amount of the available benefits can be directly related to the amount of premiums paid. Sometimes employers select insurance benefits that will not cover dental implants, but will pay what is considered an alternate benefit. This amounts to providing the benefits that would be paid for bridge, partials, or dentures.

Are dental implants ever covered by medical insurance?

Teeth are lost every day due to trauma, illness, or even some medications. Dental implants may be covered by medical insurance for people who are missing all of their teeth and/or are having extenuating medical complications. Dental implants are typically covered by dental insurance, rather than medical insurance, for situations other than these. Still, medical insurance may approve benefits for anesthesia, bone grafting, or other additional medical procedures necessary.

How does OMSH take care of insurance issues?

Our insurance specialist will contact your insurance carrier to see what oral surgery benefits you may be entitled to under both your medical and dental plans. You will be asked to take care of deductible and coinsurance amounts at the time of treatment.

What methods of payment does your practice accept?

We accept the following: cash, checks, MasterCard, Visa, American Express, and Discover.

What kind of dental specialist should I see?

If you needed heart surgery, wouldn’t you want to see a cardiologist, or a dermatologist for a concern about a mole? Dental care providers work under individual specialties, just like in medicine. Here are some examples that may help you determine what type of dental specialist to seek: Cleanings, routine check-ups, fillings, etc. General Dentist Root canals Endodontist Gum Disease Periodontist Braces / Orthodontics Orthodontist Children’s routine dentistry Pedodontist Dentures, Partials, etc. Prosthodontist Dental Implants, Wisdom teeth removal, biopsies, tooth extractions, etc. An Oral Surgeon Whatever type of care you seek, be sure to select someone who does those types of procedures on a daily basis and has the experience and training to deliver the quality of care you deserve.

How is appearance affected by bone deterioration, also known as resorption, and missing teeth?

Most people are not aware of the relationship between their teeth and the bone that supports them, so they don’t realize the impact tooth loss is having on their facial appearance. The teeth as well as the upper and lower jaws provide structural support for facial contours. Any change tooth loss causes in any of the underlying structures will impact facial features. Whenever one or more teeth are missing, the bone that previously supported the tooth or teeth begins to deteriorate or resorb. This is known as bone resorption and is very similar to muscle atrophy from lack of use. Missing teeth commonly result in dramatic changes to facial appearance, including an increased number of wrinkles around the mouth and lips that cave in and lose their shape. In more severe cases, complete tooth loss can result in unsightly total collapse of the facial structures. When all of the teeth are missing, the jaws also tend to deteriorate rapidly. As the bone melts away, the muscles are affected and pull back from their original position. Wrinkles can increase dramatically as the facial structures collapse; and, the appearance of the cheeks becomes distorted. Severe bone deterioration results in what is sometimes called “the witch’s beak,” where the nose points downward and the chin points upward as a result of lost jaw height. The process spreads as the lips cave in as they lose their support, giving the mouth a flattened look. Premature aging that occurs as the bone continues to melt away is and further accentuated.

How many years will dental implants last?

Implant-supported replacement teeth have been documented in clinical research to have lasted as long as 30 years. Typical tooth-supported bridges are known to last only 5 to 10 years; and, partials and dentures are functional for only about five years.

Is there a chance that dental implants will fail?

Documented success rates of dental implant treatment are among the most successful procedures in the field of dentistry at higher than 95 percent. One of the reasons is so high because the implants are made of a safe biocompatible material called titanium (also is used for hip and knee replacements).

Why do dentists recommended not to grind down perfectly good teeth to replace a missing tooth with a bridge?

Prior to the development of dental implants, traditional tooth-supported bridges were the preferred treatment for tooth replacement. Bridges are far superior to the removable partial dentures which accelerate bone resorption and weaken the adjacent tooth they attach to; but, they still have significant problems. A bridge basically consists of two or more crowns with one or more false teeth fused together. The crowns at each end of the bridge are cemented onto teeth that serve as bridge supports. Any false tooth between these crowns replaces the missing tooth or teeth. Cementing the bridge into place involves grinding the teeth that support either end of the bridge down to pegs so that the crowns fit over them. Unfortunately, this means that much healthy, natural tooth structure has to be removed to allow the bridge to fit properly. Dentists do not like to damage perfectly good teeth now that there are other alternatives for treatment.

Why would a dentist recommend a tooth-supported bridge since implants preserve bone?

Traditional tooth-supported bridges were considered the “gold standard” for replacing missing teeth prior to the 1980’s. Technological advancements now provide dentists more options to offer to their patients, but traditional bridges will sometimes still be the restoration of choice. This will be especially true when teeth already have large fillings and can benefit from the protection of crowns. In these cases, particularly in the back of the mouth where bone melts away much more slowly when there are adjacent natural teeth, dentists may still recommend a traditional bridge rather than dental implant treatment. Most dentists detest the idea of grinding down perfect teeth to place a bridge; so, they will recommend dental implant treatment for their patients whenever possible.

Is there ever a reason a dentist would recommend extracting a tooth and replacing it with an implant?

Natural teeth fail sometimes, possibly due to severe gum disease that has eroded the bone that supports the teeth or possibly severe decay. In such cases, it sometimes preferable to remove the tooth in order to eliminate the disease and infection; and, replace it with an implant, particularly if keeping the tooth will compromise the underlying bone. Additionally, teeth that have had root canals tend to be brittle and susceptible to fracture. In these types of cases, the tooth may need to have another root canal and the prognosis may not be favorable. If that happens, it may be best to extract the tooth and replace it with an implant-supported crown. Severely fractured teeth are usually extracted and are excellent candidates for dental implant treatment.

What exactly is jaw reconstruction?

Jaw reconstruction, or orthognathic surgery, involves reshaping a patient’s face to correct facial or jaw abnormalities. During this specialty surgery, the doctor changes the position of the jaw to improve its function (chewing and speaking) and appearance. We often perform jaw reconstruction surgery in conjunction with orthodontic treatment.

Do you offer treatments for facial rejuvenation?

At OMSH, we offer a variety of facial rejuvenation procedures that can remove fine lines and wrinkles around the mouth, eyes, and forehead. Please don’t hesitate to call our office for a consultation appointment so we can discuss your particular situation.

What do I do if my child has had an accident and his/her tooth has been entirely knocked out...especially if it is outside of your regular hours?

Call us as soon as possible for facial and dental trauma – if it is after office hours, ask that the doctor be called. If you’re calling after regular office hours, ask that the doctor be paged. To preserve the tooth until you can see us, put it in a glass of milk (it sounds strange, but it works). We may be able to replace and stabilize the tooth. If that’s not possible, we can suggest treatment options – such as dental implants – for permanent replacements.

 

Still have questions? Please feel free to call our office. Our team would be happy to assist you.