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Dental implants are a marvel! They look just like your natural teeth, and, even better, they function just like your natural teeth. So, when you’re planning on a dental implant after an extraction, you want to make sure that your implant has the best chance of success—and we do, too. That’s why we might recommend a socket preservation procedure, where socket grafting takes place immediately after your extraction.

What is a socket graft, and what does it “preserve”? Let’s take a closer look.

Socket Preservation—A Logical Choice After Extraction

You’ve decided on a dental implant for some excellent reasons.

• A missing tooth can change the appearance of your smile.
• Your remaining teeth might shift to fill the empty space, causing alignment and bite problems.
• A lost tooth affects the amount, shape, and health of the bone surrounding your teeth.

No one wants to lose a tooth, but sometimes, due to injury or decay, an extraction is the only choice for your oral health. After your tooth is extracted, if the socket bone holding the tooth is perfectly healthy and the extraction is a simple one, we might be able to place an implant post in the socket right away.

But often, bone needs time to heal before placing an implant post, and you risk losing the bone size and density you need to make a future implant possible. How can you lose bone? That’s an unfortunate consequence of losing teeth. Teeth are important not just because they let us eat comfortably—they also help maintain bone health.

Without the stimulation of biting and chewing, the bone beneath the teeth begins a process called resorption. As older cells are absorbed back into the body, new bone cells aren’t produced as quickly to replace them. The alveolar bone, the thick ridge of the jaw which holds our sockets, shrinks in size. As the bone gets smaller, gum tissue shrinks around it, causing a sunken spot where your tooth used to be.

For a dental implant to anchor successfully in the jawbone, you need healthy bone that is high enough, wide enough, and dense enough to hold the implant post securely as it fuses with the bone.

A socket graft at the time of extraction provides two important benefits: grafting material fills the empty socket immediately, preserving the bone and gum area around it, and the graft material acts as scaffolding for new bone growth, creating a firm, dense foundation for your implant.

Grafting materials are gradually and safely absorbed as your new, healthy bone tissue replaces them. The result, after several months of healing, is an alveolar ridge with normal height and width and with the density needed to anchor an implant successfully.

The Grafting Procedure

Grafting material comes in different forms, including allografts (made from donor bone), synthetic grafts (made from synthetic materials which function like bone tissue), and autografts (bone taken from your own body). Growth factors may also be included in the grafting material to encourage new cell growth. Dr. Kassan will recommend the type of graft which will work best for you.

A socket preservation procedure will frequently involve the following steps:

• Local anesthesia to numb the area before your extraction. You might choose sedation options as well, which we’re happy to discuss with you in advance.
• Careful cleaning of the site after the tooth is extracted.
• Filling the empty socket with bone grafting material.
• Placing a barrier or membrane over the graft to protect it as it heals.
• Suturing the surrounding gum tissue.

Aftercare Treatment

Aftercare treatment for a socket graft is a lot like the treatment for a tooth extraction. You’ll need to be careful around the graft area for several days as it heals, and we’ll give you specific instructions for your recovery. Normally, these may include:

• Don’t disturb or touch the area. Even pulling on lips or mouth to look at the site can put stress on your sutures.
• Immediately after the procedure, we can give you suggestions for reducing swelling and managing any pain you might be feeling.
• We’ll let you know when and how to rinse your mouth clean and when you can return to brushing. And no spitting!
• Eat carefully. We might recommend a liquid diet for a few days before transitioning to bland and cool soft foods. We’ll let you know the best diet for the period after your surgery. Don’t use a straw for your liquid diet, because suction can interfere with the wound.
• Treat yourself carefully for a few days by avoiding strenuous activities, including workouts.
• Don’t smoke. Smoking interferes with the healing process, and the suction involved does your graft no favors either.
• Visit our Montclair office for follow up appointments as recommended. We’ll monitor your healing, and give you a timeline for your future implant.

Preserving your socket now instead of repairing it later has many advantages. Immediate placement of a graft protects bone size and density, eliminates the need for a potential bone grafting procedure in the future, and makes it possible for you to enjoy the natural look and feel of a dental implant as soon as possible. If you have an extraction scheduled, let’s discuss why socket preservation might be your best path to an efficient, timely, and successful dental implant.

Dr. Kassan and our team at Gregg L. Kassan, DDS, PC understand that many of our patients have a fear of dentistry. You may be concerned about experiencing pain from sensitive teeth or routine procedures. General anxiety is also common. Do not put off visiting our Montclair office; we offer various types of sedation to take the pain and fear out of your dental procedure.

Nitrous Oxide Sedation

For many patients, nitrous oxide, combined with local anesthetics, will both provide pain relief and reduce anxiety. Nitrous oxide is beneficial because the dosage can be regulated during treatment and patients are normally capable of driving shortly after the procedure is completed.

Oral or Injected Sedation

With oral sedation, you may be given a pill or liquid to consume several hours before your procedure. You will not be able to drive yourself to the appointment. An oral liquid is often given to children before any shots or intravenous anesthesia. An intramuscular injection may be given at the office that provides relaxation benefits for 20 to 30 minutes.

Nitrous Oxide with an Oral Sedative

If you experience higher levels of anxiety, an oral or injected sedative can be offered before nitrous oxide is started. This is also effective for reducing anxiety regarding the injection of local anesthetics. A liquid medication followed by nitrous oxide is beneficial for children. This combination can produce a deep sedation level.

General Anesthesia

This type of anesthesia can be offered as an inhaled gas or intravenous liquid. If no oral sedative is given before the general anesthesia is administered, you should wake up quickly after your procedure is complete. An injection, pill, or liquid medication can be offered to reduce anxiety before intravenous sedation begins. Intravenous sedation can also be used at moderate-to-deep sedation levels without complete loss of consciousness.

Do not hesitate to ask Dr. Kassan about receiving sedation or pain prevention when you visit. We will be glad to explain the options we have available and answer all your questions to ensure that your exam is pleasant for you.

The best way to protect yourself from gum disease is to be proactive: practice good oral hygiene at home and schedule regular checkups and cleanings in our Montclair office.

How do you know if your dental routine is doing the job? There are specific symptoms you might notice when you brush and floss, and less obvious signs of gum disease we look for during your dental exams.

The early stage of gum disease is known as gingivitis. It’s generally caused by poor dental hygiene, although certain diseases, age, hormones, and a number of other factors can also put you at risk. It’s time to talk to Dr. Kassan about your gum health if you notice any of these symptoms:

• Bright red or purple gums
• Swollen gums
• Pain or tenderness
• Bleeding when brushing or flossing
• Persistent bad breath
• Receding gums

And sometimes, there are no obvious symptoms at all. That’s why regular checkups are so important. If you have gingivitis, careful attention to your oral hygiene, professional cleaning, prescription mouthwash, or other treatments as needed can reverse the effects of gingivitis and restore your gums to their normal, healthy state.

Why be so proactive? Because, left untreated, gingivitis leads to more serious gum disease, called periodontitis. The bacteria in plaque and tartar cause inflammation, and inflammation leads the gum tissue to pull away from the teeth, forming pockets which become deeper over time. Here, where brushing can’t reach, bacteria continue to multiply, leading to further inflammation, infection, and the eventual breakdown of gum and bone tissues.

The results of untreated periodontitis can be very serious, including:

• Significant gum recession, leaving roots more vulnerable to decay
• Periodontal abscesses
• Loose teeth, or teeth that shift from their proper positions
• Bone loss in the area surrounding the teeth
• Tooth loss

If we see signs of advanced periodontitis, we may refer you to a periodontist.

Periodontists specialize in the diagnosis, prevention, and treatment of gum disease. After dental school, a periodontal degree requires three years of additional advanced education. Periodontists have the training and skill to perform surgical and non-surgical procedures to treat gum disease, as well as to perform cosmetic procedures and place dental implants.

Periodontists are trained to diagnose and treat periodontitis with a number of procedures which they will recommend based on your specific needs. Among the treatments they provide to restore your gum health:

• Topical, time-release, or oral medication
• Scaling and root planing, non-surgical deep cleaning procedures which remove plaque and tartar above and below the gumline, and smooth tooth roots to remove bacteria and help the gum tissue reattach to the teeth
• Flap surgery to treat persistent gum infection, reduce pocket depth, and re-secure the gums snugly around the teeth
• Bone grafts, gum grafts, and other regenerative procedures which help restore and repair tissue damaged by gum disease

If we recommend a periodontal consultation, be proactive. The best way to protect yourself from the significant consequences of untreated gum disease is to see a specialist in this field. Your periodontist has the knowledge and experience to stop gum disease from progressing, treat damaged bone and gum tissue, and restore your healthy smile.

Temporomandibular joint disorders (TMD) describe a set of conditions that involve trouble with your jaw and face muscles. They result from a problem in the temporomandibular joint (TMJ), which is a hinge that connects the temporal bones, in your skull in front of each ear, to your jaw. The joint enables you to talk, yawn, and chew by letting your mouth move.

TMD can be very painful and interfere with functions such as eating and speaking. This what to watch for and how to try to prevent TMD.

Risk Factors for TMD

You are at higher risk for TMD if you are a women than if you are male. The disorder is most common among adults between the ages of 20 and 40 years. Other risk factors for TMJ disorders include the following.

• Arthritis in the area, making movement more difficult
• Excessive tooth grinding, because it increases stress on the joint
• General stress, which can lead you to clench your teeth and strain facial muscles

Symptoms of TMD

Symptoms of TMD can last for just a short while, or for several years. Seeing Dr. Kassan is important if your symptoms make it impossible for you to eat regularly or if you have unbearable pain or discomfort. The following symptoms can occur on both or one side of your face.

• Aching or very tired facial muscles
• Jaws that are fixed open or shut without you being able to unlock them
• Grating or popping sounds when you chew or close or open your mouth
• Pain in the entire area, including the mouth, jaw, neck, or shoulders, that comes on when you chew or yawn

Preventing TMD

You can try to prevent TMD by focusing on reducing risk factors. If you grind your teeth at night, ask Dr. Kassan about wearing a mouthguard. If you are overly stressed, look into ways to better manage your stress and relax your muscles. Another strategy for trying to prevent the development of TMD is to avoid chewing gum, since that puts stress on your jaw.

If you have questions about TMD, don’t hesitate to contact our Montclair office.