Orlando Oral & Facial Surgery
Little, Medium, Big Dental Bone Grafts
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 407-629-4444 today for a consultation with Orlando Oral & Facial Surgery
Dental Implant Success
What do you use your teeth for? Eating, drinking, speaking, laughing, the list goes on! How are these affected when you have tooth loss?

If you have missing teeth, you could be missing a lot! A very reliable and safe method for replacing teeth is dental implants.
Dental implants permanently attach prosthetic teeth to small posts or “roots” that are embedded in the jaw. These posts are made of titanium, and securely fuse to the jaw bone, this helps restore the full functionality of previously missing teeth.
Dental implants not only effectively and reliably replace missing teeth, but also help prevent the loss of jawbone density, restore the support of facial structures, and provide you with the support you need to effectively use your teeth.
The procedure for dental implants can be a quick and easy, and in some cases, can be done in a single day. Your implants become part of you, so they eliminate the discomfort of removable dentures. They also prevent the embarrassment of removing dentures at every snack or meal, as well as the need for denture adhesives.
Sliding dentures can make chewing difficult. Dental implants function like your own teeth, allowing you to eat your favorite foods with confidence and without pain. Nearby teeth are not altered in order to support a dental implant, thus more of your own teeth are left intact, improving oral health in the long-term as well as your oral hygiene.
Dental implants are very durable, lasting several years, and if they are in good care, can last a lifetime.
Don’t miss out with missing teeth, get your smile back and feel better about yourself!
Here at Orlando Oral & Facial Surgery we specialize in dental implants, so give us a call today on 407-629-4444 to discuss your future implant success!
Types of Jaw Surgery
Your 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 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.
What Happens To Them
• Osseointegration: Creates strength and durability by fusing directly to the bone and is bio-compatible. Bone cells attach themselves directly to the titanium/zirconium surface, essentially locking the implant into the jaw bone. Osseointegrated implants can then be used to support prosthetic tooth replacements of various designs and functionality. Anything from a single tooth, to all teeth in the upper and lower jaws. The teeth/crowns are usually made to match the enamel color of the existing teeth to create a natural appearance.
• Bone augmentation: Some people do not have enough healthy bone to support dental implants, so bone must be built. Procedures can include bone-grafting which means adding bone to the jaw.
Talk to us today at Orlando Oral & Facial Surgery to discuss your options with an implant specialist!
Dental Implants 101
Whether you are missing a tooth, or at risk of losing many, dental implants may be a great solution for you. Dental implants are an increasingly popular fix for missing or dying teeth, and have many benefits.
What is a Dental Implant?
Dental implants are high tech teeth. The root of your current tooth is removed, and replaced with a screw attached to a ‘cap’ that looks identical to a natural tooth. Many people report higher confidence and comfort after receiving their new tooth.

What’s so Great About Them?
The cool thing about implants is that if taken care of, they can last for life. Usually all that needs to be replaced, if anything, is the cap. The other great thing about implants is that they can’t die like natural teeth. You still have to clean and maintain them like your other teeth, but no roots are any longer at risk of causing that tooth to fail. In addition to that, many implants can last a lifetime!
What is the Surgical Process Like?
The process is done either all at once, or in steps. This depends on the recommendations for your particular case. The first step is to remove the root of your natural tooth, and place the implant in its place. If there is not enough bone to place the implant, we may encourage you to have bone grafting first. The gum is then stitched closed and allowed to heal. This can take five to six months. The next step is to reopen the gum and place an abutment on the implant, along with a temporary crown so you can heal while the permanent crown is made for you. You then return to get your permanent crown attached in a few weeks. In other cases, all of these steps can be done in a single visit, but it depends on your specific case.
If you have any questions, please call our office for more information, we would be glad to help!
Oral Cancer and Hepatitis C
The 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 Orlando Oral & Facial Surgery a call today and schedule an oral cancer screening!
Wisdom Tooth Removal – Aftercare
Having 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:
1. Try repositioning the packs. They may not be putting enough pressure on the site.
2. Sit upright and avoid physical activity.
3. Use an ice pack and bite on gauze for one hour.
4. You can also try biting on a moistened tea bag for 30 minutes (the tannic acid in tea promotes blood clotting).
5. If bleeding persists, please call our office at 407-629-4444.
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. Whitman, Dr. Martinez, Dr. Goldberg, Dr. Campbell or Dr. True 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. Whitman, Martinez, Goldberg, Campbell or True. 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:
1. Day 1-2 will be the most uncomfortable and you will experience some swelling.
2. Day 3 you should be more comfortable and while still swollen, you should be able to begin a more substantial diet.
3. 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. Whitman, Martinez, Goldberg, Campbell or True and the Orlando Oral & Facial Surgery team are tailored to fit your needs. Please call us at 407-629-4444 if you have any questions or concerns about your recovery. Happy healing!
Pediatric Facial Trauma
We’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.
This is why it is very important to always wear protective gear! Remember to always have your children wear seatbelts, and invest in booster or car seats so your children can receive the full protection of seatbelt coverage.
During play, remember shin guards, mouth guards and helmets! Especially when riding a bike!
Play it safe, and if life throws a curve ball (at your face!) give Orlando Oral & Facial Surgery a call at Winter Park Office Phone Number 407-629-4444
Eating After Wisdom Tooth Extraction
When it co
mes 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!
How Many Wisdom Teeth Do You Have?
Wisdom tooth removal has become somewhat of a rite of passage – puffy-cheeked post-extraction photos, a diet of Jell-O and mashed potatoes. But not everyone gets their wisdom teeth taken out. In fact, not everyone has wisdom teeth at all! Have you ever wondered why some people have four wisdom teeth while others have fewer or even none? We’ve got the facts behind how many wisdom teeth people have and why!
Why do we have wisdom teeth?
Third molars, or wisdom teeth, were once very useful to our ancestors. Because prehistoric man’s diet of hard-to-chew plants and uncooked meat required powerful chewing muscles, our ancestors’ jaws were large enough to fit 32 teeth, not just 28. Now that humans have evolved a better means of chewing and digesting our food, we no longer have large jaws, so we simply have no need or no room for wisdom teeth. Many scientists believe humans are currently evolving third molar hypodontia, or the lack of wisdom teeth, due to their inability to develop in the first place.
How many people have wisdom teeth?
About 20-25% of the human population is born with 1 to 3 wisdom teeth, and 35% is born without any wisdom teeth at all.
Why do some people have wisdom teeth and some don’t?
There are a few reasons why scientists believe that not everyone develops wisdom teeth:
- Genetics: Some evidence suggests that a genetic mutation occurred hundreds of thousands of years ago, causing some people to be born without wisdom teeth.
- Environment: Percentages of people who develop wisdom teeth varies from culture to culture. Certain ethnic groups are known for low percentages of wisdom teeth development, while others are known for high percentages. Environmental factors during dental development are also a possible explanation.
Will wisdom teeth become obsolete?
With the number of people lacking wisdom teeth steadily growing, it’s possible that we could someday completely evolve to not develop wisdom teeth at all. Scientists have experimented with chemically preventing the development of wisdom teeth. Researchers have found that children ages 2-6 that are given local anesthesia for dental work have a higher chance of not developing wisdom teeth later on. Maybe in the future, simple injections at a young age will keep all of us from having to go through wisdom tooth extraction!
