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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. Seeing an oral and maxillofacial surgeon is especially important for complex extractions, when you have impacted or fractured teeth, roots close to nerves, or other complications which require surgical treatment.

After your tooth is extracted, if the socket bone holding the tooth is perfectly healthy, we might be able to place an implant post in the socket right away.

But often, even with a simple extraction, 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. Mazock, Dr. Salazar, and Dr. Coleman 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 San Antonio or Castroville 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’ve scheduled an extraction with us, let’s discuss why socket preservation might be your best path to an efficient, timely, and successful dental implant.

Thanks to today’s advances in dental technology, we can replace missing teeth with implants for a smile that looks healthy, natural, and complete. If you’re worried that you’re too old for dental implants, good news! While younger patients must wait until their jaw bones are completely developed before implant surgery, there is no upper age limit for dental implants.

In fact, studies have shown that patients aged 65 and over have high rates of successful implantation, long-term implant retention, and minimal complications. Of course, as our bodies age, there are changes that take place. And some of these changes can make an implant procedure more challenging.

Fortunately, oral surgeons like Dr. Mazock, Dr. Salazar, and Dr. Coleman have the training, experience, and advanced techniques to make implants possible even in challenging circumstances. Two important concerns for older patients are bone density and healing ability. What can Dr. Mazock, Dr. Salazar, and Dr. Coleman do to address these concerns?

• Bone Grafting

A complete tooth replacement consists of an implant that serves as a “root” to anchor the tooth in the bone, an abutment that is secured in the implant and extends above the gum line, and a crown restoration that is attached to the abutment.

Dr. Mazock, Dr. Salazar, and Dr. Coleman will drill a small hole in the jawbone for the implant and carefully place it in position in the jaw. Over a period of months, this implant will become integrated into the bone just like a natural root. You can see why one of the most important requirements for a successful implant is having enough healthy bone in which to anchor it.

But after losing a tooth, the bone under the missing tooth gradually shrinks without the pressure and stimulation of chewing. As time passes, more bone loss occurs.

If there is not enough bone size and density to support an implant, you can still regain the structure you need for success with surgical bone grafting. This is a type of surgery which uses your own bone, a synthetic grafting material, or a processed bone grafting material to repair and replace damaged bone. After approximately three to four months of healing, the jawbone has recovered enough volume and density to accept an implant.

And one wonderful bonus? An implant gives your jawbone the same pressure and stimulation that your natural tooth did, preventing future bone loss.

• PRP Treatment

One consequence of aging is that older bones simply don’t heal as rapidly as younger bones.  If this is a concern for you, an encouraging new treatment for implants in older patients is Platelet-Rich Plasma (PRP). This plasma is rich in platelet growth factors and has shown promising results in bone and tissue regeneration as well as faster healing.

After drawing a small amount of your own blood, the blood is immediately centrifuged to separate and collect the platelet-rich plasma. This plasma is then mixed with bone grafting material. And, because the PRP is composed of your own blood cells and plasma, there is no chance of rejection, reaction, or disease transmission.

If you have any concerns about your age, the implant procedure, bone health, healing time, or any other issue, talk to Dr. Mazock, Dr. Salazar, and Dr. Coleman.

After all, as oral surgeons, we are specialists. We have a minimum of four years of surgical education and training in a hospital-based residency program. We train with medical residents in advanced studies, which include general surgery, anesthesiology, internal medicine, plastic surgery, and otolaryngology (the study of the ear, nose, and throat). We are experts not only in implant procedures, but in adapting procedures successfully for your individual needs.

There is nothing like the look and feel of a natural smile. Make an appointment at our San Antonio or Castroville office to talk about dental implants. After all, a healthy, attractive smile is something we deserve at any age.

If you’ve been following a vegetarian or vegan diet, you know that there’s much more to living a healthy life than simply avoiding meat products. Making sure your diet includes enough protein, as well as any nutrients that are primarily available in animal products, takes planning, and there’s no one-menu-fits-all solution.

Why? Because there’s no one menu that will suit all vegetarians. Specific vegetarian diets can allow for many different options:

• Vegan—a plant-based diet which excludes meat, fish, dairy, and egg products
• Ovo-vegetarian—includes eggs as a dietary option, but no dairy
• Lacto-vegetarian— includes dairy as a dietary option, but no eggs
• Lacto-ovo-vegetarian—a meat-free diet which allows both dairy products and eggs

If you are a pescatarian, who eats fish on occasion, or a flexitarian, who sometimes includes meat in a meal, your menu options are even broader.

So let’s look at the big picture—a healthy vegetarian diet is really more concerned with the foods you do eat for nutrition rather than the foods you don’t. You can create a meal plan rich in all your essential nutrients with a little research, no matter which type of vegetarian diet is your go-to choice.

And while you’re constructing your ideal menu guidelines, don’t forget about your dental nutrition!

In terms of keeping your teeth and gums their healthiest, what important vitamins and minerals are often missing from vegetarian and vegan diets? Let’s look at three of them.

• Calcium

Calcium is essential for maintaining strong bones and tooth enamel. Without enough calcium, a weakened jawbone leads to loose, and even lost, teeth. The acids in our food and the acids created by oral bacteria also weaken the minerals in enamel, including calcium. These weak spots can eventually become cavities. A diet rich in calcium not only supports the bones holding our teeth, but can even help repair, or remineralize, enamel which has been weakened by acidic erosion.

For vegetarians who include dairy in their diets, dairy products are a great way to include calcium. Milk, cheese, and yogurt are traditional and rich sources of this mineral.

For vegans, it’s a bit more challenging, but still doable! Non-dairy foods providing calcium include dark green vegetables (kale, broccoli, spinach), certain types of tofu, and fortified cereals, juices, and non-dairy milks.

• Vitamin D

Now you’re ready to put that calcium to work by making sure you have enough vitamin D in your diet. Vitamin D not only helps keep our bones healthy, it also enables our bodies to absorb calcium. Bonus—it’s been linked to better gum health in several studies.

So how to get more vitamin D? If you eat dairy, most dairy products have been fortified with vitamin D. If eggs are a part of your diet, egg yolks are a great source. Pescatarians can enjoy the benefits of vitamin D from fatty fish such as tuna and salmon.

Because we get most of our vitamin D from sun exposure or foods derived from animals, plant-based foods are not a practical way to obtain the vitamin D you need. But, just as non-vegetarians can get plentiful vitamin D from fortified dairy products, vegans also have options. Try adding cereals, juices, and non-dairy milks fortified with this essential nutrient to your diet, or take a vegan vitamin D supplement.

• Vitamin B12

Vitamin B12 is essential for healthy red blood cells, nerve cell development, brain function, and DNA production. (This is why it’s especially important for pregnant and nursing women.) Vitamin B12 can also impact your oral health. A B12 deficiency can cause a swollen, sore, or inflamed tongue, loss of taste, and gum, tongue, and mouth ulcers.

Unfortunately, vitamin B12 is reliably found only in animal foods and nutritional yeasts. If you would prefer an egg-free and dairy-free diet, look to B12 supplements or B12-fortified cereals, plant-based milks, energy bars, and other vegan options. This is a good subject to discuss with your physician, because even supplements and fortified foods might not provide enough B12.

In fact, Dr. Mazock, Dr. Salazar, and Dr. Coleman can be vital resources when you’re planning your healthiest vegetarian diet. The next time you visit our San Antonio or Castroville office, ask for recommendations for supplements if you’re concerned that diet alone can’t provide for all of your nutrition essentials. Finally, care should be taken to ensure that, even with supplements, you get the proper amount of the vitamins and minerals you need.

As a vegetarian, you are used to the concept of care. Whether it was concern for nutrition, the planet, the animal world, or another reason that drew you to a vegetarian diet, be sure to care for your body as well as your dietary choices. Careful planning can ensure a diet which supports not only your general health, but your oral health, for a lifetime of nourishing—and well-nourished—smiles.

Watching the clock tick down the final seconds until midnight, many of us- San Antonio Oral & Maxillofacial Surgery Associates, P.A. included- feel nostalgic about the passing year and hopeful about the new one to come. New Year’s Eve is one of the most widely celebrated holidays in the world, with over-the-top celebrations taking place in dozens of countries. The Gregorian calendar, which is widely used in Western nations and around the world, was implemented in 1582. Since that time, December 31st has marked the final day of the year, with midnight heralding the beginning of a brand new year. In the United States, New Year’s Day is a public holiday; government offices, schools, public organizations, and many businesses are closed for the day. Ponder the following fun facts as you think about your plans for the holiday:

• Approximately one billion people watch the New Year’s Eve ball drop in Times Square, New York City. This televised event is one of the most iconic New Year’s celebrations in the world. For many years, watching the ball drop meant tuning in to Dick Clark’s Rockin’ New Year’s Eve, an iconic television special dear to the hearts of many viewers.
• The idea for the New Year’s Eve ball came about because of a citywide ban on fireworks. Before 1907, when fireworks became illegal in New York City, celebrations included an elaborate fireworks show. The large, glittering, illuminated ball was developed as an alternative. Although the first ball was heavy at 700 pounds, the modern New Year’s Eve ball is made of Waterford crystal and tips the scale at six tons!
• The top five New Year’s resolutions are: to lose weight, quit smoking, get a new job, return to school, or increase personal savings. However, approximately 88% of New Year’s resolutions fail. But don’t let that discourage you! Resolutions are most likely to succeed when they are clear, achievable goals. Setting out a concrete plan to achieve your resolution also boosts your chances of success.
• Eating black-eyed peas on New Year’s Day is said to bring good fortune in the new year. Collard greens, cabbage, and ham hocks are also considered lucky foods to enjoy. Just steer clear of the chicken or turkey dinners; eating poultry is a bad omen for the year to come.

Whether you plan to stay in San Antonio or Castroville, or head out into the crowds to watch the ball drop in Times Square, New Year’s Eve is a time to enjoy friends and family. Send your loved ones well wishes for the New Year, and look for that special someone to share a midnight kiss with for good luck!