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Texas Wisdom Blog

August 16, 2012

All About Dental Bone Grafting- It’s Not As Scary As You Think

Dr. Chilcoat @ 1:49 pm

The term “bone graft” sounds really scary, I know this, and I feel for you.  I’m going to share a little information about bone grafting anyway.  I’m going to try to show you that dental bone grafting is a very good thing that helps make all kinds of other beautiful dental related things possible. Let’s focus on the positive when it comes to replacing bone for dental reasons.  Here we go!

Little, Medium and Big Dental Bone Grafts

In the instance of a missing tooth or many missing teeth, a few things can happen.  First of all, it’s important to understand that your jaw bone is what holds your teeth in place.  The roots of your teeth are surrounded by bone and attached by some other anatomical structures that we don’t really want to worry about today. If you are missing a tooth, you definitely want to replace it with something, usually a dental implant or a bridge. Once a tooth is removed, the bone doesn’t have anything to support anymore.  Over time, it begins to slowly erode until it creates a hollow or a basin shaped divot in the jaw bone.  If you try to place a bridge or a dental implant in a spot where the natural bone and gum tissue level is much lower than the surrounding areas, it’s going to look kind of funny.  A tooth in an area where the bone level is very low is going to make you look really “long in the tooth” (nobody wants that)! For Cutting Edge Grafting Techniques, Click Here

The Little Bone Graft

In the case of a lost tooth, there are a couple of ways to ensure that you will not lose excess bone dental implant with bone graft height and width.  Ideally, your dentist or oral surgeon will remove the damaged tooth and preserve the bone in the area using a simple bone grafting procedure.  In this procedure, demineralized, sterile human bone granules, (which look like coarse sand), are packed into the tooth socket immediately after tooth extraction.  The granules are covered with a protective collagen membrane and a couple stitches are used to close the tooth socket.  This procedure is simple and usually does not add to your recovery time.  Over the next several weeks, your own bone will fill the tooth socket and preserve the bone height long enough for you to have the area restored.  If you replace the missing tooth with a dental implant, the bone level will remain indefinitely.  If you replace the missing tooth with a bridge, you will lose some of the bone level over time.

Medium Bone Grafts

If the tooth, or teeth were removed years ago, there is likely some bone loss hindering the restoration of the area. A slightly more involved bone graft may be needed.  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 the area up.  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.  He will not remove a large piece of bone, rather he will shave off tiny granules and combine them with the demineralized bone.  Again, the graft is protected with a special membrane and sutures are used to close it up tight.  Over the next several months, the bone graft will heal and integrate with the surrounding bone tissue, successfully building up the width and height of the area so a nice restoration can be made. This type of graft can be used for one or multiple areas of missing teeth.

Big Bone Graft

Illustration of a sinus lift graft

Sinus Lift Graft

Patients who have been missing many teeth for a very long time have often experienced advanced bone loss which prevents adequate restoration of the teeth.  In denture wearers, the lower jaw bone often recedes so severely that their dentures no longer fit properly.  The jaw bone in cases of advanced bone loss can be as thin as a pencil in some patients.  These patients can no longer wear a denture successfully and do not have enough bone to place dental implants.  Extensive bone grafting is necessary in order to restore the missing teeth as well as restore quality of life.  In a procedure like this, a combination of demineralized, sterile human bone and the patient’s own bone is used to build up the jaw bone, creating enough width and height to accommodate dental implants.  The patient’s bone is supplied by another part of the jaw, hip or tibia in the form of a small block.  This block is anchored in place in the recipient site using specialized bone screws and sometimes plates.  Bone granules are used to enhance the graft.  The entire site is protected with a membrane, closed tightly with sutures and left to heal for a period of months before dental implants can be placed in the new bone. The upper jaw has challenges of it’s own.  Patients missing upper molar teeth often experience extensive bone loss which causes the maxillary sinuses to become involved.  The maxillary sinus is a hollow cavity which sits just above the molars in the upper jaw.  When these teeth have been lost, the maxillary sinus often begins to dip down lower and lower.  Combined with bone loss from the missing teeth, patient’s can end up with just an eggshell of bone between their gums and maxillary sinus.  You cannot place implants into a hollow cavity, so bone grafting is performed in order to raise the floor of the sinus and increase the depth and width of the bone in this area.  This procedure is often referred to as “sinus lift”. In the sinus lift, an incision is made in the gum tissue and a small window is created into the maxillary sinus cavity.  Very carefully, the sinus membrane lining the sinus wall is detached and lifted.  Demineralized, sterile human bone and the patient’s own bone is combined and packed into the new space between the sinus membrane and the bone of the sinus floor.  Once the desired thickness is achieved, a special collagen membrane is placed to protect the new bone and the window and gum tissue is closed with sutures.  The width of the bone can also be augmented at this time in order to create space for dental implants.  A graft like this will need at least 4 months to heal before dental implants can be placed in the new bone.

Dental Bone Grafting Makes New Teeth Possible

Although bone grafting is a surgical procedure which can sometimes be rather extensive, it plays a very important role in making new teeth possible.  In the not so distant past, patients without adequate bone height or width for tooth replacement with dental implants were simply told they couldn’t have implants.  These people didn’t want to wear dentures or go toothless forever.  The art and science of implant dentistry has brought us these highly specialized and successful techniques in order to restore what was lost and make it possible to have a beautiful smile.  Bone graft surgery is temporary, but being able to eat, laugh, talk and smile lasts a lifetime!

For more information about dental bone grafting, read on

We provide live chat to answer your bone grafting questions or to schedule a free consultation with your Dallas oral surgeon at Texas Wisdom Teeth, click here.

August 7, 2012

Oral Cancer Facts

Dr. Chilcoat @ 1:38 pm


oral cancer information

Oral Cancer Information


Oral Cancer is Deadly

Over 8,000 people die annually from oral and pharyngeal cancer.  As the deadliest form of head and neck cancer, it is important to know the facts and risk factors associated with this form of cancer.

Most people think that oral cancer only affects people who smoke or use chewing tobacco.  Nothing could be farther from the truth.  In recent years, much of what we believed about risk factors for oral cancer has been shown to be only a part of the big picture.


One important factor to consider is that the same virus which has been shown to cause cervical cancer, the HPV-16 (human papilloma virus), also causes oral cancer.  In fact, oral cancer is showing up in patients who are younger and younger than the over 40 high risk age group previously defined.

While traditional lifestyle choices and risk factors such as smoking, alcohol consumption and environmental risks are still considered high risk factors, younger patients with no known lifestyle risks are being diagnosed with this disease.

Early Detection Saves Lives

Oral cancer is so serious because it is often not detected until it has progressed to an advanced stage.  Late detection of oral cancer carries with it a 57% 5-year mortality rate.  When detected in the very early stages, the chances of survival increase dramatically.

In recent years, the early detection of oral cancer and precancerous lesions in the mouth, pharynx and oral tissues has been improved dramatically through the integration of specialized examination tools.  Your dentist will perform a visual and tactile oral cancer screening in addition to using one of these tools in order to ensure that you are protected.

Shining a Light on Oral Cancer

The Velscope light is one such tool which utilizes technology which is very similar to that which detects precancerous and cancerous cervical lesions.  A specialized light is used to illuminate oral tissue during examination.  Normal tissue appears green and possible abnormal tissue appears darkened.  This new method of early detection has made it possible to prevent abnormal tissue from developing into cancer.

The Best Way to Prevent Oral Cancer?

See your dentist regularly.  Have an oral cancer screening performed annually.  Do not ignore warning signs.

July 31, 2012

Olympic Athletes Need Dental Care Too!

Dr. Chilcoat @ 10:15 am

Olympic Village London 2012

The London Summer Olympics are on everybody’s mind right now, and we are all cheering on Team USA as they work to bring home the gold.  So much planning and preparation go into creating the Olympic Village and all the venues and amenities which we are accustomed to seeing when we watch the games on TV.  With the city of London Hosting over 18,000 Olympic Athletes and officials within Olympic Village this summer, keeping them all housed and fed is a huge undertaking.  One thing you might not have thought about is what happens to the athletes if they become ill, have a toothache or other health problem?

The healthcare of Olympic Athletes is not something I’ve thought of before.  I found out that the City of London built a state of the art multi-specialty clinic to take care of all the health, dental and eye care needs of the Olympians while they are staying at Olympic Village.  The £23 million facility will provide healthcare free of charge to the Olympic athletes and officials.  The center is open 24 hours a day and expects to take care of 200 people per day.

In addition to expected sports injuries and urgent care, the clinic is providing free dental care and vision care to athletes.  “We would complete and finish a root canal for someone who might not be able to get it in their own country,” said Wendy Turner, one of the dentists who works in the clinic. “There will be competitors who haven’t had much access to dental care. It is an opportunity for them to get it sorted out.”

With a small city of 18,000 athletes, coaches and officials housed in Olympic Village, it is easy to see how complex it can be to orchestrate accommodations, meals and even healthcare for these world-class athletes. It looks like London has it all figured out, having thought of every last detail to ensure comfort and hospitality for their guests from around the world.

July 24, 2012

The History of Dental Implants

Dr. Chilcoat @ 11:26 am

history of dental implants

The History of Dental Implants

With all of the interest in dental implants these days, it’s easy to think that implants are something new or even experimental.  Nothing could be farther than the truth, however.  Dental implants may be one of the oldest concepts in dental history.  Modern day research begins in 1951 with Dr. Per-Ingvar Branemark, an orthopedic surgeon.  Dr. Branemark was the first to discover that titanium is the only biocompatible metal which bone actually interacts with.  The very first titanium “roots” were implanted into the jaw of a human patient by Dr. Branemark in 1965.

The very first dental implants discovered were engineered by the ancient Mayans and belonged to a young woman about 600 B.C. who was missing 3 lower anterior teeth.  The ancients crafted false teeth from pieces of shell and inserted them into the sockets of the missing teeth.  Ancient Egyptians also practiced advanced dentistry and implanted similar prostheses bonded with gold wire into the jaws of pharaohs.   Even the Romans had their own version of permanent replacement of missing teeth.

The history of modern implant dentistry has evolved over recent decades with the first major advancement beyond the use of titanium in 1981 when German scientists, Dr.’s Schroeder and Ledermann showed that titanium plasma spray coatings improved osseointegration (the process of the bone tissue healing to the surface of the implant).  By the mid 1980’s Dr Stig Hanssen advanced the preservation of crestal bone with microtexture.

By the 1990’s dental implants had become an extremely successful and predictable method of tooth replacement.  Success rates became higher than 90% and implantologists began looking for ways to reduce the 6 month inactive healing period between implant placement and implant loading.  In the late 1990’s Nobel Biocare introduced the “All- on- Four” system which allowed for three benefits: the use of only four implants to replace a full arch, reduction in the necessity for extensive bone grafting and reduced inactive healing time.  This technique became extremely popular and is still used today.  In 2011, Thommen Medical introduced the first measurable advancement in early osseointegration with their Inicell application system.  The Thommen system utilizes a hydrophilic liquid to coat the implant just prior to insertion.  The solution draws blood cells toward the surface of the implant and has been shown to increase the rate of early osseointegration within the first 4 weeks of healing.

Today, dental implants are the most predictable and successful form of permanent tooth replacement available.  Enjoying a 97% success rate for over 40 years, patients can have confidence that their dental implants have come a long way from the ancient Mayans.


July 16, 2012

Wisdom Teeth Removal- A Rite of Passage?

Dr. Chilcoat @ 12:26 pm

Wisdom teeth removal, a rite of passage for teensWisdom teeth removal has become a rite of passage for American teenagers.  Even the name “wisdom teeth” has connotations of the coming of age.  Wisdom teeth, clinically known as third molars, have been bestowed this moniker based on the age at which they first begin to appear.  The teenage years between ages 13 and 21, historically called the “Age of Wisdom”, is the period during which the third molars begin to erupt into the dental arch.

A dentist or oral surgeon may prescribe the removal of wisdom teeth and impacted wisdom teeth based on signs and symptoms of trouble.  The human jaw typically cannot accommodate this third set of molars and as they attempt to grow into the small space, they become malpositioned and impacted.  In the case that wisdom teeth come in normally, they are often positioned so far back in the jaw that they are difficult to keep clean.  Erupted wisdom teeth which are situated very far back in the jaw are more susceptible to decay and gum disease.  Gum disease around the third molars inevitably spreads to the second molars and sometimes even further forward.  In the interest of preventive dentistry and to prevent serious problems with periodontal recession and gum disease, dentists often recommend the removal of erupted wisdom teeth.

Impacted wisdom teeth are routinely removed due to malposition of the teeth, damage or potential damage to the second molars, infection, cyst formation and other pathology often associated with impacted third molars.  Orthodontists in particular often prescribe removal of the wisdom teeth in order to prevent orthodontic relapse due to the pressure of erupting wisdom teeth on the other teeth in the jaw.

Parents across the country scramble to the oral surgeon’s office as the end of summer draws nearer in order to have their Busy summer scheduleschild’s wisdom teeth extracted before their retainers stop fitting.  Motivated by the looming possibility of repeat orthodontic therapy, and the chronic infections often associated with wisdom teeth, parents schedule surgery for their child. The challenge is often in balancing the cost of wisdom teeth extraction with their teenager’s busy summer schedules and even busier school year schedules.

Somewhere between vacation, band camp, football practice and cheer clinics lies just few days of Redbox rentals, ice cream and X-Box that every teenager dreads.  The stories and warnings from friends are fanciful and exaggerated, working each other up into a tizzy over this, the first surgery of many of their lives.  Truthfully, more than 90% of them will come through with flying colors, easily transitioning back into their normal routine within a few days.  While complications are unusual, about 10% may experience prolonged discomfort, swelling, mild bruising or even the dreaded dry socket.  Symptoms of all of these, of course, are easily relieved in the office with a post- operative visit with the oral surgeon.

The poor, unappreciated parents have the toughest role in wisdom teeth removal.  Consider the orchestration of events that a parent must pull off in order to indulge their child in this bittersweet rite of passage.  Schedules and activities must be coordinated.  If soccer practice is to be missed, then a signed, certified and notarized letter from the surgeon and the U.S. Surgeon General is often required in order to excuse the recovering patient from physical exertion during recovery.  Other children in the household must be taken into consideration, as extracurricular activities do not stop for brother’s oral surgery.  Special food must be purchased and prepared, and a day or two of work will often be missed.

Then there is the expense.  Surgery of any kind is expensive.  Most families have health insurance, but fewer and fewer have dental insurance these days.  The families who do have dental insurance have seen their out of pocket expenses increase in recent years.  How does a family without dental insurance save money on the extraction of wisdom teeth?  There are a variety of ways to accomplish this, but I would like to tell you about our solution in particular.

Dr. Robert A. Weinstein, a Dallas oral surgeon, has devised a plan to help alleviate this burden for parents.  He is an “in-network” provider for most PPO dental plans.  As such, patients often pay only about 20% of the total cost of surgery.

No insurance? A flat rate special fee for surgery and anesthesia may be the answer for you.  Depending on your diagnosis, going the cash payment route with this option can save you about 50% of the cost of full fee oral surgery.  Dr. Weinstein has decided not to charge people more when they do not have insurance.  Instead, he analyzed the “in network” fees from the top PPO plans fee schedules, and created a lower flat fee for the uninsured based on the “in network” fees associated with popular dental plans.  The only catch?  Services are paid for when rendered.  The benefits?  No surprises regarding fees or coverage.  There are no claims to file and no bills coming in 3 months because insurance didn’t pay a portion of the bill.  See our listing on Dallas Dental Implants and Wisdom Teeth for more information.

As summer winds down to a close and that busy school year inches closer with every degree the temperature rises, there is one thing that parents can do to make it all easier to deal with.  Schedule the summer wisdom teeth removal now and take advantage of the summer special on flat fee wisdom teeth removal.  (Includes post-operative ice cream and a sports/band/cheer excuse letter).


Have a wonderful summer!

June 20, 2012

Top 5 Kitchen Cabinet Dental Remedies

Dr. Chilcoat @ 9:56 am

dental healthMost people understand that good personal oral hygiene is critical to dental health.  Daily dental care and regular visits to your dentist and hygienist are key components of a healthy mouth.  People have been finding effective and natural ways to relieve dental pain and clean their teeth since history began.  The ancient people of India used twigs of the neem tree to clean their teeth.  The neem tree has antiseptic qualities which were very effective for oral hygiene.  Other ancient forms of dental hygiene tools included porcupine quills, animal hair and primitive toothpicks.  Ancient Greeks kept special slaves to clean their teeth.  The first toothbrush was used in 15th century China and was made from boar hair and a bamboo stick.

There are quite a few dental home remedies that originated in the period of history before the dental profession came to prominence, and some of those remedies can be useful even today.



Top 5 Dental Home Remedies

  1. For relief of inflammation of the gums surrounding an impacted wisdom tooth or other soft tissue inflammation, use saline soaks.  Mix ¾ teaspoon of table salt in 16 ounces of very warm water.  Dissolve the salt completely in the solution.  Take a mouthful of the solution and hold it over the affected area until it cools, spit and repeat for at least 20 minutes.  This home remedy can help relieve the pain of impacted wisdom teeth and other dental pain temporarily, until you can see a dentist or oral surgeon.
  2. For temporary relief from a toothache, try applying a few drops of clove oil to the affected tooth.  Cloclove oil for toothacheve oil will help temporarily numb the pain in a localized area.  For tooth aches and severe tooth decay, see a dentist right away.
  3. Mouth ulcers and cold sores inside the mouth are very painful. Applying a small amount of alum directly to the ulcer can help relieve the pain associated with mouth ulcers.  Alum is a pickling salt commonly used in preparation of pickled vegetables.  Use only a tiny amount, and if mouth ulcers persist be sure to see your doctor or oral surgeon for professional help.
  4. Home teeth whitening can be accomplished using baking soda, just like your mother always told you.  Baking soda is an acid neutralizer and a mild abrasive which gently removes stains and buildup on your teeth.  Baking soda is considered one of the safest home remedies for tooth whitening, and can be sprinkled directly on your toothpaste, or used alone up to twice a month.
  5. Even people who practice excellent oral hygiene can get bad breath from time to time.  If you’ve had a particularly strong meal containing strong cheeses, garlic or onions, try chewing on clove, fennel or anise seeds to help freshen breath.  You can also chew on a piece fresh parsley to freshen breath after a strong meal.  Of course, brushing after a meal like this will also go a long way toward reducing bad breath after a meal.




Dangerous Home Remedies

Some commonly practiced dental home remedies can be extremely harmful to your teetnever place an aspirin on a painful toothh and oral health.  All of the above mentioned home remedies should be used in moderation to prevent problems associated with overuse.  Here are a few  old wive’s tales regarding dental remedies which you should avoid:

  1. Never place an aspirin directly on a tooth or gum tissue. Aspirin is an acid, and direct application of aspirin to your soft tissues can cause severe ulceration of the tissue and increase pain.
  2. Overuse of toothache gels can also cause soft tissue ulceration and pain.
  3. Never rub whiskey on a teething baby’s gums.  Children should not consume alcohol in any amount, and whiskey has no numbing effect on the gums of a teething baby. Try a frozen teething ring instead.
  4. Beware of using Colloidal Silver for oral health.  Consuming high amounts silver, which is absorbed into the body, causes silver toxicity as well as severe discoloration of the skin, called argyria, in which the skin turns bluish-gray.

The important thing to remember about dental home remedies is that anything in excess can be dangerous to your health.  Remember to use any home remedy in moderation and never overuse any preparation.  Home remedies for dental pain are intended for temporary relief.  If your problems persist, be sure to seek treatment from a qualified dental professional right away.


June 4, 2012

Replacing Missing Teeth

Dr. Chilcoat @ 11:26 am

Chances are, if you are an American adult, you either know somebody who has lost a permanent tooth or you have lost a tooth yourself.  69% of all Americans will have experienced tooth loss by the age of 44.

Tooth loss has a huge impact on quality of life, overall health and self-esteem.  If you are missing teeth, you are likely

bridge vs. implant

Dental Implant

self-conscious about the way you smile, talk, laugh and even about what you eat. In the past, dentists would recommend replacing missing teeth with a dental bridge, partial denture of complete denture.  These treatments are appropriate for some patients, however, the complications and shortcomings associated with non-permanent tooth replacement can open up a brand new set of dental problems.

The biggest problem with non-permanent solutions for missing teeth involves bone loss.  In a normal, healthy jaw, your bone surrounds the tooth roots, preserving the height and width of the bone.  When tooth loss occurs, the bone tissue no longer has a tooth root to hold on to, so it begins to recede.  Over time, the jaw bone may shrink extremely, giving the appearance of a “sunken” or “puckered” face.  When bone loss occurs, so do problems with dental bridges, partial and complete dentures.

dental bridge

Dental bridge

Dental bridges for tooth replacement involve placing a false tooth in between crowns on adjacent teeth.  Over time, bone loss occurs and the jaw bone recedes in the area of the missing tooth, creating a hygiene problem and often, breakdown of the anchor teeth due to decay or periodontal infection.  While an appropriate treatment option for some patients, a dental bridge often involves the placement of a dental crown on an otherwise healthy tooth.  The anchor teeth are further compromised by the increased load distributed by the false tooth as well as being more difficult to keep clean.

Partial and complete dentures for tooth replacement inhibit function and can become loose and difficult to wear over time.  A partial denture attaches to remaining teeth with a clasp.  The pressure of biting and chewing is distributed to the remaining teeth, applying additional stress on the anchor teeth.  Over time, bone loss and stress can cause the breakdown of the anchor teeth and lead to more tooth loss.  Bone loss in the area of missing teeth can also cause the partial denture to fit improperly as the jaw shape changes and the partial denture remains the same.

Complete dentures also have a tendency to become ill-fitting over time, causing the denture to become loose and inhibiting function. Many patients who wear a complete denture complain of painful sores and ulcerations on the gum tissue which inhibits use of the denture.

Dentures that slip, click or move upon talking, eating, smiling and laughing are embarrassing and uncomfortable.  Complete dentures sit on top of the jaw bone, applying pressure to the entire ridge, and can speed up the process of bone loss and the “sunken” appearance associated with old age.  Many denture wearers are non-compliant about wearing their dentures since they are uncomfortable, unstable and loose.  Dentures which inhibit a patient’s ability to eat and chew can lead to nutritional and overall health concerns.

Replacing missing teeth with dental implants has become the gold standard for tooth replacement.  Once a very expensive and time consuming treatment option, dental implants have become simpler, more accessible and more affordable.  Dental implants for tooth replacement are used to replace a single tooth or for full mouth tooth replacement.  A dental implant replaces the root of the tooth with a titanium post.  This post is bio-compatible and preserves the bone surrounding it, inhibiting bone loss associated with missing teeth.  A dental crown is built upon the post to replace the functional and aesthetic part of the missing tooth.  Dental implants are extremely strong and durable, with a 97% success rate over nearly 50 years of research.

Multiple dental implants can be used to anchor a denture, preventing complications from loose dentures, bone loss and slippage.  Dental implant retained dentures provide stability and comfort.  Because the jaw bone is preserved, bone loss does not progress and cause a “sunken” appearance.  Patients who have worn traditional dentures for years complain of discomfort, ulcerations, loose dentures and an inability to chew favorite foods.  These patients gain an increased quality of life upon completing their dental implant procedure.

For more information about advances in implant dentistry, tooth replacement and implant dentures, contact us.



May 24, 2012

Why Choose a Maxillofacial Surgeon For Facial Cosmetic Surgery?

Dr. Chilcoat @ 12:23 pm

Trained and specializing in surgical facial reconstruction and jaw surgery, Oral and Maxillofacial Surgeons (OMFS) are specially and specifically trained in the anatomy and physiology of the facial structures including bone, muscle, nerve and tissue relationships of the face, head and neck.  For this reason, an OMFS has vast knowledge and extensive expertise in this defined area of the body.

Maxillofacial Surgery Training

An OMFS earns a degree as a dentist before pursuing four or more years of continued education and residency training in Oral and Maxillofacial Surgery.  This pre-residency training also involves tuning the eye to smaller and more minute details, providing him or her with “THE ESTHETIC EYE”.  The residency training includes training in  Plastic Surgery, Otolaryngology, General Surgery, Internal Medicine and Anesthesiology.  In fact, an OMFS is generally trained, more than any other physician, excluding Anesthesiologists, to provide general anesthesia and/or IV sedation, especially in an out-patient setting.

The Cosmetic Connection

permanent lip augmentation

Perma Facial Implant for lip augmentation

An OMFS has the ability and training to take the entire face into consideration, from bone structure to tissue quality and exacting placement, when performing a cosmetic procedure.  An OMFS’ ability to realign facial structures stems from their residency years which are filled with the treatment of multiple facial fractures and traumatic soft tissue injuries.  An OMFS is experienced in “putting back together” tissues and structures, which are deformed in an unnatural way through injury, in a manner that results in the best possible esthetic outcome.  Treating the skin is only a part of a more three dimensional perspective in the mind of an OMFS, and specifically for Dr. Weinstein who embraces this concept.

3-Dimensional Consideration

For example; a patient who has undergone tissue augmentation of the cheeks and/or lips without satisfactory results may

chin augmentation

chin augmentation

have an underlying skeletal abnormality or even missing teeth causing a sunken or hollow appearance.  Correction of this problem can often be achieved surgically through the inside of the mouth, negating the need for any visible external scarring and possibly reducing or eliminating the need for facial tissue augmentation altogether.

Complete Facial Cosmetics

Treating the face, skin and jaws as a whole provides more complete and longer lasting results.  An OMFS’s clinical understanding of the dental, skeletal and tissue relationships in facial esthetics, along with the “ESTHETIC EYE”, make him/her an ideal specialist for cosmetic facial surgery.

Dr. Robert A. Weinstein

Dr. Robert Weinstein is an Oral and Maxillofacial Surgeon with over 30 years experience in cosmetic facial surgery as well as peri-oral related surgery such as reconstructive jaw surgery, bone grafting and dental implant surgery.    His office boasts state of the art laser equipment which makes it possible to achieve a greater variety of results without invasive surgery.  The lasers used in his practice are the top rated and most advanced lasers of their kind.  Surgical techniques are minimally invasive, allowing for swift recovery and minimal scarring. Over thirty years of clinical experience combined with rigorous continuing education including orthognathic surgery, facial trauma reconstruction, facial plastic surgery, dental implantology and bone grafting surgery means that when you choose Dr. Robert Weinstein for your facial cosmetic procedure, you are choosing an expert in the field of facial esthetics.

Cosmetic Facial Surgery

May 17, 2012

Dental Emergency and First Aid

Dr. Chilcoat @ 10:04 am

Moms know how to handle anything.  As a mother of two adventurous boys, I’ve had my share of cuts, scrapes

dental emergency procedures

A dental emergency waiting to happen

and most recently, a nice sized burn.  I’m proud to say that in most instances, I handle myself pretty well.  My boys almost always cry much harder than I do when they get hurt. Being in the dental profession, I feel well-equipped to handle dental emergencies should one arise.  It occurred to me that my confidence in being able to manage a dental emergency or injury might be a rarity.   Dental injuries and emergencies can leave moms who are not dental professionals a little baffled about how to respond and what to do.

Never fear, the answers are right here!  Thanks to the American Dental Association, I am able to share these handy dental emergency first aid tips.  I hope you never have to use them, but just in case, you can print them out and keep them in your home and travel first aid kits!

Dental Emergency First Aid

dental first aid

Dental First Aid

Knocked-Out Tooth

Hold the tooth by the crown, and gently rinse off the root of the tooth in water if it is dirty.  Do not scrub it or remove any attached tissue fragments.  If possible, gently reinsert and hold the tooth in it’s socket. If that is not possible, place the tooth in a cup of milk.  The sooner you can do any of these things, the better because it helps keep the small attachment fibers on the root of the tooth alive.  Try to get to the dentist within an hour, if you can.  Don’t forget to bring the tooth with you!


Rinse the mouth with warm water to clean it out.  Use dental floss to remove any food that may be trapped between the teeth.  Never put an aspirin on the aching tooth or gum tissue.  See your dentist as soon as possible.  Over the counter pain relievers may be used, but in moderation and never for longer than a week.

Broken Tooth:

Rinse the mouth with warm water to keep the area clean.  Put cold compresses on the face to reduce swelling.  See your dentist immediately.

Bitten Tongue or Lip

Clean the area gently with a cloth, and place cold compresses to keep the swelling down. If bleeding is excessive or does not stop in a short period of time, go to your dentist, oral surgeon or hospital emergency room.

Objects Caught Between Teeth

Gently try to remove the object with dental floss.  If you are not successful, go to the dentist.  Do not try to remove the object with a sharp or pointed instrument.

Possible Broken Jaw

Apply a cold compress to the face to control swelling.  Go to your dentist, oral surgeon or hospital emergency room immediately.

With any luck, moms reading this post will never have to use any of these dental first aid tips.  If you are anything like me and my daredevil boys, all bets are off!  Either way, you are now prepared for anything.  For questions about dental injuries and dental emergencies not mentioned in this post, feel free to give Dr. Weinstein a call.  We’re happy to help!



May 10, 2012

Affordable Dental Implants

Dr. Chilcoat @ 11:04 am

If you have a missing tooth or multiple missing teeth, you are not alone.  An estimated 2 out of 3 adult Americans has at least one missing tooth.  In the past, a missing tooth was compensated for using a dental bridge, which requires the grinding down of the adjacent teeth and construction of a false “bridge” tooth in between.  While a dental bridge is still a viable option for some patients, there are several drawbacks to replacing a missing tooth with a dental bridge which should be considered prior to deciding on a treatment plan.

bridge vs implant

dental bridge

  • Dental bridges do not support good oral health.  They are difficult to floss around, promoting tooth decay of the adjacent teeth as well as increased risk of periodontal disease.
  • A bridge can sacrifice otherwise healthy adjacent teeth, since those teeth must be ground down in order to attach the bridged tooth in the center.
  • A bridge does not maintain the bone height and width in the area of the missing tooth, allowing recession over time.
  • A bridge has a life span of approximately 5-10 years.
  • A failed bridge often requires extraction of the adjacent abutment teeth and extension of the bridge.


Many patients coping with one or more missing teeth choose to proceed with a dental bridge simply because they are unaware of all the options available.  Dental implants to replace missing teeth are a mainstream permanent solution for missing teeth.  A dentist or oral surgeon should present your restorative options to you so you can weigh the pros and cons yourself, and decide upon a treatment option that is best for you.  Some patients do not consider a dental implant simply because the perception is that they are too expensive.  The truth is, dental implants, even when the initial cost is higher than that of a bridge, are significantly more cost effective over time.  Since the life of a bridge is expected to be 5-10 years, it will require replacement or expansion sometime in the near future.  A longer bridge spanning additional missing teeth will increase the cost.  A dental implant has a success rate of over 97% over 47 years of research.  This means that when you replace a missing tooth with a dental implant, there is a good chance that that implant will stay with you for the rest of your life.


Here are some of the benefits of replacing missing teeth with dental implants:

  • Predictable and precise treatment

    dental implant picture

    dental implant

  • Permanent solution for missing teeth
  • 97% successful over 47 years
  • No sacrifice of adjacent teeth
  • No decay
  • Easier to keep clean
  • Feel, look and function like natural teeth

Many doctors, such as Dr. Robert Weinstein, believe so strongly in the positive outcomes from dental implants that they have made them more affordable than ever.  Visit our seasonal specials page for more information on the actual cost of dental implants.

When considering your treatment options for the replacement of missing teeth, make sure you have all the facts.  While a dental bridge may be the best option for some patients, dental implants for permanent tooth replacement may provide a permanent and more predictable outcome.



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14856 Preston Rd., Suite 104, Dallas, TX 75254 USA
Charles Chilcoat, DDS Dallas TX Dentist (972) 960-1111 care@texaswisdom.com