Benefits of iCAT 3D Cone Beam CT Scanner

Imaging is useful in diagnosing the causes of many dental, oral and maxillofacial conditions, from a toothache to an abscess. In the past, dentists had to rely on grainy two-dimensional pictures produced on film by x-rays, but now better tools are available to enhance treatment planning.

Three-dimensional pictures, like those produced by cone beam CT scanners, have revolutionized the process of preparing for oral surgery procedures like wisdom teeth extraction.

The iCAT 3D cone beam CT scanner is one such tool that provides a lifelike depiction of the patient’s mouth. These scans are particularly valuable because they give the oral and maxillofacial surgeon a realistic view of what the surgical landscape will be before any incisions are made.

Even panoramic x-rays, which once represented the highest quality image available to an oral surgeon, pale in comparison to three-dimensional cone beam CT scans. Panoramic x-rays may not fully prepare the oral surgeon for the surgical landscape, and this can lead to longer surgeries when the surgeon encounters an unexpected feature.  Panorex x-rays are good dental screening tools to identify issues, but are limited by being two dimensional and possessing distortion and magnification artifacts, but medical cone beam CT scans are the standard of care now in advanced oral and maxillofacial surgery practices. 

These scans are particularly valuable because they give the oral and maxillofacial surgeon a realistic view of what the surgical landscape will be before any incisions are made.

Other important facial structures, like nerves, can be identified precisely and made visible in a cone beam CT scan but not in a traditional x-ray. It is also easier for the oral surgeon to identify abnormalities and pathology with a cone beam CT scan.

Cone beam CT scanners use highly targeted rays to capture data on specific areas. This reduces the patient’s exposure to radiation in comparison to traditional medical CT scans, which compile information from a number of slices to build the image.

Furthermore, cone beam CT scanners are more comfortable for patients than traditional radiography equipment. With cone beam CT, patients don’t need to bite down on anything while the scan is being taken. The scan is also completed in a matter of seconds, much more quickly than standard x-rays.

Additionally, the cone beam CT scans are digital, so they can be downloaded to a computer and viewed instantly. Your oral surgeon won’t have to wait for the film to develop to begin working on your case.

The iCAT 3D cone beam CT scanner offers patients a number of benefits. Ask our team at ORA® Oral Surgery & Implant Studio if this tool would be useful in planning your surgical procedure. Call 312-328-9000 to schedule your consultation today.

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On March 6th, 2013, posted in: toothache by

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Abscessed Wisdom Teeth Symptoms

You are probably aware that the third molars, otherwise known as the wisdom teeth, can cause a number of problems for the modern human. Although these large teeth were valuable to our ancestors, who lost teeth with greater frequency and needed to process rougher diets, they no longer serve a purpose for us.

Most people have jaws that are too small to allow the wisdom teeth to erupt properly, and as a result those teeth become impacted. Impacted wisdom teeth must be extracted surgically, and many patients have their initial interactions with an oral surgeon to undergo that procedure.

Impacted wisdom teeth are associated with a number of negative outcomes, including significant discomfort, adjacent tooth damage, cysts and tumors and infection, possibly leading to wisdom tooth abscess.

An abscess occurs when infection reaches a tooth’s innermost structures or develops in the space between the gum and the root. This condition can be extremely painful. Abscesses also pose a danger locally by spreading into multiple facial spaces and because if the bacteria gets into the patient’s bloodstream, it can lead to a potentially deadly systemic infection known as sepsis.

If you still have your wisdom teeth, you should be aware of the signs of a wisdom tooth abscess so that you can seek treatment as soon as possible. Any of the following symptoms may indicate an abscess:

  • Severe, persistent toothache
  • Bad odor from the area
  • Sensitivity to temperature extremes
  • Inflamed or swollen gums
  • A sore on the gums that will not heal
  • Fever
  • Swollen glands in the neck
  • Discharge from area
  • Nausea/Vomiting
  • Swelling of any part of the face or neck

Patients who are experiencing any of the above problems should consult with an oral surgeon for a diagnosis immediately and to develop a treatment plan. If a patient develops an abscessed wisdom tooth, not only will the patient need to have the tooth removed, but also possibly an incision and drainage of the abscess as well as a powerful course of antibiotics also will be prescribed.

It is recommended that most patients have their wisdom teeth removed before they reach their late twenties to avoid problems like wisdom tooth abscesses. Older patients should still have their wisdom teeth removed, but there can sometimes be a greater likelihood of complications and the recovery period will probably be longer.

Contact the wisdom tooth expert, Drs. Steven Koos DDS, MD for more information. Call 312-328-9000 to schedule your professional consultation today.

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Tips for Relieving Dental Anxiety

Many patients have at least some anxiety when they meet with an oral surgeon. The prospects of surgery in the mouth can raise fears in some people, and occasionally those worries are so extreme that the patient may delay seeking treatment until the physical pain outweighs the psychological discomfort.

Procedures like surgical tooth extraction are important in preserving a patient’s oral health, and having problems addressed earlier can keep harmful oral diseases from progressing. So, if anxiety is holding a patient back from seeking treatment, that patient should look into alternatives that can make the experience a more comfortable one.

In particular, choosing sedation for tooth extraction can help fearful patients get the valuable oral surgery interventions that they need. In fact sedation now for even single tooth removal is a common mainstay for almost every type of patient.  Sedation dentistry helps patients achieve a deep state of relaxation during the procedure, after all, who wants to even feel the pressure or remember the experience of a tooth extraction. 

…choosing sedation for tooth extraction can help fearful patients get the valuable oral surgery interventions that they need.

With this technique, the oral surgeon will administer a specific medication, often from an anti-anxiety class of drugs known as benzodiazepines, to ease the patient’s nerves. The patient may take the medication orally in advance of the appointment (to give the drug sufficient time to achieve the desired effect), or delivered intravenously. The patient may also inhale a gas like nitrous oxide to relax.

For patients who might otherwise need to rely on full general anesthesia for oral surgery, deep sedation offers a good alternative. Full general anesthesia, with a muscle paralytic given, renders the patient unconscious and requires artificial airway maintenance during the surgery.

Under moderate sedation, it may seem that the patient is sleeping, but the patient actually remains conscious throughout the procedure. Sedation does not compromise the airway, either.

When the sedative wears off, the patient has no recollection of the appointment. This is another advantage of sedation for tooth extraction. The patient won’t have a bad experience that reinforces dental anxiety.

If your fears have kept you away from the oral surgeon, consider sedation as a solution to the problem. At your initial consultation with our dual degree oral and maxillofacial surgeon at ORA® Oral Surgery & Implant Studio, discuss your concerns and learn more about the different available sedation options to decide which one might be best for you.

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Tooth Extraction Complications: Maxillary Sinus Exposure/Perforation – Part 4

There is a certain degree of risk that comes with any surgical procedure. An oral surgery procedure such as the removal of the wisdom teeth is no exception.  Although your oral surgeon will make every attempt to provide you with a flawless and uneventful experience, it is always recommended that you be familiar with all of the risks and benefits of tooth extraction surgery.

As a part of our normal anatomy, the upper molars and premolars are located relatively close to the sinuses and there are times where the tips of the roots lie within the sinus cavity itself.  The maxillary sinus cavities are air-filled openings in the area behind the cheekbones. The roots of the upper back teeth are located just beneath the sinuses, and this relationship can sometimes present unwanted complications when these teeth are removed.

During surgery, the roots of the upper back teeth can puncture the bone that surrounds the sinuses. In some cases, the bone can be especially thin, decreasing the amount of space that separates the teeth from the sinus cavities. In fact, for some patients, as mentioned above, there is no bone between the teeth and the sinuses and the roots of the teeth are positioned within the sinus cavity. When the tooth is removed, a gap or hole is left in the sinus, a condition known as a sinus exposure or perforation.

If a sinus perforation occurs at the time of surgery, it is usually detected immediately and repaired immediately while a patient is still under general anesthesia.  Generally, sinus exposures can be expected to heal from that point naturally, with little or no additional treatment.  However, if an exposure should occur, you will be instructed to take a few special precautions in order to promote a speedy recovery:

  • Avoid blowing your nose forcefully for at least 21 days. The pressure could disrupt the natural healing process. Instead, you will be advised to use nasal decongestants as necessary.
  • Avoid any other blowing action that involves the nasal cavity. This includes any blowing up balloons, musical instruments, scuba diving, and even strenuous exercise.
  • Avoid drinking through a straw for 21 days as well as any carbonated beverages.
  • You will instructed to also perform open mouth sneezing if the urge should arise.
  • Antibiotics are also usually always prescribed too since there can be travel of bacteria from the oral cavity up into the sinus cavity from the perforated area.

Our skilled and dedicated team at ORA® Oral Surgery & Implant Studio is prepared to review the details, risks, and benefits that are related to your wisdom teeth removal. Call 312-328-9000 to schedule your consultation today.

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Tooth Extraction Complications: Different Types of Nerve Injuries – Part 3

Although the procedure for having your wisdom teeth extracted is more predictable than ever before, there is the potential for complications to arise. Each year, a small percentage of oral surgery patients suffer from a condition known as paresthesia, in which unavoidable nerve damage occurs during the tooth extraction process.

Occasionally, the nerve that is found in the jawbone can become bruised or damaged during the surgical process. When this nerve that is located near the wisdom teeth is affected, you can expect to experience a prolonged sensation of numbness to the tongue, lips, chin, or gums. In regards to the wisdom teeth, there are a few sensory nerve pathways that lie particularly close to the roots or the crown of the teeth.

Generally, the symptoms of paresthesia will disappear after a few weeks (or months) without any additional treatment. For a small percentage of patients, the symptoms will last more than 6 months, and an even smaller percentage who could demonstrate permanent numbness.

In the jawbone, there are two sensory nerves that are most likely to be bruised or damaged during surgery:

  • The inferior alveolar nerve which provides sensation to the bottom teeth, the chin, and the bottom lip.
  • The lingual nerve which is responsible for your sense of taste to the front half of the tongue. This nerve is also responsible for the tongue’s sense of touch as well as the sensation to the surface of the gums located closest to the tongue.

Nerve injuries that occur as a result of wisdom teeth extraction are particularly rare and are often temporary in nature. Risk factors such as the location of the wisdom teeth, the nature of the surgical procedure, and the age of the patient can influence the possibility of paresthesia.  Still, it is recommended that patients be aware of the potential for such complications and the proposed treatments for these injuries prior to having any teeth removed.

To find out more about your risk for such an injury, contact the wisdom tooth expert, Dr. Steven Koos DDS, MD today for a personalized consultation.

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Tooth Extraction Complications: Inferior Alveolar Nerve Injury – Part 2

Oral and maxillofacial surgical procedures such as tooth extractions can sometimes result in damage to the anatomical area surrounding the tooth. Though approximately 98% of oral surgery procedures can be successfully completed without incident, there are some risks that must be brought to your attention.

An inferior alveolar nerve injury, a serious injury to the sensory nerve that runs the length of the lower jaw, is an example of a well-known risk associated with the extraction of a lower tooth, particularly impacted teeth, that can result in numbness of the lip and chin area.

In most cases, the potential for nerve damage mainly depends on the anatomic relationship between the nerve pathway and the tooth that is to be removed.  When the nerve and the tooth are relatively close together, there is a higher risk of nerve damage during the surgical procedure. In some instances, the nerve can run dangerously between the roots of the lower teeth.

The risk for nerve damage can be assessed with information gathered from your x-ray, but only an advanced film like a 3D CT scan. The nerve pathway and the position of the teeth and roots cannot be accurately visualized and determined on a 2D dental panoramic x-ray.

The inferior alveolar nerve is a branch of the Trigeminal Nerve, which is one of the 12 cranial nerves in the head and neck region.  This particular branch carries only sensory fibers and no motor fibers, therefore, it is not responsible for movement – only sensation, i.e. Temperature, pressure, pain, light touch, vibration.  The most common consequence of inferior alveolar nerve damage is prolonged numbness or tingling of the lip or chin. For some patients, this sensation may continue for several weeks, and for others, many months. The great majority of patients will see a full recovery within a year.   The incidence of permanent injury is less than 1-2%.

Complications such as nerve damage can arise, even in the hands of a highly skilled oral surgeon. These unexpected occurrences should not be attributed to a lack of care or skill on behalf of the oral surgeon, and every reasonable measure will be taken to avoid any damage at all.  In fact, prior to the removal of the tooth, your surgeon will assess the risks versus the benefits to determine if the procedure should be performed at all.

To learn more about the risks and the benefits of oral surgery and tooth extraction, call the office of Dr. Steven Koos to schedule a consultation today.

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Tooth Extraction Complications: Adjacent Tooth Injury – Part 1

When you have a toothache, your top priority is stopping the pain, even if that means having the tooth removed. It’s hard to function normally throughout your day, hard to concentrate at work, and even harder to get a good night’s sleep until the pain is gone.

An experienced oral surgeon can guide you through the tooth extraction process to relieve the pain and get you back to normal as soon as possible. Prior to the removal of the tooth, it’s important that you are fully aware of the risks and consequences associated with the surgical procedure.

Though there are some risks of complication both during the surgery and afterwards in recovery, most tooth extractions take place without any adverse effects at all. For example, during the extraction, there is a risk that the adjacent teeth could be damaged. In light of the steps that must be taken to remove a tooth, the root or crown portion of the adjacent tooth could be fractured. 

Though there are some risks of complication both during the surgery and afterwards in recovery, most tooth extractions take place without any adverse effects at all.

Using a small instrument called an elevator to loosen the tooth from the bone, and a pair of forceps to grasp the tooth, your oral surgeon can remove the tooth from the socket. If gum tissue or bone is covering the tooth, additional surgical techniques may be required in order to expose the entire tooth. In cases where the tooth is mostly surrounded by bone, or when the tooth roots are fused to the bone, it may need to be sectioned into smaller pieces that are easier to remove.

In most cases, the tooth that is to be extracted is in close proximity to another tooth, which can make it more challenging to successfully remove the tooth while taking care to preserve its neighbor.

Today’s oral surgery and imaging techniques are so sophisticated that surgical complications are rare. Still, there are risks associated with all oral surgery, even simple oral surgery like tooth removal, and any procedure should not be taken lightly.

To learn more about what you should expect when you have a tooth extracted, call ORA® Oral Surgery & Implant Studio located in Downtown Chicago at 312-328-9000 for a consultation today.

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How Much Does Wisdom Teeth Extraction Cost? Part 4: PPO Dental Insurance Fees

oral surgery ChicagoAt the time of your wisdom teeth evaluation, your Downtown Chicago oral and maxillofacial surgeon will carefully explain the procedures that will be required to perform your treatment. A detailed treatment plan will be developed, including a list of each dental code and the corresponding fees.  Your treatment plan will reflect an estimate of your insurance contributions as well as your patient co-pay amounts. This information will clearly outline your out-of-pocket responsibilities for your wisdom tooth removal.

The specific details of your treatment plan will depend heavily upon the procedures that are required to complete your treatment. In planning your oral surgery, your surgeon will need to determine if your wisdom teeth extraction will be simple or surgical. Are the wisdom teeth impacted beneath the bone or the gums? Are the wisdom teeth infected or abscessed? Will sedation be necessary?

As you consider your dental treatment plan, remember that your level of coverage and the amount of your co-pay will be unique based on your particular insurance plan.  Generally, you will find that PPO plans include oral surgery benefits and often include a generous allowance towards the extraction of the wisdom teeth.

To aid in the development of your treatment plan, nationally recognized codes will be utilized:

ADA(American Dental Association) CDT (Current Dental Terminology) codes and average PPO dental insurance oral surgery procedure fees:

  • 7210 Surgical Extraction – $215
  • 7220 Soft Tissue Impaction – $268
  • 7230 Partial Bony Impaction – $353
  • 7240 Complete Bony Impaction – $416
  • 7241 Complete Bony Impaction With Complicating Factors – $465
  • 9220 Deep Sedation first 30 minutes – $341
  • 9221 Deep Sedation subsequent 15 minute increments – $117
  • 9241 Conscious Sedation first 30 minutes – $317
  • 9242 Conscious Sedation subsequent 15 minute increments – $129
  • 9610 Parenteral Administration of Therapeutic Medication – $42
  • 9910 Administration/Application of Desensitizing Agent – $30

Some examples of dental insurance PPO plans include:

  • AetnaPPO
  • Blue Cross/Blue Shield PPO
  • Cigna PPO
  • Delta Dental PPO
  • Dental HealthAlliance(DHA) PPO
  • First Commonwealth PPO
  • Humana PPO
  • Preferred Plan PPO

For more information on planning your treatment, contact ORA® Oral Surgery & Implant Studio, Chicago’s premiere dental surgery clinic, at 312-328-9000 for your appointment today.

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On November 20th, 2012, posted in: oral surgery by

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Birth Control, Dry Socket, and Wisdom Tooth Extraction

anesthesia for tooth extractionAs you prepare to have your wisdom teeth extracted in Chicago, there are a number of things to consider. Will I be able to be comfortably sedated for my tooth extraction? How can I avoid complications both during and after the procedure has been completed?

Understanding what you should expect and following your Downtown Chicago oral surgeon’s instructions can help to ensure that your procedure is as pleasant as possible and that you experience a speedy recovery.

For most patients, the procedure for extracting the wisdom teeth is painless and non-eventful. With advanced techniques, digital imaging, sedation dentistry, and effective anesthesia, the teeth can be removed smoothly with little or no discomfort.

More often, complications during the healing process are the cause of discomfort. A condition known as dry socket (fibrinolytic alveolitis), in which the blood clot disintegrates or dislodges from the extraction site and does not reform, can be the source of moderate to severe discomfort. In the absence of the blood clot, chemical pain mediators are released/activated and the jaw bone and “nerve endings” are exposed. Patients may notice prolonged bleeding as well as a delay in the healing process. 

Taking steps to promote health and healing will be helpful in preventing the onset of dry socket and keeping you comfortable.

Although this condition may seem frightening and uncomfortable, there is no need for alarm. The incidence rate for developing dry socket is typically less than 5%, and the condition is more likely to occur with the removal of the lower wisdom teeth than any other extractions. Once dry socket has occurred, you may expect an additional 3-4 weeks of healing time.

Taking steps to promote health and healing will be helpful in preventing the onset of dry socket and keeping you comfortable. Avoiding common pitfalls like smoking, forceful spitting and vigorous rinsing, carbonation, and drinking through a straw can help to preserve the blood clot.

For women, taking oral contraceptives can also increase the risk. Scheduling your treatment when estrogen levels are lowest or inactive (during the last week of the menstrual cycle) has been found to reduce the risk dramatically.

To keep you comfortable during the healing process, your oral surgeon will provide detailed post-operative instructions for you. Disclosing your full health history, including medications such as birth control, will ensure that you receive the most accurate information.

For more information about removing your wisdom teeth, contact the office of Dr. Steven Koos, your dual degree Chicago IL oral and maxillofacial surgeon, to schedule your professional consultation today.

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How Much Does Wisdom Teeth Extraction Cost?

Chicago oral surgeonPart 3: DMO/HMO Dental Insurance Fees

Your dental insurance plan can significantly offset the cost of your wisdom teeth extraction when you visit your Chicago oral surgeon. Though the entire procedure is not covered, your insurance benefits can be maximized when you select a dental surgeon like Dr. Steven Koos, who accepts your particular insurance plan.

Compared to some other insurance plans, DMO/HMO plans generally have more exclusions, and more limitations, on oral surgery coverage.  One important distinction is that HMO/DMO medical and dental plans require that any patient that wants to see a specialist requires a written referral from their general dentist or physician first.  There may also be higher co-pay amounts with surgical specialty extractions for impacted teeth. With the help of the office’s financial coordinator, you can receive an estimate for your care prior to beginning treatment and after your consultation.  This pre-planning can help you to understand the initial cost of your care, the portion that should be covered by your insurance plan, and the portion that you will be expected to pay.

Some examples of the major DMO/HMO insurance plans includes:

AetnaPPO & DMO/HMO

Blue Cross/Blue Shield PPO & DMO/HMO

Cigna PPO & DMO/HMO

Humana Comp Benefits

Delta Dental PPO & DMO/HMO

FirstCommonwealthPPO & DMO/HMO

Guardian

To compile your treatment plan and provide you with the most accurate estimate of the total cost of your care, your oral surgeon will utilize the most current national CDT (current dental terminology) codes. This list of procedure codes is recognized by your insurance company to describe the procedures that your oral surgeon plans to provide for you. According to your plan’s limitations and guidelines, these codes will help to generate your final treatment estimate.  Keep in mind these fees are generalized from several different HMO/DMO insurance plans and increase every year and are also dependent on the zip code that the treatment is being perfomed.

ADA(American Dental Association) CDT (Current Dental Terminology) codes and average DMO/HMO dental surgery procedure fees:

  • 7210 Surgical Extraction – $165
  • 7220 Soft Tissue Impaction – $200
  • 7230 Partial Bony Impaction – $285
  • 7240 Complete Bony Impaction – $340
  • 7241 Complete Bony Impaction With Complicating Factors – $420
  • 9220 Deep Sedation first 30 minutes – $270
  • 9221 Deep Sedation subsequent 15 minute increments – $135
  • 9241 Conscious Sedation first 30 minutes – $195
  • 9242 Conscious Sedation subsequent 15 minute increments – $95
  • 9610 Parenteral Administration of Therapeutic Medication – $35
  • 9910 Administration/Application of Desensitizing Agent – $30

If understanding the details of your DMO/HMO plan can be confusing for you, trust the professionals at our Chicago dental surgery office to assist you throughout the process. Why not call ORA® Oral Surgery & Implant Studio inIllinois to schedule your personalized consultation today?

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On October 19th, 2012, posted in: oral surgeon by

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