Jun 12, 2021

Removing teeth is an important part of oral and maxillofacial surgery. When done properly, removing teeth can be done in a minimally invasive manner.

Besides wisdom teeth and more advanced types of oral surgery, one of the most common things we do in our practice is to remove decayed teeth. We also do many simple extractions. Many of these patients are referred to us by their general dentist. The dentists realize that, with our advanced level of training, we can remove these teeth with minimally invasive techniques.

I explain to the patients that local anesthesia works well in many cases, that once the local anesthesia has taken effect, removing a tooth is no different than having a dental filling placed. We also can offer the patient nitrous oxide (sometimes called “laughing gas”) to help decrease the anxiety level before performing the extractions, and we even offer patients IV sedation or general anesthesia if they prefer, to remove these teeth.

Today, Lidocaine is likely the most commonly used anesthetic in dentistry, but there are many others. They all have names ending in “-caine.”

Even simple extractions many times can turn into a more advanced procedure, and with our advanced training, we are able in all cases to keep a simple extraction a simple extraction.

One example is that teeth that have undergone root canal treatment tend to be extremely brittle. Even though on an x-ray clinically it looks as if it could be a simple extraction, once a tooth has undergone a root canal it attaches to the surrounding bone much more tightly. These teeth usually require additional techniques to remove the tooth and do it in such a way so that the result is a simple extraction, which an easy procedure for the patient.

If you have been referred to us by your dentist, please contact us by phone or email anytime and we will be happy to schedule a consultation.

Dr. Leonard Spector

May 15, 2021

Dental patients get the best of both worlds: treatment from both their dentist and an oral and maxillofacial surgeon.

Your and your family’s oral health is our top priority. We completely understand many of our new patients have fear about dental visits, so our staff is here to provide you and your family with the gentle and caring dental care that you deserve in a comfortable environment.

Treatment in my office often involves a team approach between my office and the referring office. The key is good communication to ensure that the patient gets excellent overall care. I think a lot of patients would be surprised at the level of communication between myself and the referring dentist.

Routinely a general dentist, a prosthodontist, or another dental specialist will refer a case to my office. I will initially talk to that referring dentist before the patient coming to the office, and then when I meet with the patient, we do a detailed workup and either take x-rays, or models, or whatever is required. We regard our practice as an extension of the referring dentist’s practice, so when a patient is referred by another office, we try to keep the same level of care and quality attention with that patient as they have experienced in their dentist’s office.

I send a letter to my referring doctor via e-mail. It is not unusual for me to have multiple rounds of communication with a referring dentist, which may include not only e-mails but also phone calls. In some cases, we will even meet at a second appointment together for a group consult to discuss treatment options with the patient.

We feel that in this way the patient views treatment as not just a single practitioner’s type of procedure, but the patient is getting the benefit of having both the referring doctor and my office team working on treatment together.

If you or anyone in your family is interested in learning more about our oral and maxillofacial surgery practice, please feel free to contact us.

Dr. Leonard Spector

Apr 17, 2021

Corrective jaw surgery, also known as orthognathic surgery, is often used when orthodontics alone cannot correct a significant bite problem.

Corrective jaw surgery is a more commonplace name for orthognathic surgery or reconstructive jaw surgery. In these cases, the orthodontist moves teeth into the best position possible, but when the underlining problem is not the teeth but the position of the bones, then surgery may be indicated.

In these cases, there is an underlying skeletal problem. For example, I had a patient who was 19-years-old when he was referred to me by his orthodontist for reconstructive jaw surgery. There was a discrepancy in the growth of the upper and lower jaws so that his teeth did not come together in a functional bite. Due to this problem, orthodontics alone could not correct his bite.

In this case, the patient’s upper and lower teeth did not come together properly, and he was unable to chew or eat his food. He also had difficulty swallowing his food. After the orthodontist had done preliminary orthodontic treatment with braces, the patient was taken to the operating room, and during multiple procedures, the upper and lower jaws were aligned into their proper position.

He did not have his jaws wired together after surgery, he was able to open and close immediately after surgery, and he spent only one night in the hospital and was discharged the next day. All these procedures are completed through minimal incision surgery. After the surgery, he required approximately six additional months of finishing orthodontics, and now he has a functional bite along with a proportional facial profile.

Some common conditions that indicate the need for corrective jaw surgery include:

  • Facial injury
  • Birth defects
  • Difficulty chewing food
  • Difficulty swallowing
  • Protruding jaw
  • Inability to make the lips meet without straining
  • Chronic mouth breathing
  • Unbalanced facial appearance from the front, or side
  • Chronic jaw or jaw joint (TMJ) pain and headache
  • Excessive wear of the teeth

If you have been suffering from an underlying skeletal issue and are not considered a good candidate for traditional orthodontics alone, please feel free to call us to set up an initial consultation.

Dr. Leonard Spector

Apr 3, 2021

Dental implants are becoming the treatment of choice for patients with missing teeth. They are now placed with minimal time and discomfort.

Many patients delay needed dental implant treatment because they have the mistaken belief that the procedure is going to be a very painful and prolonged. In fact, most implants are placed with very minimal discomfort, swelling or bleeding afterward. Most patients can carry on their daily activities a few days after the implants are placed.

Also, the expense of implants used to be a reason not to have implants, but we have made it more available to our patients by offering different types of financing and also being able to work with any applicable insurance coverage to keep the cost down.

As technology has developed over the past 10 to 15 years, dental implants have become much more mainstream, and much more acceptable to patients and also to referring dentists. The technological breakthroughs help many patients who have been wearing either complete dentures, or partial dentures or nothing at all to replace their missing teeth. In these cases, the dental implants allow them to have permanent teeth again.

The impact on the patient is very positive. When they smile, they feel much more confident, and they tend to smile more. They are happier and much more secure in everything that they do in their daily lives. From a functional standpoint, dental implant treatment also allows them to eat certain foods that they were unable to eat before. After implant dentistry, they have substantially increased chewing capacity and efficiency.

Overall there is a tremendous degree of satisfaction in these patients. We have been able to take many of these patients from having significant dental problems and given them a new life with a new set of teeth.

Patients who delay dental implant treatment and then finally move forward often comment that they wish that they had done it years earlier.

If you think dental implants may be a good fit for your smile, please do not hesitate to give us a call and make an appointment.

Dr. Leonard Spector

Mar 20, 2021

Dental implants allow 65-year-old-man to have fixed dental implants after wearing removable dentures for over 25 years.

An excellent way of discussing the benefits of going from a removable denture to permanently fixed dental implants is to give an actual example. One of my patients was a 65-year-old man who for 25 prior years had been wearing a removable partial denture – an appliance that comes in and out and connects to one’s real teeth.

This patient had lost his back molar teeth on either side, and he found it increasingly difficult to eat certain foods without food getting trapped under his denture. The denture was also doing harm to the other teeth by putting too much pressure on the teeth that held the denture in place.

After reviewing his case, taking x-rays and finding that he had adequate bone for implants, I placed five lower implants these were restored by his dentist with permanent single teeth. At this point, he did not need to wear his denture again because he had a full complement of lower teeth.

As permanent tooth replacements, these teeth acted just as his natural teeth. He was able to chew and to eat foods that he had not be able to eat for many years due to the movement of his denture. Now he has teeth that are as close to his natural teeth as possible.

After treatment, he told me that he cannot discern the difference between the implants and his natural teeth, which is a comment I frequently hear from dental implant patients. He also said that the dental implants feel so natural that when he bites it seems as though he is biting on his natural teeth.

His dental implants also allow him to grind food with his molar teeth—something that he was unable to do very efficiently before with his removable partial denture. Also, he now has much more confidence when he smiles, speaks, and socializes.

Dr. Leonard Spector

Feb 6, 2021

Lutherville oral and maxillofacial surgeon Dr. Leonard Spector explains how his professional team puts patients at ease and treats them with respect.

We get so many compliments from patients after procedures about how comfortable they were during procedures, but I realize that many patients are anxious when they first enter an oral and maxillofacial surgery office.

I have a very compassionate team who always keep the patients’ best interest in mind. All of my team members give patients individual attention. They are well-qualified and they always treat patients with the utmost dignity and respect.

There is mutual respect among all my employees. I find my staff to be highly professional and they have a clear focus on patient care that can be seen by the patients, who notice and comment on how well all the team members support each other and work together.

I have also tried to foster a sense of belonging in the office, as I regard myself as a great motivator of people. I have allowed my staff to have a very enjoyable place to work. In fact, they love to come to work because they have a very strong commitment to excellence and they show great passion for their profession.

Above all, I find that when patients are at first concerned about the thought of oral surgery when they arrive, my team puts people at ease and encourages these patients to smile and relax.

One of the hallmarks of my practice is that we spend time with our patients. We do not rush the patients through the process. We try to educate our patients about what they can expect before, during, and after the surgery. Even in post-op appointments, we try to spend time with our patients to listen to their needs, and we are open to talking about anything they would like to discuss with us. We are happy to be there for them.

I have been in practice for over 32 years. Recently, when I opened my own practice again as the only oral surgeon, I was fortunate to attract people who are just fantastic in how they relate to our patients.

Dec 12, 2020

Oral cancer warning signs that all patients should recognize are listed and reviewed by Maryland oral and maxillofacial surgeon Dr. Leonard Spector.

Oral cancel has many warning signs that patients should review. Patients should see their dentist regularly for examinations. In my oral surgery office, we educate our patients regarding oral cancer, screen all patients, treat patients as appropriate, and refer patients to other health care professionals when indicated.

Here are some warning signs for oral cancer:

  • Persistent mouth sore, where the sore on the mouth does not heal. This is probably the most common symptom of oral cancer.
  • Pain or persistent mouth pain including pain in the teeth or jaw. This is another common oral cancer sign.
  • A lump or thickening in the cheek.
  • A white or red patch on the gums, tongue, tonsil, or lining of the mouth.
  • A persistent sore throat or feeling that something is caught in the throat that does not go away.
  • Difficulty swallowing or chewing.
  • Difficulty moving the jaw or the tongue.
  • Numbness to the tongue or elsewhere in the mouth.
  • Jaw swelling that makes dentures fit poorly.
  • Voice changes not related to other causes.
  • A lump in the neck.
  • Persistent bad breath.
  • These signs and symptoms can be present for days or weeks. It is important to note that these symptoms may have causes other than oral cancer, but they should all be considered warning signs and be evaluated by a professional. In our oral and maxillofacial surgery office, we evaluate each patient carefully, review their medical history, and either perform a biopsy or refer them out for more extensive care.

In fact, in our office, every patient whom I see in the office gets a complete oral cancer screening. This includes a full inspection of the mouth and the throat, including the soft palate and the tonsil area, and also a full neck examination and palpation.

Even if the patient has not been referred specifically for an evaluation of an area of the mouth that could be a potential area of cancer, everybody is screened.

Dr. Leonard Spector

Nov 14, 2020

Lutherville oral surgeon Dr. Leonard Spector receives many referrals from dentists, and he also welcomes new patients from other patients and his website.

Our office is accepting new patients. We receive referrals to our oral and maxillofacial surgery practice from many excellent dentists in various communities in and around Baltimore, including Havre de Grace and Lutherville, where our offices are located, as well as many other communities.

Patients will often call the office and say, “Can I be seen by you even though I do not have a dentist or have not been referred to your office by a dentist?” Although the majority of the patients are referred directly to our office by other referring dentists, there are many also patients who are referred to us by our loyal patients of record who have benefitted under our care. I think the highest compliment that can be afforded to me is that a patient whom I have already treated refers a friend or family member to my office. I always tell patients that their referrals are welcome and encouraged. A referral from a dentist or physician is not required for someone to call the office and make an appointment.

There are other patients who have visited our website who have sought us out for their oral surgery care. When patients are referred to us and they do not have a general dentist, we are able to refer them to a dentist for their general dental care, including exams and cleanings, thanks to our large referral base and professional relationships with excellent dentists in the area.

I have a great office team that will discuss a new patient’s needs with them over the phone before they are scheduled and take the appropriate information. Some patients only require a consultation to discuss their specific dental needs. If they need our services and we are able to provide care, we discuss treatment options with them in detail before any treatment is provided and we refer them as needed to a restorative dentist or another specialist such as an orthodontist if necessary for their overall care and well being.

Dr. Leonard Spector

Oct 3, 2020

Replacing missing teeth promptly – even those in the back of the mouth—has many benefits, because one missing tooth can affect many teeth and cause numerous problems.

When I tell patients that they need to have a back tooth replaced, they will often say, “Well, it’s a back tooth. You can’t see it. So why do I really need to have it replaced?” The answer is that each tooth in your mouth has a specific function.

The back broad molar teeth are used to grind your food. The molar teeth are designed to work with an opposing molar—the tooth in the other arch that makes contact with that tooth when you bite. So if you’re missing either an upper or a lower molar, there is no corresponding opposing tooth in the other arch. The result is that you cannot, therefore, grind your food.

Another problem is that when you are missing a tooth, the opposing tooth in the other dental arch, over time, will super-erupt into that space which may prevent you from having a dental implant because there may not be enough space to place the restoration on the implant. This problem can be corrected, but the point is that replacing a missing tooth promptly is the best course of action.

Also, if you lose a molar tooth, bone loss will tend to occur in that area, with the potential of the adjacent teeth shifting into that space where the molar used to be. This situation can lead to additional tooth and bone loss over time. Also, as you lose your back teeth, there is more pressure applied to the front teeth. Your front teeth are not designed to take these forces and the result could be tooth fracture or loss of bone around the front teeth. When teeth are subjected to too much force they also tend to shift, which alters the bite and makes it more difficult to clean around these teeth. As a result, the patient could experience problems with tooth decay and gum disease.

The bottom line is that it is not just a simple matter of losing one tooth, because when you lose one tooth, there is a cascading effect on the other teeth.

Dr. Leonard Spector

Jul 30, 2020

Dr. Leonard Spector, oral and maxillofacial surgeon, explains his extensive training and experience and offers advice to those who need oral surgery procedures.

I have been in private practice as an oral and maxillofacial surgeon for 32 years. My training involved four years of college followed by four years of dental school. I graduated second in my class from the University of Maryland Dental School in 1981.

After dental school, I completed a three-year accredited advanced dental education program in oral and maxillofacial surgery in a residency program at the Washington Hospital Center in Washington, D.C.

My training involved a very strong background in general anesthesia, placement of dental implants, orthognathic surgery, and dentoalveolar surgery. I think many patients would be surprised to know that as a dentist training to become an oral surgeon my hospital-based program included rotations in cardiology, internal medicine, as well as rotations to the Surgical Intensive Care Unit and advanced trauma training.

This great breadth of training gave me the skills necessary not only to perform procedures in my specialty but also to treat many patients who are medically compromised and referred to my office.

I started my private practice 32 years ago in the Baltimore area, specifically in the Towson, Maryland area in 1984.

One of my specific areas of interest in the practice is dental implants. My team and I do very advanced cases of dental implant surgery in our office for the convenience of the patient. This includes everything from replacing a single missing tooth with a dental implant to replacing an entire arch of teeth or even both arches with dental implants.

Another professional interest is day-to-day dentoalveolar surgery, which involves procedures such as extracting teeth when necessary, including the extraction of third molars–sometimes called “wisdom teeth”–when this procedure is indicated.

My advice to all patients who need oral and maxillofacial surgery procedures is to seek out a specialist in this highly complex field, ask about training and qualifications, and do not hesitate to ask the doctor questions before treatment begins. We are very open with our patients and we find that this approach creates trust and sets the stage for a very good experience.

Dr. Leonard Spector