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 6, 2021

Dental implants are used to replace congenitally missing teeth. Left untreated, patients may also have periodontal issues, malocclusion and reduced chewing ability.

I once had a patient who was a 25-year-old female. Although the patient was very attractive, it turns out that she had not formed her upper lateral incisor teeth at birth. We call these congenitally missing teeth or hypodontia because she did not lose them. They just never formed.

This condition, which often results in an unfavorable appearance, is common and required, in the past, very costly treatment. Left untreated, patients may also suffer from periodontal damage, malocclusion, reduced chewing ability, insufficient alveolar bone growth, and other conditions.

When my patient smiled, she showed lots of her teeth, and we wanted to give her a very natural looking result with dental implants, something that cannot always be attained using conventional fixed bridgework.

After she had orthodontic treatment to straighten and align her teeth, two dental implants were placed. Three months later the implants were restored by her general dentist as single crowns. The result looked so natural that it will be difficult to tell which teeth are implants and which are her natural teeth. So, what we were able to give her were permanent tooth replacements, something that could not be achieved without dental implants.

The simplest way to think of dental implants is replacement tooth roots. Implants provide the foundation for both permanent and removable replacement teeth that are fashioned to match your natural smile.

That is a very crucial point in dental implant treatment. It is not just the matter of replacing a tooth with an implant but also being able to mimic nature and having a result that is esthetically natural-looking.

Dr. Leonard Spector

Feb 20, 2021

Dental implants benefit older patients, Dr. Leonard Spector explains. He talks about an 83-year-old lady who is now able to eat all the foods she loves.

I am going to tell you a story, a very typical story, about how dental implants can have very predictable outcomes and benefits in older patients. This story begins with an 83-year-old female who was referred to me by her general dentist. This lovely lady had an inability to wear her dentures. She had had all her teeth removed approximately 20 years before visiting my office. Due to long-term denture wear, she had lost a lot of the bone in her lower jaw. So, she was unable to wear her denture due to the severe bone loss, and that limited the amount of food and types of food she could eat.

After meeting with her and discussing treatment with her dentist, I recommended that two dental implants be placed in the lower jaw to help retain a clip-on lower denture. This procedure was successfully performed in my oral and maxillofacial surgery office under local anesthesia. Three months later, after the implants were placed, her dentist made her a new lower denture that clipped onto the implants and allowed her to eventually eat the foods that she wanted to eat, which included biting into an apple that she was unable to do before. This little thing, of course, made her euphoric and allowed her to have as close to having permanent lower teeth again.

You can imagine after 20 years of not being able to eat the foods she wanted how gleefully happy she was after successful dental implant treatment.

This story just goes to show that with implants over the past ten years or so that the procedure has become more mainstream. People are seeking dental implant treatment because they hear from their friends, from colleagues, from other professionals how predictable implants are and how they can benefit them in many cases.

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.

Jan 23, 2021

A sinus lift procedure performed by an oral surgeon may be indicated as part of the process to augment bone needed to place dental implants.

A sinus lift is a surgical procedure performed by specialists such as oral surgeons that is used to add bone to the upper jaw in the area of your molars and premolars. It is sometimes called a sinus augmentation.

A sinus lift is used for cases where there is not enough bone height in the upper jaw for the sinuses, or the sinuses are too close to the jaw for dental implants to be placed. Bone is added between your jaw and the maxillary sinuses, which are on either side of your nose. To make room for the bone, a sinus membrane has to be moved upward or lifted, and that is where we get the term “sinus lift.”

There are several reasons why patients may not have enough bone in their upper jaw for dental implants to be placed. People who have lost teeth in their upper jaw, particularly in their molar areas, do not have enough bone for implants to be placed because tooth loss leads to bone loss. Once you lose teeth, bone begins to resorb or break down where the teeth used to be. If the teeth have been missing for a long time, there is usually not enough bone left to place the implant.

It is also true that the back part of the upper jaw has inherently less bone than the lower jaw. Another factor to consider is that bone might be lost due to periodontal disease around the teeth.

Also, the shape and the size of the maxillary sinuses vary from person to person. The sinus can get larger as you age. The result is that even when you have teeth in that area, you can have a sinus that will move closer to the roots of the teeth and need a sinus lift procedure.

Sinus lift procedures are often done in my office using appropriate anesthesia. The procedure has become routine and predictable and it enables patients to have implant dentistry who otherwise would not be candidates for that procedure.

Dr. Leonard Spector

Jan 9, 2021

Oral cancer risks increase significantly for patients who smoke and drink heavily and there are also associations with HPV.

About 80 percent of people with oral cancer and oropharyngeal cancers use tobacco in the form of cigarettes, chewing tobacco, or snuff. Oropharyngeal cancer is a disease in which malignant cells form in the tissue of the oropharynx. The oropharynx is the middle part of the throat that includes the base of the tongue, the tonsils, the soft palate, and the walls of the pharynx. The pharynx is the tube or cavity, with its surrounding membrane and muscles, that connects the mouth and nasal passages with the esophagus.

The risk of developing oral cancer depends on the duration or frequency of tobacco use. For people who smoke and also drink excessive amounts of alcohol, the risk of developing oral cancer is substantially higher than for people who neither smoke nor drink.

With regard to prevalence, oral cancer and oropharyngeal cancer are twice as common in men as in women. The difference may be related to more use of alcohol and tobacco among men. However, according to the American Cancer Society, gender difference is decreasing among oral cancer patients as tobacco and alcohol use among women is increasing.

There has also been research regarding the human papilloma virus, HPV, which includes about one-hundred similar viruses. Many of these viruses cause warts, but some are involved with cancer. Most noteworthy, the HPV virus that is related to the development of cervical cancer is also a risk factor for oral and oropharyngeal cancers.

About 25 percent of patients with oral cancer are also infected with the same HPV cancer viruses that are seen with cervical cancer. The HPV virus appears to be a more serious risk factor for oropharyngeal cancers than for other oral cavity cancers. It is interesting that patients with HPV virus-related cancers may be non-smokers or non-drinkers.

These patients may have a very good prognosis, because these virus-involved cancers do not produce any symptoms and only a small percentage of these infections actually develop into cancers. We are aware, however, that many patients will come in with small papillomas on their palettes and these are all biopsied for the HPV virus.

Oral cancer treatment can involve something as simple as an excision with early cancers. These early cancers are can just be excised with an appropriate margin of tissue removed, and that can be the cure. The more invasive or more aggressive type cancers may require more extensive excision of tissue and bone. For these reasons, attention to lifestyle issues and early diagnosis are really the key with these cancers.

Dr. Leonard Spector

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 28, 2020

Havre de Grace oral surgeon Dr. Leonard Spector explains how dental implants secure dentures and give patients total confidence when they eat and smile.

One of the most frequent types of cases I am asked to evaluate is a patient who has been wearing conventional dentures for many years. Due to this long-term denture wear, they have lost the supporting bone in their mouth to retain a denture. This problem can occur in the upper or lower jaw or in both jaws.

The two ways we use implants to secure a denture is by using two or four implants in the in the jaw and having retentive attachments on the denture that clip onto the implants. This allows the patient, when they are wearing the implant-retained denture, to have a secure denture that enables them to eat or smile naturally. These dentures also have the benefit that they can be taken out to be cleaned and then clipped back on to the implants.

One of the best ways of using implants, though, is to support a fixed bridge, one that is screwed onto the implants and cannot be removed except by a dentist. The fixed bridge is the most predictable and, by far, the best and most natural way of giving teeth back to people who have lost all the teeth in their jaw.

Another great benefit with either type of implant-supported denture is that patients can eliminate the use of dental adhesives. This benefit is made possible because implant-supported teeth are securely attached to the implants and there is no need for messy denture adhesive. People who wear conventional dentures often worry that their denture is going to fall out when they laugh or when they eat. These worries are justified because even the best denture adhesive cannot hold a conventional denture in place the way that implants can secure a denture.

We always review options with patients and work with the patient and their dentist to determine the best type of implant-retained denture that will best suit the patient.

Dr. Leonard Spector