San Francisco Surgical Arts, Inc.

Better Breakfast for a Better Smile

Breakfast truly is the most important meal of the day. It kick starts your body and provides you with enough energy to make it through your hectic morning as well as keep your mind focused on the task at hand. Eating a balanced breakfast is not only good for you body, but also good for your teeth. Being mindful of the acidity and sugar levels in your food is key to keeping your teeth in tip-top shape!

When it comes to breakfast foods, there are a few foods we recommend eating in moderation! These include, but are not limited to, orange juice and sugary cereals. Orange juice has a very high acidity and by drinking too much, the acid can wear down your tooth enamel. Cereals that are high in sugar have a similar effect on your teeth, but the sugar can also cause cavities.

Eating a balanced breakfast that is low in sugar and acid, but high in protein will make your body and teeth feel great! Protein rich foods will help to build up your enamel and keep your teeth stronger than ever.

Here are a few recipe ideas for a healthy and balanced breakfast:

Overnight Oats:

o 1/3 cup of oats
o 1/3 cup of milk (or substitute almond, soy, coconut, etc.)
o 1/3 cup of plain Greek Yogurt
o 1 tbsp chia or flax seeds OR ¼ cup chopped nuts
o Fresh fruit/ berries of your choice!

Mix all of the ingredients together in a sealed container, or mason jar, and place in fridge the night before. Open and enjoy the next morning for a healthy and balanced breakfast!

Avocado Toast:

o 1-2 slices of whole grain toast
o 1 ripe avocado
o 1 egg (cooked to your preference)
o 1 ripe tomato
o Seasonings of your choice (salt & pepper, hot sauce, red pepper flakes, etc.)

Pain management and opioid use

Recently with all the attention on opioid abuse, I thought it would be wise to share the recommendations that we all must abide by when we prescribe pain medications to patients after surgery.  These recommendations are referred to as the “white paper”, a position paper by the American Association of Oral and Maxillofacial Surgeons (AAOMS).  During our daily practice, we try to limit the number of opioid prescriptions by providing a preoperative and preemptive medications to reduce and prevent the onset of pain and swelling after surgery.  Most patients have the following regimen:

  • Preemptive medications through their IV prior to surgery: non-steroidal anti-inflammatory drugs (NSAIDs) such as toradol, and / or corticosteroids such as dexamethasone and / or medrol dosepak.
  • Prescriptions for acetaminophen (Tylenol) combo drugs to be used in conjunction with prescription strength NSAIDs (Ibuprofen or aka motrin 600-800mg), which synergistically help the effectiveness of each other, reducing the need for opioid medications.  We recommend that patients alternate between these two classes of medications for the first two days and then to gradually come off these medications after the second day.
  • As a result, I have rarely had to refill opioid prescriptions, on rare occasions for a second time, but never a third time; as studies show that patients that request a third refill are more likely to be drug abuser.
  • If any any point there is suspicion of drug abuse, we are required by law to check the national database for the patient in question, which shows all the medications that have been prescribed to the patient in the past.
  • I have never had the need to provide long-lasting and time released opioid such as oxycontin in our office.
  • Each patient is provided with verbal and written instructions on how to take all their medications, with emergency after hours contact information.

See the “white paper” below.

 

How to Make Your Own Ice Cream

As you may or may not know, July is officially National Ice Cream Month! While it is fun to go and grab ice cream from your local shop down the street, it can be more fun and rewarding to make your own ice cream for you and your family to enjoy. Ice cream is also a great treat to enjoy after different types of oral surgery. You don’t need an ice cream maker'ice cream' in order to make delicious, creamy ice cream. Just follow our instructions below!

Servings: 2-3

Ingredients:

– 2 cups of milk
– 3 tablespoons of sugar
– 2 teaspoons of vanilla

Materials:

– 3-4 cups of ice
– 2/3 cup salt
– 1 quart sized Ziploc bag
– 1 gallon sized Ziploc freezer bag

Instructions:

– Combine milk, vanilla and sugar in quart sized bag
– Press any air out of bag and seal tightly
– Mix ice and salt in gallon sized bag
– Place quart sized bag into gallon sized bag and seal tightly
– Shake the bag vigorously for about 5 minutes.
It will be very cold, be careful!
– Liquid inside smaller bag should start to harden
– Let bags sit for a few minutes with ice in large bag surrounding small bag
– Open bags up and scoop ice cream out
– Enjoy!!

As you can see, it isn’t hard to shake up some ice cream that the whole family can enjoy, using fairly standard household ingredients. Use chocolate/strawberry milk instead of regular milk to change the flavor, or use half and half for a creamier product. This year, celebrate National Ice Cream month by making your own ice cream at home!

Oral Cancer Increase Among Men in 2017

'man thinking about oral cancer'A recent study by the American Cancer Society reports that oral cancer cases in men is expected to increase in 2017 by 4%, while the rate of new cases among women stays the same year over year. “Oral Cancer”, which is a common way to refer to all head and neck cancers, involves cancer of the oral cavity, lips, tongue, pharynx and esophagus.

Unfortunately, oral cancers often go undetected until their later stages when they are more difficult to treat, giving them an even worse reputation than many other cancers.

Oral cancer is more likely in those who:

  • Drink Alcohol Excessively (more than 2 drinks a day for men and more than 1 drink a day for women)
  • Smoke or Chew Tobacco
  • Have HPV (certain strains of the HPV virus are known to cause oral and other cancers)

HPV and Oral Cancer

Along with the rise of HPV among men has come the rise of oral cancers as well. Unfortunately, it has now been estimated that half of U.S. men are infected with HPV. While most of these will not go on to develop cancer, certainly, these increases may continue to create a rise in head and neck cancers until the disease is brought under control.

What You Can Do

Prevention and detection are the most important things when it comes to the fight against oral cancer. With early detection, we can do better for survival rates and, as we have seen with general cancer cases, prevention in the form of abstaining from tobacco and drinking in moderation can reduce the number of cases over time. In order to protect yourself and your family and help us with survival rates, we urge you to see us for an oral cancer screening. It only takes a few minutes for us to examine you – and it could save your life.

For more information on oral cancer, call us at San Francisco Office Phone Number 415-813-6400 or visit oralcancerfoundation.org.

Where Do Dental Implants Come From?

'children playing in dirt'Dental implants have a surprisingly rich and interesting history. Across centuries and throughout cultures around the world there is evidence of attempts at replacing missing teeth with various objects and materials.

The oldest dental implants can be traced back to 2000 BC in China, where missing teeth were substituted with bamboo pegs.

Fast forward a bit to around 1000 BC and you’ll find an ancient Egyptian King whose tomb was recently discovered along with his mummified remains; a copper peg hammered into place where a tooth once lived. This may have been the first time in history that we know of when metal implants were used.

Across the globe some time around 300 BC, an iron tooth was found in a French grave thought to be Celtic in origin. It is possible this implant may have been a post-mortem placement to honor the dead, as an attempt to perform the surgery using a live patient would have been an excruciatingly painful process.

Just 2000 years ago missing teeth were being substituted for animal teeth, and the poor were even selling their teeth to the wealthy, just to make ends meet! The body often rejected these surrogate teeth, causing infection.

More recently in 1931 in Honduras, Dr. Wilson Monroe and his wife found a jawbone amongst other artifacts, with teeth fashioned from shells and attached to the jawbone of an ancient man.

Today we are lucky enough to have dental implants that not only look and feel like real teeth, and anesthesia for the pain is also a plus. Thanks to studies conducted by Per-Ingvar Brånemark of Sweden in the 1950’s, oral surgeons have been able to perfect the process over the years to create today’s implants, which have a 98% success rate! Through a process known as osseointegration, metals and other implant materials are able to be skillfully placed so that your jaw bone actually attaches itself to the implant creating a seamless support system.

Missing a tooth or two? Give us a call at San Francisco Office Phone Number 415-813-6400 to discuss your dental implant options today!

Autograft vs Allograft

'woman smiling after receiving bone graft'So, you were recently told by your doctor that you need a bone graft, but you aren’t quite sure what that means.

A bone graft is a surgical procedure that is used to fix bones or joints that were damaged by trauma, and it is also used to replace bone that is missing to provide structural stability around the body, including the jawbone. There are many types of bone grafts we can use to grow bone – the two most common are autografts and allografts.

An autograft is a bone or tissue that is transferred from one spot to another on the patient’s body. It is often thought of as the “gold standard” in bone grafting because of its reliability. Its high success rate is due to the fact that it is living tissue and thus its cells are kept intact.

An allograft is a bone or tissue that is transplanted from one person to another. They typically come from a donor, or cadaver bone. The allograft is safe, ready to use and available in large amounts. The main advantage of an allograft is that it requires one less procedure than the autograft, which must first be taken from the patient. Surgical time is minimized and the recovery can be quicker. The allograft comes from a reputable and reliable tissue bank.

Knowing which bone-grafting option you will need can be confusing, but we are here to answer any questions you may have. Please schedule a bone grafting consultation with us by calling San Francisco Office Phone Number 415-813-6400. We will perform a thorough evaluation of your oral health. After our evaluation, we will recommend what bone graft is best for you. We are happy to discuss your options and answer any questions you may have. We want you feeling confident with our choice and worry free.

Immunotherapy and Oral Cancer

You may have heard: Immunotherapy is proving to be very promising in the treatment of a variety of cancers, in particular lung cancer and advanced melanoma. However, immunotherapy has not found its way (yet!) into the treatment regimen for head and neck cancers. 'woman thinking about oral cancer'

What is immunotherapy?

Immunotherapy is the process of enlisting the patient’s own immune system in the fight against cancer cells. Several drugs have been used successfully to aid in the treatment of advanced lung cancers and melanoma, giving patients a longer prognosis in many cases.

Cancer Cells are Tricky

Cancer cells are notoriously sneaky – their ability to hide from immune cells is one of the reasons that cancer is so hard to treat. This is where “checkpoint inhibitors”, one of the most common classes of immunotherapy drugs in cancer treatment, come in. These drugs help to block the activation of proteins that help cancer cells hide from immune cells.

The Connection with Oral Cancer

Recurring head and neck cancers are very difficult to treat. Often they are resistant to the best chemotherapy drugs, so the hope has always been that immunotherapy drugs may some day step in to assist with the oral pathology fight. A recent trial in the UK has shown that the day may be coming sooner than we thought! The trial proved successful in extending prognosis for many of the patients.

Reduced Side Effects

The research also noted that side effects were reduced to give patients a better quality of life during treatment.

More Testing Needed

While more research is needed before the drugs receive FDA approval for the treatment of oral cancer, the good news is that because these drugs are already approved and on the market for other cancers, the application process for use in oral cancers will be quicker (and smoother) than it would be for a new drug.

At Dr. Massoomi, our commitment to your care, comfort, health and safety is evident from the minute you walk through our door. Call us at San Francisco Office Phone Number 415-813-6400 for more information about oral cancer.

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Root Canal anyone? Gutta Percha?

Well, I know that for many undergoing a root canal is not the most pleasant experience.

As for my dental colleagues, you may not know this but 67% of all the RCT’s are done by GP’s!

So below is a summary from the American Association of Endodontics (AAE) on endodontic diagnosis.  Very informative.

3D Printers and Bone Grafting

There is exciting news in bone grafting technology that will hopefully find its way into the oral surgeon’s office over the next decade! Researchers have been able to create a synthetic bone material using 3D printers that may be better than what is being used now. '3D printed bone graft'

3D printers create three-dimensional objects out of a variety of materials using a computer as a precise guide. Although the concept has been in the news a lot recently, the practice actually dates back to before the 21st century. In fact, 3d printing’s roots go back to the early 1980s. Since then, everything from jewelry to synthetic human organs has been printed, much to the amazement of modern society!

And now, surgeons have successfully implanted the 3D-printed synthetic bone grafting material into animals with bone defects. This “hyperelastic bone” was made using just the right combination of bioactive materials and polymers to make a material that could be layered while still wet, allowing for better adherence between layers.

Here are some of the expected benefits of this new material:

  • Very elastic, allowing for cutting without crumbling, which can be a problem with current grafting materials.
  • Blood vessels move in quickly because the material is porous.
  • Biodegradable as the body replaces it with genuine tissue.
  • Doesn’t dry out right away.
  • So far the animals haven’t rejected the implant, which could mean less complications for humans as well.
  • Could be a great option for children since it will grow with them.

While human trials are potentially five or more years away, the news is very exciting for the surgical community, and we are can’t wait to see what benefits this will bring to our patients.

To find out more about bone grafting in general or to set up a consultation with our office, please call us at San Francisco Office Phone Number 415-813-6400.

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The Audacity of Love