Our Blog

If you have lost a tooth or teeth, dental implants can restore your smile. Implants look natural, don’t impact the healthy teeth around them, and protect the underlying bone from the bone loss that can be caused by a missing tooth.

One important prerequisite for a successful implant: the bone in the jaw that will hold the implant must be healthy, and must be the appropriate size and strength to allow osseointegration (the fusion of the implant with the jawbone) to take place. If the bone isn’t wide enough, high enough, or dense enough, the success of the implant will be in jeopardy.

An implant, unlike a denture or a bridge, is rooted in the jaw much like your tooth. A cylinder is implanted in the bone, and will later hold the abutment which attaches to the final crown. Because a great deal of pressure is placed on our teeth with everyday functions such as chewing, the bone must be strong enough to successfully fuse with the implant.

Fortunately, Dr. Matthew Hilmi can actually restore the density and shape of your jawbone if the bone isn’t suitable for an implant. This reconstruction is accomplished with bone grafting.

Why Would You Need a Bone Graft?

The bone structure which supports our teeth can be compromised in a number of ways. We might recommend a bone graft if you have insufficient bone due to causes such as:

• Bone Loss Caused by Tooth Loss

The bone tissue which supports our teeth needs the stimulation of biting and chewing to stay healthy. Without that stimulation, the bone area under the missing tooth gradually shrinks. The bone tissue is resorbed into the body, which, in a relatively short amount of time, can lead to a noticeable sunken spot where the tooth used to be. Bone grafting will rebuild this area—and a dental implant will provide the tissue stimulation that a natural tooth would, helping to prevent future bone loss in the jaw.

• Gum Disease

As gum disease progresses, the gums pull away from the teeth, leaving the bone and connective tissue exposed to infection and bacteria. Infection and the body’s own response to bacteria can cause deterioration in the bone structure supporting the teeth. Bone loss cannot be reversed, but a graft can replace lost bone and allow healthy tissue to regenerate.

• Pre-existing Bone Conditions or Traumatic Injuries

In the case of bone structure that is naturally less thick or dense, or bone which has been damaged by accident or injury, a bone graft can provide a solid basis for an implant.

What Takes Place in a Bone Grafting Procedure?

Bone grafting is a type of oral surgery. Bone tissue for grafting may be taken from your own body, or a graft material composed of safe and sterile donor tissue or synthetic substitutes can be used. This second kind of graft will be absorbed gradually by the body as your own new, healthy bone tissue replaces it.

If you decide a bone graft is your best option, we will discuss the options for grafting with you during your appointment at our Kingston office, and use imaging to map out the area of bone loss and to create the best individual treatment plan for you.

After anesthesia, an incision will be made in the gum tissue to reveal the damaged bone. Grafting material will be shaped and secured to the affected area, and sutures are generally used to close the incision. We will give you careful instructions for after care and follow-up visits. The time it takes for you to heal completely will depend on the type and size of the graft.

We recommend bone graft surgery when it will provide the best, most successful foundation for your dental implant procedure. Oral surgeons have years of medical and surgical training in the complex relationship and interaction of bone, muscle, and nerve. We are uniquely qualified to provide a skillful, safe, and effective bone grafting procedure.

When you choose an implant, one of your primary goals is the aesthetic restoration of your smile. Just as important, you are also making sure that the bones supporting your teeth will remain heathy and strong. Talk to us about bone grafting, and how we can start you on your way to a lifetime of beautiful smiles.

Dr. Matthew Hilmi, as well as our team at Mid-Hudson Oral and Maxillofacial Practice, would like to give those patients with flex spend, health savings, or insurance benefits a friendly end of the year reminder that it’s high time to schedule your dental visits so you optimize your benefit.

Now is the time to reserve your appointment with us. Space is limited and we tend to get busy around the holidays, so don’t wait to give us a call at our convenient Kingston office!

TMJ is the quick way of referring to your Temporomandibular Joint. Pardon the pun, but that’s quite a mouthful! What is this joint, what does it do, and, if your doctor or dentist has told you that you have a TMJ disorder, what can Dr. Matthew Hilmi do to help?

The Temporomandibular Joint

Your two temporomandibular joints are amazing works of anatomical design. These are the joints where the temporal bone in the skull meets the mandible bone of the jaw, and allow our mouths to open and close, move back and forth, and slide from side to side. Muscle, bone and cartilage work together to provide easy movement and to cushion the joint. But sometimes, the joint doesn’t work as smoothly as it should, and this can lead to Temporomandibular Joint Disorder, or TMD.

When Should You Suspect You Have TMD?

You might have TMD if you experience any of these symptoms:

• Painful chewing
• Pain around your TMJ, or in your face or neck
• Earaches
• Changes in your bite
• Jaws that are limited in movement or lock open or shut
• Clicking, popping or grating noises when you open and shut your jaw

There are many conditions linked to TMD. If you grind your teeth at night, have arthritis in the jaw, have suffered an injury or infection in the area, or have problems with your bite, for example, you might be more likely to experience TMJ problems. If you suspect you have TMD, or suffer from any of the symptoms listed above for an extended period, an oral surgeon like Dr. Matthew Hilmi can provide the answers you’re looking for.

Why Choose an Oral and Maxillofacial Surgeon?

Oral and maxillofacial surgeons have a minimum of four years of advanced studies in a hospital-based residency program, where they train with medical residents in the fields of general surgery, anesthesiology, internal medicine, and other specialties with a specific focus on the bones, muscles, and skin of the face, mouth, and jaw. They are uniquely qualified to diagnose and treat a complex disorder such as TMD.

How Do We Treat TMD?

First, we will check your medical history, and begin with a careful examination of the joint, its movement, and the structures of the head and neck surrounding it. When necessary, we will use imaging studies for further examination of the joint. If indicated, a conservative treatment plan might be recommended:

• Anti-inflammatory drugs and/or over-the-counter pain relievers, ice packs, moist heat compresses
• A custom-fitted mouthguard, bite plate, or bite splint to reduce the effects of bruxism, or teeth grinding
• Orthodontic treatment for a malocclusion (bad bite)
• Physical therapy, which might include exercises for the jaw muscles
• Behavior modification, with techniques to avoid jaw pain (giving up gum chewing, jaw clenching, nail biting), and techniques for relaxation and stress relief.

If these treatments aren’t successful, or if there is damage to the joint, we might suggest surgical options.

• Arthroscopy, a minimally invasive surgical procedure performed under anesthesia, in which a thin tube with a video lens and light is inserted through a small incision in front of the ear. This technology allows us to get a good look at the joint and the area surrounding it. Depending on the results of our examination, arthroscopic surgery might be used to repair joint damage.
• Arthroplasty, surgery performed under anesthesia, can repair, replace, or reposition damaged parts of the joint. For example, surgery can remove bony growths, repair damage to the articular disc (which cushions your joint) or replace it, and access areas which an arthroscopy can’t.

Luckily, most cases of TMD are temporary and don’t become worse over time. But any persistent discomfort is a good reason to visit our Kingston office. Whether you have TMD, or any other problem causing you pain in the head or jaw, the causes for your temporomandibular joint discomfort can be complicated. We have the unique surgical training and experience to diagnose and treat these remarkable joints.

By now, everyone knows that smoking is bad for you. But the truth is its broad-reaching health effects are not all known by everyone. This is especially true of oral health. Smoking can have serious repercussions in this regard. To give you a better idea of how smoking can affect your oral health, Dr. Matthew Hilmi and our team have listed some issues that can arise.

Oral Cancer

Oral cancer can have steep ramifications for anyone that gets it. Surgery can be required to eliminate the cancer before it spreads to more vital parts of your body. Any type of cancer is about the worst health effect you can get, and this especially holds true to the affects that smoking has on your mouth. The type of mouth surgery required with oral cancer can leave your face deconstructed in certain areas, and it is all due to smoking or use of other tobacco products.

Tooth Discoloration and Bad Breath

At the very least, it is fair to say that as a smoker you will often have bad breath, and while you may try to cover it up with gum or mints, tooth discoloration is a whole other story. The chemicals and substances in cigarettes stick to your teeth staining them brown and yellow colors that are increasingly difficult to disguise.

Gum Disease and Loss of Bone

Another effect of smoking is the increased risk of gum disease. Your gums may start to recede, which can eventually lead to the loss of teeth. Smoking can also increase bone loss and density in your jaw which is vital to the health of your mouth. Gum disease and bone loss are two signs that smoking is definitely bad for your mouth.

When it comes to the health of your mouth, the question is not whether smoking affects your health, it's how does it affect your health and to what degree. If for no other reason than because smoking involves your mouth as its entry point, it is safe to say that it can have long-lasting and detrimental consequences on your oral health.

To learn more about smoking and your oral health, contact our Kingston office to schedule an appointment with Dr. Matthew Hilmi.