Southern Maine Oral and Maxillofacial Surgery

Time after Time: How long does it take to place a dental implant?

Between depictions in pop culture and advertisements promising “teeth in a day”, the completion timeline of a high-quality dental implant confuses a lot of patients–and for good reason! The most intricate (and time consuming) part of placing a dental implant happens below the surface of the gum, unseen by the patient.

High quality dental implants do not happen in a single day. The average timeline from consultation to completion is 9 months. Depending on patient variables, an individual’s timeline from implant consultation to completion can range from 6 to 12+ months.

At Southern Maine Oral & Maxillofacial Surgery (SMOMS), we want our patients to feel confident in their procedure, and that starts with having all of the facts! Keep reading for a realistic, general timeline for dental implants:

1. Consultation: Every patient walks into our office with a different degree of overall oral health; a patient’s oral health is the single greatest variable for their independent timeline of implant placement. During this initial consultation, one of our SMOMS surgeons will complete a thorough oral exam to determine a patient’s oral health, and to decide if they are a good candidate for dental implants. 

1A. Pre-Implant Treatments: Depending on the results of this exam, pre-implant treatments such as tooth extractions or bone grafts may be necessary. These procedures can add anywhere from 3 – 12 months to a patient’s individual implant timeline. However, they are absolutely necessary for the patient’s overall oral health and the success of the implant.

2. Fixture Placement: Our SMOMS surgeon will place the implant fixture into the patient’s jaw bone. The implant fixture is the screw-like part of the implant that holds the entire implant in place–just like the root of a natural tooth. After the fixture has been placed, it must fully bond with the patient’s jaw bone during a process called “osseointegration.” The osseointegration process takes roughly 3-6 months. 

3. Abutment Placement: Once the implant fixture has osseointegrated with the jaw bone, our SMOMS surgeon and team will place the implant abutment into the fixture. The abutment serves as a sort of landing pad for the implant crown. After the abutment is placed, the patient’s gums will need about 2 weeks to heal around the surgery site. 

4. Crown Placement: Finally a tooth! The crown of the implant is the part that can be seen above the gum-line. This is the part of the implant that will chew a patient’s food, be brushed and flossed, and smile at their friends and family. At this point in the procedure, the patient’s restorative dentist takes the wheel, and will place the crown on the abutment. This is a rewarding–and sometimes emotional–day for the patient! 

A high-quality dental implant is an investment in a patient’s oral and overall health. When placed properly in a healthy mouth–and treated with good care by the patient and their dental team–a dental implant is a smile solution that will last a lifetime. For more information about smile solutions, check out our Blog SMOMS Post: “A Tale of Two Smiles.”

If you are a current implant patient with SMOMS and have questions about your individual timeline, please ask! We look forward to answering every one of your questions. If you or a loved one would like to become an implant patient with SMOMS, call us at 207.774.2611 to schedule your consultation with our team.

(Images courtesy of Wilson Dental Group)

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A Fireside Chat with Dr. Dan Traub

At SMOMS, we are beating the winter blues with a series of Fireside Interviews with our fantastic doctors. Sit down, warm up, and learn more about the SMOMS surgeons!

Dr. Dan Traub joined SMOMS after leaving the United States Naval Reserves in 2015, and has been treating our patients with dedicated precision and skill ever since. 

Q: What inspired you to enter the oral surgery field? 

Dr. Traub: My older brother went to dental school ahead of me and I always thought his work looked interesting. It’s a different path, but we both took it.

Q: What was the first surgery you performed?

Dr. Traub: My first surgery that I did was a tooth extraction. I think that’s pretty much the case for every oral surgeon. It’s a straightforward procedure.

Q: What is the most challenging aspect of your job?

Dr. Traub: Oral surgeons are the only type of surgeon to take care of a patient’s anesthesia and surgery at the same time. Other surgeons have anesthesiologists take care of the first part and then come in to do the procedure. It takes your full concentration, all the time.

Q: What is the most rewarding aspect of your job? 

Dr. Traub: Balancing both the anesthesia and surgery is very rewarding when it’s over. Seeing a successful procedure through start to finish is great. The financial stability of our jobs can’t be overlooked either. 

Q: What is your favorite procedure to perform? 

Dr. Traub: Any dentoalveolar surgery–surgery that involves the alveolar bone which is the bone which supports all of the teeth. It’s always very technical. 

Q: How does your career impact the way you see the world? 

Dr. Traub: I definitely notice people’s teeth first when I meet them. I’ve had the chance to do a good number of surgeries internationally, such as corrective palate surgeries in Asia, which is eye-opening. American dentistry strives for the highest standard, and we’re very lucky. But we’re so lucky that our dental culture starts to value cosmetic aesthetics over simple function. I think that’s important to keep in mind. 

Q: When you were little, what did you want to be when you grew up? 

Dr. Traub:  I always wanted to be a doctor. I joined the Naval reserves out of surgical school and went right to work. 

Q: What’s your favorite kind of music?

Dr. Traub: I like Pearl Jam and Led Zeppelin. 

Q: Who is one person from history who you’d like to have dinner with? 

Dr. Traub: Admiral Nimitz–the Naval Commander in Chief of the U.S. Pacific Fleet in WWII. He’d be extremely interesting to speak with.   


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A Fireside Chat with Dr. Tim Mitchell

At SMOMS, we are beating the winter blues with a series of Fireside Interviews with our fantastic doctors. Sit down, warm up, and learn more about the SMOMS surgeons!

Dr. Tim Mitchell came to SMOMS in 2001, and has been treating our patients with care, skill, and the wit that only an Irishman can supply. 

Q: What inspired you to enter the oral surgery field? 

Dr. Mitchell: I always wanted a job where I was helping people with problems. I definitely enjoyed dental school, but I chose oral surgery because it addresses the basic necessity of people having teeth and jaws that function properly. 

Q: What was the first surgery you performed?

Dr. Mitchell: A good ol’ fashioned tooth extraction! 

Q: What is the most challenging aspect of your job?

Dr. Mitchell: Managing patient expectations can be challenging because you have to balance their wants with medical reality. Sometimes they don’t mesh very well, and we have to be that bridge to explain the difference.

Q: What is the most rewarding aspect of your job? 

Dr. Mitchell: I love meeting our patients. We meet so many people every day and get to work through the technical logistics of their specific case with them. I like seeing cases transition through from beginning to end. 

Q: Do you get nervous before surgeries? 

Dr. Mitchell: Not about the actual procedures, no. I think everyone on staff feels some pressure and nerves just hoping that every day goes well. But that makes us perform better, by doing our best to prepare for every day. We try to control as many variables as possible. 

Q: How does your career impact the way you see the world? 

Dr. Mitchell: I grew up surrounded by a very old-school and super-Irish view that life is hard and full of burdens. We see people at their worst–when they’re in a lot of pain, on top of their other everyday hardships. I see what I do as a chance to get something off of their list of burdens. 

Q: When you were little, what did you want to be when you grew up? 

Dr. Mitchell: A policeman! 

Q: What is your favorite animal? 

Dr. Mitchell: My beagle is the greatest animal in the entire world. 


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A Fireside Chat with Dr. Jeff Doss

At SMOMS, we are beating the winter blues with a series of Fireside Interviews with our fantastic doctors. Sit down, warm up, and learn more about the SMOMS surgeons!

Dr. Jeff Doss joined SMOMS in 1989. Since then, he has been keeping our patients smiling with his kindness, skill, and never-ending supply of jokes.

Q: What inspired you to enter the oral surgery field? 

Dr. Doss: My uncle was a radiologist and my aunt was a nurse. I used to read their medical text books for fun, so I guess I always had the intention of being in medicine. I enjoy the combination of using your hands and using science. I fractured my jaw in high school and my oral surgeon was incredible. That’s how I found the specific field. 

Q: What was the first surgery you performed?

Dr. Doss: My first surgery that I performed was a simple extraction. But the first surgery I ever saw was a transfemoral amputation. I almost passed out. 

Q: What is the most challenging aspect of your job?

Dr. Doss: It’s challenging to juggle surgeries, staff, patients, and the business side of the practice–out of those four aspects, surgery is the easy part! 

Q: What is the most rewarding aspect of your job? 

Dr. Doss: Whether we’re doing a simple extraction or a more complicated procedure, it’s wonderful just to make the patients happy. Also, like I mentioned, I love using my hands. A lot of what we do is fairly artistic–you have to know and trust your hands. 

Q: What is your favorite surgery to perform? 

Dr. Doss: I really enjoy dental implants because you see the whole process of removing something and putting it back. You’re making it whole again. The FDA first approved our modern model of dental implants in 1984 when I was just entering the field, so I’ve seen the full evolution. Our accuracy with implants today is truly incredible. 

Q: How does your career impact the way you see the world? 

Dr. Doss: It broadens my view of what people do with their lives. I always ask patients what they do for work–it’s a practical question when I’m considering their healing procedure, but I also like hearing all of the different walks of life people are on. 

Q: When you were little, what did you want to be when you grew up? 

Dr. Doss: A doctor! I had a 2.1 GPA in high school, and 3.2 in college, and a 3.9 in dental school. I think that really shows where my head was from a young age. 

Q: What’s your favorite food? 

Dr. Doss: Chicago-Style hot dogs. Whenever I’m in Chicago–even if I’m connecting through O’Hare airport in the morning–I get one. My wife thinks it’s gross. But I think they’re perfect. 

Q: What is your favorite animal? 

Dr. Doss: I really like racoons. I had a pet racoon when I was a kid. His name was Snuffy.

Our patients on Dr. Doss: “Dear Dr. Doss–I so appreciate your incredible skill, talent, and kindness. You’ve made such a positive impact on my life and well-being!”

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A Fireside Chat with Dr. Rick Crawford

At SMOMS, we are beating the winter blues with a series of Fireside Interviews with our fantastic doctors. Sit down, warm up, and learn more about the SMOMS surgeons!

Dr. Rick Crawford came to SMOMS in 1993, and has been treating our patients with skill, care, and compassion ever since. 

Q: What inspired you to enter the oral surgery field? 

Dr. Crawford: I always liked using my hands, so I always intended to go into either medicine or dentistry. I interned for an ear, nose, and throat doctor in Pennsylvania, which piqued my interest in the operating room and the surgery scene. If it’s broken, I want to fix it. 

Q: What was the first surgery you performed?

Dr. Crawford: Extractions were my first straightforward surgery, but my first major surgery I performed was fixing a jaw fracture. 

Q: What is the most challenging aspect of your job?

Dr. Crawford: Being on hospital call is challenging because of the trauma cases that we see. For example, gunshot wounds to the face which require extensive corrective jaw surgery are difficult–there’s a lot that’s broken. But that’s even more to fix so there’s a positive spin. 

Q: What is the most rewarding aspect of your job? 

Dr. Crawford: I come to work everyday to make my patients comfortable. We want to take away any pain, suffering, or infection that they might be suffering from. My job also brings on a feeling of true community service and making a difference. 

Q: Do you get nervous before surgeries? 

Dr. Crawford: There’s obviously a lot of pressure on the surgeon and I certainly feel that pressure before each procedure. There’s no back up! We’re the first and last line for our patients. But we surgeons do have partners at our practice, and at SMOMS I have terrific partners. We go to each other for questions and advice. 

Q: How does your career impact the way you see the world? 

Dr. Crawford: I’ve developed a profound practice of non-judgement in my time as a surgeon. I try to meet people where they are by embracing my humanity and the humanity of my patients. 

Q: When you were little, what did you want to be when you grew up? 

Dr. Crawford: A doctor. That hasn’t changed much! I remember getting my medical and dentistry merit badges in Boy Scouts. I’ve always loved it. 

Q: Do you have a hidden talent? 

Dr. Crawford: I’m not too shabby at golf. 

Q: What’s your favorite holiday? 

Dr. Crawford: The Fourth of July

Our patients on Dr. Crawford: “We want to express our deepest gratitude for Dr. Crawford’s expertise and kindness with our son’s wisdom teeth extraction. Our son came through with flying colors and feels he’s overcome his fear of needles, thanks to Dr. Crawford’s genius approach!”

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A Tale of Two Smiles: Dental Bridges vs. Dental Implants

In the United States, approximately 120 MILLION adults are missing at least one permanent tooth. Missing teeth disrupt all types of everyday dental functions–from eating to smiling. For patients who would like to fill the gap of a missing tooth (or teeth!), they can opt for a dental bridge or a dental implant. Although they achieve the same purpose of filling a smile, bridges and implants differ both in structure and long-term success. Let’s take a look.

Dental Bridges bridge the gap between missing teeth. Structurally, the false teeth of the dental bridge are anchored and supported by crowns that are fitted to the natural teeth on either side of the gap. Some bridges require the anchor teeth to be prepared by being filed down to fit in the crown; others have porcelain or metal wings which are cemented to the backs of the anchor teeth. 

Dental Implants fill the gap of a missing tooth by implanting a porcelain tooth crown (replacing the missing tooth’s crown) fitted to a titanium screw post (replacing the missing tooth’s root). Dental implants are placed with a multi-step process: First, an oral surgeon inserts the titanium screw into the jawbone. The implant screw and jawbone are then given time to fuse (usually 3-6 months) by a process called osseointegration. After the implant screw and jawbone have fused, a dental crown is fitted on top and voila! A new tooth for your smile. 

Missing teeth don’t just disrupt eating and smiling functions. Unstimulated gum tissue and jawbone begin to decay and cannot be recovered. Our natural teeth and roots stimulate our gums and jawbones, keeping them healthy. Dental bridges do not stimulate gum tissue or jawbone; after the osseointegration process, dental implants interact with and stimulate oral tissue and bone just like our natural teeth! 

Pros and Cons:

 1. Time: Because dental bridges do not require surgery, the time commitment needed to receive a dental bridge is considerably less than that required to place a dental implant.

2. Care: Dental bridges require additional care to keep them clean and well-maintained. Dental implants can be treated and cared for like your natural teeth.

3. Oral Side Effects: Because they sit above the gum line, dental bridges do not stimulate gum and bone tissue. Because dental implants include a replacement root, they do stimulate gum and bone tissue. The placing of a dental bridge requires intrusive preparation and procedure on anchor teeth, adversely affecting your remaining natural teeth. Dental implants do not affect your remaining natural teeth. 

4. Durability: When properly maintained, dental bridges can last between 5-15 years. When properly maintained, dental implants can last for a lifetime.

5. Cost: Because dental bridges don’t require surgery, a single bridge typically costs less than dental implants. However, because dental bridges last for a few years, most patients will require multiple bridges. Eventually the cost of multiple bridges eclipses the cost of a single dental implant. 

Every smile is beautiful, but every mouth is different. If you’d like to fill the gap of a missing tooth, talk to your dentist about the best option for you.

If you do choose to have dental implant surgery, come to SMOMS for a consultation! The surgeons at Southern Maine Oral Surgery excel at placing dental implants–thanks to their surgical skill, the SMOMS Staff, and the unparalleled precision of X-Guide guided implant technology exclusively offered at each SMOMS Office. Talk to your dentist and make your appointment with Southern Maine Oral Surgery.

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What’s in a Name? Know your Different Dentists

Medical words have a reputation for being tough to pronounce–and nearly impossible for non-medical personnel to understand. This is typically because medical vocabulary uses Greek or Latin roots that seem far away from our everyday language. 

However, the proper name of something or someone can tell us a lot about what it is or what they do! For example, not every doctor who works on your mouth is a “dentist.” They may be an orthodontist, a periodontist, an endodontist…the list goes on! Let’s demystify the list and learn more: 

1. General Dentist: (DENT = tooth, IST=specialized) Specializing in teeth, a general dentist takes care of the tooth surface, providing cleanings and routine exams.

2. Orthodontist: (ORTHO = straight, IST = specialized) Orthodontists want to straighten everything out. That’s why they’re responsible for aligning teeth and jaws for comfortable, beautiful smiles.

3. Periodontist: (PERI = around, IST = specialized) What’s around the teeth? Gums! Periodontists treat gum disease, gum recession, and other gum issues, keeping the area around your teeth comfortable and healthy.  

4. Pedodontist: (PEDO = child, IST = specialized) Pedodontists typically go by the alias “pediatric dentist.” Children have different dental needs and concerns than adults, and pedodontists provide specialized care for them! 

5. Endodontist: (ENDO = within, IST = specialized) What’s inside teeth? Nerves. Lots and lots of sensitive nerves. Typically, those nerves are protected by the tooth enamel. However, if that enamel erodes or decays, the nerves are exposed and cause severe pain. Endodontists perform root canals and other procedures relating to dental nerves.

6. Prosthodontist: (PROS= in addition to, IST=specialized) Prosthetics are supplemental limbs, digits, or other devices added to a body. Similarly, prosthodontists provide all sorts of supplemental treatments (such as teeth whitening, veneers, dentures, crowns, and other cosmetic dentistry) which add to the beauty of a natural smile.  

7. Oral Surgeon: Dr. Doss, Dr. Crawford, Dr. Traub, and Dr. Mitchell are all oral surgeons. In addition to receiving their doctoral degrees from dental school and their dentistry licensure, they all served a 4-6 year surgical residency. After all this investment of time and energy, our doctors obtain their board certification and are finally able to begin practicing as licensed and certified oral surgeons.

Oral surgeons perform routine extractions as well as intricate procedures to treat oral diseases of the teeth and jaw bone. 

No matter their name, modern dentists perform invaluable work to extend the lifespan and increase the quality of life of their modern patients. Next time you visit an orthodontist, endodontist, or oral surgeon, be sure to ask what inspired them to choose their particular path of dentistry!

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How to Beat Dental Phobia

At Southern Maine Oral Surgery, we love seeing and treating our patients…but we know that feeling isn’t always mutual! Not everyone loves going to the dentist, and patient anxiety can range from a mild apprehension to full blown Dental Phobia (a fear so intense that it causes people to avoid the dentist completely).

Because we are an oral surgery practice, our patients have an especially pressing need to be seen and treated. From our front desk staff, to our dental assistants and our surgeons, the entire SMOMS team strives to help our patients feel comfortable and at ease. The fact remains that oral surgery is a bit more invasive than a cleaning at a regular dentist, and this can result in even more anxiety for our patients.

It’s completely normal to be nervous about going to the dentist or oral surgeon! Studies estimate that 75% of adults in the United States have some sort of apprehension at the prospect of oral treatments and surgery. If you or a family member are feeling a little nervous about an upcoming visit to SMOMS, here are three tips to help you relax on your way to a healthier smile: 

1. Don’t keep your phobia secret! If you suffer from anxiety or fear caused by the thought of your dentist visit, tell us! Our compassionate and knowledgeable staff can talk through every step of your procedure and answer every question. Information is power, and having all the information about your treatment can make you feel more at ease. 

2. Make it musical! Music helps us relax and distract us throughout the day, and the dentist/oral surgery office is no different. Bring your headphones, and play your favorite pump up song in the waiting room. When you’re in the chair, ask our staff about keeping one or both pods in so that you can immerse yourself in your favorite tunes. Forget your fear and find the beat! 

3. Take a deep breath! Take a cue from yogis around the globe and try to focus on your breath during your next appointment. Measured, intentional techniques such as belly breathing and measured breathing gives your body more oxygen and helps your nervous system relax. Start your deep breathing at home, on the way to the office, continue in the waiting room and throughout your appointment to create a sense of calm.



Three Strikes and You’re Out! What are Third Molars?

  Third molars are just that: the third molar to erupt on the length of your jaw. Because these third molars appear later in life (usually between 17 and 21 years old), they have the popular name of wisdom teeth. 

Our neanderthal ancestors had longer jaws with more teeth–particularly molars–to grind up tough food. As the human jaw evolved to be shorter and our food became softer, human beings lost the biological need for the third molar.

While some modern people have a jaw structure with ample room for their third molars, a large percentage of the population do not. When there isn’t enough room for third molars, they will become impacted, meaning they are unable to erupt properly into function in the mouth. Third molars can be either partially impacted (erupting only partially into the mouth) or completely impacted (totally covered by bone and not likely to erupt properly, if at all).

Impacted teeth can cause a number of complications for you and your teeth including pain, gum disease, bacterial infection, damage to adjacent teeth, and cyst or tumor formation. In order to avoid these negative side effects, it is important that you and your dentists closely monitor your wisdom teeth as they develop and erupt. 

X-ray images allow your dentist to get an idea of how your third molars are coming in and if/when they will need to be extracted. Your dentist will refer you to an oral surgeon like Dr. Doss, Dr. Mitchell, Dr. Traub, or Dr. Crawford at SMOMS to get a full evaluation on your third molar extraction. 

It’s completely normal to feel some anxiety at the prospect of having teeth extracted, but you shouldn’t put off the procedure. It is better to have third molars removed as soon as possible; earlier extraction allows for an easier surgery with fewer complications. For more information about third molars, check out the wisdom teeth procedure page on the SMOMS site! 

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Who’s Behind that PPE?

Just like other medical procedures, oral surgery has always required top-notch sanitization and safety gear. With the rise of COVID-19 at the start of 2020 however, the CDC implemented standardized Personal Protective Equipment (PPE) guidance for Dental Settings.

Between gowns, surgical masks, eye protection, scrub hats, and gloves, it might seem like a patient is visiting the Invisible Dentist. Underneath the layers of PPE however, the faces of the SMOMS team are just as smiling and caring as ever. Our Summer Social series “Who’s Behind that PPE?” will demystify personal protective equipment and unmask a different SMOMS team member! Follow SMOMS on Instagram and Facebook @southernmaineoralsurgery and find out who’s behind that PPE this summer! 

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