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We have all had it happen…we are sitting in our favorite pizza place waiting for our food to arrive and we impatiently take that first bite as soon as it comes. Next thing we know, we’ve just burned our tongue or roof of the mouth with the hot pizza. That burned  mouth pain will remind us, that we should have waited for that pizza to cool off. We now, regretfully, look towards days of discomfort and pain.

Degrees Of Burn

First Degree Burn – normal signs and symptoms of a 1st degree burn include pain, redness, dryness, and minimal swelling. If you have a first-degree burn in your mouth, the topmost layer of affected tissue in your mouth may peel in 1-2 days, and your mouth should heal on its own in about 3-6 days time. This is the usual “pizza burn”.

Second  degree burns -This level of burn in your mouth and throat can lead to further complications. Second-degree burns often cause severe pain, redness and blistering. This burn involves layers beneath your top layer of skin. They may not heal for weeks and are at higher risk of complications such as infection.

Third-degree burns-This type of burn requires immediate medical attention. Third degree burns can lead to dry, brown, charred, or waxy, white skin. This type of burn usually involves all layers of underlying tissues and may require a skin graft. Because this type of burn damages the nerves, it may not initially be painful. Get immediate medical attention if you think your mouth has a second- or third-degree burn or if you have any internal mouth burn that swells, develops infection and increases in redness.

Tips For A “Pizza Burned” Mouth

The next time a first degree mouth burn happens to you, follow these simple steps to find relief and let it heal faster:

1. Apply Ice – Sucking on an ice cube or eating ice cream can help bring relief from the burning sensation. Even gargling with ice cold water can give relief.

2. Drink Milk – Milk is a great tool in this situation because of its coating action on the skin in the mouth. The milk will coat the burned area.

3. Pain Medication – These can include Tylenol, Advil, Aspirin, or Alleve. These are all  good choices to relieve some of the discomfort. A product called orabase is sometimes helpful as well. Orabase is a topical anesthetic that can help directly on the burned area acting in a localized way. Don’t use anbesol or aspirin directly on a burn, it tends to further irritate the damaged tissues.

4. Avoid Certain Foods – While the burn is healing you want to avoid any food that might irritate it further. These can include acidic foods, crunchy foods, very hot foods,   or even very salty and spicy dressings.

5. Vitamin E – This has been shown to promote would healing so squeezing vitamin E from a capsule over the wound can speed up healing and allow new tissue to grow in and heal the wound.

Another good tip is to maintain good oral hygiene during this period to avoid further infection or irritation. You should keep the area as clean as possible just like any wound on the body. Warm saline rinses are also helpful. This extra care will facilitate healing.

Conclusion

All of us have burned our mouths in the past, and are highly likely to do it again in the future. Try to monitor the temperature of the foods you will be eating, and remember to be patient enough to wait before eating smoking hot food.Use your best judgement before diving into a scalding hot meal or drink, and you will have less frequent painful mouth burns. Another good tip, is to take smaller test bites, so if it is too hot, we would only create a very small burn to our mouth and not have as much discomfort. So, enjoy your pizza, take care not to burn yourself, and if you do, take the proper steps for relief.

Dental implants in dentistry have become a highly successful dental procedure. Most studies show that dental implants have a success rate of around 96-98% when placed properly. Dental implants have become a highly reliable procedure for the replacement of lost teeth. This means, almost all patients who undergo the procedure for dental

Dental Implants Marielaina Perrone DDS

implants with a highly competent surgeon, will have success. What about the other 2-4%? What can go wrong with dental implants?

Success of dental implants is related to the dentist or surgeons skill, quality and quantity of the bone available at the site, quality of materials used, the patient’s healing ability, and maintenance of good oral hygiene.

Possible Dental Implants Complications

Failed Integration of Dental Implants – This occurs when the bone does not grow and fuse between the threads of the implant. This fusion of bone to dental implant is called osseointegration. If this does not occur, the dental implants will not function properly,will become uncomfortable, become loose, or come out completely. To reduce this risk, your dental surgeon will evaluate the quality and density of the jaw bone prior to surgery. This will help to only place dental implants in areas where there is a highly predictable success rate. If osseointegration does not take place, the dental implants can be removed, and surgery can be attempted again once the area has fully healed.

Infection –  This is the most common complication of dental implant surgery. The surrounding bone and gums can get infected during the surgical procedure. This can happen due to non-sterile technique, a contaminated implant, poor healing ability(diabetic, smoker, osteoporosis medications), pre-existing infection. The most likely time for this to occur would be during the surgical placement of the dental implant into the bone. Implant infection is a condition referred to as peri-implantitis. Peri-implantitis is characterized by inflammation or swelling of the tissues surrounding the implant area. Peri-implantitis can also present as a secondary infection later on is a form of periodontal disease that can lead to inflammation, bone loss and implant failure if not treated quickly and properly. Although implant infections are usually caused by the presence of bacteria during or immediately after the oral surgery for the placement of the dental implants, an implant infection can occur months or years after surgery.

Post Surgical Bleeding – Some bleeding following surgery is normal and should be expected for about 1-2 days. Biting gently on a gauze pad placed over the surgery area for 30 minutes should normally stop the bleeding. Excessive bleeding is not normal and you should notify your dentist immediately if you have concerns about your dental implants.

Damage To Surrounding Tissues – Dental implant complications related with surgical errors affecting adjacent teeth, nerves or sinus are directly correlated with the experience and skills of the dentist or surgeon. An experienced and skilled implant dentist is able to identify potential problems by examining x-rays or CT scan (computer tomography), design the proper surgical plan for ideal location and angle, and execute it successfully without complications. Even with the most skilled implant dentist there is always a possibility of dental implant complications. The complications can be limited by choosing an implant dentist with the skills and experience necessary to handle any complications if they arise.

The following areas could be damaged:

1Surrounding Teeth – During the placement of dental implants, the dentist may damage the crown or the roots of adjacent teeth. Root canal therapy may be needed to repair the injured teeth. The dentist must carefully review the x-rays or CT-scan

Dental Implants Marielaina Perrone DDSbefore drilling because the teeth are not always in ideal positions. A skilled implant dentist will be prepared for any changes necessary.

2. Nerve Damage – While rare, this is a complication of implant surgery in the lower jaw (mandible). There is a nerve (inferior alveolar nerve) that runs through the lower jawbone that can be injured during dental implants placement. Nerve injury may cause pain, numbness or painful tingling in teeth, gums, lips, tongue or chin. Similar symptoms may occur if the implant is placed right on top of the nerve, causing severe pain when chewing down. If the nerve fails to heal and the symptoms persist, the dental implant will likely need to be removed. X-rays and CT scans can help the implant dentist to identify the exact location of the nerve and minimize the possibility of nerve damage.

3. Perforation into Sinus – This occurs during placement of dental implants in the upper jaw. This occurs during implant placement, when an implant is placed into the sinus cavity. With proper planning, the bone around the sinus can be grafted and lifted (sinus augmentation) to allow for the necessary length of the dental implants. To prevent this implant complication, the dentist must check carefully the CT scans and proceed with ‘sinus augmentation’ if needed to provide sufficient bone for successful implant placement.

4. Bone Fracture – Jaw fracture is another possible complication of dental implants placement. If there is not enough bone or bone density, the jaw can fracture under the pressure during the surgical placement of the dental implants (during drilling or implant insertion).

5. Inflammation – Inflammation and swelling of the surrounding tissues is the immediate symptom of implant infection. Improper placement or size of the abutment and crown restoration, that puts under pressure and traumatizes the soft tissues around or beneath it, may also cause dental implants complications. Dental implant inflammation triggers an inflammatory response from the body’s immune system that attacks gum tissues and surrounding bone. This can result in bone loss around the dental implant and if left untreated the dental implants will become loose and will need to be removed. The dentist has to eliminate the inflammation as soon as possible to prevent further bone loss that can cause dental implants failure. The inflammation can be treated by antibiotics and cleaning if caused by implant infection, or by removing or adjusting the defective restoration if caused by trauma.

Other reasons for failure of Dental Implants

-Rejection – An extremely rare complication but it has been noted in the research literature. The dental implants can sometimes be viewed as a foreign body.

Unusable Dental Implants – An implant that has successfully integrated with bone, but the area or extreme angle of placement deem it unrestorable.

Dental Implants Conclusion

Implant dentistry has come a long way. It has become an almost routine procedure. Understand, that just because it is done often does not make it a simple procedure thatDental Implants Marielaina Perrone DDS anyone can do. Implant surgery is an intricate and comprehensive process that involves several stages. Treatment consults, treatment planning, and treatment procedures (which can include multiple surgeries) need to be undertaken with extreme care. General dentists DO NOT have the same training as surgeons, and are generally better at restoring the implants after surgical placement. As with all types of surgery, there are risks involved during both the actual dental implants procedure as well as during the recovery period. While most dental implant complications are quite minor, it is important to be aware of them prior to surgery. These complications can be minimized by choosing an implant dentist with the skill and knowledge to overcome any challenges that may come your way before, during, or after surgery. Choose your surgeon based on skill level and not price, and you will be much more likely to have a long term success.