Top Dentists in Delaware: The Inside Story
Michael R. Kremer
photograph by Jared Castaldi
“If you have pain in your mouth, you have some level of infection,” says maxillofacial surgeon David A. King. The cause of that pain can often be treated by your dentist or a specialist, but they sometimes need help. Meet the oral pathologist. Though there are very few certified oral pathologists in Delaware, maxillofacial surgeons often see and deal with the same conditions. “We are constantly on the lookout for things that are malignant,” says surgeon Michael R. Kremer.
The core of the surgeon’s practice is removal of wisdom teeth, implant surgery, and treatment of facial trauma such as broken bones. “But we see enough pathology to keep it interesting,” Kremer says.
Most of the problems they see are benign: scratched palates, fibrous growths in soft tissue, blocked salivary glands. Some irritations will heal when the source of the trouble is removed. Growths are removed by the surgeon—a simple in-office procedure performed under local anesthetic or mild sedation—then biopsied. Recovery occurs quickly, thanks to the high number of blood vessels in the mouth and bacteria-fighting antibodies in saliva. In fact, the mouth is so good at healing itself, Kremer says, most procedures don’t even need follow-up therapy with antibiotic medications.
The surgeons do occasionally see serious problems such as cancerous tumors, but they amount to less than 10 percent of their cases, King says. Most dentists screen for such problems during their patients’ regular checkups, then refer them to the surgeon only when they see something unusual. Both Kremer and King stress what they see most is people who suffer from advanced periodontal disease.
“There are lots of people who don’t go to the dentist, King says. “It’s usually that pain drives them to the dentist. Tooth pain can be bad, and infections from teeth can be horrible. “If there’s one piece of advice for avoiding problems,” he says, “it’s brush your teeth.”