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The decision about what treatment to provide to a patient must be made by a periodontist in the exercise of his or her best judgement. However, in light of the precautions, periodontists are advised to determine whether a patient is receiving intravenous bisphosphonate therapy. If so, invasive dental procedures should be avoided unless absolutely necessary. Conversely, if a periodontist becomes aware that a patient is going to be treated with intravenous bisphosphonates, any needed invasive dentistry should, if possible, be performed before the initiation of such treatment. Finally, periodontists should endeavor to identify ONJ and other oral complications of cancer and cancer therapy.

Bisphosphonates, also known as bone-sparing drugs, are commonly used in the treatment of osteoporosis and cancer that has spread to the bone. They are a class of drugs that inhibit the resorption of bone. It's uses are the prevention and treatment of osteoporosis, osteitis deformans (Paget's disease of bone), bone metastatis (with or without hypercalcemia), multiple myeloma, and other conditions that feature bone fragility. Doctors prescribe intravenous bisphosphonate therapy, which was the subject of precautions set out by the FDA for patients with cancer that has spread to the bone to help decrease associated pain and fractures. In addition, emerging research is exploring the ability of intravenous bisphosphonate therapy to inhibit the spread of some cancers to the bone.

Here are some examples of bisphosphonate drugs including the brand name, manufacturer, and generic name:

Actonel - Proctor & Gamble Pharmaceuticals - risedronate

Boniva - Proctor & Gamble Pharmaceuticals - ibandronate

Fosamax/Fosamax Plus D - Merck & Co. - alendronate

Skelid - Sanofi Pharmaceuticals - tiludronate

Didronel - Proctor & Gamble Pharmaceuticals - etidronate

Reclast - Novartis Pharmaceuticals - zolendronate

Aredia - Novartis Pharmaceuticals - pamidronate

Bonefos - Aventis - clondronate

Nerixia - Abiogen Pharmaceuticals - neridronate

Olpadronate - Gador SA - olpadronate

Signs of ONJ include:

Exposed bone, pain, swelling or infection of the gums, poor healing of the gums, numbness or feeling of heaviness in jaw, drainage with sequestration, and loosening of teeth



Symptoms of ONJ include:

pain, swelling, infection of the gums, loosening of teeth, poor healing of the gums, numbness, feeling of heaviness in the jaw, and exposed bone

This condition has been observed in cancer patients who undergo invasive dental procedures such as dental implants or tooth extractions while receiving treatment with intravenous bisphosphonates. ONJ can cause severe, irreversible and often debilitating damage to the jaw.

The FDA recognizes additional risk factors associated with the development of osteonecrosis (not limited to the jaw) in cancer patients, such as female sex, advanced age, edentulous regions, combination cancer therapy, blood dyscrasis/metastatic disease, anemia coagulopathy, surgical dental procedures, and prior infection.

We offer Care Credit Financing. Care Credit is a credit card for medical as well as dental services. It is easy to qualify for. We also offer Capital One Financing.

We offer three different options to address dental anxiety.

1. Nitrous Oxide

2. Oral Sedation

3. Intravenous (IV) Sedation



We want to do everything in our power to ease your anxiety and ensure a pleasant experience in our office.

When you come into our office for an exam and consultation, we will present a treatment plan for you that will describe the services needed and the costs that pertain to those services.

We are located on the West side of Woodlands Parkway near FM 2978 across from the Super Walmart. We are next door to Chase Bank. If you are coming from I-45, take Woodlands Pkwy West past Kuykendahl, you will go through a few more stop lights and then stop signs. Before you get to FM 2978, you will make a right turn onto Montfair. Immediately turn left into the Chase Bank parking lot. Go past the Chase Bank, and you will see us on the corner of the strip center just West of the Chase Bank.

An implant is the most natural replacement for teeth that are lost due to trauma or periodontitis (periodontal disease).



A titanium implant replaces the natural root of a tooth. Once placed into the jaw and allowed to heal, your general dentist will attach a crown or appliance to restore your natural contour, function, comfort, esthetics, speech, and health of your mouth.

Once you know you are needing an implant, we will have you come in for a presurgery/consultation appointment, usually one week before your surgery. This gives you the opportunity to ask any questions prior to the surgery.



Most people have to wait about 3 months to allow the implant to heal and fuse with the bone. Once you have healed you will come in to have the abutment placed. The abutment is an attachment that screws onto the implant. The abutment is what the crown will be cemented to.



After the abutment is placed, you will go to your general dentist on the same day to have your temporary crown placed. We make sure we have coordinating appointments with your general dentist.



It usually will take the dental lab about 4 weeks to make your final/permanent crown. You will then go back to your general dentist to remove the temporary crown and have the permanent crown cemented.

During the procedure, you will be completely numb so you won\'t feel any pain. After the procedure, you will be given pain medication. Everyone has a different level of pain tolerance, but many of our patients have stated that Advil/Tylenol was all they needed. Any discomfort you have after the procedure usually only lasts 1 or 2 days.

With traditional periodontal therapy, the periodontist has to make an incision and then place sutures at the end. The discomfort post surgery can last up to 2 weeks. Regular cleaning and probing can resume 3 months post surgery.



With laser surgery, the periodontist does NOT make an incision and does NOT place any sutures. The discomfort post surgery only lasts 1-2 days. Regular cleaning and probing can resume 6 months post surgery.



With both the traditional surgery and laser surgery it is important to have your occlusion (bite) assessed to ensure that it doesn\'t interfere with your healing. It is especially vital with laser surgery, because any excessive pressure on an area can cause irritation to the healing tissue.

The recovery period after laser surgery is fairly quick. If you have IV sedation, you will probably need that day to rest, but you will be fine the next day. Most people return to work the day after the surgery.

The laser is very comparable to the fee for conventional periodontal surgery. It is not more because it is a new technology.

You may experience some soreness. Dr. Bradshaw will prescrible some antibiotics and an anti-inflammatory to take care of any discomfort you may experience.

LANAP stands for Laser Assisted New Attachment Procedure.



LANAP reduces periodontal gum pocket depth by helping:

A. The dentist to have improved visualization of the laser-detached gum pocket soft tissue linings to aid scaling and root planing for removal of calculus (tartar) deposits.

B. Reattachment of the laser treated gum tissues to the roots by promoting growth of new bone and/or root surfaces.



LANAP treatments are generally less painful than traditional flap surgical procedures and in the doctor\'s opinion have greater predictability for reattachment of gum tissue and bone growth. Thus, LANAP helps promote long term periodontal health.

We do not use any special codes because it is laser surgery. We use the same codes that every office uses for periodontal surgery.

Periodontitis is one of the major reasons for tooth loss. It is an infection of the tissue surrounding the teeth (periodontia) caused by an imbalance between bacteria in the mouth and a person\'s immune system. This condition is treatable through a variety of both surgical and non-surgical methods depending on each individual\'s needs. Surgical methods are usually reserved for only the most advanced forms of this disease. The objectives of surgery are to stop the progression of the disease, thereby preserving existing bone and teeth, eliminate pockets, and to grow new bone and attachment where possible. Success rates are high, exceeding 80% in most patients.

Gingivitis is an infection of the gingiva (gums). The bacteria that is in the plaque on your teeth irritates the gums causing them to become inflammed and bleed. This infection is 100% reversible if treated promptly and you maintain good oral hygiene practices at home.



Periodontitis is gum disease also caused by bacteria, but the bacteria not only infect the gums they also attack the underlying bone causing bone loss and gum recession. This disease is not as easily reversed. With scaling and root planing and good oral hygiene practices at home, the progression of periodontitis can be stopped and a healthy state can be acheived. In order to reverse any bone loss or gingival recession, surgery may be required such as bone or gum grafting.

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10110 Woodlands Parkway, Suite 1000, The Woodlands, Texas 77382

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