Minimizing COVID-19 Risk With Nitrous Oxide (Laughing Gas) Delivery

For information concerning the Silhouette, you can reach Dr. Guyette at [email protected]

The Silhouette System is a paradigm shift in how Nitrous Oxide is delivered. It is designed to be more comfortable for patients while providing incredible access for doctors performing dental treatment. Silhouette is a single use system which greatly decreases escaping gas that is known to transmit the SARS-CoV-2 virus.

The following videos are from our 2015 FLIR Silhouette Nitrous Oxide study. The first video below shows the typical nasal cannula at 4 L/m (2 L/m O2 and 2 L/m N20). The thermal cloud is Nitrous Oxide visualized in real time. One might extrapolate that this also reflects potential viral aerosolization.

The next video again uses thermal imaging with the same flow rate and gas mixture connected to standard scavenging. There is minimal gas leakage. Head movement shows no increase in escaping gas. This may reduce risk of viral exposure when delivering only oxygen.

We are currently evaluating the silhouette system to minimize the potential for virus dissemination in view of the COVID-19 pandemic. Please contact me with any comments or questions. You can find out more information about the silhouette system by clicking on the following link or by contacting me directly:

Things To Think About If Are Considering Oral or Facial Surgery Now



Here are some things you might want to think about if you are still considering Oral or Facial Surgery but are unsure the best next steps during the pandemic.

There are currently a lot of unknowns when it comes to when the nation will once again be able to pursue any elective surgery, whether it be a wisdom tooth extraction, dental implants, or even cosmetic and facial surgery. What we do know for sure is that at some point, most likely within the next few months or sooner, the ban on elective surgeries will be lifted.

The question a lot of our patients are calling in and consistently asking is “What are my options? Am I a good candidate for oral or facial surgery now?  How can I be ready once the ban is lifted on elective surgeries?” Knowing there are still unknowns, to help with answering this question, we’ve put together a number of things to consider that you CAN take action on now, better preparing you for when elective surgeries become available again.

Do Your Research Now So You’re Prepared When The Ban Is Lifted

Knowing that once the ban is lifted, every person that was considering any form of elective surgery over the past few months will quickly be scrambling to learn what procedure they think is most likely to be the best fit for them, which doctor(s) they like, and then trying to get on our doctor’s calendar over the next few months. If you take the time to do your research now, you can determine the procedure(s) that you think make the most sense for your situation.  Our doctors are board certified with years’ of experience, credibility, and positive reputations.


We are still holding patient consultations right now. We are just altering our approach when it comes to their consultations. The idea of telemedicine has been around and practiced for some time, but now, more than ever, it’s becoming increasingly important to use this more efficient service. During this time, talk to one of our associates to setup a secure video consultation using video telemedicine software that is HIPAA compliant and has at least 128-bit encryption security, so you can rest assured no one other than you and the doctor will be privy to the discussion.

Though, in many cases, an actual physical appointment will most likely still be necessary in order to fully confirm the best procedure for you, this virtual consultation with a doctor will allow you to ask questions, learn more about the procedures that are most likely the best fit for you, and even get on a wait list, so you don’t have to scramble to book an appointment once the ban on elective surgeries is lifted.


Going back to our initial point of being prepared, once you have done your research and spoken with a doctor either via the phone or using a secure video consultation, you should have a good idea of the procedure you’d like to pursue. The main difference with what can occur now and what was available before the ban on elective surgeries is simply that in-person appointments cannot currently be conducted.

That said, most credible surgeons were already booking surgeries months in advance, prior to the U.S. Government ceasing the ability to perform elective surgery. For this reason, once there is confirmation regarding when the ban will be lifted, the teams at almost every credible oral & facial surgery practice will begin reaching out to their existing patients and people they have on a waitlist to book their appointment or procedure.

This is why we strongly recommend considering getting on a waitlist now since each of these waitlists will be on a first come first serve basis. The sooner you are able to confirm the procedure you are considering and be placed on a waitlist, the more likely you are to be able to book an appointment at one of our offices.  The likelihood is the demand for elective and cosmetic surgeries has not gone down, just the ability to perform this service has been temporarily put on pause. In summation, you should consider getting on a waitlist now so you aren’t potentially waiting until the fall or winter to have your procedure.

If you have any questions or would like to book a secure video consultation with our office, call us today or fill out the form on this page to set up your appointment.

Contact Our Phoenix Area Oral & Facial Surgeons

For 30 years, Guyette Facial & Oral Surgery Center has been Arizona’s leader for oral surgery and facial cosmetic surgery. Dr. Robert Guyette and Dr. Mark Beehner are board-certified Oral & Maxillofacial Surgeons and dentists who are dedicated to changing the lives of their Scottsdale and Avondale patients. Focused on improving form and function, our team takes an all-inclusive approach to your health and aesthetics. Undergoing treatment at our state-of-the-art facility is a uniquely superb experience. With a relaxing environment and a kind, compassionate staff, Dr. Guyette and Dr. Beehner are both top-of-the-line choices for a facial and oral surgeon. To schedule a consultation, contact our practice serving Scottsdale, Avondale, and the entire Phoenix area.

What Causes Dental Implant Problems?

Full Mouth Reconstruction Procedures | Guyette Facial & Oral Surgery, Scottsdale

Dental implants have become the easiest and most reliable way of replacing damaged and missing teeth. These replacements consist of metallic screws and crowns that resemble natural teeth. They are screwed into the jawbone and tightened in order to give a permanent teeth replacement solution. The good thing about modern dental implants is that they are specially designed to fit in the space in your gum snugly so that they can restore your natural smile. However, at times these dental implants can develop complications, either shortly after the replacement procedure or a few years later. Here are some of the most common factors that can lead to dental implant problems.

Gum Infections

Before you undergo the teeth replacement procedure, your doctor should examine your mouth to see if you have any gum diseases. These are infections that leave the gum damaged and weak. If a dental implant is placed in an infected gum, the infection will develop around the implant and cause failure. Therefore, it is advisable to talk to treat the infection before you get the implants. Your oral surgeon should be able to analyze the extent of the infection and advise you on the best ways to handle it.

Insufficient Jawbone

Since the dental implants are planted into the jawbone, they require enough bone tissue to be able to stick. This means that if you do not have enough healthy none tissue, the oral surgeon won’t be able to place the dental implants into the jaw. And if they are placed into a weak jawbone, they will become loose and eventually fall off. Bone loss is mainly caused by osteoporosis, which develops when your bone density is decreased. It can also be caused by severe gum infections. With osteoporosis, your bones become weak and you face a higher risk of sustaining fractures. Your doctor should be able to tell if you have enough healthy bones to be able to receive dental implants.

Medical Conditions

If you have an autoimmune syndrome or other chronic diseases such as diabetes and rheumatoid arthritis, then you face a very high risk of dental implants failure. These diseases weaken the body’s immune system, causing it to heal slowly. Delayed healing prevents osseointegration – the integration of the dental implant with the jawbone. Certain medicines can also cause implant failure. So, you have to go for the necessary medical tests before you can have your teeth replaced with dental implants.

Contact Our Phoenix Area Oral & Facial Surgeons

For 30 years, Guyette Facial & Oral Surgery Center has been Arizona’s leader for oral surgery and facial cosmetic surgery. Dr. Robert Guyette and Dr. Mark Beehner are board-certified Oral & Maxillofacial Surgeons and dentists who are dedicated to changing the lives of their Scottsdale and Avondale patients. Focused on improving form and function, our team takes an all-inclusive approach to your health and aesthetics. Undergoing treatment at our state-of-the-art facility is a uniquely superb experience. With a relaxing environment and a kind, compassionate staff, Dr. Guyette and Dr. Beehner are both top-of-the-line choices for a facial and oral surgeon. To schedule a consultation, contact our practice serving Scottsdale, Avondale, and the entire Phoenix area.

Questions to Ask When Looking for a Scottsdale AZ Oral Surgeon

Finding an oral surgeon in the Scottsdale Arizona area is not a daunting task nowadays thanks to the growing number of dental clinics and qualified dental surgeons in the area. As the demand for high-quality dental services increases in the area, more experienced dentists continue to emerge. But even though there are many dentists and surgeons offering this service, not all of them can guarantee you the best results.

So, you still have a task of find the right oral surgeon for your operation. The important question is: How do you differentiate between a real oral surgeon and a quack? Here are some of the critical questions you need to ask when looking for a Scottsdale AZ oral surgeon.

Do they have the necessary board certifications & experience?

Like in any other medical situation, oral surgery requires a fully trained and highly experienced surgeon to carry out the operation. Therefore, you have a duty of checking the surgeon’s level of training and years of experience before you hire them. The right surgeon should be able to provide a portfolio of at least one or two similar operations that they have done successfully before. You should also take the time to read their reviews online to know what their previous clients think about them. This will give you a rough idea of what to expect.

The most common board certifications are American Academy of Oral & Maxillofacial Surgeons (AAOMS) and the American Board of Oral & Maxillofacial Surgeons (ABOMS). You may check these websites to find your oral surgeon’s professional certifications.

Do they accept your insurance?

While some oral surgeries are fairly affordable, others are quite expensive. Therefore, you need to find a cheaper way of taking care of the expenses. Although most insurance companies do not cover aesthetic oral surgeries, some do under certain terms and conditions, especially involving bone structure issues like TMJ. So, it is important to find out if your oral surgeon in Scottsdale AZ accepts insurance. Even if they don’t, you will be able to plan your finances prior to the surgery and look into options like CareCredit and other medical procedure financing. These types of surgeries typically qualify for HSA/FSA accounts, but check with your insurance provider for details.

What does the procedure entail?

A good oral surgeon should be able to explain to you in detail what the entire procedure involves. This information is necessary because it helps you to prepare yourself both physically and emotionally foe the procedure. It is also important to have an idea of the expected outcome.

How is the recovery?

This is the most important step of the whole process because it determines how successful the operation is going to be. Your oral surgeon should be able to take you through the recovery process and explain to you how long it will take for you to fully recover and resume your normal life. They should show you case studies and examples of the same procedure you are having. They should be able to make you extremely comfortable with the process you are about to undergo, including a realistic conversation about recovery time.

Have they contributed to medical textbooks or the body of oral surgery literature?

Typically, an oral surgeon spends minimum of 7 years in post-graduate school including residency. After that, they pursue a lifetime of continuing education, attend industry conferences and generally stay updated on new process or procedures, if not lead in the development of these techniques. A genuinely good oral surgeon never stops learning and seeking knowledge. Look for this type of person when choosing an oral surgeon.

Talk with an experienced oral surgeon for options to know your options

Surgical experience & skill dictate the level of quality and given options for your oral surgery. Talk to a Scottsdale oral surgeon today that has more than 30+ years experience in the field.

Special Considerations for Pregnant Women Undergoing Oral Surgery

Since dental health is an integral part of everybody’s life, many pregnant women are often concerned about their safety when undergoing dental procedures. It is even more disconcerting when such procedures involve oral surgery. One of the many questions that always come up is: How safe is oral surgery during pregnancy? There isn’t a direct answer to this question because some oral surgeries can be done safely during pregnancy while others are considered unsafe. Therefore, a lot of deliberations must be made before any invasive dental procedure can be performed on an expectant woman.

Certain Drugs and Procedures Cannot Be Used With Pregnant Women

As a pregnant woman, you must inform your dentist of your pregnancy before he or she performs any operations on you. This is important because most oral surgeries involve the use of sedative drugs and anesthesia in order to ease pain and nervousness. However, these drugs can have a major effect on the unborn child. According to medical experts, the best time to perform any form of oral surgery on an expectant woman is in her first and second trimester. It becomes extremely risky to operate on a woman who is in her third trimester. Even if the surgery doesn’t involve the use of sedatives, the pain and anxiety involved in such a procedure can negatively affect the unborn child.

Experienced Oral Surgeons Weight The Risks & Benefits

A good oral surgeon should be able to take into account the type of surgery, its necessity and the possibility of postponing it until the child is born without putting the wellness of the child and the mother at risk. In many cases, dentists prefer to postpone all dental procedures that do not put the life of the pregnant mother at risk until after childbirth. Only in extreme circumstances where the safety and wellness of the mother is pegged on an oral surgery does a dentist agree to carry out such a procedure.

Even in such situations, oral surgeons must take serious safety measures when operating on the expectant woman to minimize potential dangers to the woman and her unborn child. They have to choose the safest and most reliable surgical procedure for the woman, especially if she is in her third trimester. As an expectant woman, you should not just visit any dentist or oral surgeon for your oral surgery. Make sure the person operating on you is fully trained and has enough experience to perform such procedures safely. Ask them all the important questions regarding your situation to determine if they are the right choice.

Immediate Tooth Replacement


Immediate Tooth Replacement

As we age, our teeth become more brittle. As a result, fracture lines can form and teeth can break, frequently at the gum line. This process is accelerated if you have had a root canal or your teeth have been veneered or crowned. If this happens, many times it is not possible to save the tooth.

As improbable as it sounds, it is sometimes possible to remove a single tooth, place a dental implant and within 2 days, have a natural appearing tooth attached to the implant. This is possible because of improved implant materials and design and our expanding knowledge of the biology of bone healing and implant integration.

What this means for you is that should you have the unsettling experience of breaking a front tooth, if everything goes as expected, you can have a replacement tooth that is both fixed and very aesthetic. This avoids the need for wearing a removable tooth replacement appliance that can be uncomfortable and negatively impact the long-term result.

Even though the tooth replacement can look much like the natural tooth it replaced, it is not ready to function like a normal tooth. It takes 2-4 months for the implant to integrated with the bone before you can use it normally. During that time, you will have to chew carefully and avoid biting in the area of the tooth.

If you find yourself breaking a tooth and don’t know what to do next, contact your dentist or give us a call and we can quickly determine if you are a good candidate for immediate tooth replacement.

Orthognathic Surgery

Orthognathic Surgery | Guyette Facial & Oral Surgery, Scottsdale

When patients have a misaligned bite, orthodontic treatment can be used to correct the problem. However, for some patients, orthodontic treatment such as braces is only one step in the treatment process. If alignment problems extend beyond the teeth, to the jaw bone, surgery may be required to get your jaw properly aligned. Scottsdale oral surgeon Robert F. Guyette performs orthognathic surgery to align the jaw and give patients improved function as well as an improved appearance.


How will you know if you need orthognathic surgery? There are some signs to look for that may indicate that your jaw bone is misaligned. Some common symptoms that are experienced by patients with a misaligned jaw include:

  • Difficulty chewing, swallowing, or speaking
  • Pain or tightness in the jaw (such as those experienced with TMJ disorder)
  • Difficulty breathing through your nose
  • Frequent snoring
  • An obviously protruding upper or lower jaw bone
  • A misaligned bite (particularly when your upper and lower teeth do not open in the front)
  • Receding chin
  • Sleep apnea

Some of these symptoms may also be a result of orthodontic problems. Orthodontic treatment may be performed before orthognathic surgery, and may be required afterwards as well. If your symptoms are not relieved by orthodontic treatment, Dr. Guyette can let you know if you are a candidate for orthognathic surgery.

Orthognathic Surgery

With orthognathic surgery, Dr. Guyette is able to reposition the teeth, upper jaw, lower jaw, and chin to place them in a correctly aligned position. Bone can also be added or taken away as necessary. The areas of the jaw that are actually altered will depend on each patient’s unique issues. Each surgery will be customized to address every patient’s specific areas of concern. Dr. Guyette employs use of all of the most advanced equipment to show you exactly how your orthognathic surgery will be performed. With x-rays and computer video images, Dr. Guyette will show you exactly where (and how) your bite will be corrected. Many patients who require orthognathic surgery have a jaw bone that protrudes unnaturally or gives an asymmetrical, disproportional appearance. Orthognathic surgery will not only restore function and comfort to your jaw, but any visually aesthetic problems will be corrected as well. Before your surgery, Dr. Guyette can show you a computer image of what your newly aligned jaw will look like.


Following your orthognathic surgery, you will be given instructions for a modified diet to make sure your jaw is not strained during your recovery. During the initial recovery period of one to three weeks, you may experience some moderate pain. The pain can be treated with pain medication. While the jaw should feel comfortable and function normally within six weeks after surgery, it can take nice to 12 months for the jaw to be considered completely healed.

Schedule an Appointment

For our patients in Scottsdale, oral surgery can be performed to correct a number of problems. If you believe you may be a candidate for orthognathic surgery or have other areas of concern, schedule an appointment to discuss your concerns with Dr. Robert F. Guyette. Dr. Guyette can perform an exam and provide you with a personalized treatment plan.

Gum Graft Surgery

Gum Graft Surgery | Guyette Facial & Oral Surgery, Scottsdale

For patients who are missing one or more of their natural teeth, there is no treatment that restores form, function, and health to the mouth quite like dental implants. By replicating the entire structure of the missing tooth, from root to crown, dental implants provide the strongest, most durable, and most natural-looking replacement for missing teeth currently available. Patients emerge from dental implant surgery with a renewed ability to chew, bite, speak, and smile. The procedure has been responsible for improving the oral health and overall quality of life for countless patients.

Scottsdale oral surgeon Robert Guyette performs the surgical placement of the titanium implant posts that serve as artificial tooth roots for crowns, bridges, and dentures. Many of the finest dentists in the area choose to collaborate with Dr. Guyette because of his exceptional surgical skills, as well as his ability to perform the grafting procedures that enable patients who might otherwise not be able to receive dental implants to become suitable candidates for the treatment. At his practice in Scottsdale, gum graft surgery has helped to transform the lives of many patients whose periodontal tissues had fallen into disrepair due to missing teeth.

Why Gum Graft Surgery Is Necessary for Some Dental Implant Patients

Dental implants are titanium posts that, when embedded in the jawbone, assume the function of absent tooth roots. The posts fuse with the jawbone, which does not detect titanium as a substance foreign to the human body; they, therefore, essentially become part of the patient’s natural anatomy. Once they have fused into place, they provide peerless support for tooth restorations, from single crowns to full sets of dentures.

Unfortunately, the longer a person waits to replace missing teeth, the less likely he or she will be good candidates for dental implants. This is because the structures that once supported these missing teeth begin to degrade once they no longer serve their intended purpose. The soft and hard tissues that were once integral to the health and preservation of a tooth fall into a state of disuse and eventually begin to disintegrate when that tooth is no longer there. By the time a person seeks to replace missing teeth with dental implants, there may be insufficient bone and gum tissue to support those implants.

Fortunately, both the bone and the gums can be restored through grafting procedures. Bone grafting is performed prior to implant placement, as the implant requires sufficiently dense bone in order to fuse properly. Once the bone tissues have been built up to the point that they can support the titanium implants, the patient can proceed with the treatment. After the implants fuse with the jawbone, the gum graft procedure will be performed to ensure that the implant is surrounded by snugly conforming periodontal tissue, as a natural tooth would be. The body will then receive the signal that the hard and soft tissues are once again serving an important purpose, and they will thrive.

The Procedure

Periodontal tissue is remarkably similar to the tissues of the hard palate (or roof) of the mouth. In performing gum graft surgery for his Scottsdale dental implants patients, Dr. Guyette removes a small amount of tissue from the hard palate, prepares it, and then sutures it to the area around the implant. Within two weeks, this grafted material will heal into place, and the sutures can be removed. Gum graft surgery helps to reduce the risk of infection, post-procedural pain, and implant failure.

Contact Dr. Robert Guyette

If you would like to learn more about gum graft surgery, or if you are a dentist looking to work with an experienced oral surgeon in the Scottsdale area, please contact Dr. Robert Guyette today.