Services

Opening practice in 1981, Dr. Crayton R. Walker DDS, MD has 30 years of experience. We proudly provide care for children, adults, and seniors. Dr. Walker understands the need for consistent care. We treat each patient like family. Our compassionate, professional staff is dedicated to providing the highest level of care possible. Because we are dentist and physician owned, we are patient driven. This means that we can focus more on providing excellent care, and less on the bottom line. We provide effective care that is responsive to the needs of the community of Salt Lake City and the surrounding areas. Being independently owned means that we are able to focus on you!

Although we do offer same-day appointments when available, we encourage making appointments as far in advance as possible. Our friendly staff will be happy to answer any questions you have regarding scheduling and payment arrangements.

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1060 East 100 South Suite 204
Salt Lake City, Utah 84102
Phone: 801-322-5423
Fax: 801-364-9437

Wisdom Teeth

Pain in the jaw, swelling overlying the wisdom tooth, infection in the jaw, and crowding of the erupted teeth.

A clinical examination and Panorex X-ray will help determine if there is room for eruption and normal occlusion of these teeth.  If they are impacted in the jaw and not erupted, they should be surgically removed.

This surgery is best done by an oral surgeon because we have four to seven years of additional surgical training beyond dental school to better provide this surgical service.  This surgery can usually be performed under light general anesthesia providing the most comfortable and safest experience for the patient.

Most of these advertised discount providers are general dentists that provide this service.  They lack the post-graduate extensive surgical training to better provide this service.  This additional training many times prevents the potential complications from this surgery, including post-operative swelling, infection, pain, and nerve damage to the tongue, lower lip and chin.  Should any of these problems develop, more expenses including further surgery and hospitalization may become necessary.  It is best to try to avoid these potential problems.

Dr. Walker has graduated from both dental school and medical school.  He has completed a one-year internship in anesthesiology and a four-year residency in oral and maxillofacial surgery.  He is Board Certified by the American Board of Oral and Maxillofacial Surgery and has thirty years of private practice experience.

Temporo Mandibular Joint (TMJ)

Patients with TMJ problems can have pain overlying their TM joints, pain and limited opening of their mouths, pain in their ears, ringing of their ears and radiating pain to their neck, back and shoulders.  They can also have chronic headaches which may mimic “migraine type headaches.”

Treatment is best performed after a thorough history and clinical examination is performed.  This may also involve x-ray imaging of the TM Joints with Panorex x-ray, Cone-Beam scans and possibly MRI x-rays of the TM Joints.

Treatment for these problems generally starts with conservative therapy.  This includes TM Joint bite splint therapy, physical therapy and possible trigger point injections to the face and neck.  Muscle relaxants and pain medications are usually utilized.  Sometimes psychological counseling is recommended.  Most patients respond well to this conservative therapy.

Should conservative therapy fail, than consideration for possible surgical intervention may be indicated.  The details of this surgery are best determined after MRI x-ray imaging of the TM Joints.  This surgery could include conventional repair of the meniscus and surgical removal of scanning and joint adhesions.  If severe arthritis and joint destruction is present, this may include partial joint replacement or total joint replacement of the temporomandibular joint.  This surgery is similar to surgical reconstruction of the knee or hip joint with prosthetic joint replacement.

Dr. Walker has been performing these different surgical procedures for over 30 years’ time.  He is a recognized expert in these temporomandibular joint surgical procedures and has published papers in the medical literature concerning these TM Joint surgical procedures.

As a graduate of both dental and medical school and completion of a four-year residency in Oral and Maxillofacial Surgery, this better helps me understand the many different problems causing patients to have TMJ pain.

Some of these are dental problems with malocclusion of the teeth, excessive grinding or wearing of the teeth, and muscle spasms, which are present.

Other medical concerns are patients with degenerative arthritis and rheumatoid arthritis. Patients with cysts and tumors of the jaws can also have chronic pain. Other times, psychological issues and problems can mimic, these same pain issues and TM Joint problems.

Seeing patients with these TMJ problems over the last 30 years’ time, better helps me establish an accurate diagnosis. Treatment options can then proceed, based on these diagnostic treatment findings.

Dental Implants

Dental implants are titanium dental posts that are surgically placed into the jaws to replace previous missing or lost teeth.  Typical uses for dental implants in the jaws are the following:

  1. Replacement of one or more missing or lost teeth
  2. Placement of dental implants to avoid cutting down adjacent and healthy teeth, with conventional dental bridgework.
  3. Stabilization of complete maxillary or mandibular complete dentures.
  4. Stabilization of maxillary or mandibular partial dentures.
  5. Replacement of multiple missing teeth with dental fixed bridgework.  This avoids going to partial or complete dentures, which are taken in and out of the mouth.

There needs to be adequate bone present in the jaws before dental implants are placed. Should the bone not be adequate, then bone grafting with synthetic bone may be necessary, before dental implant placement.

Normally dental implant surgery is a two-step process. The first surgery involves surgical placement of the dental implant into the jaw. The implant is left in place for typically three months time for the implant to become fused or osseous integrated into the jaws.

Next the second stage surgery is performed with exposure of the dental implant head and placement of a gingival healing cuff. After this, restoration of the dental implant with the restorative dentist can begin.

Occasionally, the first and second stage surgery can be performed on the same day with the patient “getting their teeth in one day.” This depends on the quality of the bone and size of the dental implant that can be placed. Immediate loading of the dental implant lowers the overall long-term percentage success for the implant procedure, from 96% to 80-85%.

Dental Implant surgery can best be performed from an oral and maxillofacial surgeon. I have been involved with dental implant surgery and bone grafting over the last thirty years’ time. The best overall results for the patients, are obtained with a coordinated treatment plan between the patient, oral surgeon and restorative dentist.

Corrective Jaw Surgery

Corrective Jaw Surgery is when surgical repositioning of the upper jaw (maxilla) and lower jaw (mandible) for better function and occlusion of the patients’ teeth. Most patients requiring this jaw surgery will have been seen by an Orthodontist for correction of their bite (mal-occlusion). When orthodontic’s alone will not correct the patients’ bite, further evaluation with possible jaw surgery may be necessary. This is because the jaw alignment needs to be satisfactory for the best results to be obtained from the orthodontics.

This jaw surgery is performed under general anesthesia either in an outpatient surgical facility or in the Hospital based upon the magnitude of the surgery needed to correct the jaw problem.

This corrective jaw surgery, may also improve the patients’ facial appearance and facial profile. These cosmetic benefits are in addition to the functional benefits obtained with correction of the patients jaw relationship and bite.

My training as both a dentist and physician along with my training as an Oral and Maxillofacial Surgeon helps me better understand the degree of the jaw problems and what can be done to correct these problems.

My surgical training along with 30 years private practice experience have more than qualified me to provide the best treatment possible for these patients. I generally try to provide the least surgery possible, to gain the greatest positive results for the patient. This generally provides less surgery for the patients, less surgical costs, and quicker recoveries for these patients.

Cosmetic Facial Surgery

Cosmetic Facial Surgery is part of my practice in Oral Maxillofacial Surgery. These procedures are cosmetic in nature to “turn back the clock of time.”

Some of these procedures are considered minimally invasive procedures, performed in the office with minimal anesthesia. Two of these main procedures are the injection of collagen facial fillers and Botox (botulinum toxins) injections. Both of these are well suited to either younger patients who desire a small procedure or older patients who desire a “small change” to their face.

Botulinum toxins – Botox – are used to treat skin wrinkles and forehead functional lines of the face. The Botox deactivates the hyper functional muscles on a selective basis depending on where it is injected. It can be used on the forehead to deactivate the forehead muscles preventing the patient from scowling of the eyebrows, with the forehead wrinkles. It can also be used around the mouth, to diminish the vertical “lipstick lines” of the upper and lower lips.

Botox is also used at times, to diminish the muscle function of patients with excessive jaw clenching and masseter muscle hypertrophy.

Botox is also used for patients with a history of migraine headaches and temporalis muscle hyper function.

The effects of Botox gradually wear off over approximately 7 – 9 months time. These injections need to be repeated, for best long-term best results.

Cosmetic facial fillers have improved greatly since originally coming on the market in the year 2000. The Hyaluronic acid based injectable fillers, are used to give added volume to the face, as it ages. They can be utilized to smooth out wrinkles and increase the prominence of the upper and lower lips.

Younger patients desire volume augmentation to simply have bigger lips. Older patients require more comprehensive filler injections, to provide volume enhancement, better lip definition and less perioral wrinkles around the mouth.

The clinical effect of the injectable fillers slowly fades with time, and will need to be repeated in 12 – 18 months time. With repeat injections, usually less filler is required again for optimal results.

More major cosmetic surgical procedures include laser skin resurfacing of the face with a CO2 laser, facial liposuction and chemical peels. Cosmetic Zygomatic and Chin implants can also be performed. These surgical procedures are more major in nature requiring IV sedation and/or general anesthesia. There is post-operative down time, after these procedures, before the patient is able to return to work or their normal activities.

The cosmetic procedures available in my office are “customized to each patients desires” depending upon what cosmetic issues are being addressed, for best treatment results for the patient.

Anesthesia / IV Sedation

Many oral surgical procedures can be performed in the office with nitrous oxide sedation and local anesthesia. This provides some sedation for the patient during the surgical procedure, but avoids any long-term anesthetic effects for the patient. Patients can drive their car after these procedures and return to work.

The option for IV Sedation / Light General anesthesia is also available in the office on an outpatient basis. With this anesthesia, the patient lightly goes to sleep during the surgical procedure. Patients need to have nothing to eat or drink for six hours prior to the surgical procedure and have someone to drive them home after the surgical procedure. They will not be able to return to work the day of their surgical procedure.

These different anesthesia options are available to make your experience and surgical procedure as “painless as possible” for you the patient.

Dr. Walker has completed a medical internship in Anesthesiology and a four-year residency in Oral and Maxillofacial Surgery. He has provided outpatient anesthesia services in his office for over thirty years’ time. He is an expert in providing these anesthesia services, in a safe and affordable way for you, the patient.

Sleep Apnea

Sleep Apnea is many times an unrecognized medical problem. Mild forms of sleep apnea can simply be loud snoring. This usually affects the bed partner and those around you, with the increased noise.

Patients with sleep apnea have their posterior pharynx (throat) become blocked while sleeping. This can lead to gasping or snorting in your sleep. Patients can wake up tired after a full nights’ sleep, and have problems with daytime sleepiness, and falling asleep in the day while driving their car. Many times these patients have a chronic headache, problems with their memory and concentration, and may be cranky or short-tempered with their behavior.

Patients with sleep apnea have excessive daytime sleepiness, chronic hypertension and ischemic heart disease. They also have a greater incidence for having a stroke. Patients with OSA also have an increased incidence of cardiac arrhythmia during sleep, leading to sudden death.

It is important to get treated, to have a better nights rest and avoid daytime sleepiness. Treatment is also necessary to prevent the serious medical problems caused from obstructive sleep apnea (OSA).

The first step in possible treatments for sleep apnea involves an accurate diagnosis. As an Oral and Maxillofacial Surgeon, I am uniquely qualified to evaluate the teeth and the patients’ bite, along with evaluation of the tongue size and size of the posterior airway space. This diagnosis may also include x-ray imagining with a Panorex x-ray, cephalometric x-ray and analysis, and Cone Beam Scan. An overnight screening pulse oximetry evaluation may also be performed.

I also work with Pulmonary Sleep Medicine Specialists. This medical evaluation including formal overnight sleep study may also be performed.

Nonsurgical Treatments:

Pulmonary Sleep Medicine Specialists may recommend the use of a CPAP appliance. This provides air with possibly oxygen supplementation, to be forced thru the nose down the posterior pharynx and into the lungs for better overall breathing at night. The use of the CPAP appliance take getting use to by the patient when sleeping. Some people have a hard time getting use to the CPAP nasal mask when using this equipment.

A mandibular dental sleep appliance may also be fabricated to advance the mandible forward while sleeping at night. This usually provides better breathing for the patient and may eliminate the need for use of the CPAP appliance at night. There are multiple different dental sleep appliances that can be used to advance the mandible forward while sleeping. The best appliance for each patient, is determined after a complete examination has been performed.

Life style changes including losing weight, eliminating the use of alcohol and sedatives, not eating heavy meals late at night and avoiding supine sleeping positions are all helpful.

Surgical Options

Surgery for obstructive sleep apnea may be indicated should nonsurgical therapy fail to correct the problems.

LAUP and UPPP procedures remove the uvula and part of the soft palate opening the posterior airway pharyngeal space. The LAUP procedure is performed with IV sedation in the office, on an outpatient procedure. The UPPP is performed in the Hospital under general anesthesia. Both procedures can be effective to correct or cure the OSA (obstruction).

Maxillary and mandibular osteotomies of the jaws – moving the jaws forward and opening the posterior airway space are sometimes recommended for treatment of the OSA. These surgical procedures are usually only considered when less invasive surgical procedures have first been tried. This would best be determined after a complete sleep evaluation has been completed determining the severity of the obstructive sleep apnea.