Dr. Maneesh Rai, Dentist, Bhopal

Subtitle

Oral Surgery

Extraction

EXTRACTION OF TEETH

 

One of the main goals of modern dentistry is the prevention of tooth loss. All possible measures should be taken to preserve and maintain your teeth because the loss of a single tooth can have a major impact upon your dental health and appearance. However, it is still sometimes necessary to remove a tooth. Here are some of the reasons a tooth may need to be extracted.
 

  • Severe Decay
  • Advanced periodontal disease
  • Infection or abscess
  • Orthodontic correction
  • Malpositioned teeth
  • Fractured teeth or roots
  • Impacted teeth
If you've just had a tooth extracted or your dentist has recommended that a tooth be extracted, the following information will help you get through the first few days after your extraction. Should anything occur that seems out of the normal, do not hesitate to call your dentist.

 

POSTOPERATIVE INSTRUCTIONS

 

  • DO NOT DISTURB THE WOUND : In doing so you may invite irritation, infection and/or bleeding. Be sure to chew on the opposite side for 24 hours and keep anything sharp from entering the wound (i.e. eating utensils etc. ).

     
  • DO NOT SMOKE FOR 12 HOURS:: Smoking will promote bleeding and interfere with healing.

     
  • BRUSHING: Do not brush your teeth for the first 8 hours after surgery. After, you may brush your teeth gently, but avoid the area of surgery.

     
  • MOUTH WASH: Avoid all rinsing for 24 hours after extraction. This is to insure the formation of a healing blood clot which is essential to proper wound healing. Disturbance of this clot can lead to increased bleeding or the loss of the blood clot. If the clot is lost, a painful condition called dry socket may occur. You may use warm salt water or mild antiseptic rinses after 24 hours only if prescribed.

     
  • DO NOT SPIT OR SUCK THROUGH A STRAW: This will promote bleeding and may dislodge the blood clot causing a dry socket.

     
  • BLEEDING: When you leave the office, you will be given verbal instructions regarding the control of postoperative bleeding. A rolled up gauze pad will be placed on the extraction site and you will be asked to change this dressing every 20 minutes or so depending on the amount of bleeding that is occurring. It is normal for some blood to ooze from the area of surgery. We will also give you a package of gauze to take with you to use at home if the bleeding should continue. Should you need to use the gauze at home, remember to roll it into a ball large enough to cover the wound. Hold firmly in place, by biting or with finger pressure, for about 20-30 minutes. If bleeding still continues, you may fold a tea bag in half and bite down on it. Tea contains Tannic Acid , a styptic, which may help to reduce the bleeding. Please be sure to inform us prior to your appointment if you have bleeding problems or are taking blood thinning medications such as Warfare or Aspirin.

     
  • PAIN :Some discomfort is normal after surgery. Analgesic tablets ( i.e. Aspirin, Tylenol etc. ) may be taken under your dentist's direction. Prescription medication, which may have been given to you, should also be taken as directed. If pain continues, call your dentist.

     
  • SWELLING : This is normal following surgical procedures in the mouth.  After 2-3 days, the swelling should begin to recede.  If swelling persists or interferes with your ability to eat or talk or swallow, do not hesitate to call our office.To prevent swelling, apply an ice pack or a cold towel to the outside of your face in the area of the extraction during the first 12 hours. Apply alternately, 20 minutes on then 20 minutes off, for an hour or longer if necessary.

     
  • DIFFICULTY IN OPENING MOUTH: You may have difficulty opening your mouth. This is because the jaw muscles become stiff from holding your mouth open during surgery. It usually lasts 3 to 4 days. Massage the jaw muscles gently. Apply moist heat for 10 minutes, remove for 10 minutes and repeat. Eat soft nutritious food like eggs, milk shakes, juices, soup (warm, not hot),pasta,rice,idlis, bananas. Do not force your mouth open.

     
  • DIET:As stands to reason, liquid and soft foods are recommended for the first couple days (i.e.- milkshakes, yogurt, soups, mashed potatoes, bananas...)  Also, please take all medications as directed, since they are prescribed to not only control discomfort, but to reduce swelling and infection.  It is a very good idea to begin taking medications prior to the numbness wearing off to allow you a smooth transition and comfort. Eat normal regular meals as soon as you are able after surgery. It is also important to drink plenty of fluids.

     

    REPORT ANY UNUSUAL OCCURRENCES IMMEDIATELY !
     
    If you have any questions regarding these directions, call your dentist for clarification.

Wisdome Teeth (3rd Molars)

There is much folklore regarding wisdom teeth and their removal. Below we will explain the problems associated with them and the different treatment options avialable.
 
 
Frequently Asked Questions

At what age are they likely to cause problems?

Wisdom teeth commonly cause the majority of problems during the late teens and early twentys as it is during this period that they are erupting. After age 25 there is a much lesser likelyhood of problems occuring.

Why do we have problems with wisdom teeth?

Due to the way we have evolved we have shorter jaw bones but still the same number of teeth. Space is limited at the back of the mouth and as the wisdom teeth are the last to erupt they may become impacted. The term impacted means that they become jammed in between the second molars and the bone at the back of the jaw and cannot therefore erupt fully. When the tooth is partially erupted a gum flap extends over the crown of the tooth. Bacteria and food get stuck underneath this flap which makes the area become inflammed and swollen.

The gum flap on this tooth has collected bacteria and plaque underneath it. This makes it sore and it swells up and becomes red. This condition can become so severe that the jaw becomes swollen and there is difficulty in opening the mouth. The immediate treatment is to give antibiotics which will reduce the swelling and pain. The technical name for this condition is 'pericoronitis'.
 
Will I have to go to hospital to have them taken out?

This all depends on how deep the wisdom teeth are within the jaw. If the majority of the tooth is above the gum then any dentist should be able to remove them without much problem. Many 'impacted' teeth may need to have bone removed in order to extract them as the bone partially covers the top of the crown. This is may be carried out in clinic under Local anaesthesia or a hospital under a general anaesthetic.

Are there any risks involved?

Occasionally a nerve may be damaged when removing a wisdom tooth. This may result in a numbness of the lower lip which may last for upto 6 months though in some cases it could remain for good.

How can I avoid problems with my wisdom teeth?

Pain with wisdom teeth is usually started by a plaque build up around the gum flap which partially covers the tooth. This may occur because it is a difficult area to reach with a toothbrush and is easily overlooked during toothbrushing. By brushing in front of a mirror, you can see where you are actually brushing thereby making sure that you don't miss any area. Many patients who, after attending with 'pericoronitis' have taken this advice don't have any further problems .

The use of a mouthwash may also help. Chlorhexidine mouthwash is recommended for short term use with pericoronitis. Care should be taken though as this mouthwash may cause staining of the teeth if toothbrushing is not carried out beforehand as it reacts with the plaque.

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