Oral Surgery

Tooth extractions are the most common procedure performed by oral surgeons. Besides the extraction of teeth, many other types of surgical procedures may be needed to ensure health and provide a suitable restoration for a healthy dentition. Oral Surgeons, or Oral and Maxillofacial Surgeons are qualified Dentists who have completed an additional 4-6 years of surgical residencies and whose offices are equipped to handle more complex dental cases.

Patients who are more anxious may need an oral medication that is stronger than nitrous oxide. With oral sedation, the patient may be sleepy but can be aroused and will respond to simple commands. Minor side effects such as nausea or vomiting can occur with some medications. Before a visit in which a patient is to receive oral sedation, he/she will receive instructions about eating and drinking, what to expect and what to watch for after treatment. You will need assistance to get home after sedation.

Crown lengthening is a surgical procedure that re-contours the gum tissue and often the underlying bone of a tooth. Crown lengthening is often for a tooth to be fitted with a crown. It provides necessary space between the supporting bone and crown, which prevents the new crown from damaging bone and gum tissue.

When the extraction of a tooth is required:

1. An incision in the gums is made
2. The tooth is removed
3. The area is stitched up and is allowed to heal

During this time, it is important to think about a tooth replacement option. An extracted tooth leaves an open area in the jaw which, in time, allows the neighboring teeth to drift into the area where the tooth was extracted. This in turn, causes a chain reaction to all the surrounding teeth. Also, if you are considering placing an implant in the future, you should consider asking your dentist to place a bone graft at the time of surgery to preserve the bone width and height.

1. DO NOT RINSE MOUTH TODAY
   Tomorrow rinse mouth gently every 3 to 4 hours (especially after meals) using one quarter teaspoon of salt to a glass of warm water. Continue rinses for several days.
2. BLEEDING
   Following extractions, some bleeding is to be expected. If persistent bleeding occurs, place gauze pads over bleeding area and bite down firmly for one-half hour. Repeat if necessary.
3. SWELLING
   Ice bag or chopped ice wrapped in a towel should be applied to the operated area; one-half hour on, and one-half hour off for 4-5 hours.
4. PAIN
   For mild to average pain, use any non-aspirin type of medication you like. If the doctor prescribes a specific pain medication, follow the instructions and do not mix with other medications unless approved by your doctor.
5. FOOD
   Light diet is advisable during the first 24 hours.
6. BONY EDGES
   Small sharp bone fragments may work up through the gums during healing. These are not roots; if annoying, return to our office for their simple removal.
7. If any unusual symptoms occur, call the office at once.
8. The proper care following oral surgical procedures will hasten recovery and prevent complications.

Fold a piece of clean gauze into a pad thick enough to bite on and place directly on the extraction site. Apply moderate pressure by closing the teeth firmly over the pad. Maintain this pressure for about 30 minutes. If the pad becomes soaked, replace it with a clean one as necessary. Do not suck on the extraction site (as with a straw). A slight amount of blood may leak at the extraction site until a clot forms. However, if heavy bleeding continues, call your dentist. (Remember, though, that a lot of saliva and a little blood can look like a lot of bleeding.)

The Blood Clot

After an extraction, a blood clot forms in the tooth socket. This clot is an important part of the normal healing process. You should therefore avoid activities that might disturb the clot.

Here's how to protect it:

• Do not smoke, rinse your mouth vigorously or drink through a straw for 24 hours.
• Do not clean the teeth next to the healing tooth socket for the rest of the day. You should, however, brush and floss your other teeth thoroughly. Gently rinse your mouth afterwards.
• Limit strenuous activity for 24 hours after the extraction. This will reduce bleeding and help the blood clot to form. Get plenty of rest.
• If you have sutures, your dentist will instruct you when to return to have them removed.

Medication

Your dentist may prescribe medication to control pain and prevent infection. Use it only as directed. If the medication prescribed does not seem to work for you, do not increase the dosage. Please call your dentist immediately if you have prolonged or severe pain, swelling, bleeding, or fever.

Swelling & Pain

After a tooth is removed, you may have some discomfort and notice some swelling. You can help reduce swelling and pain by applying cold compresses to the face. An ice bag or cold, moist cloth can be used periodically. Ice should be used only for the first day. Apply heat tomorrow if needed. Be sure to follow your doctor's instructions.

Diet

After the extraction, drink lots of liquids and eat soft, nutritious foods. Avoid alcoholic beverages and hot liquids. Begin eating solid foods the next day or as soon as you can chew comfortably. For about two days, try to chew food on the side opposite the extraction site. If you are troubled by nausea and vomiting, call your dentist for advice.

Rinsing

The day after the extraction, gently rinse your mouth with warm salt water (teaspoon of salt in an 8 oz. glass of warm water). Rinsing after meals is important to keep food particles away from the extraction site. Do not rinse vigorously!