Last Resort!
Extraction
Extraction must be considered as the last option for severely damaged teeth.It should be known that alveolar bone starts to resorb after extractions. Therefore, if it is planned to place a dental implant to the extraction site it is very important to use a bone preservation protocol just after the extraction. This approach will eliminate or minimize bone resorption and increase the implant success rate.
The extraction decision in orthodontic treatments must be taken after detailed clinical and cephalometric analysis of the patient. It must be known that the fixed treatment technique used by the orthodontist has also an important role in extraction decision. As a general rule, it must be avoided to perform extractions to force patient’s values to the population norms
If your orthodontist asked for the removal of your wisdom teeth, these extractions must be done as soon as possible to ensure the stability of your teeth.
About!
Wisdom Teeth
Wisdom teeth are the third and final set of molars that most people get in their late teens or early twenties. Sometimes these teeth can be a valuable asset to the mouth when healthy and properly aligned, but more often, they are misaligned and require removal.
Wisdom teeth are the third and final set of molars that most people get in their late teens or early twenties. Sometimes these teeth can be a valuable asset to the mouth when healthy and properly aligned, but more often, they are misaligned and require removal.
Wisdom teeth also can be impacted — they are enclosed within the soft tissue and/or the jawbone or only partially break through or erupt through the gum. Partial eruption of the wisdom teeth allows an opening for bacteria to enter around the tooth and cause an infection, which results in pain, swelling, jaw stiffness, and general illness. Partially erupted teeth are also more prone to tooth decay and gum disease because their hard-to-reach location and awkward positioning makes brushing and flossing difficult.
Impacted Teeth
When a permanent tooth does not fully erupt, or does not erupt at all, the tooth is impacted. This is a relatively common occurrence, and for some people, an impacted tooth does not cause any problems. For others,an impacted tooth may result in pain, bite misalignment and other complications.
A tooth can become impacted for a variety of different reasons. A tooth may not erupt or only partially erupt if the mouth is already overcrowded. If your jaw lacks sufficient room for additional teeth, it can prevent the tooth from fully erupting. Another possible cause for impaction is the displacement of the tooth. It may begin to emerge at an odd angle, which can prevent full eruption.
An orthodontist should examine you before the extraction decision of the impacted tooth. Some of the impacted teeth may erupt by means of the orthodontic treatment.If this is not possible, extraction of the impacted tooth may be required.
When residuals of a tooth root remain as the result of an incomplete prior extraction, the removal of this residual root must be done before any other dental procedure.
Residuals of Tooth Root
From a procedural standpoint, the surgical extraction of a residual tooth root is a straightforward event. Your dentist will provide local anesthetic to numb the area, or if you are overly anxious about the procedure, analgesia may be administered. Then, your dentist will make an incision along your gumline, creating what is known as a “surgical flap.” This “flap” of tissue allows a dentist to gain access to the bone along the side of the jaw that is encasing the tooth root.
Once the tooth root has been removed, and depending on your next steps for care, your dentist may conduct a tooth socket graft to prevent bone resorption that begins rather immediately after the loss of a tooth, or simply allow the opening in the gum to heal on its own as with wisdom tooth extraction. An immediate, or, future dental implant, may also be performed or recommended.
Apical Resection
Apical surgery is considered a standard oral surgical procedure. It is often a last resort to surgically maintain a tooth with a periapical lesion that cannot be managed with conventional endodontic treatment. The main goal of apical surgery is to prevent bacterial leakage from the root-canal system into the periradicular tissues by placing a tight root-end filling following root-end resection.
After Extraction
- Bite on the gauze pads during 30 minutes after extraction.
- Do not eat for the first two hours. If necessary , you may drink water after 30 minutes.
- Do not drink on a straw. Use a glass to drink if necessary.
- Do not spit saliva instead swallow your saliva for the next 48 hours after extraction.
- Do not consume hot foods and drinks in the first day.
- Smoking may increase the bleeding and may alter the healing. Do not smoke at least for the first 72 hours.
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Do not spit or rinse excessively or engage in physical activity since this stimulates bleeding.
Some oozing could last up to 24 hours. - If heavy bleeding persists for more than 48 hours, contact the dentist for further review.
Contact The Doctor If:
- Bleeding is excessive and cannot be controlled.
- Discomfort is poorly controlled.
- Swelling is excessive, spreading , or continuing to enlarge after 48 hours.
- Allergies or other reactions to medications occur.
After Surgery
Bleeding: Biting on the gauze pads will probably be necessary at least for the first few hours to control bleeding. Keep the head elevated and rest. Do not spit or rinse excessively or engage in physical activity since this stimulates bleeding. Some oozing could last up to 24 hours. If heavy bleeding persists, replace the gauze with a clean folded gauze pad over the surgery site and maintain pressure until the bleeding stops. Call your doctor if bleeding doesn’t stop or is heavy for too long
Swelling: This is normal following a surgical procedure in the mouth. It should reach its maximum in 48 hours and then diminish by the fifth post operative day. The anti-swelling medicine we usually give cuts it way down to less than of what it would normally be. Place cold compresses (not ice) on the face in the region of the surgery for ten minutes every half hour for the first eight to 12 hours. Cold compresses is only effective on the day of surgery.
Discomfort: The most discomfort that you will experience will occur as the anesthetic wears off (usually 1-2 hours after surgery). Do not wait for the pain to become severe before taking the medications since the medicine will require 30-45 minutes to take effect. Pain will gradually diminish over the next few days.
Diet: A nutritious liquid diet is necessary for the first day. Hard foods eaten while you are numb can dislodge the gums that were lifted up and then sutured in place. When the numbness wears off , you can gradually progress to harder foods. Especially in the first three months after surgery, you should take care of your diet to improve osseointegration of the implant.Take Vitamin C from natural sources like fresh juices, kiwi , strawberry , orange, grapefruit and apple. Consume milk and yogurt.
Smoking: If you smoke , avoid smoking during the first week after surgery.
Activity: For the first 24-48 hours , you should rest in head up position. Patients who have sedation should refrain from driving an automobile or from engaging in any task that requires alertness for the next 24 hours.
Starting The Day After Surgery:
- Brush teeth but avoid the surgery area. As healing takes place , you can gradually brush teeth near the surgery site. For the first weeks , use a soft toothbrush or soften the bristles by placing them under hot water.
- Use warm salt water as a mouth rinse 3-5 times per day for 5-7 days after surgery.
- If antibiotics are prescribed , be sure to take them all as directed. They can render birth control pills ineffective.
- Don't chew hard (even on a hard crust of bread or on ice) for 4-6 weeks or participate in sports where you may hit in the jaw.