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Healing after Extractions and Oral Surgery

After one or more teeth have been removed, you will want to do all the right things for the area to heal quickly and smoothly. This requires that a blood clot is formed. The blood clot covers the extraction site and allows the area to heal. A lot of the tips below help the blood clot to form properly and not become dislodged.

Do’s:

  • It is normal for the area to be tender for the first few days, and in most cases simple over-the-counter pain relief is enough to ease any discomfort. Start taking painkillers immediately afterwards – don’t wait until pain sets in! It’s far easier to prevent pain than to make it go away. The usual painkillers of choice are ibuprofen or ketoprofen (some products have codeine added for extra pain relief). Check with your dentist or another health care provider that you can take these (for example, asthma sufferers shouldn’t). If you can’t, your dentist will be able to recommend an alternative. Avoid disprin (aspirin) as this thins the blood and can make your mouth bleed. Check with your dentist or pharmacist if you feel you need something stronger.
  • Go home, take it easy for the rest of the day, and don’t exercise for at least 12 to 24 hours. If you want to lie down, and for the first night following surgery, keep your head up with pillows if possible. Do not bend over or do heavy lifting for 2-3 days.
  • If you still feel numb 6 hours later, call your dentist or oral surgeon! If you get back in within 24 hours, your oral surgeon can inject some steroids into the nerve area, which can help reduce swelling and may help speed recovery. Prolongued numbness can also be due to a longer-lasting local anaesthetic (marcaine) – in this case, the effect is intentional, but your oral surgeon should have specifically told you that they’ve used this.
  • Your dentist should let you know how to control any bleeding. Usually, a gauze pad will be placed on the area, and you should try and keep firm pressure on it. You should change this dressing about every 30 to 45 minutes, depending on the amount of bleeding. WARNING: Some people are freaked out by the amount of blood. Relax – a small amount of blood is mixed with a larger amount of saliva (or “spit” in dentist speak), which can make it look a lot more dramatic than it is! Many dentists will give you a package of gauze to take home with you, but you may want to buy some gauze beforehand. If you need to use it, fold the clean gauze into a pad, thick enough to bite on, then moisten it and place it directly on the extraction site. Hold the gauze firmly in place, by biting down on the pad or using finger pressure, for about half an hour to an hour. If this doesn’t stop the bleeding, moisten a tea bag with water and fold it in half and bite down on it for 30 minutes (the tannic acid in black tea helps stop bleeding). Some slight bleeding for the first day or so is normal. But if you still bleed more heavily after an hour or two, contact your dentist.
  • While you shouldn’t rinse for the first 24 hours, after this initial period you should gently rinse 4 times a day using warm salt water (1 teaspoon of salt in a glass of warm water). Do not spit out forcefully! Rinse after every meal and snack, making sure that the water removes any bits of food around the area where the tooth is missing.
  • Your dentist may also advise you to use chlorhexidine mouth rinse (Corsodyl in the UK, available in pharmacies, Peridex in the US, prescription-only) for 10 days or so following surgery. This kills bacteria.
  • Be careful not to dislodge the blood clot when brushing near the extraction site for 3-4 days. You can carefully wipe the area with a clean, wet gauze pad. If you can’t get a toothbrush into your mouth due to swelling or discomfort (after wisdom tooth removal), chlorhexidine mouthwash (see above) is a handy adjunct.
  • Stick to a liquid or soft food diet for the first day or two. Examples include soups, yoghurts, fruit milkshakes, smoothies, mashed potatoes, etc. A Vitamin C supplement may also be helpful. Avoid spicy foods, hot drinks and sodas for 3-4 days, to prevent irritation and burns.
  • If you’ve been prescribed antibiotics, follow the instructions and make sure you finish the course.
  • Swelling and sometimes bruising can occur after surgery, esp. with so-called “wisdom teeth” (short for wizzies). The worst swelling, pain and jaw stiffness normally occurs 2 or 3 days after surgery. On the day of the surgery, apply ice packs for 15 minutes on then 15 minutes off until bedtime. This will keep swelling to a minimum. Also keep your head elevated until bedtime. Moist heat after 36 hours may help jaw soreness. Arnica (a homeopathic treatment available from pharmacies and health stores) can be taken orally and/or as a cream to help with the swelling.
  • After wizzie removal, try to gently keep stretching your mouth open to get it moving again. It can be tempting just to not open it wide at all, but that can lead to permanent limitated opening (“trismus”). Don’t overdo it, though!
  • If you can get hold of it in time, chlorine dioxide gel is great for post-op healing after extractions and anything which might leave your gums a bit sore. It’s also great for oral ulcers and burns. Unfortunately, it’s not sold in shops, so unless your dentist sells it, Oxyfresh Dental Gel is only available by mail order.

Don’ts:

  • Don’t be tempted to rinse the area for 24 hours after tooth removal.
  • Avoid hot food or drinks until the numbing wears off. You cannot feel pain while you’re numb and may burn your mouth. Also take care not to accidentally chew your cheek!
  • Don’t poke at the extraction site! – keep your fingers and tongue away from this area.
  • Avoid sucking (ahem… through straws and stuff), spitting, and blowing your nose (unless you have to). This is because positive or negative pressure could dislodge the blood clot. If you have a cold or allergies or anything that will want you blow your nose or sneeze, take appropriate medications to treat these.
  • Try not to smoke for as long as possible afterwards, but at the very least for the rest of the day. Smoking can interfere with the healing process, and also the sucking motion could dislodge the blood clot.
  • Avoid alcohol for 24 hours, as it could delay the healing process.

The Healing Process:

It usually takes gum tissue about 3-4 weeks to heal. The bone can take up to 6 months to heal completely. However, pain should be lessening by the second day. But it varies from person to person, and also depends on how easy or difficult the tooth removal was.

“There’s a piece of bone coming out where the tooth has been pulled!”

You may feel the sharp edge of the socket with your tongue and sometimes, little bits of bone may make their way to the surface and work their way out. This is perfectly normal and harmless. If a small bit of bone is annoying you and you don’t want to wait until it comes out by itself, you can ask your dentist to remove it for you.

“I’m still in pain. What should I do?”

Pain that lasts for up to a week or so but is gradually getting better is normal. You could ask your dentist or pharmacist for stronger painkillers.

Pain that starts to get worse after two days is considered abnormal and you may want to see your dentist. This could be a sign of “dry socket”.

Dry Socket

A dry socket occurs when the blood clot for healing becomes dislodged or doesn’t form. In that case, the bone and fine nerve endings are not protected and exposed to air, food, and liquids. Dry socket delays the healing process and can be very painful.

If you suspect dry socket, see your dentist. S/he will place a medicated dressing in the socket which will almost instantly relieve pain. If the area is infected, your dentist may also prescribe a course of antibiotics. The medicated dressing should be changed every day or two at the start, and then at longer intervals. Though some dressings are designed to stay in and dissolve by themselves.

If you follow the “do’s” and “don’ts” above, you’ll minimize your chances of getting dry socket.

“My dissolvable stitches aren’t dissolving!”

This is a common problem with dissolving stitches. You can get your dentist to remove them if they don’t come out by themselves. Many people are worried about the removal of the stitches (whether dissolvable or not) but it is an entirely painless process and you don’t need any numbing for it:

“I had them removed after 10 days so needed to cut them to take them out – cut is the wrong word it was more of a ‘snip’, I had about 6 to 8 ‘snips’ altogether for 13 extraction sites – then gently using a pair of tiny tweezers pulled them out with barely any feeling at all, kind of a little tug – please note there was NO PAIN what so ever and it took seconds.”

“just a small pinch and that was it”

“everyone was right, it wasn’t painful, just felt like a tug”

“I just felt a tiny bit of tugging”

factsheets

  • Prophylaxis

    Prophylaxis is any medical or public health procedure whose purpose is to prevent, rather than treat or cure, a disease or other medical issue. In general terms, prophylactic measures are divided between primary prophylaxis (to prevent the development of a disease) and secondary prophylaxis (whereby the disease has already developed and the patient is protected against worsening of this process).

    Dental prophylaxis is the first step in the treatment of caries and periodontosis. Professional prophylaxis systematically carried out at the clinic with the patient’s adaptation to the guidelines for daily care ensure healthy teeth and gums, and thus a beautiful smile, saving time and money for treatment.

    We offer professional services in the field of preventive dentistry:

    • - Removal of tartar (ultrasonic scaling)
    • - Removal of sediments and stain with prophylactic gritter (sandblasting)
    • - Fluoridation (teeth varnishing). It is based on fluorine lacquer coating the teeth and is designed to strengthen the enamel which results in the increased resistance to decay.

  • Descaling

    Dental scale is a hard calcareous deposit that builds up on your teeth. (Especially on the inside of the incisors and the canines) Scale is formed by a calcification of the dental plaque, constantly in contact with the minerals of the saliva. Tobacco is not at the origin of dental scale; however, tobacco gives previously formed dental plaque a dark brown color. As far as that goes. A calcareous drinking water doe not provoke scale since it only stays in your mouth for a few seconds. Accumulated dental scale must be eliminated by a dentist on a regular basis since it can provoke an inflammation of the gums, also called gingivitis. A professional descaling must be performed regularly; your dentist will determine the frequency of this operation according each patient.

  • The dental bleaching or thinning

    Dental bleaching, also known as tooth whitening and swabbing, is a common procedure in general dentistry but most especially in the field of cosmetic dentistry. According to the FDA, whitening restores natural tooth color and bleaching whitens beyond the natural color. There are many methods available, such as brushing, bleaching strips, bleaching pen, bleaching gel, laser bleaching, natural bleaching, and swabbing.

    Bleaching methods use carbamide peroxide which reacts with water to form hydrogen peroxide. Carbamide peroxide has about a third of the strength of hydrogen peroxide. This means that a 15% solution of carbamide peroxide is the rough equivalent of a 5% solution of hydrogen peroxide. The peroxide oxidizing agent penetrates the porosities in the rod-like crystal structure of enamel and bleaches stain deposits in the dentin. Power bleaching uses light energy to accelerate the process of bleaching in a dental office. A new bleaching agent is 6-phthalimido peroxy hexanoic acid (PAP).

    Tooth bleaching is not a modern invention. Ancient Romans, for example, used urine and goat milk to make and keep their teeth whiter

  • Veneers

    Ceramic dental Veneers need to have a thin enamel surface removed. With their help the mounted, broken, spaced, very colored or unsatisfying-shaped teeth can be realigned. The ceramic Veneer represents the easiest method used to change the color and shape of teeth in order to have a perfect smile. They are extremely thin, varying between 0.3 and 0.5 mm and they adhere on the surface of the tooth.

    Before staring any intervention, there are pictures taken to the patient which are deeply analyzed in order to find the best solution from the esthetic point of view, then tests are being ran using different facets until the patient feels completely satisfied regarding the shape, length and color. All these procedures are performed without touching the teeth with the bur. Not until the final decision regarding all the esthetic aspects it is taken, the preparation of teeth begins. With the help of these porcelain facets, a smile can be totally transformed only in a matter of days!

  • Inlay-onlay

    In dentistry, an inlay is an indirect restoration (filling) consisting of a solid substance (as gold or porcelain) fitted to a cavity in a tooth and cemented into place.
    An onlay is the same as an inlay, except that it extends to replace a cusp. Crowns are onlays which completely cover all surfaces of a tooth.

    Inlay

    Sometimes, a tooth is planned to be restored with an intracoronal restoration, but the decay or fracture is so extensive that a direct restoration, such as amalgam or composite, would compromise the structural integrity of the restored tooth or provide substandard opposition to occlusal (i.e., biting) forces. In such situations, an indirect gold or porcelain inlay restoration may be indicated. When an inlay is used, the tooth-to-restoration margin may be finished and polished to such a super-fine line of contact that recurrent decay will be all but impossible. While these restorations might be ten times the price of direct restorations, the superiority of an inlay in terms of resistance to occlusal forces, protection against recurrent decay, precision of fabrication, marginal integrity, proper contouring for gingival (tissue) health, and ease of cleansing offers an excellent alternative to the direct restoration.

    Onlay

    When decay or fracture incorporate areas of a tooth that make amalgam or composite restorations inadequate, such as cuspal fracture or remaining tooth structure that undermines perimeter walls of a tooth, an onlay might be indicated. Similar to an inlay, an onlay is an indirect restoration which incorporates a cusp or cusps by covering or onlaying the missing cusps. All of the benefits of an inlay are present in the onlay restoration.
    The onlay allows for conservation of tooth structure when the only alternative is to totally eliminate cusps and perimeter walls for restoration with a crown. Just as inlays, onlays are fabricated outside of the mouth and are typically made out of gold or porcelain. Gold restorations have been around for many years and have an excellent track record. In recent years, newer types of porcelains have been developed that seem to rival the longevity of gold. If the onlay or inlay is made in a dental laboratory, a temporary is fabricated while the restoration is custom-made for the patient. A return visit is then required to fit the final prosthesis. Inlays and onlays may also be fabricated out of porcelain and delivered the same day utilizing techniques and technologies

  • Dental implants

    Un implant Dental implants are artificial substitutes for natural tooth roots. The implants – small anchors shaped like screws or cylinders-are placed into the jawbone by the implant surgeon. Replacement teeth are attached to the part of the implant that projects through the gums. Used for many years, dental implants are effective, natural-looking replacements for missing teeth. Most specialists in dental implants work as a team-the implant surgeon surgically prepares your jaw and a prosthodontist, the restorative specialist, makes your replacement tooth or teeth.

    The advantages of dental implants.

    Dental implants can support replacement teeth in much the same way as tooth roots support natural teeth. Dental implants provide an alternative to a denture that wobbles clicks or causes pain. Dental implants can also prevent embarrassment about spaces from missing teeth. You can enjoy your favorite foods again. And you can smile and speak with confidence! When reputable dental implants systems are placed by trained dental specialists, they can have a success rate of over 90 percent. In fact, with effective oral care at home and regular visits, dental implants have lasted as long as 20 years and may last a lifetime.

  • Dental Fixed Bridges

    All of your teeth play an important role in speaking, chewing and in maintaining proper alignment of other teeth. Tooth loss doesn’t necessarily have to occur as you age, but if you do lose teeth they must be replaced to maintain proper function of your mouth. Fortunately, there are options for correcting tooth loss.

    Dental Bridge Options

    A bridge — a device used to replace missing teeth — attaches artificial teeth to adjacent natural teeth, called abutment teeth. Bridges are either permanently attached (fixed bridges), or they can be removable.
    Fixed bridges are applied by either placing crowns on the abutment teeth or by bonding the artificial teeth directly to the abutment teeth. Removable bridges are attached to the teeth with metal clasps or by precision attachments.
    If you’re missing one or more teeth, you may be aware of their importance to your appearance and dental health. Your teeth work together for many daily functions from eating to speaking. With missing teeth, it’s difficult to do these things. Missing teeth can and should be replaced. Fixed bridges are a great way to restore your dental health and appearance.

    What exactly is a “bridge” or fixed partial denture?

    A bridge (fixed partial denture) is a device which fills the gap where teeth are absent. Fixed bridges are bonded into place and can only be removed by a dental professional. Removable bridges, as the name implies, can be taken out and cleaned. Fixed bridges offer more stability than their removable counterparts.

  • Removable Dental Prosthesis

    Replacing your missing or damaged teeth will benefit not only your appearance but your overall health. Using state-of-the-art technology and updated materials, dentures can now be custom designed to look more natural and feel more comfortable. It may take some time to adjust to your dentures. Speaking and eating may feel different at first, but these regular activities will resume normally once you are accustomed to your dentures. Complete Dentures Complete dentures are artificial, removable replacements for the natural teeth of the upper or lower jaw or both.

    Upper dentures
    Upper dentures are held in place by a vacuum created between your appliance and the palate of your mouth.

    Lower dentures
    Lower dentures are horseshoe-shaped to accommodate the tongue, and, due to lack of suction, are often held in place by implants placed in the jaw for support.

    Partial Dentures
    Partial dentures are removable appliances that replace missing teeth by attaching via a metal framework to your natural teeth.

  • Conservative dentistry

    Within conservative dentistry our Office performs caries treatment and prophylaxis, endodontic treatment popularly referred to as canal treatment as well as aesthetic dentistry, treatment of changes in mucous membranes of oral cavity and treatment of children. Caries is a disease of hard tissues of a tooth such as enamel and dentine.

    If not treated it leads to inflammation of pulp and periapical tissues. On the other hand, if discovered early it can be stopped by remineralisation processes. At our Office we perform prophylactic procedures as well as treatment and reconstruction of teeth damaged by caries or injuries.

    The procedure is performed under effective anaesthetic which is safe both for children, pregnant women, patients with heart diseases and other.

    Caries prophylaxis in children and adults: sealing, lacquering

    • Caries treatment: fillings
    • Aesthetic dentistry: veneers, reconstruction, rebuilding with a fibreglass
    • Teeth whitening
    • Hypersensitivity treatment
    • Removal of dental accretions with ultrasounds, sandblasting
    • Endodoncy, that is chemical and mechanical development of root canals and proper filling
  • Endodontic therapy

    Endodontic therapy or root canal therapy, colloquially root canal, is a sequence of treatment for the pulp of a tooth which results in the elimination of infection and protection of the decontaminated tooth from future microbial invasion. This set of procedures is commonly referred to as a "root canal." Root canals and their associated pulp chamber are the physical hollows within a tooth that are naturally inhabited by nerve tissue, blood vessels and other cellular entities.

    Endodontic therapy involves the removal of these structures, the subsequent shaping, cleaning, and decontamination of the hollows with tiny files and irrigating solutions, and the obturation (filling) of the decontaminated canals with an inert filling such as gutta percha and typically a eugenol-based cement. Epoxy resin, which may or may not contain Bisphenol A is employed to bind gutta percha in some root canal procedures.

    After endodontic surgery the tooth will be "dead," and if an infection is spread at the apex, root end surgery is required.

    Although the procedure is relatively painless when done properly, the root canal remains a stereotypically fearsome dental operation.

  • Healing after Extractions and Oral Surgery

    After one or more teeth have been removed, you will want to do all the right things for the area to heal quickly and smoothly. This requires that a blood clot is formed. The blood clot covers the extraction site and allows the area to heal. A lot of the tips below help the blood clot to form properly and not become dislodged.

    Do’s:

    • It is normal for the area to be tender for the first few days, and in most cases simple over-the-counter pain relief is enough to ease any discomfort. Start taking painkillers immediately afterwards – don’t wait until pain sets in! It’s far easier to prevent pain than to make it go away. The usual painkillers of choice are ibuprofen or ketoprofen (some products have codeine added for extra pain relief). Check with your dentist or another health care provider that you can take these (for example, asthma sufferers shouldn’t). If you can’t, your dentist will be able to recommend an alternative. Avoid disprin (aspirin) as this thins the blood and can make your mouth bleed. Check with your dentist or pharmacist if you feel you need something stronger.
    • Go home, take it easy for the rest of the day, and don’t exercise for at least 12 to 24 hours. If you want to lie down, and for the first night following surgery, keep your head up with pillows if possible. Do not bend over or do heavy lifting for 2-3 days.
    • If you still feel numb 6 hours later, call your dentist or oral surgeon! If you get back in within 24 hours, your oral surgeon can inject some steroids into the nerve area, which can help reduce swelling and may help speed recovery. Prolongued numbness can also be due to a longer-lasting local anaesthetic (marcaine) – in this case, the effect is intentional, but your oral surgeon should have specifically told you that they’ve used this.
    • ....

      More +

  • Précautions suite à une extraction dentaire

    You are not alone. Millions of people has a complete or partial dental prosthesis. While this may seem a bit difficult at the beginning, with a little patience and practice you will find soon a new sense of confidence and security.

    You want to forget your dental prosthesis while you eat, speak, smile or laugh with your family, with friends or with colleagues at work. A dental prosthesis snugly and completely clean will give you the confidence you need.

    Helpful Hints If your dental prosthesis moves from time to time during the day when you laugh, cough, bite on dental prosthesis and cane to reposition. Over time, if your dental prosthesis becomes uncomfortable or does not fit perfectly, contact your dentist. A change in your state of health, a gain or loss of weight can significantly affect the fit and comfort of your dental prosthesis.

  • Tooth fracture

    Tooth fractures can range from minor (involving chipping of the outer tooth layers called enamel and dentin) to severe (involving vertical, diagonal, or horizontal fractures of the root). Enamel and dentin are the two outer protective layers of the tooth. The enamel is the outermost white hard surface. The dentin is a yellow layer lying just beneath the enamel. Enamel and dentin both serve to protect the inner living tooth tissue called the pulp. The visible one-third of the tooth is called the crown, while the remaining two-thirds of the tooth buried in the bone is called the root. Dental X-rays are necessary in most instances to diagnose, locate, and measure the extent of tooth fracture.

    What is a serious tooth fracture?

    A serious fracture is one that exposes both the dentin and the pulp tissue and should be treated promptly. The tooth may be displaced and loose, and the gums may bleed. To prevent the loose tooth from falling out completely, the dentist can splint the loose tooth by bonding it to the adjacent teeth to help stabilize it while the underlying bone and gums heal. Because of the high risk of pulp death, a root canal procedure may need to be performed during the first visit. Alternatively, the dentist may elect to only apply a sedative dressing on the splinted tooth to help calm the tooth pain. The tooth will then be reevaluated in two to four weeks for root canal procedure followed by a dental filling or crown. The splint is also removed at that time.

    The most serious injuries involve vertical, diagonal, or horizontal fractures of the tooth roots. In most instances, fracture of the tooth root leaves the injured tooth very loose, thus necessitating tooth extraction. The extracted tooth is replaced with a removable plate containing a false tooth. Teeth with horizontal fractures near the tip of the root may not need extraction. However, root canal treatment for the injured tooth may be required in the future if symptoms of pulp death and tooth infection appear. Therefore, periodic X-rays of the fractured tooth are performed.