ORAL SURGERY

Oral surgery is the summary name of various dental treatments from tooth extraction to dental implant placement. 

TOOTH EXTRACTION/SURGICAL:

Having a tooth pulled in adulthood is sometimes necessary. Although permanent teeth were meant to last a lifetime, there are a number of reasons why tooth extraction may be necessary. A very common reason involves a tooth that is too badly damaged, from trauma or decay, to be repaired. Other reasons include:

Infection. If tooth decay or damage extends to the pulp -- the center of the tooth containing nerves and blood vessels -- bacteria in the mouth can enter the pulp, leading to infection. Often this can be corrected with root canal therapy (RCT), but if the infection is so severe that antibiotics or RCT do not cure it, extraction may be needed to prevent the spread of infection.

Periodontal (Gum) Disease . If periodontal disease -- an infection of the tissues and bones that surround and support the teeth -- have caused loosening of the teeth, it may be necessary to the pull the tooth or teeth.

A crowded mouth. Sometimes dentists pull teeth to prepare the mouth for orthodontia. The goal of orthodontia is to properly align the teeth, which may not be possible if your teeth are too big for your mouth. Likewise, if a tooth cannot break through the gum (erupt) because there is not room in the mouth for it, your dentist may recommend pulling it.

WHAT TO EXPECT WITH TOOTH EXTRACTION

Dentists and oral surgeons (dentists with special training to perform surgery) perform tooth extractions. Before pulling the tooth, your dentist will carefully investigate the case and discuss all treatment options. To set up a proper opinion it is required to take an x-ray. If extraction is necessary the dentist will give you an injection of a local anesthetic to numb the tooth and surrounding soft tissue where the tooth will be removed.

If the tooth or root is impacted, the dentist will cut away gum and bone tissue that cover the tooth and gently loosen it from the jaw bone and ligaments that hold it in place. Sometimes, a hard-to-pull tooth must be removed in pieces. This procedure is called Surgical tooth extraction.

Once the tooth has been pulled, a blood clot usually forms in the socket. The dentist will pack a gauze pad into the socket and ask you bite down on it to help to stop the bleeding. Sometimes the dentist will place a few stitches  to close the gum edges over the extraction site.

WISDOM TOOTH EXTRACTION

Many people require removal of their wisdom teeth.,

as there is not enough room in the jaws to allow them to come through normally. This can lead to wisdom teeth that are impacted, teeth that are trapped beneath the gum tissue by other teeth or bone. If teeth are impacted, swelling and tenderness may occur.

Wisdom teeth that only partially emerge or come in crooked can also lead to painful crowding, and disease. 

These wisdom teeth cause pain and infections as when they are below the gum, we cannot keep them clean and hence it is common that food gets trapped around them and infections can develop. Not all people who have wisdom teeth buried in the gum require them to be removed. This is discussed on an individual basis, following a clinical and radiographic (x-ray) exam. The wisdom teeth are only removed when it is felt that there will be an obvious benefit to the patient in doing so.  Such benefits would include preventing pain, decay and infection that are already present, or such symptoms that appear to be developing.

Removal of a wisdom tooth could be a normal tooth extraction, or in more difficult cases, when the tooth is partially erupted a surgical extraction might be necessary. There are some cases when the position of the wisdom tooth makes extraction extremely difficult. In these cases the removal requires a specialist. Your dentist will refer you to an oral surgeon, or into the dental hospital to carry out your treatment.

AFTER YOU'VE HAD A TOOTH PULLED

Following an extraction, your dentist will send you home to recover. Recovery typically takes a few days. The following can help minimize discomfort, reduce the risk of infection, and speed recovery.

  • Take painkillers as prescribed.

  • Bite firmly but gently on the gauze pad placed by your dentist to reduce bleeding and allow a clot to form in the tooth socket. Leave the pad in place for 10-15 minutes after the extraction.

  • Apply an ice bag to the affected area strictly after the injection wore off to keep down swelling. Always wrap the ice bag with a towel and  apply it for max 2-3 minutes at a time and leave at least 5 minutes between sessions. Do not do it more than 2 hours to avoid freezing soft tissue. 

  • Relax for at least 24 hours after the extraction. Limit activity for the next day or two.

  • Avoid rinsing or spitting forcefully for 2 days after the extraction to avoid dislodging the clot that forms in the socket.

  • Do not smoke, which can inhibit healing.

WHEN TO CALL THE DENTIST

It is normal to feel some pain after the anesthesia wears off. For 24 hours after having a tooth pulled, you should also expect some swelling and residual bleeding. Sometimes, the blood clot in the socket breaks loose, exposing the bone in the socket. This is a painful condition called dry socket. If this happens, your dentist will likely place a sedative dressing over the socket for a few days to protect it as a new clot forms.

You should call your dentist if you experience any of the following:

  • Pain getting stronger instead of relief

  • Painkiller does not help, or only for a few hours (1-2 hours)

  • Signs of infection, including fever and chills

  • Nausea or vomiting

  • Redness, swelling, or excessive discharge from the affected area

  • Cough, shortness of breath, chest pain, or severe nausea or vomiting

 

The initial healing period usually takes about one to two weeks. New bone and gum tissue will grow into the gap. Over time, however, having a tooth (or teeth) missing can cause the remaining teeth to shift, affecting your bite and making it difficult to chew. For that reason, your dentist may advise replacing the missing tooth or teeth with an implant, fixed bridge, or denture.

Ardrum Clinic - Ardrum House, Bishopstown Road, Cork

ardrumclinic@gmail.com/ PHONE (021) 480 0888