Believe it or not, some bleeding after tooth extractions is beneficial; good blood flow usually means good healing. The purpose of the gauze that you were given is to apply firm, consistent pressure to the extraction sites for 30-45 minutes at a time. If you have gauze in your mouth and you are not biting down firmly, the gauze is doing no good. Likewise, taking the gauze in and out every five minutes to look at it just tends to stir up more bleeding. Often, when patients are removing their gauze after surgery, they are surprised at how wet and red the gauze appears, and this is often perceived as excessive bleeding. Most of the time, the gauze is saturated with saliva with a few drops of blood that give it the appearance of a lot of bleeding when it really isn’t. If you run out of gauze, most pharmacies sell it or you can bite on tea bags; the tannic acid in tea helps in clot formation. If your mouth is rapidly filling up with blood and the above measures are not helping to slow down the bleeding, call our office for assistance. Also, it is not unusual to notice small episodes of bleeding for several days after having teeth removed. If this occurs simply bite on gauze again in the area of bleeding.
Change your gauze every thirty minutes until the bleeding in that area has stopped. It is recommended that you wet the gauze, squeeze out the excess water, and then apply firm bite pressure to surgical site. If there is no bite pressure on the gauze, then bleeding will not be controlled. Once bleeding stops, there is no need for gauze.
The term “dry socket” refers to a condition called alveolar osteitis which is a premature breakdown of the blood clot present in an extraction site. Smoking, poor oral hygiene, and over-exertion in the post-operative period can contribute to this condition, but sometimes there is no obvious cause. Typically, a “dry socket” presents itself 3-5 days after the surgery with increased pain, foul odor and taste, and bad breath. This condition is very easily treatable and requires that we wash out the socket and place a medication dressing. This provides pain relief usually within an hour after placement. These medicated dressings typically are replaced every 2-3 days in our office until the condition subsides in one to two weeks. If you are experiencing symptoms consistent with a “dry socket,” the best solution is to call our office when it opens in the morning at 8:00am so that we can arrange to have you seen that day for treatment.
There are several causes of post-operative nausea and vomiting. First, if you were sedated with IV medications, nausea is a side-effect of nearly all the medications used for sedation. The best treatment is to start out with clear liquids (water or Gatorade) on the day of the surgery. The goal is to maintain good hydration in order to prevent dehydration. After holding down clear liquids for several hours without nausea, your diet can progress to soft foods. Dairy products (milkshakes) are not the best food on the day of the surgery and may contribute to nausea and vomiting. Second, the narcotic pain medication is also a major culprit for causing post-operative nausea and vomiting. The best treatment is prevention by using a non-narcotic medication (like ibuprofen), and only using narcotic if it is absolutely necessary for pain control, if the doctor considerer it necessary. If you find that you are experiencing nausea within an hour after taking a narcotic pain medication, simply stop taking the medication and use the non-narcotic medication prescribed by your doctor. Third, and most importantly, dehydration is a cause of post-operative nausea and vomiting. Again, the best treatment is prevention. Clear liquids are very important in maintaining an adequate level of hydration. If you are simply not able to hold anything down and your condition is worsening, call us for assistance. If you are diabetic and are experiencing post-operative nausea and vomiting, strict blood sugar control is vital post-operatively.
Yes, in most instances, the stitches are placed at the time of surgery simply to assist with initial control of bleeding and clot formation. This is especially true with wisdom tooth surgery and other tooth extractions. Thus, loss of a stitch is not considered an emergency, even if it occurs on the day of surgery. If your surgeon has performed a bone-grafting procedure and the stitches are coming out prematurely, please contact our office so that the doctor may determine whether or not you need to be seen on that day.
We cannot allow more than the patient alone into the surgical area. Under HIPAA, there is a need to maintain patient’s privacy, therefor only the surgical staff and the patient is allowed in the surgical area. There are also multiple procedures occurring and there is no “waiting area” in the surgical suite. If there is a medical/legal necessity to have someone with the patient, please include this information in the initial exam so preparations can be made.
Your dentures/partials, your inhaler if you have one, and if you do not have a ride, you can bring your items to sit on the back shelf until the end of your surgery with your phone turned OFF.
Since you are unable to control your gag reflex, if you eat something before surgery, your stomach contents could regurgitate into your airway, causing complications such as pulmonary aspiration which, in severe cases, can be fatal.
If the teeth are whole, you can take your extracted teeth with you. It is important that you let the surgical team know before surgery that you want to keep your teeth, crowns, or caps.
At the time of your exam, your surgeon should go over what you can and cannot take. In most cases, you will continue your normal home medications as prescribed without alteration. If you have additional questions, call the office to confirm before your surgery date.
You can eat as soon as you get home. We recommend starting with soft, light foods such as soups, mashed potatoes, and apple sauce. Make sure the food you eat is not HOT, as you will be numb and unable to feel if your tongue or lip has been burnt.
We suggest that you take the rest of the day to rest, particularly if you have been sedated intravenously. Many people can feel tired and should not be allowed to drive or exercise for 24 hours after sedation. For wisdom tooth extraction, it can take several days to fully recover. If dry sockets develop, the healing period will be extended beyond one week.
You should stop eating no less than 6 hours prior to your surgery unless otherwise instructed by your doctor, who may recommend a longer period.
The chemical nicotine is a vasoconstrictor, which means that it restricts proper blood flow which hinders nutritional blood from the surgical site, impairing healing. The smoke dehydrates the mouth, and also brings into the mouth smoke debris which can infect the surgical site. This inability to properly heal can lead to a dry socket or infection.
Please allow up to 2 weeks for the results. If you are scheduled for a follow-up appointment, then the results will be discussed with you at that time. If you are not scheduled, our office will call you as soon as the doctor reviews the results.
An oral and maxillofacial surgeon is a specialist in the treatment of disease problems associated with the jaws, teeth, mouth and face. The type of problems that we see may be as simple as a tooth extraction or as complicated as reconstructive or tumor surgery. Educational requirements include graduation from dental school and completion of an approved internship and residency training program which is typically University and hospital based.
Board Certification (also known as Diplomate of the American Board of Oral and Maxillofacial Surgery) is the highest level of academic achievement. It is not a requirement to practice oral surgery however, those individuals who are board certified have demonstrated their capabilities and desires to obtain this level of achievement. To become board certified, an applicant must have completed an approved internship and residency training program, applied to the board and been accepted (board eligible) and complete the exam. Certification is awarded after a rigorous set of exams including a written portion as well as an oral (verbal) portion are passed. Many hospitals and insurance plans are now requiring board certification to participate as a provider.
Many patients are seen and treated the same day. This is typical especially for extraction and other simple problems. Complicated problems will require separate consultations.
Before you left our office we made sure that the bleeding was under control. We do recommend you leaving the gauze over the Surgery site for at least 30 minutes after you arrive home. Bite down with firm pressure during that time. Then gently remove the gauze. If bright red blood flows from the Surgery area, put a clean piece of moistened gauze in your mouth and again bite down with firm pressure for another 30 minutes. After that, bleeding should have eased. A pink tinge to your saliva is normal and may continue for a day or two.
Remain calm. Have you been keeping FIRM CONTINUOUS pressure on the gauze? If not, do so for 30 more minutes. Do not talk or spit. Remain at rest during this time. You might try using a moistened tea bag wrapped in gauze on the surgery site. Tea bags contain tannic acid, which promotes clotting. Remove the bag and gauze after 30-45 minutes.
Begin taking prescribed pain medication as soon as possible after surgery. We recommend that you first eat something to alleviate nausea that pain medication can cause. Continue taking the medication on the prescribed schedule for the first day or two. After that time, take pain medication as needed in accordance with prescribed directions.
You have undergone significant surgery and your body needs time to recover. Plan at least three or four days to rest from normal activity. How quickly you recover depends on how you cooperate with your body’s healing process (resting, drinking liquids, taking your medications, avoiding hard foods and vigorous chewing, rinsing gently, etc.). By following these guidelines, you will minimize complications such as infection and the breakdown of the blood clot (“dry socket”) and return to your routine more quickly.
Typically, this indicates some type of a localized infection. Please call our office, so we can evaluate this and recommend appropriate treatment.
Numbness of the lip, tongue, gums, teeth etc. is a common occurrence after lower jaw surgery, and sometimes after wisdom teeth surgery. It is usually caused by some type of irritation to the nerves involved and over 90% of the time resolves within a few days or weeks. Occasionally, it may take longer to resolve. Fortunately, it is just a feeling sensation and does not cause a muscle weakness. It is however, important for you to have us evaluate this so appropriate recommendations can be made.
We typically use resorbable sutures (stitches). They begin to dissolve within 2-3 days. Its ok for them to come out. If you notice any significant and persistent bleeding please let us know.
The “holes” or better, extraction sockets will generally close within 6 weeks. It will take several months for the sockets to actually fill with bone. If food gets trapped in the socket area, be sure to clean it with the water syringe given to you at the time of your surgery.
No. The bad breath may be caused by food getting into the socket area. Be sure to keep the surgery site clean and this should resolve.
A dental implant is a substitute tooth root that serves virtually the same function as a natural tooth root. It preserves bone and provides a stable foundation for a replacement tooth that looks feels and functions like a natural tooth. Dental implants are made of titanium, which is a biocompatible material used in orthopedic implants.
A dental implant provides several advantages over other tooth replacement options. In addition to looking and functioning like a natural tooth, a dental implant replaces a single tooth without sacrificing the health of neighboring teeth. The other common treatment for the loss of a single tooth, a tooth-supported fixed bridge, requires that adjacent teeth be ground down to support the cemented bridge.
Because a dental implant will replace your tooth root, the bone is better preserved. With a bridge, some of the bone that previously surrounded the tooth begins to resorb (deteriorate). Dental implants integrate with your jawbone, helping to keep the bone healthy and intact.
In the long term, a single implant can be more esthetic and easier to keep clean than a bridge. Gums can recede around a bridge, leaving a visible defect when the metal base or collar of the bridge becomes exposed. Resorbed bone beneath the bridge can lead to an unattractive smile. And, the cement holding the bridge in place can wash out, allowing bacteria to decay the teeth that anchor the bridge.
Your new replacement teeth will look, feel and function like natural teeth. And since dental implant treatment is the only tooth replacement option that prevents bone resorption, which can cause your smile to look unnatural, the long-term esthetics are usually much better than with any other treatment option.
The home care recommended varies depending upon the type of implant supported replacement teeth. For example, a single implant supported crown is cleaned like a natural tooth, with regular brushing and flossing. Implant supported bridges that replace a few teeth are cleaned like tooth supported bridges, brushing and flossing with a floss threader. Home care is a little more complicated for people who are missing all of their teeth, in that special brushes and floss are often recommended. With overdentures, it is necessary to clean the implant attachments, as well as the overdenture. Permanently fixed implant supported replacement teeth are cleaned like all other bridges. In all cases, it is recommended that patients see their dentist and hygienist at least every 3/4 months. It is usually recommended that the patient see the surgical specialist at least once each year as well. These visits, combined with proper home care, are essential to the long-term success of implant treatment.
Nearly everyone who is missing one or more teeth and in general good health is a candidate for dental implant treatment. There are a few medical conditions that can undermine the success of implant treatment, such as uncontrolled diabetes. However, there are very few conditions that would keep someone from having implant treatment altogether. Quality and quantity of available bone for implant placement is more often a factor in qualifying for dental implants than medical conditions. However, even people who have lost a significant amount of bone can qualify for dental implant treatment with additional procedures to add bone or create new bone.
Documented clinical research demonstrates that dental implant treatment has a long-term success rate of over 95%, which is much better than the success rates for tooth-supported bridges, partial and full dentures. Dental implants are designed to be permanent; however many factors contribute to the long-term success of implant treatment, such as home care and regular maintenance visits to the dentist or dental specialist. By comparison, research demonstrates that the typical tooth supported bridge lasts from 7-10 years and that partials and dentures are functional for approximately 5 years.
Dental implant treatment is one of the most successful procedures in the medical-dental field, with documented success rates over 95%. Although successful treatment is very predictable, there are rare occasions where the bone does not completely bond to the implants. When this occurs, new implants are placed.
The length of treatment time depends largely upon whether someone is a candidate for Immediate loading procedures. Patients who qualify for this type of treatment receive their replacement teeth the same day implants are placed, although there is a significant amount of treatment planning that takes place prior to implant placement. For the majority of patients, treatment can take anywhere from several weeks to several months, depending upon the quality and quantity of bone in which the implants are placed. If procedures are needed to augment the bone, the total treatment time is usually somewhere between six to nine months.
Most patients report that the discomfort is far less than they expected, even less than having a tooth extracted. Although everyone is different with regard to pain tolerance, most patients are very comfortable simply taking Tylenol and Ibuprofen afterward.
An investment in dental implant treatment is an investment in overall health, appearance and well being, since it involves preserving the integrity of facial structures, as well as replacing missing teeth. The actual cost of implant treatment is based on a number of factors, such as the number of missing teeth being replaced, the type of implant supported teeth (treatment option) recommended and whether additional procedures are necessary to achieve the proper esthetic and functional result. There is often a misconception that there is a set cost for each implant. The fees are calculated based on the amount of time your dentist and surgical specialist anticipate spending to complete treatment (implant placement, other surgical procedures, fabrication of replacement teeth, etc) as well as the estimated cost of implants, other components and materials necessary to complete treatment and dental laboratory fees. The fee is usually comparable to other methods of tooth replacement; however, long-term, implant treatment is generally more cost effective than other options, such as bridges, partials and dentures, which need to be replaced every 5-10 years.
There are a few cases where medical insurance is available for people who are missing all of their teeth, and as a result, have medical conditions. This type of coverage depends solely on the individual policy. Other than these situations, medical coverage is very rare. Work related injuries and other types of accidents are the other cases that are sometimes covered by insurance.
Denture wearers often lack confidence that their denture will firmly stay in place in their mouth without becoming loose or floating. For patients who are having this difficulty, denture stabilization implants will help you eat and speak more confidently. This is especially helpful for the lower denture. Also, because the denture no longer slides on the gums, denture implants help retain the jaw bone.