Oral Surgery

Abbeymead Dental CentreOral Surgery

Thank you for following the link, below is some important information which must be read prior to your treatment at the Abbeymead Dental Centre

IMPORTANT INFORMATION.

UPPER AND LOWER JAW TOOTH REMOVAL WARNINGS

This list is not exhaustive, nor is it predictive. The most pertinent warnings have been included here to advise you and for your information.

• Pain; It is a surgical procedure, there will be soreness after the tooth is removed. This can last for several days. Painkillers you are able to tolerate such as Ibuprofen, paracetamol, Solpadeine or Nurofen Plus are very effective. Obviously, the painkiller you use is dependent on your medical history and the ease with which the tooth is removed.

• Swelling; there will be swelling afterwards. This can last for up to a week. Use an icepack or a bag of frozen peas pressed against your cheek adjacent to the removed tooth; this will help to reduce the swelling. Avoidance in the first few hours post-op of alcohol, exercise or hot foods/drinks will decrease the degree of swelling that will develop. Occasionally, there is bleeding into the cheek. The swelling caused by this may take much longer to resolve; at the same time, there may well be limitations to mouth opening. This also improves with time.

• Bruising; some people are prone to bruise. Older people, people on aspirin or steroids will also bruise that much more easily. The bruising can look quite florid; this will eventually resolve, but can take several weeks to go away. ( in the worst cases)

• Stitches; The extraction site will often be closed with stitches. These are dissolvable and “fall out” within 10-14 days.

• Mouth opening; Often the chewing muscles and the jaw joints are sore after the procedure so that mouth opening can be limited for the next few days. If you are unlucky enough to develop an infection in the socket afterwards, this can make the limited mouth opening worse and last for longer.

• Post-operative infection; you may develop an infection in the socket after the operation. This tends to occur 2-4 days later and is characterised by a deep-seated throbbing pain, bad breath and an unpleasant taste in the mouth. This infection is more likely to occur if you are a smoker, or are on the contraceptive pill, or on drugs such as steroids and if bone has been removed to facilitate tooth extraction. If antibiotics are given, they are likely to react with alcohol and/or the contraceptive pill; (that is, the Pill will not be providing protection.)

• Surrounding teeth; the surrounding teeth may be sore after the extraction; they may even be slightly wobbly but the teeth should settle down with time. It is possible that the fillings or crowns of the surrounding teeth may come out, fracture or become loose. If this is the case, you will need to go back to your dentist to have these sorted out. Every effort will be made to make sure this doesn’t happen. In very rare circumstances, the surrounding teeth may actually come out as well as the intended tooth.

• Surgical removal; to facilitate the removal of teeth, it is sometimes necessary to cut the gum and/or remove bone from around the tooth. If this is the case, you can expect the extraction site to be sorer afterwards, the swelling to be greater and more prone to infection. Hence, stronger painkillers are needed; use of icepacks mandatory and antibiotics will probably be prescribed. The bone largely grows back to what it was. Care thought will be taken not to be “wasteful” in bone removal as this effects afterwards the provision of dentures, bridges and implants.

• Numbness of the lip, chin and/or tongue; (LOWER TEETH) The nerves that supplies feeling to the tongue, lower lip and the chin, run close to the root-ends of the molar teeth and exit on the onto the skin close to the roots of the premolars/bicuspids. There is a risk that when back lower teeth (wisdom teeth especially) are removed, these nerves can be crushed, bruised or stretched resulting in numbness (at the worst end of the scale) in the lower lip, chin and/or tongue.  This nerve bruising tends to be temporary (rarely is it permanent) but “temporary” can stretch from several days to several months. It is hard to predict who will get nerve bruising and if it will be temporary/permanent, and if temporary, how long it will last.

• Mouth-sinus communication; (UPPER TEETH) Upper molar and upper premolar teeth often have their roots in close proximity to the sinus. In removing these teeth, there is a chance that a communication can be made between the mouth and the sinus (this is sometimes evident at the time of the operation but may develop 4-6 weeks afterwards). If this communication persists or is left unrepaired, every time you drink, fluid can come out of the nose and you may develop a marked sinusitis. This communication, if small enough, can spontaneously close. It can be assisted in this by “cover plates” that prevent food and fluids going into the sinus allowing the hole to close naturally. However, communications above a certain size need to be surgically closed.

• Root tips; in rare instances, the very ends of the teeth may break off. These may stay where they are in the socket or may be pushed into the sinus or pterygoid plexus. If these tips are left behind in the socket (this is done, as trying to remove the tips may make the situation far worse), there is not likely to be any problems associated with this. However if the root tips have gone into the sinus or pterygoid space, the will need to be recovered.

• Bony Flakes; if a number of teeth are removed at one go, the resulting gums may feel a bit rough. Occasionally, bony flakes (sequestra) from the lining of the tooth sockets can work their way loose out through the gum. These can be quite sore. They often work their way loose without any problems, but may need to be teased out or even smoothed; this is quite normal.

• Failure of Anaesthesia; in rare cases the tooth can be difficult to “numb up”. This can be due to a number of reasons. The more common reasons include inflammation and/or infection associated with the tooth, anatomical differences and apprehension. If the tooth fails to “numb up” then its removal will be rescheduled with antibiotic cover or perhaps to be done under sedation or General Anaesthetic (GA)

• Fractured Tuberosity/Buccal Plate; The molar tooth, can, from time to time, be fused with the bone around it so that , in removing the molar tooth, the bone comes with it. This can make a communication into the sinus larger (see above) Closure of the communication is followed with antibiotics, painkillers and decongestants. Nose-blowing is forbidden for at least a week afterwards.

• Bleeding into the cheeks; Swelling that does not resolve within a few days may be due to bleeding into the cheek. The cheek swelling will feel quite firm. Coupled with this, there may be limitation to mouth opening and bruising. Both the swelling, bruising and restricted mouth opening will resolve in time.