Fold a piece of clean gauze into a pad thick enough to bite on and place directly on the extraction site. Apply moderate pressure by closing the teeth firmly over the pad. Maintain this pressure for about 30 minutes. If the pad becomes soaked, replace it with a clean one as necessary. Do not suck on the extraction site (as with a straw). A slight amount of blood may leak at the extraction site until a clot forms. However, if heavy bleeding continues, call your dentist. (Remember, though, that a lot of saliva and a little blood can look like a lot of bleeding.)
The Blood Clot
After an extraction, a blood clot forms in the tooth socket. This clot is an important part of the normal healing process. You should therefore avoid activities that might disturb the clot.
Here's how to protect it:
- Do not smoke, rinse your mouth vigorously or drink through a straw for 24 hours.
- Do not clean the teeth next to the healing tooth socket for the rest of the day. You should, however, brush and floss your other teeth thoroughly. Gently rinse your mouth afterwards.
- Limit strenuous activity for 24 hours after the extraction. This will reduce bleeding and help the blood clot to form. Get plenty of rest.
- If you have sutures, your dentist will instruct you when to return to have them removed.
Your dentist may prescribe medication to control pain and prevent infection. Use it only as directed. If the medication prescribed does not seem to work for you, do not increase the dosage. Please call your dentist immediately if you have prolonged or severe pain, swelling, bleeding, or fever.
Swelling & Pain
After a tooth is removed, you may have some discomfort and notice some swelling. You can help reduce swelling and pain by applying cold compresses to the face. An ice bag or cold, moist cloth can be used periodically. Ice should be used only for the first day. Apply heat tomorrow if needed. Be sure to follow your doctor's instructions.
After the extraction, drink lots of liquids and eat soft, nutritious foods. Avoid alcoholic beverages and hot liquids. Begin eating solid foods the next day or as soon as you can chew comfortably. For about two days, try to chew food on the side opposite the extraction site. If you are troubled by nausea and vomiting, call your dentist for advice.
The day after the extraction, gently rinse your mouth with warm salt water (teaspoon of salt in an 8 oz. glass of warm water). Rinsing after meals is important to keep food particles away from the extraction site. Do not rinse vigorously!
- DO NOT RINSE MOUTH TODAY
Tomorrow rinse mouth gently every 3 to 4 hours (especially after meals) using one quarter teaspoon of salt to a glass of warm water. Continue rinses for several days.
Following extractions, some bleeding is to be expected. If persistent bleeding occurs, place gauze pads over bleeding area and bite down firmly for one-half hour. Repeat if necessary.
Ice bag or chopped ice wrapped in a towel should be applied to the operated area; one-half hour on, and one-half hour off for 4-5 hours.
For mild to average pain, use any non-aspirin type of medication you like. If the doctor prescribes a specific pain medication, follow the instructions and do not mix with other medications unless approved by your doctor.
Light diet is advisable during the first 24 hours.
- BONY EDGES
Small sharp bone fragments may work up through the gums during healing. These are not roots; if annoying, return to our office for their simple removal.
- If any unusual symptoms occur, call the office at once.
- The proper care following oral surgical procedures will hasten recovery and prevent complications.
Bone grafting is commonly performed by an oral and maxillofacial surgeon to replace or augment bone in areas of tooth loss. Bone grafting to the jaws and facial structures may be necessary for a wide variety of scenarios. The most common bone grafts are the facial skeleton and jaw procedures. Other common procedures include tooth extraction site graft, bone graft reconstruction and for a sinus lift. Shrinkage of bone often occurs when a tooth is lost due to trauma, severe caries, or periodontal disease. Additionally, bone loss may have already occurred due to infection or pathology around a tooth. There are many artificial biocompatible bone substitutes available; however, the best material for a bone graft is your own bone, which most likely will come from your chin, the back part of your lower jaw or your hip bone. The hip is considered to be a better source because the hip bone has a lot of marrow, which contains bone-forming cells. There are also synthetic materials that can be used for bone grafting. Most bone grafts use a person's own bone, possibly in combination with other materials.
To place the removed bone in the recipient site, little holes are drilled in the existing bone to cause bleeding. This is done because blood provides cells that help the bone heal. The block of bone that was removed will be anchored in place with titanium screws. A mixture of the patient's bone marrow and some other bone-graft material will then be placed around the edges of bone block. Finally, a membrane is placed over the area and the incision closed.
The bone graft will take about 6 to 12 months to heal before dental implants can be placed. At that time, the titanium screws used to anchor the bone block in place will be removed before the implant is placed.
When a tooth is lost, both bone and gum tissue compete for the vacant space. The gum tissue generates more quickly than bone, subsequently occupying the space. With a membrane placement we can keep the gum tissue from invading the space, which will ideally give the bone sufficient time to regenerate. Bone regeneration is often used to rebuild the supporting structures around the teeth, which have been destroyed by periodontal disease. Bone surgery may be used to attempt to rebuild or reshape bone. Grafts of the patient's bone or artificial bone may be used, as well as special membranes.
Santa Clara Dental has Oral and Maxillofacial Surgeons on staff, who are trained, skilled and uniquely qualified to manage and treat facial trauma. Injuries to the face, by their very nature, impart a high degree of emotional, as well as physical trauma to patients. Some of our doctors may also be on staff at local hospitals to deliver emergency room coverage for facial injuries, which include the following conditions:
- Facial lacerations
- Intra oral lacerations
- Avulsed (knocked out) teeth
- Fractured facial bones (cheek, nose or eye socket)
- Fractured jaws (upper and lower jaw)
The Nature of Maxillofacial Trauma
There are a number of possible causes of facial trauma; e.g. Motor vehicle accidents, accidental falls, sports injuries, interpersonal violence and work related injuries. Maxillofacial facial injuries can range from injuries of the teeth to severe injuries of the skin and bones of the face. Typically, facial injuries are classified as either soft tissue injuries (skin and gums), bone injuries (fractures), or injuries to special regions (such as the eyes, facial nerves or the salivary glands).
Soft Tissue Injuries of the Maxillofacial Region
When soft tissue injuries such as lacerations occur on the face, they are repaired by suturing. In addition to the obvious concern of providing a repair that yields the best cosmetic result possible, care is taken to inspect for and treat injuries to structures such as facial nerves, salivary glands and salivary ducts (outflow channels). Dr. Trinh is proficient at diagnosing and treating all types of facial lacerations.
Bone Injuries of the Maxillofacial Region
Fractures of the bones of the face are treated in a manner similar to the fractures in other parts of the body. The specific form of treatment is determined by various factors, which include the location of the fracture, the severity of the fracture, and the patients age and overall health. When an arm or a leg is fractured, a cast is often applied to stabilize the bone to allow for proper healing. Since a cast cannot be placed on the face, other means have been developed to stabilize facial fractures.
One of these options involves wiring the jaws together for certain fractures of the upper and/or lower jaw. Certain other types of fractures of the jaw are best treated and stabilized by the surgical placement of small plates and screws at the involved site. This technique called "rigid fixation" of a fracture profoundly improved the recovery period for many patients, allowing them to return to normal function more quickly. The treatment of facial fractures is accomplished in a thorough and predictable manner so the patient's facial appearance to be minimally affected.
Injuries to the Teeth and Surrounding Dental Structures
Isolated injuries to teeth are quite common and may require the expertise of various dental specialists. Oral surgeons usually are involved in treating fractures in the supporting bone or in replanting teeth that have been displaced or knocked out. These types of injuries are treated by one of a number of forms of splinting (stabilizing by wiring or bonding teeth together). If a tooth is knocked out, it should be placed in salt water or milk. The sooner the tooth is re-inserted into the dental socket, the better chance it will survive. Therefore, the patient should see a dentist or oral surgeon as soon as possible. Never attempt to wipe the tooth off, since remnants of the ligament that hold the tooth in the jaw are attached and are vital to the success of replanting the tooth. Other dental specialists may be called upon such as endodontists, who may be asked to perform root canal therapy, and/or restorative dentists who may need to repair or rebuild fractured teeth. In the event that injured teeth cannot be saved or repaired, dental implants are often now utilized as replacements for missing teeth.
Crown lengthening is a surgical procedure that re-contours the gum tissue and often the underlying bone of a tooth. Crown lengthening is often for a tooth to be fitted with a crown. It provides necessary space between the supporting bone and crown, which prevents the new crown from damaging bone and gum tissue.
Canine teeth are also commonly referred to as cusped or "eye teeth" since the teeth align under your eyes. You should have two canines in both your upper and lower jaw. They are the strongest teeth you have, used for tearing into your most meaty meals. Because of this need for strength, your canines have the longest roots of all your teeth. They are an essential part of your bite and balanced smile for two main reasons:
- Your Bite
Due to their length, the canines guide your other teeth together when chewing and biting. Canines are essential for maintaining a proper bite.
- Your Appearance
Without canines, large gaps appear in your smile. This can lead to your other front teeth becoming twisted or crooked.
Your canine teeth are generally some of the last teeth to erupt. Occasionally they do not erupt. The two most common reasons are:
- Overcrowding in your mouth
Extra teeth or a small jaw can cause the space where your canines are supposed to come in to be very small, resulting in impaction, or failure to erupt.
- Abnormal growths
Tissue may have developed in your jaw that prevented your canines from reaching the surface.
The fact that teeth don't always come in like they're supposed to highlights the need for regular dental visits when young teeth are developing. If you suspect your child has impacted canines, don't hesitate to make an appointment with Santa Clara Dental. With regular dental visits, x-rays and examinations, the problem of impacted canines can be found out early when treatment is easier. If you are an adult and your canines have not erupted Santa Clara Dental can help. Set an appoint today for an x-ray and consultation. Your smile is up there waiting for you.
Treatment for Impacted Canines
After assessing your situation, Santa Clara Dental will devise a plan to make room for your canines. Will a typical oral surgery and the assistance of an orthodontist your canine will find their way into their proper place over time.
When the extraction of a tooth is required:
- An incision in the gums is made
- The tooth is removed
- The area is stitched up and is allowed to heal
During this time, it is important to think about a tooth replacement option. An extracted tooth leaves an open area in the jaw which, in time, allows the neighboring teeth to drift into the area where the tooth was extracted. This in turn, causes a chain reaction to all the surrounding teeth. Also, if you are considering placing an implant in the future, you should consider asking your dentist to place a bone graft at the time of surgery to preserve the bone width and height.
Wisdom teeth generally begin to form in your pre-teen years. By late teen years, the crown of the wisdom teeth will begin to erupt through the gums if there is adequate room. By mid twenties, your wisdom teeth will either be able to fully erupt or will have become impacted. Early removal of wisdom teeth makes the procedure easier for the patient to tolerate and promotes faster healing after wards. By your early forties, the wisdom teeth roots have become fully anchored to the jawbone and if required to be extracted, will be much harder and will need more time to heal.
Wisdom teeth under ideal circumstances should grow in straight like any other tooth. However, it is common for wisdom teeth to become impacted inside the jaw or just under the gums. If this occurs, your wisdom teeth should be removed.
- Horizontal Impaction
- Angular Impaction
- Vertical Impaction
- Soft Tissue Impaction
The problems involving your wisdom teeth may be caused by the size of your jaw and/or by how crowded your teeth are. Common warning symptoms that there is an un-natural problem in the development of your wisdom teeth could be pain and swelling.
Symptoms can be caused by:
- Infection to the gums
- A crowded tooth displacing neighboring teeth
- A decayed wisdom tooth
- Poorly positioned wisdom tooth
- A cyst that destroys bone