There are a number of reasons that your dentist might recommend a tooth extraction. Some dental patients suffer from tooth decay; others need to remove teeth hindering orthodontic treatment, whereas various patients simply need wisdom teeth removal. While a tooth extraction can be a serious dental procedure, aftercare is just as critical as the procedure itself. As the dental patient, it is important to understand that pain and the risk of infection can be lessened with proper care.

Care immediately following surgery:

After your tooth has been extracted, healing will take some time. Within 3 to 14 days, your sutures should fall out or dissolve. For sutures that are non-resorbable, your doctor will schedule a follow-up appointment to remove the stitches for you. Your tooth’s empty socket will gradually fill in with bone over time and smooth over with adjacent tissues.

Possible complications after a tooth extraction

Bleeding – Bleeding after a tooth extraction is entirely normal. A pinkish tinted saliva and subtle oozing is fairly common during the first 36 hours. If bleeding gets excessive, control it by using dampened gauze pads and biting down to keep pressure on the area. As an alternative to gauze pads, a moistened tea bag can be used, as the tannic acid helps blood vessels contract. Apply pressure to the gauze or tea bag by gently biting down for 30 minutes. Please remember that raised tempers, sitting upright, and exercise can all increase blood flow to the head, which can cause excess bleeding. Try to avoid these as much as possible. If your bleeding does not reduce after 48 hours, please call the practice.

Bone sequestra (dead tooth fragments) – Some patients have small sharp tooth fragments that were unable to be completely removed during surgery. During the recovery period, these dead bone fragments, or bone sequestra, slowly work themselves through the gums as a natural healing process. This can be a little painful until the sequestra are removed so please call our practice immediately if you notice any sharp fragments poking through the surgery site.

Dry socket – In the days that follow your tooth extraction, pain should gradually subside. Rarely, patients report that pain increases to a throbbing unbearable pain that shoots up towards the ear. Often this is a case of dry socket. Dry socket occurs when the blood clot becomes irritated and ousted before healing is complete. Food and debris can then get into the socket causing irritation. Tobacco users and women taking oral contraceptives are at a higher risk of getting dry socket. Dry socket is not an infection but does require a visit to our office. If you think you may be suffering from dry socket, please contact the practice immediately.

Lightheadedness – Because you may have been fasting prior to surgery, your blood sugar levels may be lower than normal. Until your body has had the chance to catch up and process some sugars, you should remember to stand up slowly when getting up from a relaxed position. For somewhat immediate relief, try eating something soft and sugary, stay in a relaxed position, and reduce the elevation of your head.

Numbness – Many patients report still feeling numb hours after their tooth extraction procedure. An extended lack of feeling around the mouth is normal and can last 10-12 hours after surgery.

Swelling – Swelling should subside almost entirely within 10 days after surgery. Immediately following your tooth extraction, apply an ice pack to the facial areas near the extraction. Continue using the ice in 15 minute intervals for the first 36 hours. After 36 hours, ice will no longer be beneficial in reducing swelling and moist heat should be used instead. To decrease swelling, apply a warm damp cloth to the sides of your face.

Trismus (difficulty opening and closing mouth) – If you experience a sore jaw and difficulty chewing or swallowing, do not be alarmed. Occasionally patients’ chewing muscles and jaw joints remain sore 3-5 days after surgery. This soreness can also make it difficult to open and close your mouth. Soreness should eventually subside.

Following dental implant surgery, patients must take detailed care of the area surrounding their new implant.  For the first month the dental implant is still integrating with the bone and tissues so the patient’s care routine will be slightly more involved during this initial period.  Above all, do not disturb the wound in the initial days that follow surgery.  Avoid rinsing, spitting, and touching the mouth for 24 hours after surgery to avoid contaminating or irritating the surgical site.  After dental implant surgery it’s important to follow these care instructions:

What does recovery involve?

While each patient’s case is different, recovery after dental implant surgery happens in a series of phases. With your new dental implants, maintaining proper oral hygiene should be your primary focus. In order for the implant to properly fuse with the jawbone, it must remain clean. Also keep in mind that when properly cared for, a dental implant can serve its owner for life.

When maintaining proper hygiene, oral discomfort should gradually lessen. Swelling, bruising, and minor bleeding may still occur. If any pain does continue, feel free to continue using the pain medications.

Healing time differs depending on whether a patient receives immediate crown placement, or waits for the implant to fuse with the jawbone. Your recovery timeframe will depend on your individual case and treatment plan; follow-up appointments will be scheduled accordingly.

Prior to your dental surgery you will have the opportunity to address any concerns you might have during your pre-op appointment. We encourage you to ask questions and make us aware of any fears you might have. Our main goal is to create a secure, comfortable environment for our patients on the day of surgery so the more you communicate with us, the easier we can accommodate your needs. The following guidelines are meant to serve as reminders in helping you prepare for your dental surgery. If you have any questions, feel free to contact our practice.

Leading Up to the Day of Surgery

            – Cardiac medications
            – Pulmonary medications
            – Steroids
            – Anti-seizure medications
            – Anti-Parkinson’s medications

Day of Surgery

If you have any change in health the morning of you appointment, please contact the practice immediately. A cold or fever with chest and sinus congestion may dangerously affect surgery so it is imperative that our practice is made aware of the situation. If it is necessary to reschedule your appointment, we will notify you.

Oral and maxillofacial surgeons are specialists with advanced training and expertise in the diagnosis and treatment of various head and neck conditions and injuries.  After four years of dental school, an oral and maxillofacial surgeon completes four to six years of additional formal training in treating the craniomaxillofacial complex.  This specialty is one of 9 dental specialties recognized internationally and by the American Dental Association (ADA).

An oral and maxillofacial surgeon can diagnose and treat a wide variety conditions.  The following are just some of the many conditions, treatments and procedures oral and maxillofacial surgeon deal with on a daily basis:

Whether your dentist refers you to our office, you have pain or symptoms causing you concern, or you simply have questions you would like answered, please contact our office today to schedule an appointment. We are here to answer your questions and provide the treatment you deserve!

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An oral exam is routinely performed by the dentist during the course of an initial comprehensive exam and regular check-ups. An oral cancer exam refers to the identification and management of diseases pertaining to the maxillofacial and oral regions.

The soft tissue of the mouth is normally lined with mucosa, which is special type of skin that should appear smooth in texture and pink in color. Any alteration of the color or texture of the mucosa may signal the beginning of a pathologic process. These changes may occur on the face, neck, and areas of the mouth (e.g., gums, tongue, lips, etc.). The most serious of these pathologic changes (which may or may not be painful) is oral cancer, but there are also many other common pathologic problems.

Geographic Tongue – Also known as Benign Migratory Glossitis or Erythema Migrans, is a condition where the tongue is missing papillae (small bumps) in different areas, and a map-like appearance can develop. This condition is usually seen as red well defined areas on or around the sides of the tongue. The red patches (which can look like an unsightly rash) may come and go from hours to months at a time and cause increased sensitivity to certain substances.

Median Palatal Cyst – This cyst is of developmental origin and is essentially a fluid filled skin sac. It usually appears in the middle of the palate and may cause substantial discomfort.

Hairy Tongue – An overgrowth of bacteria or a yeast infection in the mouth which can cause the tongue to appear hairy and black. This condition is usually a result of poor oral hygiene, chronic or extensive use of antibiotics, or radiation treatments to the head or neck. It is often also seen in HIV positive patients and those who are intravenous drug users. Hairy Tongue may or may not require treatment.

Treatment of Pathological Diseases

In the majority of cases, the pathological changes experienced in the oral region are uncomfortable and disfiguring, but not life threatening. However, oral cancer is on the rise (especially among men) and the chances of survival are around 80% if an immediate diagnosis is made.

Oral cancer is a general term used when referring to any type of cancer affecting the tongue, jaw, and lower cheek area. Since it is impossible for the dentist to decisively diagnose a pathological disease without taking a biopsy sample of the affected area, seeking immediate treatment when changes are first noticed might be a life and death decision. For less serious problems, there are several options available, such as:

Oral Examinations

During the course of a regular check up, the dentist will thoroughly inspect the soft tissue of the mouth and take serious note of any changes. If there are cell changes present, the dentist will take a biopsy of the affected area and send it away to be analyzed by laboratory specialists. When definitive results are obtained, the dentist can decide on the best course of treatment.

Oral Cancer Screenings

An oral cancer screening is usually performed during a comprehensive or recall (check-up) exam. Screening is painless and only takes a few minutes. The dentist or hygienist will use a laser light to assess the soft tissue for cell changes that might be indicative of oral cancer. If such cell changes are present, a small biopsy will be taken and sent to a laboratory for review. If the biopsy indicates that oral cancer is present, an excision (removal) will generally be performed.

Humans have two upper (maxillary) canines and two lower (mandibular) canines. Canine teeth are sometimes referred to as cuspids, fangs, or “eye teeth” because of their direct positioning beneath the eyes. Canine teeth have thicker and more conical roots than incisors and thus have an especially firm connection to the jaw. Canine teeth often have the longest root of all teeth in the human mouth and are the last to fully erupt and fall into place, often around age 13.

An impacted tooth essentially means that it is blocked, stuck, or unable to fully erupt and function properly. Third molars (wisdom teeth) most commonly fall victim to impaction, but the upper canine is the second most common tooth to become impacted. Wisdom teeth serve no important function in the mouth and are frequently removed; however, impacted canines are a critical condition and require treatment for the following reasons:

What causes canine teeth to become impacted?

There are several main causes for impacted canine teeth:

Extra Teeth – If extra teeth are present, the natural eruption of the canine teeth may be inhibited. The eruption progress of the canine may be directly blocked by an extra tooth or the subsequent overcrowding might leave no room on the dental arch for the canine.

Overcrowding – In some cases, poor alignment of the front teeth can lead to overcrowding. The existing teeth compete for space which means that the canines do not have sufficient room to become functional.

Unusual Growths – On rare occasions, unusual growths on the soft tissue of the gums can restrict the progress of canine teeth, which leads to later impaction.

Early and thorough examination of the teeth can pre-empt problems with impacted canines. It is important for the dentist to document the number teeth present when the patient is around 7 years of age in order to record the presence or absence of canine teeth. The older the patient becomes, the less likely it is that an impacted canine tooth will erupt naturally. If canine teeth are missing or very slow in fully erupting, the dentist can make recommendations for proper treatment.

Oral Examination

The dentist initially conducts a thorough visual examination of the teeth, accompanied by a panorex x-ray and/or individual x-rays. Once the cause of the impaction has been determined, there will be several treatment options available depending upon the age of the patient. The objective is to aid the eruption of the impacted canines, and this can be skillfully done by the dentist, an oral surgeon, or an orthodontist.

What does the treatment of impacted canines involve?

If your mouth is overcrowded for any reason, the dentist may recommend extraction of teeth. The extraction will generally be performed under local anesthetic by an oral surgeon. The un-erupted canine will then be exposed by lifting the gum, and guided into place using a special bracket.

In the case of younger patients, an orthodontic brace may be fitted to create a space on the dental arch for the impacted canine. Surgery for impacted canines usually does not require an overnight stay. Pain medication will be prescribed as necessary, and you’ll be given post treatment advice for your recovery.

The teeth are held firmly in place by strong roots that extend into the jawbone. Molars and premolars tend to have several roots, whereas the front incisors only have a single root. The end or tip of each root is termed the apex. The apex is where the nerves and blood vessels enter the tooth and aids in the delivery of blood to the crown (the part of the tooth you can see in your mouth).

A root canal treatment refers to the cleaning of the canals and the removal of infected and inflamed tissue within the root. When the inflammation or infection persists after the root canal treatment, an apicoectomy may be required. An apicoectomy is essentially the removal of the apex (or root tip), followed by a filling procedure to seal the root from further infection. When left untreated, infected roots can damage other teeth, spread infection, and cause regression of the jawbone.

Reasons for an apicoectomy

Infected and inflamed soft tissue around the root of a tooth can be exceptionally painful and debilitating. The purpose of an apicoectomy is to eliminate the infection in the tissue and to ultimately preserve the function of the tooth and save it from extraction. An apicoectomy will rarely be considered by the surgeon unless a prior root canal treatment has failed.

There are several reasons why an apicoectomy may be necessary:

What does getting an apicoectomy involve?

Prior to the surgery, the surgeon will generally prescribe an antibiotic or anti-inflammatory medication to treat the underlying infection. Panoramic X-rays will then be taken to enable the surgeon to plan the apicoectomy, which will be performed under local anesthesia.

The surgeon will make a small incision in the gum and expose the root by lifting away the gum. In some cases, a tiny fraction of the jawbone may be removed to properly expose the root. The edge of the root tip and any infected connective tissue will be removed using ultrasonic instruments. The root will be sealed using a retrofill (filling material), and the surgeon will suture the gum with several stitches.

This surgery does not require an overnight stay, and full aftercare instructions and pain medications will be provided as needed. After several days, the surgeon will remove the stitches, and the connective tissues will fully heal several months after the procedure.

If you are experiencing extreme sensitivity or are suffering from advanced periodontal disease, you may be required to have a tooth extracted.  With a simple extraction, the dentist can safely remove the affected tooth without the need for major surgery.

Reasons for a tooth extraction

There are numerous situations in which a simple extraction can help alleviate pain or prepare you for another cosmetic or restorative procedure.  Some common reasons for extraction include:

How is a tooth extracted?

As a precaution, the dentist will first take X-rays of the tooth or teeth in question, to help plan the procedure.  After preparing a method of extraction, you will be given a local anesthetic that will prevent you from feeling pain during the procedure.  Next, the dentist will use a tool called an elevator to lift the tooth and loosen ligaments and gum tissue around the base of the tooth.  Finally, the dentist will use a pair of forceps, to gently rock the tooth back and forth until it breaks free of the ligaments holding it in the gum tissue.  Occasionally, a stubborn tooth will resist the dentist’s soft tug, refusing to come out.  In these and more complex cases, the tooth may need to be broken up into smaller pieces for removal. 

Once removed, we will pack gauze into the socket and have you place pressure on the area by biting down.  If necessary, the dentist will place stitches to close the socket.

If you are sick the week prior to your scheduled extraction or on the day of, please contact our office, as alternative arrangements may need to be made.  Please contact us if you have any questions or concerns.

Pediatric dentists (or pedodontists) are qualified to meet the dental needs of infants, toddlers, school-age children, and adolescents.  Pediatric dentists are required to undertake an additional two or three years of child-specific training after fulfilling dental school requirements.

In addition to dental training, pediatric dentists specifically study child psychology.  This enables them to communicate with children in an effective, gentle, and non-threatening manner.

The American Academy of Pediatric Dentistry (AAPD) recommends that children see a pediatric dentist before the age of one (or approximately six months after the emergence of the first primary tooth).  Though this might seem early, biannual preventative dental appointments are imperative for excellent oral health.

Parents should take children to see a pediatric dentist for the following reasons:

What does a pediatric dentist do?

Pediatric dentistry offices are colorful, fun, and child-friendly.  Dental phobias are often rooted in childhood, so it is essential that the child feel comfortable, safe, and trusting of the dentist from the outset.

The pediatric dentist focuses on several different forms of oral care:

Prevention – Tooth decay is the most prevalent childhood ailment.  Fortunately, it is almost completely preventable.  Aside from providing advice and guidance relating to home care, the pediatric dentist can apply sealants and fluoride treatments to protect tooth enamel and minimize the risk of cavities.

Early detection – Examinations, X-rays, and computer modeling allow the pediatric dentist to predict future oral problems.  Examples include malocclusion (bad bite), attrition due to grinding (bruxism), and jaw irregularities. In some cases, optimal outcomes are best achieved by starting treatment early.

Treatment – Pediatric dentists offer a wide range of treatments.  Aside from preventative treatments (fluoride and sealant applications), the pediatric dentist also performs pulp therapy and treats oral trauma.  If primary teeth are lost too soon, space maintainers may be provided to ensure the teeth do not become misaligned.

Education – Education is a major part of any pediatric practice.  Not only can the pediatric dentist help the child understand the importance of daily oral care, but parents can also get advice on toothpaste selection, diet, thumb-sucking cessation, and a wide range of related topics.

Updates – Pediatric dentists are well informed about the latest advances in the dentistry field.  For example, Xylitol (a naturally occurring sugar substitute) has recently been shown to protect young teeth against cavities, tooth decay, and harmful bacteria.  Children who do not see the dentist regularly may miss out on both beneficial information and information about new diagnostic procedures.

Primary teeth, also known as “baby teeth” or “deciduous teeth,” begin to develop beneath the gums during the second trimester of pregnancy.  Teeth begin to emerge above the gums approximately six months to one year after birth.  Typically, preschool children have a complete set of 20 baby teeth – including four molars on each arch.

One of the most common misconceptions about primary teeth is that they are irrelevant to the child’s future oral health.  However, their importance is emphasized by the American Dental Association (ADA), which urges parents to schedule a “baby checkup” with a pediatric dentist within six months of the first tooth emerges.

What are the functions of primary teeth?

Primary teeth can be painful to acquire.  To soothe tender gums, biting on chewing rings, wet gauze pads, and clean fingers can be helpful.  Though most three-year-old children have a complete set of primary teeth, eruption happens gradually – usually starting at the front of the mouth.

The major functions of primary teeth are described below:

Speech production and development – Learning to speak clearly is crucial for cognitive, social, and emotional development.  The proper positioning of primary teeth facilitates correct syllable pronunciation and prevents the tongue from straying during speech formation.

Eating and nutrition – Children with malformed or severely decayed primary teeth are more likely to experience dietary deficiencies, malnourishment, and to be underweight.  Proper chewing motions are acquired over time and with extensive practice.  Healthy primary teeth promote good chewing habits and facilitate nutritious eating.

Self-confidence – Even very young children can be quick to point out ugly teeth and crooked smiles.  Taking good care of primary teeth can make social interactions more pleasant, reduce the risk of bad breath, and promote confident smiles and positive social interactions.

Straighter smiles – One of the major functions of primary teeth is to hold an appropriate amount of space for developing adult teeth.  In addition, these spacers facilitate the proper alignment of adult teeth and also promote jaw development.  Left untreated, missing primary teeth cause the remaining teeth to “shift” and fill spaces improperly.  For this reason, pediatric dentists often recommend space-maintaining devices.

Excellent oral health – Badly decayed primary teeth can promote the onset of childhood periodontal disease.  As a result of this condition, oral bacteria invade and erode gums, ligaments, and eventually bone.  If left untreated, primary teeth can drop out completely – causing health and spacing problems for emerging permanent teeth.  To avoid periodontal disease, children should practice an adult-guided oral care routine each day, and infant gums should be rubbed gently with a clean, damp cloth after meals.