• Extractions: Reasons why they may need extraction and homecare after an extraction.
• Wisdom teeth: Why they need to be extracted.
  

One of the main goals of modern dentistry is the prevention of tooth loss. All possible measures should be taken to preserve and maintain your teeth because the loss of a single tooth can have a major impact upon your dental health and appearance. However, it is still sometimes necessary to remove a tooth. Here are some of the reasons a tooth may need to be extracted.

• Severe Decay
• Advanced periodontal disease
• Infection or abcess
• Orthodontic correction
• Malpositioned teeth
• Fractured teeth or roots
• Impacted teeth

If you've just had a tooth extracted or your dentist has recommended that a tooth be extracted, the following information will help you get through the first few days after your extraction. Should anything occur that seems out of the normal, do not hesitate to call us.

POSTOPERATIVE INSTRUCTIONS

• DO NOT DISTURB THE WOUND : In doing so you may invite irritation, infection and/or bleeding. Be sure to chew on the opposite side for 24 hours and keep anything sharp from entering the wound (i.e. eating utensils etc. ). Do not try to exam the area by pulling on your lip or cheek for a better look. This could break any sutures that were placed and induce bleeding and poor healing. 
• DO NOT SMOKE FOR 12 HOURS: Smoking will promote bleeding and interfere with healing.
• BRUSHING: For the first 8 hours after surgery, you can brush your teeth not directly adjacent to the surgical site. Do not use toothpaste during this first 8 hours to prevent the toothpaste  additives from getting into the wound - only use a moist toothbrush.  
  After 8 hours, you may brush your teeth gently with toothpaste, but still avoid the area of surgery for the next 2 days.
• MOUTH WASH: Avoid all rinsing for 24 hours after extraction. This is to insure the formation of a  blood clot which is essential to proper wound healing. Disturbance of this clot can lead to increased bleeding or the loss of the clot. If the clot is lost, a painful condition called dry socket may occur. You may use warm salt water or non-alcoholic antiseptic rinses after 24 hours.
  If we prescribed a special mouthrinse, you may begin using it also after 24 hours. 
• DO NOT SPIT OR SUCK THROUGH A STRAW: This will promote bleeding and may dislodge the blood clot causing a dry socket.
• BLEEDING: When you leave the office, you will be given verbal instructions regarding the control of postoperative bleeding. A rolled up gauze pad will be placed on the extraction site and you will be asked to change this dressing every 30 minutes or so. It is normal for some blood to ooze from the area of surgery. We will also give you a package of gauze to take with you to use at home if the bleeding should continue. Should you need to use the gauze at home, remember to roll it into a ball large enough to cover the wound. Hold firmly in place, by biting or with finger pressure, for about 30 minutes. If bleeding still continues, you may place a fresh tea bag over the site and gently bite down on it. Tea contains tannic acid , a styptic, which may help to reduce the bleeding.
• PAIN : Some discomfort is normal after surgery. Analgesic tablets ( i.e. Aspirin, Ibuprofin, Tylenol etc. ) may be taken under your dentist's direction. Prescription medication, which may have been given to you, should also be taken as directed. If pain continues, call your dentist.
• SWELLING : To reduce swelling, apply an ice pack to the outside of your face in the area of the extraction.  Do not leave the ice pack on your face continually - apply alternately, 15 minutes on then 15 minutes off, during the first 12 hours after surgery, or until you go to sleep for the evening.
  Additionally, it's a good idea to sleep with an extra pillow for the first night to elevate your head slightly. This also helps reduce swelling and discomfort.
• DIET: Eat normal regular meals as soon as you are able after surgery. However, for the first 24 hours, do not eat foods containing small seeds such as tomatoes, sesame seeds, etc., since these seeds could lodge into the extraction site and delay healing.
  Cold, soft foods such as ice cream or yogurt may be the most comfortable for the first day. It is also important to drink plenty of fluids.

If you have any questions regarding these directions, call our office for clarification.

Wisdom Teeth

Wisdom teeth (the molars that are farthest back on both the upper and lower jaw) do not normally erupt until an individual is in the late teens or early 20's. Some time their appearance is delayed until even later in life. Occasionally these molars do not erupt, or break through the gum. Often, they grow sideways. A common problem is impacted wisdom teeth. In this case, the tooth remains trapped beneath the gum line.

Removal of these teeth is necessary for a number of reasons. The most common reason is that they can become painful and sometimes infected. When this happens, an oral surgeon places the patient under anesthesia and then surgically removes the tooth or teeth.

Often, dentists will recommend the removal of the wisdom teeth before they become painful. This is normally based upon review of x-rays that show the misplacement of the wisdom teeth.