ORAL, DENTAL AND MAXILLOFACIAL SURGERY

TOOTH EXTRACTION

The teeth that are too carious or broken to be treated with filling, crowing or similar methods and the loose teeth due to progressed gingival disease must be extracted. Besides, the teeth may be extracted if the orthodontist deems necessary for saving space during orthodontic treatment. It is also appropriate to extract milk teeth that are not loose when it is time.

Why should an acute abscessed tooth not be extracted? Should antibiotics be used before each tooth extraction?

diş çekimi.jpg If the tooth has acute abscess (pain, swelling, fever and common weakness), the tooth cannot be extracted on the day of visiting dentist. It is necessary to use antibiotics for minimum two days prior to tooth extraction. The reason for using antibiotics is to prevent tooth infection from spreading over the body through blood. But, no teeth can be treated with antibiotic therapy alone, therefore it must be treated by the dentist. The chronic abscessed tooth may be extracted without antibiotic therapy.

What should you do before tooth extraction?

If your dentist prescribe antibiotics, you must take your antibiotics regularly and on time. If you have any systemic diseases or allergy, and if you continuously use drugs for your condition, you need to discuss this with your dentist. No anticoagulants like aspirin or blood thinners should be used before extraction. You should thoroughly brush your teeth and rinse your mouth with and antiseptic mouthwash, if possible. So, the risk for developing an infection is mitigated by reduced bacteria in the mouth.

Will I have pain after tooth extraction? What is alveolitis?

If the patient follows the recommendations of dentist after a quick and atraumatic tooth extraction, they will not experience pain other than a slight pain on the first day that can be controlled by analgesics. However, the most common cause for the pain following a tooth extraction is dry osteitis. The dry osteitis, also known as alveolitis, occurs when food particles get into the well of the removed tooth, resulting in oral malodor and pain, after the clot is excreted by eating hot food or drinking hot drinks, using straws, sucking or manipulating the wound site, or smoking. It is seen 2-3 days after tooth extraction. In this case, you must immediately see your dentist.

What to do after your tooth is removed

  • You must keep the sterile gauze dressing applied for clot formation for about half an hour in the mouth.
  • Do not tamper the wound site with the tongue or a foreign object.
  • Do not rinse your mouth on the day of tooth extraction and avoid spitting as much as possible.
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A cold compress (ice) should be applied over the extraction site on the chin right after the operation for 10 minutes, then another cold compress should be applied for 10 minutes after allowing for 5 minutes. A cold compress will prevent facial swelling especially following a difficult tooth removal.
The bleeding may continue in the form of leak. However, if you experience a heavier bleeding, put and keep a tea bag in the warm water for some time, take it out and apply it on the wound site for 1 hour. If you have prolonged bleeding, you must see your dentist as soon as possible.
Applying a piece of cotton on the wound site in case of bleeding will impair the wound healing, and the bleeding will be increased when removing the cotton. Therefore, no cotton must be applied on the wound site.

  • Do not use the extraction site for chewing for the first 24 hours.
  • Do not drink anything using a straw for the first 24 hours.
  • Do not smoke or take alcoholic drinks for the first 24 hours.
  • Remember to gargle with warm salty water or a mouthwash prescribed by your dentist every two hours after the first 24 hours. To prepare the mixture of salt and water, boil a glass of water first, then allow it to cool down to a temperature suitable for your mouth, and add a teaspoon of salt in the warm water.
    You should start to brush your teeth on the day after tooth extraction using a smooth toothbrush and use maximum care for oral hygiene without damaging the wound site.
    Avoid spicy, hot, sour, sweet, too hot or too cold food for the first five. .

If you have excessive facial swelling and difficulty in opening or closing your mouth, you may apply a warm compress on the face after consulting with your dentist.
If your dentist prescribe drugs for you to use after extraction, remember to take your drugs regularly on time and do not stop until you complete the medication. It is not necessary to use drugs every time you have your tooth removed. Do not insist on using drugs if your dentist prescribes no medication.



EXTRACTION OF WISDOM TEETH

What are the wisdom teeth?

A wisdom tooth is the third molar and erupts between the ages of 17 and 26 years. Wisdom teeth are the third and final set of molars on the left and right side of the mandible and maxilla.

When should I have my wisdom tooth removed?

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The wisdom teeth cannot erupt in some individuals because there is no enough room on the jaw. They may completely remain underneath the gingiva and jawbone, or may only be found semi-impacted underneath the gum. In this case, the food may get into and deposit in the eruption site of a wisdom tooth, resulting in infection. This manifestation is called pericoronitis that causes swelling and redness of the gum surrounding the wisdom tooth, sever pain radiating towards the neck and ears, swelling of lymph nodes, and pain when opening mouth and swallowing something. In this case, the wisdom teeth must be removed.

It is more difficult to brush wisdom teeth than to brush other teeth because they are not easily accessible. They may easily decay and result in pain and oral malodor because of insufficient brushing. Furthermore, they may impact the adjacent tooth and cause that tooth to decay. The wisdom teeth must be extracted in this case.

In some cases, the wisdom tooth may compress on the teeth anterior to them, resulting in crooked teeth. The wisdom tooth that is identified to cause crookedness must be removed.

A wisdom tooth that is fully impacted and has gone unnoticed for long years may lead to formation of a large-size cyst in the jaw and result in serious problems. Therefore, fully impacted wisdom teeth must be monitored even if they do not cause any problems.

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Should every wisdom tooth be removed?

A fully erupted problem-free wisdom tooth not need to be extracted. However, such wisdom teeth needs special care, i.e., a good hygiene and cleaning, and should be under regular control of a dentist. Again, a fully impacted wisdom tooth that causes no problem may remain in the mouth under regular radiologic control.

Is it difficult and painful to extract a wisdom tooth?

Extraction of a fully erupted wisdom tooth is not different from extraction of other teeth. Extraction of semi-impacted and fully impacted wisdom teeth can be easily performed by minor surgical procedure under local anesthesia without pain. Our patients can quickly return to their daily life following atraumatic and quick operations performed by a team of specialists using state-of-the-art technology devices such as laser and Piezo Surgery available at our clinic.

What to do after extraction of a wisdom tooth

You should avoid spitting, brushing teeth, rinsing your mouth strongly, using straws, or gargling on the first day of extraction. Avoid taking a hot shower. Application of ice cubes will reduce the swelling and bruise within the first twenty-four hours. You should eat warm, non-granular and soft food for the first two days. Use antiseptic mouthwash recommended by your dentist every time you eat something and brush your teeth. The analgesics, and antibiotics -if prescribed- must be taken regularly on time. Do not smoke within the first 48 hours because it will impair the healing process. Visit your dentist to remove the sutures in one week.

Will I have swelling on my face after removal of wisdom tooth?

The swelling caused by edema developed after operation varies from person to person. Application of ice cubes will reduce the edema within the first twenty four hours. It is very important to regularly use the drugs prescribed by your dentist.



SURGERY FOR IMPACTED TOOTH

Why is a tooth impacted?

•The milk teeth remain in the mouth more than necessary

• The milk teeth are lost early

• Genetic causes

• Prolonged inflammation thickens the mucosa on the teeth.

• The bone has a very high density.

• There is no enough room on the jaw and impaction of adjacent teeth

• The permanent teeth have an extra tooth or cystic formation around them.

• The jawbone has an infection.

• Previous diseases of the mother (scarlet fever, measles, and chicken pox) and medication used during gestational period

How is an impacted tooth recognized?

An impacted tooth is defined as a tooth that does not appear on the array of teeth even if it is time to erupt, remaining underneath the mucosa or bone. It is only identified during a radiological examination because it does not cause discomfort most of the time.

Is it necessary to remove an impacted tooth?

The dentist’s decision is important after an impacted tooth is radiologically examined. However, the common practice is to remove the impacted tooth. Bone degradation and periodontal problems may be observed around the adjacent teeth on which an impacted tooth relies. Moreover, the root of the adjacent tooth may be melted away, resulting in loss of the tooth, without causing any discomfort. Pathological conditions such as cyst and tumor may be originated from the dental sac that contains the impacted tooth. The pain on the jaw or earache or temporomandibular joint pain of unknown origin may sometimes disappear when the impacted tooth is removed. An impacted tooth should be preoperatively removed in case of orthodontic treatment because it would prevent dental maneuvers.

Could an impacted tooth be placed in the mouth?

At a young age, an impacted tooth on the front side in particular can be placed in the array of teeth with orthodontic treatment if its position is appropriate.

What to do after surgery of an impacted tooth

You should avoid spitting, brushing teeth, rinsing your mouth strongly, using straws, or gargling on the first day of extraction. Avoid taking a hot shower. Application of ice cubes will reduce the swelling and bruise within the first twenty-four hours. You should eat warm, non-granular and soft food for the first two days. Use antiseptic mouthwash recommended by your dentist every time you eat something and brush your teeth. The analgesics, and antibiotics -if prescribed- must be taken regularly on time. Do not smoke within the first 48 hours because it will impair the healing process. Visit your dentist to remove the sutures in one week.

SURGERY FOR CYSTS OF THE JAW

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A cyst of the jaw is often a benign, slowly developing formation. However, if not intervened and treated on time, it may develop in very large size and cause damage to the normal anatomic cavities such as sinus, nasal cavity and nerves, or evolve into a malignant tumor. An untreated or unidentified cyst slowly develops in time and weakens the jawbone. It makes the jawbone so weak that it can be fractured even by a minor trauma. Therefore, it is necessary to remove any cyst of the jaw.

Is the surgery for jaw cyst a painful procedure?

What is pre-prosthetic surgery?

Frenectomy: The tongue-tie or lip-tie that is called frenulum is longer in some individuals. This may cause problems for the denture prosthesis. This tie or frenulum should be removed by a procedure called frenectomy. It is also necessary to remove denture induced tumor and fibromas that develop due to irritation of denture on the soft tissue before making a new denture in patients who wear ill-fitting denture for a long term. The bone is thinned or lost as a result of uneven transfer of chewing compression to the bone in patients who wear the same denture for long years due to loss of teeth at an early age. The gum on the bone becomes motile. It is very important to remove such motile tissue.

Augmentation of crest:

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A procedure to increase the volume of jawbone in vertical and horizontal direction in patients who have no sufficient amount of bone.

APICAL RESECTION

What is apical resection?

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If the size of an abscess or cystic lesion in the dental root is too large to be treated with root canal therapy, the gum is incised for resection of the infected root site. This procedure is called apical resection.

Would it still be necessary to remove my tooth after apical resection?

The apical resection is a choice of treatment that must be evaluated before tooth extraction. However, infection may recur after apical resection.

What to do after apical resection ?

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You should avoid spitting, brushing teeth, rinsing your mouth strongly, using straws, or gargling on the first day of surgery. Avoid taking a hot shower. Application of ice cubes will reduce the swelling and bruise within the first twenty-four hours. Do not attempt to lift up the lips and see the wound site and do not apply pressure. You should eat warm, non-granular and soft food for the first two days. Use antiseptic mouthwash recommended by your dentist every time you eat something and brush your teeth. The analgesics, and antibiotics -if prescribed- must be taken regularly on time. Do not smoke within the first 48 hours because it will impair the healing process. You may experience dysesthesia on the operated site that may persist for days or weeks. Visit your dentist to remove the sutures in one week. Visit your dentist for controls in six months.

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