Extractions

You and Dr. Moss, Dr. Diamond, Dr. Novelli, Dr. Han or Dr. Illuzzi-Russo may determine that you need a tooth extraction for any number of reasons. Some teeth are extracted because they are severely decayed; others may have advanced periodontal disease, or have broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth), or in preparation for orthodontic treatment.

The removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, and shifting teeth, which can have a major impact on your dental health.

To avoid these complications, in most cases, Dr. Moss, Dr. Diamond, Dr. Novelli, Dr. Han or Dr. Illuzzi-Russo will discuss alternatives to extractions as well as replacement of the extracted tooth.

The Extraction Process

At the time of extraction the doctor will need to numb your tooth, jaw bone and gums that surround the area with a local anesthetic.

During the extraction process you will feel a lot of pressure. This is from the process of firmly rocking the tooth in order to widen the socket for removal.

You feel the pressure without pain as the anesthetic has numbed the nerves stopping the transference of pain, yet the nerves that transmit pressure are not profoundly affected.

If you do feel pain at any time during the extraction please let us know right away.

Sectioning a tooth

Some teeth require sectioning. This is a very common procedure done when a tooth is so firmly anchored in its socket or the root is curved and the socket can’t expand enough to remove it. The doctor simply cuts the tooth into sections then removes each section one at a time.

After Tooth Extraction

Oral Surgery or the removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.

 

Here are some simple DO’S and DON’T’S following oral surgery:

Don’t spit, suck through a straw, or smoke the week following surgery

Don’t eat crunchy or spicy foods for 2 weeks following surgery (avoid nuts, granola, popcorn, or chips, etc)

Don’t touch wounds or sutures (with tongue, fingers, or utensils) as much as possible

 

Do hydrate well (sports drinks, fruit juices, water) the week following surgery

Do eat cold creamy foods (ice cream, frozen yogurt, milk shakes without a straw) the day of surgery      

Do rinse with warm salt water for 1-2 weeks beginning the day after surgery, especially after eating

Do use cold compresses for 2-3 days following surgery

 

  1. BLEEDING CONTROL: A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for 30 minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for 30 minutes. The tannic acid in the tea bag helps to form a clot. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.

 

  1. Spitting, sucking through a straw, or smoking causes additional bleeding and should be avoided. If bleeding persists, call the office.

 

  1. SWELLING: The swelling that is normally expected is usually proportional to the surgery involved.Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until two to five days post-operatively. Swelling can be somewhat controlled by the use of ice and heat as follows:

 

  1. Ice: Two plastic bags filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be placed 20 minutes, then off for 20 minutes continuously while you are awake. After 36 hours, ice has no beneficial effect.
  2. Heat: If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Swelling and stiffness may be relieved by warm, moist heat applied to the jaws on the 4th or 5th days following the surgery.  The stiffness that can sometimes occur will usually be relieved by the application of heat, the use of chewing gum for short periods of time (15-20 minutes) and gentle stretching exercises beginning 5-6 days after surgery.

 

  1. MOUTH CARE: DO NOT RINSE MOUTH OR BRUSH TEETH FOR 24 HOURS: Rinsing or brushing may dislodge a blood clot and interrupt the normal process of healing. After 24 hours, the mouth should be rinsed gently with a warm salt-water solution (1/4 teaspoon of salt in 8 oz. of warm water) after each meal and at bedtime. The teeth may also be brushed gently, but avoid the site of surgery.

 

  1. Patients may feel hard projections in the mouth. These are the hard bony partitions that surround the roots of teeth. These will absorb or work themselves out.
  2. If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline.

 

  1. PAIN AND INFECTION CONTROL: It is normal to experience some discomfort following oral surgery.  For controlling minor discomfort, taking ibuprofen or Tylenol every 3-4 hours may be all that is needed. Follow the manufacturer’s recommendation for the appropriate dosage.If a prescription for pain medication was written for you, take the medication as directed.

 

**WARNING: DO NOT DRIVE OR OPERATE MECHANICAL EQUIPMENT AFTER TAKING PRESCRIPTION   PAIN MEDICATION

**If you have been given an antibiotic prescription for the control of infection, it is essential that you have it filled and take as directed until the prescription is completed.

**IF YOU SHOULD DEVELOP HIVES, RASH, OR DIARRHEA, DISCONTINUE ALL MEDICATION AND IMMEDIATELY CONTACT THE OFFICE.

**Women please note: some antibiotics may interfere with the effectiveness of your birth control pills. Please check with your pharmacist.

 

  1. DIET: Drink liquids after general anesthesia or sedation. Do not use straws when drinking from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical site(s). High calorie, high protein intake is very important. Try to maintain a normal diet. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least five to six glasses of liquids should be taken daily. Try not to miss a meal. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat.CAUTION: If you suddenly sit up or stand from a lying position, you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.

 

  1. NAUSEA: if nausea is encountered in the immediate post-operative period, taking the pain medication often increases it. In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on stirred Coke, tea, or ginger ale. You should sip slowly over a 15-minute period. Remember not to take the pain medication without something in your stomach. This can be followed with mild tea, broth, and soft foods before resuming your regular diet.

 

  1. BRUISING: Depending on the nature of the surgery which was performed and the nature of the person, some discoloring on the face may be seen for 3-5 days after the surgery. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal postoperative occurrence. If this happens, do not be alarmed.Moist heat applied to the area may speed up the removal of the discoloration.

 

  1. NUMBNESS, TEMPERATURE, SORE THROAT: Numbness, temperature and sore throat are common after affects of the procedure. If numbness of the lip, chin, or tongue occurs, there is no cause for alarm. As stated before surgery, this is usually temporary in nature.

 

  1. A slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
  2. Sore throat and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in two to three days.
  3. Stiffness (trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event that will resolve in time.
  4. If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.

 

  1. SUTURES: Some procedures requiresutures placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged.  This is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures will be removed approximately one week after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure. So it’s really nothing to worry about.

 

  1. POST-OPERATIVE VISIT: Please return to the office for your following visit as directed.

 

 

SAFE and SECURE MEDICINE DISPOSAL – Unused medications that remain in your medicine cabinet are susceptible to theft and misuse. To prevent medications from getting into the wrong hands, New Jersey’s Office of the Attorney General and Division of Consumer Affairs urge you to properly dispose of your expired and unwanted prescription medicine at a nearby Project Medicine Drop location.  DROP OFFS SIMPLE, ANONYMOUS AND AVAILABLE 24 HOURS A DAY – 365 DAYS A YEAR, NO QUESTIONS ASKED. Simply bring in your prescription and over-the-counter medications and discard them in an environmentally safe manner. Always scratch out the identifying information on any medicine container you are discarding. For a list of Project Medicine Drop locations, please visit www.NJConsumerAffairs.gov/meddrop.

 

**NOTE: COVERAGE FOR EMERGENCIES IS AVAILABLE 24 HOURS A DAY, 7 DAYS A WEEK.

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