Whenever any surgery / Tooth extraction takes place the first thing we want is to let it heal properly ,quickly and smoothly. As a common practice, most of the dental surgeons have standard post surgery instructions printed which are handed over to the patient. One must follow these instructions given by the dentist. Apart from those instructions there are few things which need to be taken care post extraction.
Try to take some rest. You may feel great but don’t exercise at least for a day.When taking rest,keep your head lifted on a pillow.
Let the clot be formed on the tooth extracted site , which covers it and allow it to heal. Bite on the gauze piece, which the dentist has put on the extraction socket, minimum for an hour. Don’t chew on that gauze piece but put a steady pressure. This will help in stopping the bleeding and formation of clot which acts like a cork on the bottle. Change gauze after every half an hour depending on the amount of bleeding. If clot is dislodged,the nerve endings are exposed,nerves and capillaries spasm and constrict,limiting essential blood supply which causes delay in healing. If the bleeding doesn't stop one should try putting a wet tea bag in the site, as tannic acid present in black tea helps stop bleeding.
Don’t spit minimum for 24 hours because it can dislodge the clot. If the clot is dislodged you can have very painful condition known as dry socket. Afterwards one should spit 3-4 times in a day so that no food is lodged near the area where the tooth is removed. Dentist may advice CHLOROHEXIDINE mouth rinses as they kill bacteria.
Don’t smoke for 48 hours. The chemicals in the smoke can effect the clot and hence the chances of developing dry socket.
Don’t take solids till the numbness is there. When you start feeling your jaws you can start taking solids.
Take your medicines as prescribed by your dentist. Don’t skip the medicines. If antibiotics are given they should be taken regularly. Pain killers and anti-inflammatory drugs help in reducing the pain and swelling. If the pain continues even after two days and bleeding starts then you should call your dentist.
Avoid Sucking of any type - SMOKING, SIPPING, EATING HARD VEGETABLES. Try taking soft and liquid food options such as soups, mashed potatoes, yogurts, milkshakes, smoothies etc. Avoid hot drinks, spicy foods, sodas, etc.
If you are daring enough to avoid these instructions, you may be a strong contender for some complications.
WHAT COMPLICATIONS CAN BE THERE AFTER EXTRACTION?
- Bleeding
- Infection
- Dry socket
- Jaw fracture
- Sinus perforation
- Broken Bone Fragments (Sequestrii)
- Part of the Tooth Left (Retained Roots)
- Osteonecrosis
Bleeding : If one follows the instructions of the dentist after extraction to take rest and to keep the gauze piece for 1 to 2 hours after extraction then the problem of bleeding is not there. The patients who are taking anticoagulants like Heparin or Coumadin or the patients who have bleeding disorders like hemophilia should give the history to the dentist. The patients who are taking aspirin or nonsteroidal analgesics have increased bleeding time.
Infection : Infection is the most common complication after extraction. Our mouth Is full of bacteria. One cannot sterilize it. Dentist decides whether to give antibiotics after the extraction or not. Normally for the simple extractions antibiotics are not required but if patient has pain and swelling or pus then it is better to go for preventive antibiotics. Bleeding continuing after 48 hours, acute pain and swelling are very common signs of infection after the extraction and the patient must visit the dentist in such circumstances to avoid further complications.
Dry Socket: It is the most dreaded and painful condition which can happen after extraction. For a day or two after extraction the patient is fine, and then he has acute pain and becomes very restless. Patient complains of bad taste in the mouth. It is more common after the extraction of lower teeth than the upper teeth. It can happen even after the simplest extraction.
Jaw Fracture : It can happen but very rarely and that too in lower jaw. The dentist who is doing the extractions knows that how much pressure has to be put to pull out the tooth. But sometimes dentist before doing the extraction see the x-ray and tell the patient that the bone structure around the tooth has become fragile and chances of fracture are there. In such cases patient and the dentist are prepared beforehand to manage the situation.
Sinus Perforation: The back teeth are in close proximation with the sinus. Sometimes if you see the x-ray it looks as if the roots of the back teeth are virtually in the sinus. It never happens. There is always a thin bone separating the sinus from the roots of the teeth. But sometimes during extraction the piece of the bone comes along with the sinus. This normally happens when the tooth is close to the bone because of infection. In that case perforation occurs. If perforation occurs you cannot suck because in that case the air will rush from the nose to the sinus and through perforation to the mouth. If the perforation is small the patient complains of bleeding from nose. If the perforation occurs then the patient should follow certain instruction like:
- Do not suck anything till the extraction socket heals.
- Do not do anything which will dislodge the clot. If the clot is not disturbed then no complication arises.
- Do not smoke at least for a week because the chemicals in the smoke either dissolve the clot or dislodge it.
- Do not blow up the balloons or anything else, it will disturb the clot..
- Avoid aerated drinks instead you can take fruit juices.
- Don’t sneeze, it sneezing will surely dislodge the clot.
If the perforation is big and it does not heal by itself then another surgical procedure is carried out in which tissue graft is put to close the perforation.