ORAL SURGERY RISKS

My philosophy with all my treatment is to do no harm, but there are risks associated with any surgery. The mouth is a highly innervated area with a rich blood supply, along with lots of bacteria. I have outlined my concerns.

BLEEDING: Any tooth extraction or cutting of the tissue will bleed. A history of excessive clotting problems, or hemophilia should be reported to us. Please follow post-up instructions to control bleeding.

INFECTIONS and DRY SOCKETS: If the surgery site or tooth is infected you will be placed on an antibiotic to help control and eliminate the infection. Any open wound such as an extraction site or tumor removal can become infected. Fever, chills, swelling, heat and redness, swollen glands, or general malaise must be reported to this office. Dry sockets or local osteitis occur when the blood clot is lost. Following instructions decreases your chance of a dry socket. Dry sockets usually occur about 3-4 days after a tooth extraction and are characterized by moderate to severe pain. Extraction of teeth and other bony surgeries put pressure on adjacent structures. A weakened tooth or old filling could break; bone can break as well. Be assured that any damage will be reported to you and appropriate treatment of the problem will be taken. It is my policy to not place permanent fillings in an adjacent tooth during the surgery appointment but I will Make sure you are comfortable and the tooth is stable.

RISKS: A weakened tooth or old filling could break; bone can break as well. Be assured that any damage will be reported to you and appropriate treatment of the problem will be taken. It is my policy not to place permanent fillings in an adjacent tooth during the surgery appointment but I will make sure you are comfortable and the tooth is stable.

ROOT TIPS: A tip of the root can remain in the tooth socket during an extraction. If the tip is visible and loose I will remove it. If it is frozen to the bone or impossible to see, I will not dig blindly into an open socket. This can cause damage to adjacent structures. If a root tip is left behind it usually will either stay frozen in the bone forever or work its way out and can then be removed with tweezers. I will periodically check the retained root tip with an x-ray to assure that it is not causing a problem.

BONE SPURS: Tooth extraction and bony surgery can loosen bone and cause small spurs or splinters of bone to work to the surface. These can be easily removed.

PARASTHESIA: Pressure on the nerves around a surgery site can cause permanent or temporary altered sensation in the nerve. Lower wisdom teeth often sit close to the nerve that innervates the lower teeth and lip. This risk factor is one of the reasons I will not work blindly in a socket.

SINUS OPENING: The upper back teeth are positioned close to the maxillary sinus. Removal of a root, cyst, or tooth in that area can cause a sinus opening. If this happens, you will be stitched very tightly, given antibiotics and nose drops to keep your nose and sinus clear, and followed closely after surgery.

POST OPERATIVE INSTRUCTIONS

Rest, lots of fluids, and very limited activities for 48 Hrs. after surgery are important.

DIET: You should try to maintain your normal intake of calories and nutritious food while healing. Eat soft foods such as soups, pasta, chowders, yogurt, cooked vegetables, and soft fruits for the first 48 hours. Avoid any foods with a seed or hull like popcorn, peanuts or sesame bagels until the surgery site heals. This may take a week or two. Avoid alcoholic beverages, carbonated drinks, or sucking through a straw on the day of the surgery.

SMOKING: Smoking increases the chance of infection and delays healing. Smoking should be avoided at least 24 hours after surgery.

ORAL HYGIENE: Begin brushing and flossing your teeth again after the bleeding stops and the anesthesia wears off. Go gently around the surgery site. Salt water rinses help (8 ounces of water with ½ tsp of salt) beginning on the second day. Listerine diluted with some water will also help to kill germs and freshen your mouth beginning the second day. Do not rinse your mouth on the same day of surgery. This can cause bleeding.

MEDICATION: If you are given an antibiotic, take it until it's gone. Pain killers should be taken as directed. If you were not given a prescription, take Ibuprofen or Tylenol for your pain. Call the office if over-the-counter medications do not relieve your discomfort.

SWELLING: Swelling of the surgery site can be lessened by using ice packs on the day of surgery to prevent swelling and by heat packs starting the day after surgery. Heat increases the circulation to the area and helps to carry excess tissue fluid away.

CONTROLLING BLEEDING: If you have an extraction, the area will be packed with gauze. You should bite on this gauze for ½-1 hour and then remove it. If you are still bleeding, place another gauze and keep it in place for at least a half hour. If you run out of gauze, you can use a moistened tea bag. Often when the anesthesia wears off, you start to bleed again. Repack the area if this occurs.

Other things you can do to control the bleeding are to sit in a reclined position with your head above your heart or lay down with an extra pillow under your head. Avoid talking or chewing, and stay relaxed. You may want to put a towel over your pillowcase the first night in case you are still bleeding a little.

WHEN TO CALL:

Call if you have any questions or concerns after treatment
Call if you cannot control the bleeding
Call if you have any sign of infection such as fever, chills, swelling, or malaise
Call if you are in a lot of pain or if the pain gets worse instead of better as the days go by.

WEB DISCLAIMER

***If you are allergic or have had any adverse reaction to aspirin, motrin, aleve, Ibuprofen, or any Non-steroidal anti inflammatory drugs (NSAIDS), do not take medications listed above. Call the office for proper instruction.

***If you are on other medications, there is a possibility of an adverse drug reaction. Please call us and/or your physician or pharmacist before starting any medication, including those listed above.