The two tooth extraction methods: Simple and surgical.

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Tooth extractions

Some of the conditions that lead to the removal of a tooth include:

  • Serious gum disease that leaves the tooth mobile and exposed.
  • Extensive decay.
  • Failed fillings and root canals.
  • Not enough space for the tooth the enter your mouth.
  • Accidents when teeth become gravely injured and half-lodged from their sockets.

What is the procedure for an extraction?

Following the diagnosis and decision to extract the tooth your dentist will have a conversation with you to assess your general health, mental health and understand your oral disease history.

The difficulty of the extraction will be assessed, this will vary depending on:

  • Anatomy of the tooth, in particular its root structure (eg curved, bulbous or fused roots can be challenging).
  • The tooth’s proximity to important anatomical factors (eg nerves and blood vessels).
  • The tooth’s location in your mouth and accessibility to the tooth.
  • Your general health and compliance.

Once all these factors have been considered your dentist will recommend either a simple or surgical extraction. Below are explanations for simple and surgical extractions.

Simple extractions

Simple extractions are relatively easy procedures that can be performed by your dentist in their rooms. This type of extraction is done on teeth that are:

  • Full erupted and clearly visible in your mouth.
  • Easy to access.
  • Have a simple root anatomy (ie roots not too bulbous, long or curved).
  • Not located too close to vital anatomy.

Once your dentist has thoroughly numbed the surrounding area, he or she is able to use a tool called an elevator to help loosen the tooth from its socket. After the tooth is sufficiently loosened, forceps can be used to fully remove the tooth in question.

Simple extractions are generally a quick procedure, and often multiple teeth can be removed at once if they need to be. Your dentist will instruct on precautions to take after tooth removal, such as keeping the site clean and certain foods to avoid for the first few days.

A slight ache and mild swelling are normal after a simple extraction. You may need to take painkillers for a couple of days.

Surgical extractions

Surgical tooth extractions are more complex procedures and involve higher risk. A surgical approach may be required when the tooth:

  • Has not come up through the gum into the mouth eg impacted wisdom teeth.
  • Is difficult to access.
  • Has a difficult root anatomy.
  • Is located close to vital anatomy such as nerves and blood vessels.

Before your surgical extraction, an orthopantomogram (OPG) will be required. This is an xray which shows your upper and lower jaws.

During surgical extraction, your surgeon will make a small incision in your gum to access the tooth, then remove the tooth either intact or by breaking it into smaller pieces. Generally, surgical extractions can be performed with a local anesthetic, but sometimes general anesthesia is required to make the process easier for patient and doctor.

Surgical extractions generally involve a more diligent aftercare routine in the days following your procedure, so be sure to check with your surgeon about how best to care for yourself and your mouth. In general, a maxillofacial oral surgeon will be the best qualified person to do these extractions.


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What is a dry socket?

A dry socket (also called alveolar osteitis) occurs when the blood clot which normally forms in the extraction site, dislodges after surgery.  The clot is important as it protects the bone and nerves from bacteria and constant stimulation, allowing optimum healing to occur.

Dry sockets occur in 2 -5% of all extractions, but unfortunately this can rise to 30% when wisdom teeth are extracted

What are the symptoms of a dry socket?

  • Severe sharp pain which can radiate from the site of extraction to the eyes ears or nose.
  • Unpleasant taste in the mouth.
  • Bad breath that remains even after brushing teeth.
  • Visible bone in the extraction site due to loss of blood clot.

Who is more likely to get a dry socket?

The most common risk factors are:

How to prevent a dry socket?

Before surgery

  • Let your surgeon know all the medication you are taking.
  • If you are a smoker  – this might be a good time to consider quitting.  It is advised to refrain from smoking the day before your scheduled procedure.

After surgery

Follow your surgeon’s post-operative instructions carefully to minimise the risk of a dry socket.

  • Take medication as prescribed.
  • Avoid using straws & carbonated drinks for at least one week after surgery.
  • Eat a soft diet such as yogurt, jelly, clear soup, apple juice until you can manage semi-soft foods. Avoid crunchy foods such chips, popcorn and berries with seeds.
  • Gently use a saltwater rinse as a mouthwash several times a day (especially after eating). Don’t be too vigorous or you may dislodge the clot.
  • The day after surgery you can resume gentle brushing of the teeth around the extraction site.
  • Refrain from smoking for 48 hours after surgery, the use of a nicotine patch may help with cravings.

If you experience any of these signs or symptoms of a dry socket you should contact to your Oral & Maxillofacial surgeon for a review.  They will look at the socket and may conduct additional tests or X-rays to rule out other potential cause of pain before diagnosing a dry socket.

 

 


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Wisdom teeth extraction surgery is a relatively standard procedure. Whilst it is a routine procedure for your oral and maxillofacial surgeon, it may not feel the quite same for you. Following is some information about wisdom tooth extraction and tips for what can be done to assist with a speedy recovery.

The day of your surgery

Depending on the degree of difficulty, wisdom tooth surgery is done under either local or general anaesthetic.

If the extraction is simple it can be performed in your oral surgeon’s rooms using local anaesthetic. During the procedure you may be given an oral sedative, nitrous oxide (laughing gas) and/or intravenous sedation to help you relax.

More complicated wisdom teeth extractions will require a general anaesthetic, you’ll will go to a private day surgery. Whilst the actual operation is quick, the whole procedure from admission to going home can take half a day.

Your oral and maxillofacial surgeon will discuss the anaesthetic options with you, so you know what to expect.

After your surgery, you will be given instructions for pain relief and what to do during home care. At this stage pain, swelling, and slight oozing of blood are normal. Application of an icepack can assist with swelling and discomfort.

Diet

Most oral surgeons will tell you only to eat soft foods during the first few days to minimise discomfort, keep the wound clean and prevent the blood clot from dislodging.

The blood clot that forms over your socket will protect your jaw bone and nerves during the healing process. This blood clot is delicate for the first 24 hours after surgery. Loss of this clot can lead to a condition known as dry socket. Dry socket can cause severe pain and can lead to complications.

Working and driving

It’s a good idea to take a day or two off after surgery as you recover from the anaesthetic. If you received a sedative, you should wait for at least 24 hours before driving, and at least 48 hours after receiving a general anaesthetic.

Home care advice

Your oral surgeon should provide you with wisdom tooth removal recovery tips. Taking care of your mouth will speed up healing and prevent infections from taking hold.

The most common advice you’ll hear is:

1) Not to brush your teeth or floss or use mouthwash for at least a day after the procedure.

2) Starting the day after your operation, you can use salt water to gently rinse your mouth. Be gentle and don’t vigorously rinse or spit the water out.

3) Eat soft cool foods for the first day, and soft foods for the first week after your surgery.

4) Avoid drinking from a straw, as this can dislodge the blood clot that’s protecting the wound.

If you notice severe pain, including in your jaw, jawbone, eyes, ears, and throat, or excessive bleeding days after your operation, get in touch with your oral and maxillofacial surgeon.  While some soreness is normal, it should start to subside a week after your operation.  Rising pain can indicate potential complications and possible infection.

How long does it take to recover from wisdom teeth removal?

The time from getting your wisdom teeth removed to recovery will depend on you. People heal at different rates, and while one person may be walking around a day after they had their teeth removed, another may be out for several days.

Most people start feeling better about three days after the surgery, but you may still have swelling and pain for several weeks after the surgery

How to speed up healing

The best way to speed up healing is to ensure that the blood clot that protects the wound remains in place. You can do so by following the home care advice mentioned above.

To prevent infections, you need to exercise good oral hygiene during the recovery process. Also, try and eat healthy, soft foods that are nutritious. Your body needs a lot of fuel to recover and heal from wisdom teeth extraction, so try to eat plenty of liquids, soft vegetables, soft eggs, smoothies, yogurts, soups, and other approved foods. Smoking and alcohol should be avoided during the healing period.

If you have any questions or concerns, don’t hesitate to contact your Dr Kristian van Mourik.

 


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Dental implants are a major surgical procedure. Whilst post-operative pain is minimal and normal activities are usually resumed within a couple of days, the recovery process varies from patient to patient and depends on several factors:

  • How many implants were placed – the more implants, the longer your recovery.
  • Staging of implant placement – generally if a tooth is extracted and an immediate implant is placed, recovery will take slightly longer. If the tooth being replaced was extracted a couple of months prior to implant placement the implant generally integrates faster with the bone.
  • Pre-existing medical conditions some medical conditions such as diabetes and osteoporosis may delay healing.
  • Infection – if the tooth being replaced by an implant is infected at time of surgery, recovery will take longer
  • The amount of bone existing – if there is a good volume and quality of bone, recovery is faster. If there is bone loss, and grafting material  is required recovery can take longer.
  • Quality of the implant being placed 
  • Skill of the surgeon placing the implant.
  • Management of oral hygiene – this is a huge factor in the success of an implant. Regular brushing of the teeth and saltwater rinsing helps immensely.
  • Following diet guidelines – eating a soft diet initially, taking care not to bite down on hard foods such as nuts and chewy bread allows the implant to integrate well with the surrounding bone.
  • Smoking – delays the healing process.
  • Attending regular review appointments with your surgeon ensures your recovery is running smoothly.

Recovery time line

Day of your operation

If you’ve general anaesthetic or IV sedation you will require someone to assist you get home. If done under local anaesthetic, you can drive home yourself.

Once the anaesthetic wears off you will feel slight pain coming from the site of the implant. Normal painkillers are usually all you’ll need. An icepack can help reduce any swelling or pain.

Approximately 2 hrs after the implant placement you can commence a soft food diet. Ice cream, smoothies and soup are good.  Avoid hard foods and drinking from a straw. Take it easy for the rest of the day.

1-3 days after your operation

For a couple of days you will experience increased bruising and swelling. This is a normal part of the healing process and is assisted by hot and cold compresses. A soft food diet is to be continued. It is recommended to start gentle brushing of the implant site with a soft toothbrush.

3-7 days after your procedure

Facial swelling and bruising peak at around 3-4 days after your operation, from then onward it will begin to reside. On the 5th day after your surgery you should be feeling much better, pain killers required will be minimal. Your diet will still consist mainly of soft foods. With caution you can proceed to resume normal activities such as light exercise.

7-14 days after procedure

One week after the procedure you are feeling much better, pain killers are usually not required, swelling and bruising should be almost gone by the 2 week mark.  Normal diet can recommence, just be careful with hard and crunchy foods.

Beyond 14 days.

Following the above guidelines, you will heal comfortably and successfully.  The pain and discomfort will have subsided and you can resume normal activities and diet. In a couple of months the integration of your implant with the jawbone will be complete.


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Considering dental implants overseas? Some factors to consider.

When considering dental implants, many weigh the pros and cons of doing it overseas. The major consideration of it being cheaper is a big attraction! Below are some reasons why dental surgery and implants done overseas may not work out long term.

  1. Dentist or specialist qualifications

All dentists and doctors practicing in Australia are qualified under the Dental and Medical Boards of Australia. This can be easily verified by a quick search on the internet. These regulatory boards:

  • Ensure the highest standard of training
  • Maintain continuing education protocols
  • Handle complaints. Should you have any concerns about your treatment they will assist you so that you can have complete peace of mind.

If you decide to travel overseas for dental or surgical procedures, you will not have the comfort in knowing that the practitioner will be trained in accordance to rigorous Australian medical standards. Should something untoward happen, there is no guarantee of a regulatory body to assist you.

A certificate on a wall, or an impressive website biography wall does not equate to being a properly trained dentist or doctor. Unfortunately there have been some instances reported where some of these qualifications were shown to be fake.

 

  1. Dental implant work is not a quick procedure

Dental implant work, when done properly, require more than one visit over a period of time.

First a titanium screw is inserted into the jaw bone at the site of the missing tooth. 3 to 6 months after, once the gum tissue and bone around the implant have healed, a crown (fake tooth) will be attached to the titanium screw.  During this period regular monitoring is required to ensure healing is progressing well, and that there are no foreign bodies or infection. Once time has been allowed for the implant screw to integrate with the bone, the implant crown can be placed.

Overseas dental implant placement does allow for time between the various stages.   When a dental implant procedure is not staged appropriately the chances of failure are much higher .

  1. The possibility of something not going to plan

There is no such thing as a guaranteed surgery, all surgeries can come with some risks!

Doing dental work overseas, even if successful at the first point, can still have a chance of infection. Problems can develop slowly and not show for some time. Dealing with any problems will be much easier with a local dentist/specialist who is familiar with your implant history.

 

  1. Post-operative care

Once dental implants are placed post-operative care might be required for up to several months. It is important to have someone to consult if the crown does not match your other teeth,  if the implant placed is uncomfortable, or if the implant does not integrate with the bone.

 

  1. Dental materials used and infection control

When medical and dental procedures are performed in Australian clinics you can have peace of mind that hospital grade sterilization protocols are being adhered to.  You can also trust that the genuine implants and components are being used. Unfortunately, there are a lot of counterfeits on the market, particularly when going abroad.

 

Although saving a bit of money does have its appeal, the risks involved in medical tourism are significant. Not to mention the additional costs which may be incurred if the dental implants are done poorly.  Is it worth taking a gamble with your teeth, appearance and health?

 


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5 Factors which can affect the success of dental implants

Dental implants are often the best option for tooth replacement because they feel so much like natural teeth in terms of how they look and function. Tooth implants are very life like, they look just like natural teeth and allow you to speak and eat as you did prior to tooth loss.

There are some factors that can affect the success of dental implant instalment.  The success of your dental implant/s are also dependent on your knowing how to care for and maintain them.

Below are the main reasons

1.Smoking

Smoking significantly reduced blood flow, therefore impairs healing and decreases the chance of implant success. If you are a smoker and are considering dental implants, consider stopping smoking for 6 months prior to implant surgery in order to increase the implant success.

2. Bone health

Good bone quantity and density greatly contribute to the success of the implant treatment. However, bone grafting can be considered if there is not sufficient bone quality to support the implant.

3. Implant placement staging

The staging of implant surgery is the time taken to allow healing between extraction of the bad tooth, the implant screw placement and implant crown insertion (part that looks like a tooth which you can see in your mouth). The timing of the various surgical procedures needs to be carefully considered. If the process is rushed or not staged appropriately the implant can have an increased risk of failure.

Sometimes, immediate implant can proceed if the bone and site is ready after extraction. However, most of the time, a two-stage implant is done. This allows a couple of months between tooth extraction and dental implant placement.

When you are discussing your implant plan, your surgeon will evaluate your anatomy to determine a treatment plan that will allow you the best outcome with longevity.

4. Diet

It is important to maintain a soft food diet, and try to avoid chewing in the area of surgery for three months after implant surgery, or as directed by your surgeon. A balanced diet is good for your overall health, assists with your healing and will help the implant/s to succeed.

5. Hygiene

A good oral hygiene routine plays a very role in implant success. Brushing, flossing and rinsing daily will help keep the implant site clean and reduce the chances of an infection. Infection due to poor oral hygiene can even develop years after implant placement and may compromise the integrity of your implant.

If you would like to know more if you are a candidate for dental implants, please feel free to contact us (02) 9416 4809.


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Do I need my wisdom teeth removed?

Whether or not you require your wisdom teeth to be extracted can be a difficult decision and requires professional advice from your dentist or oral and maxillofacial surgeon.

Wisdom teeth enter your mouth between the ages of 18 to 24. Since they are the last adult teeth to come through, there often is not enough space for them to enter your mouth and align properly.

Impaction is the term given to when wisdom teeth become stuck. It is recommended to get your impacted wisdom teeth removed if they are causing the following problems:

Reasons to remove wisdom teeth
  • Causing you pain
  • Infection of surrounding tissue
  • Crowding of other teeth
  • Cyst formation in surrounding bone
  • Erosion cavity – pressure applied by wisdom teeth can cause neighboring teeth to dissolve/erode
  • Decay of wisdom teeth and neighboring teeth – due to crowding wisdom teeth are often hard to clean. Food may get trapped and rot leading to decay of not only your wisdom teeth but neighboring teeth.

If your wisdom teeth are infected antibiotics can help in the short term, however pain and infection will most likely return. Some wisdom teeth infections can become complicated and spread to your neck and chest.

When not to remove your wisdom teeth

Some wisdom teeth may not require removal if they are:

  • Completely through your gums
  • Healthy
  • Positioned correctly in your bite
  • Easy to keep clean

If removal is recommended, before the age of 30 is advised.  This is because your wisdom teeth roots have not developed fully and your bone is softer. Leading to smoother surgery with less chance of complications and a faster recovery.

 

 


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How to relieve painful wisdom teeth?

Impacted wisdom teeth can cause symptoms such as swelling, pain and tenderness. If this occurs it is often recommended to have them removed.

Before surgical removal, the following at home remedies can be tried to assist the relief of pain.

Salt water rinse

Salt is a natural disinfectant which impairs bacteria growth. Rinsing with salt water can help to clean debris around infected wisdom teeth and reduce inflammation.  This in turn may reduce pain.

Dissolve half a teaspoon of salt in 1 cup of warm water, rinse for 1 minute a couple of times a day.

Ibuprofen

Ibuprofen is a non-steroidal anti-inflammatory drug that is available over the counter at pharmacies. Ibuprofen helps to reduce pain and inflammation.

Take the recommended dose to help relieve discomfort and gum inflammation.

Ice pack

Ice can help to reduce inflammation, swelling and therefore reduce pain. It can also have a numbing effect.

Use a cold pack or fill a plastic bag with ice and wrap in a tea towel.  Apply to the outside of your face adjacent to the affected area for 15 minutes. Wait 15 minutes than reapply. Repeat throughout the day.

Numbing gel

Dental numbing gels (containing benzocaine) can be purchased over the counter at pharmacies. You apply them to the gum surrounding the painful wisdom tooth. It is important to follow the product instructions

Removal

In most cases home remedies are only assist in the short term and surgical removal of your teeth will be recommended by your dentist.


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Why do my wisdom teeth hurt? Part 2

Your wisdom teeth are the last teeth to come through at the very back of your mouth. They are often referred to as third molars. They usually grow through your gums between the ages of 17 and 24.

Sometimes due to the lack of space, wisdom teeth become ‘impacted’ and can enter your mouth at an angle or only partially come through the gum.

When wisdom teeth become impacted they can be very difficult to keep clean, especially since they are located so far back in your mouth. Food can accumulate and cause decay, not only of your wisdom teeth but also of the neighbouring tooth. Tooth decay is painful.

In most cases wisdom tooth removal is recommended to alleviate the pain.


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Why do my wisdom teeth hurt? Part 1

Your wisdom teeth are the last teeth to come through at the very back of your mouth. They are often referred to as third molars. They usually grow through your gums between the ages of 17 and 24.

Sometimes due to the lack of space, wisdom teeth become ‘impacted’ and can enter your mouth at an angle or only partially come through the gum.

This can make them difficult to clean. Food can accumulate around your wisdom teeth and can cause infection of the gums. This infection causes pain. In severe cases the infection can spread to the soft tissue surrounding your lower jaw and neck, impair your airways and lead to hospitalisation.

In most cases wisdom tooth removal is recommended to alleviate the pain.



Dr Kristian van Mourik Logo White


(02) 9416 4809

reception@kristianvanmourik.com.au

Suite 5, 12 Tryon Rd, Lindfield 2070, NSW


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