Surgical treatment
Oral Surgery
Minor and major surgical procedures handled in the office, which for most patients means one less referral and one less unfamiliar building.
What oral surgery covers
The term covers any procedure that involves cutting or removing tissue in the mouth. The most common by a distance is extraction: taking out a tooth that is too broken, too decayed or too loose to keep. Other procedures include surgical removal of a root left behind from an old extraction, removing a cyst, exposing a tooth that has not come through, and reshaping bone or gum so a denture can seat properly.
An extraction is either simple or surgical. A simple extraction removes a tooth that is visible and can be loosened and lifted out whole. A surgical extraction is needed when the tooth is broken at the gum line, has curved or spread roots, or is buried in bone, and it involves lifting the gum and sometimes removing a small amount of bone or sectioning the tooth to get it out in pieces.
At the appointment
Planning comes first. X rays show the shape and depth of the roots and their relationship to the nerve in the lower jaw and the sinus in the upper. Tell the office about your medications and medical history beforehand, particularly blood thinners, bisphosphonates and any heart condition, because those affect how and when the procedure is done.
The area is fully numbed with local anaesthetic. During the procedure you feel firm pressure and hear noise, but not sharpness. If you do feel anything sharp, say so, because more anaesthetic can be given. Afterwards the socket is cleaned, stitches are placed if the gum was lifted, and you bite on gauze to let a clot form.
Visits, Recovery and When to Call
Visits and timing
Most extractions are a single appointment. A straightforward one takes minutes once numb. A surgical extraction takes longer. Stitches, where used, are often the dissolving kind, otherwise a short visit about a week later removes them.
Afterwards
Bite on gauze for the first hour. Expect swelling that peaks at around two days, and soreness for several days. Ice on the outside for the first day, then soft food, no smoking, no drinking through a straw and no vigorous rinsing for twenty four hours, because all three can dislodge the clot.
Call sooner if
Pain gets worse rather than better from day three, which can mean the clot has been lost from the socket, bleeding restarts and does not stop with twenty minutes of firm pressure, swelling keeps growing after day three, or numbness of the lip or tongue is still there the next day.
The gap afterwards
Ask about the gap before the tooth comes out rather than after. The bone where a tooth used to be shrinks over the months that follow, and the teeth either side and above start to move. That does not mean every gap has to be filled, but the options are wider and simpler when the decision is made early.
Keep reading
Questions About Oral Surgery?
Describe the problem on the phone. That conversation is usually enough to work out the first appointment. Mandarin, Taiwanese, English and Japanese are spoken.