Tooth Extraction and Minor Surgeries

Tooth Extraction and Minor Surgeries

Many people have to have a tooth removed at some stage of their lives. Some people need to have their wisdom teeth removed, usually because they are growing in the wrong direction and causing problems. Sometimes teeth are over-crowded, and some may need to be extracted as part of orthodontic (tooth straightening) treatment. Gum disease can cause teeth to become loose in the later stages, which may mean they need to be extracted, and sometimes teeth can simply become too damaged, either accidentally or through decay, and need to be taken out.

We are fortunate enough to be able to offer the services of Specialist Oral Surgeons so patients requiring extractions are in very good hands.

The procedure for an extraction is usually very simple from a patient’s perspective. We numb your tooth and the surrounding area so you feel no pain. We then hold the tooth firmly and ease it out. There is usually a little bleeding so we place a gauze pad in the tooth socket and ask you to bite down on it for about half an hour, after which it can be thrown away.

In the case of wisdom tooth extractions, you may have some swelling after the procedure and discomfort that can be eased with over-the-counter painkillers. In cases of advanced gum disease or periodontitis, antibiotics will be prescribed to reduce the risk of further infection.

Gingivectomy :

A gingivectomy is a periodontal surgery performed to treat severe cases of gum disease, also known as periodontitis, that do not respond to antibiotics or root planing alone. This procedure is necessary when the gums have pulled away from the teeth, creating deep pockets. Plaque and tartar often form in these pockets, causing gum disease. If the disease is left untreated, it progresses to the point that it damages the roots of the teeth and potentially leads to tooth loss. The gingivectomy procedure is designed to remove loose or diseased gum tissue in order to prevent tooth loss and is performed by either a periodontist or an oral surgeon

Procedure:-

In preparation for a gingivectomy, a local anesthetic is applied to the gums. Usually a laser is then used to remove loose or diseased gum tissue, although a scalpel may also be used for this purpose. This process may take up to an hour. Once the gum tissue has been removed, a periodontal dressing, something like a protective putty, is placed over the gums to protect them as they heal.

Risks of a Gingivectomy:-

The greatest risk of a gingivectomy is getting an infection either in the gums themselves or systemically. This is because the surgical procedure may allow harmful bacteria to gain access through the gums into the bloodstream. For patients who have conditions that put them at increased risk of infection, the doctor may prescribe antibiotics to be taken both before and after surgery. This group includes patients who have:

• Heart conditions.
• Damaged immune systems
• Certain heart problems
• Undergone recent surgeries

Patients with heart problems may be at increased risk of developing a heart infection known as endocarditis and individuals who have had recent surgeries involving joint replacement may be more vulnerable to other infections.

Recovery from a Gingivectomy:-

For a few days after treatment, patients may experience temporary discomfort, which can be alleviated with over-the-counter analgesics at a dosage prescribed by the dentist, and by the use of ice packs. Following a gingivectomy, it is important that patients follow postsurgical guidelines, including:

• Eating bland soft foods
• Chewing on the other side of the mouth
• Avoiding hot or iced beverages
• Not using straws
• Avoiding smoking and alcohol
• Avoiding looking at or handling the affected area

Although complete recovery from the gingivectomy procedure may take as much as a few weeks to a few months, patients are not usually troubled by discomfort for long and can generally resume their activities soon after the anesthetic wears off. The contour of the gums may change somewhat as a result of the surgery, so patients should be prepared for small changes in appearance.

As always, oral hygiene is important in maintaining dental and gum health. Fortunately, keeping the teeth and gums clean after the procedure should be easier than it was before. In most cases, a gingivectomy stops gum disease before any teeth are affected and, after treatment, the gums return to their normal healthy state

Flap Surgery :

Current surgical flap techniques are based on a sound understanding of wound healing and are therefore designed to enhance and maximize the body’s healing potential. Flap surgery is the most conservative and versatile way to treat periodontal pocketing. An internal surgical opening is used to access the affected gum tissues to create and raise a “flap” of gum tissue, similar to opening the flap of an envelope, aimed at the conservation of all healthy tissue. This approach allows:

• Removal of inner diseased tissue lining the pockets. (This tissue is ulcerated, resulting in open sores within the gum tissues, which are chronically inflamed.)
• Access to treat and clean root surfaces completely.

• Regeneration of lost bone and periodontal ligament.
• Intimate closure of the healthy tissues leaving no open wounds for rapid and comfortable healing.

Crown Lengthening :

Most people have heard the term dental crown before. But fewer know what crown lengthening is or why you’d need it. Yet dental crown lengthening is often a required step in preparing your tooth for a dental crown.

Dental crown lengthening involves the removal of gum tissue, bone or both to expose more of a tooth’s structure. Why would you need it? You might have broken a tooth at the gum line. Or you might just have a decayed tooth. Sometimes after your dentist removes the tooth decay, there isn’t enough tooth structure left above the gum line to support a dental crown (or even a large tooth filling). Without enough structure to grab on to, ill-fitting dental crowns may cause chronic inflammation and irritation. Even worse, tooth decay may get in under the dental crown, creating the need for more dental treatment. You might even lose the tooth completely.

Although less common, crown lengthening may also be used cosmetically to treat what’s called a “gummy smile.” When an unusually large amount of gum tissue shows around the upper teeth, crown lengthening might help. Your dentist can expose more of your teeth, then sculpt your gum line to create the look you want.

The Lowdown on Crown Lengthening:-

Dental crown lengthening is a type of oral surgery. It is performed by a periodontist, a dentist who specializes in treating diseases of the gums and bone tissue that support the teeth. Crown lengthening surgery can be performed on one or several teeth or your entire gum line, depending on your specific needs. Crown lengthening surgery is a simple procedure usually done at your dentist’s office using local anesthesia. If necessary, sedation dentistry can be used to ease dental fear during the procedure.

If you have a temporary crown in place, the periodontist will remove it before beginning surgery and replace it after. The periodontist starts by making cuts to the tissue to pull the gum away from the tooth. This provides access to the roots of the teeth and the surrounding bone. In some cases, removing just a little gum tissue will do the trick. More often, the removal of some bone is also required.

Once the periodontist has exposed enough of the tooth’s structure, he or she will wash the area with saline water and stitch the gums together. Some periodontists will cover the incision with a special bandage.

Recover, Then Repair:-

Dental crown lengthening is considered a fairly minor surgery causing relatively little pain. Just in case, the periodontist will provide a prescription for managing pain. You will also be given a special mouth rinse and dental care instructions for taking care of your teeth during recovery. You should continue your usual oral hygiene routine, taking caution to avoid brushing the gums in the affected area.

About a week after crown lengthening surgery, your periodontist will remove the stitches. Your gums will need to heal awhile longer before your tooth can be fitted with the final dental crown.

As with all surgeries, crown lengthening has risks. You may experience bleeding or develop an infection after surgery. Because the root of your tooth is exposed, you may be more sensitive to hot and cold. This will go away once the dental crown has been put in place. Removing bone from around a tooth can loosen it. Should the tooth ever be lost, it might be difficult to place dental implants in that area.

If your dentist recommends a dental crown, ask whether you’ll also need crown lengthening. Depending on the amount of healthy tooth your dentist has to work with, crown lengthening may be necessary to ensure the best outcome. If you don’t have a dentist, we can help you find one.