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Why Should I Remove any Teeth?

Often the decision to remove teeth is made after considering all other options.  If the tooth has a large cavity and is broken down, your dentist will first attempt to restore it.  But if this is not feasible, then the tooth should be extracted so as not to cause infection of the jaws.

Occasionally, good teeth may have to be removed if the jaw is too crowded and your dentist or orthodontist cannot find another way to maintain those teeth.

When should I NOT remove my teeth?

     
 

The removal of teeth is an actual surgical procedure. There are some cases where that decision can be questioned by Dr. Matouk or Dr. Sperling.

  • In cases where you may not be medically able to undergo the procedure
  • In cases where your jaw had undergone radiotherapy for cancer and it needs prior care before extracting those teeth so as not to cause serious problems.
  • In cases where you are taking medications that inhibit your jaw healing such as Aredia (Pamidronate) or Zometa (zoledronic acid)
 
     

These conditions and others that will be discussed by Dr Matoukor Dr. Sperling may delay or  even cause the cancellation of your procedure.

The Surgical Procedure

The removal of teeth is no longer the “primitive” procedure it used to be.  Often, miniaturized equipment is used to minimize trauma and speed healing.  Also, if implants are planned, they may occasionally be placed at the same time as the extraction or the site may be prepared with grafting (socket preservation) for delayed implant placement and to reduce potential jawbone shrinking (alveolar resorption).

Socket preservation is performed by placing particles of artificial bone into the socket. A collagen material is placed on top of the bone and is held down by a suture. The artificial bone is treated by the body is diseased bone that needs to be replaced.  Then, over the next 2-3 months, it is replaced by your own bone filling the socket.

The removal of teeth can now be performed with minimal discomfort. All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. Dr Matouk has the training, license and experience to provide various types of anesthesia to allow patients to select the best alternative.

In most cases, the removal of  teeth is performed under local anesthesia, laughing gas (nitrous oxide/oxygen analgesia) or general anesthesia.  These options as well as the surgical risks (i.e. sensory nerve damager, sinus complications) will be discussed with you before the procedure is performed.  Once the teeth are removed, the gum is sutured as needed. To help control bleeding, bite down on the gauze placed in your mouth.  You will rest under our supervision in the office until you are ready to be taken home.  Upon discharge, your post-operative kit will include postoperative instructions, a prescription for pain medication, antibiotics and a follow-up appointment in one week for suture removal.  If you have any questions, please do not hesitate to call us at 954.566.0300. 

Our services are provided in an environment of optimum safety that utilizes modern monitoring equipment and staff that are experienced in anesthesia techniques.

Surgical Risks

     
 

Done correctly, the removal of teeth is very safe.  However. Often there are some anatomical variations that may put some patients at risk.
The upper teeth are often close to the sinus and may be displaced into it or root tips may fall in it. Also, there is a risk for an opening between the mouth and the sinus that may need to be closed later.

  • The lower teeth are close to the nerves that give sensation to the lip and tongue and may cause numbness of these areas.
  • Any extraction has the risk of damage to adjacent teeth, bleeding, swelling, and infection.
  • Each patient is different and these risks will be specifically discussed with you.
 
     

The Post-Operative Period

The removal of impacted wisdom teeth and the surgical removal of teeth is quite different from the extraction of erupted teeth. The following conditions may occur, all of which are considered normal:

     
 
  1. The surgical site may hurt for a few days
  2. The surgical area will swell.
  3. Swelling peaks on the 2nd or 3rd post -operative day
  4. Trismus (stiffness) of the muscles may cause difficulty in opening your mouth for a period of days.
  5. You may have a slight earache.
  6. A sore throat may develop.
  7. Your other teeth may ache temporarily. This is referred pain and is a temporary condition.
  8. If the corners of the mouth are stretched out they may dry and crack. Your lips should be kept moist with cream or ointment.
  9. There will be a space where the tooth was removed. After 24 hours this area should be rinsed following meals with warm salt water until it is healed. This cavity will gradually fill in with new tissue over the next few months
  10. There may be a slight elevation of temperature for 24 to 48 hours. If temperature continues, notify us.
  11. It is not unusual to develop bruising in the area of an extraction.
  12. The suture will fall out by itself. Also, if you had a socket preservation, you may feel sand-like particles occasionally in your mouth. This is some of the artificial bone. Do not be alarmed as we usually overfill the socket.
 
     

Please take all prescriptions as directed and take pain medications if you are experiencing pain. Pain medications can cause side effects and nausea and should not be taken if there is no pain.

Women please note: Some antibiotics may interfere with the effectiveness of your birth control pills. Please check with your pharmacist.

After the Removal of Multiple Teeth

     
 
  • A small amount of bleeding is to be expected following the operation. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 minutes. If bleeding continues, a moist tea bag can be used for 30 minutes. If bleeding occurs, avoid hot liquids, exercise, and elevate the head. If bleeding persists, call our office immediately. Do not remove immediate denture unless the bleeding is severe. Expect some oozing around the side of the denture.
  • Use ice packs (externally) on the same side of the face as the operated area. Apply ice for the first 36 hours only. Apply ice continuously while you are awake.
  • For mild discomfort use aspirin, Tylenol or any similar medication; two tablets every 3-4  hours. Ibuprofen (Advil, Motrin) 200mg can be taken 2-3 tablets every 3-4 hours.
  • For severe pain use the prescription given to you. If the pain does not begin to subside in 2 days, or increases after 2 days, please call our office. If an antibiotic has been prescribed, finish your prescription regardless of your symptoms.
  • Drink plenty of fluids. If many teeth have been extracted, the blood lost at this time needs to be replaced. Drink at least six glasses of liquid the first day.
  • Do not rinse your mouth for the first post-operative day, or while there is bleeding. After the first day, use a warm salt water rinse every 4 hours and following meals to flush out particles of food and debris that may lodge in the operated area. (One half teaspoon of salt in a glass of lukewarm water.). After you have seen your dentist for denture adjustment, take out denture and rinse 3 to 4 times a day.
  • Restrict your diet to liquids and soft foods, which are comfortable for you to eat. As the wounds heal, you will be able to advance your diet.
  • The removal of many teeth at one time is quite different than the extraction of one or two teeth. Because the bone must be shaped and smoothed prior to the insertion of a denture, the following conditions may occur, all of which are considered normal:
    • The area operated on will swell reaching a maximum in two days. Swelling and discoloration around the eye may occur. The application of a moist warm towel will help eliminate the discoloration quicker. The towel should be applied continuously for as long as tolerable beginning 36 hours after surgery (remember ice packs are used for the first 36 hours only)
    • A sore throat may develop. The muscles of the throat are near the extraction sites. Swelling into the throat muscles can cause pain. This is normal and should subside in 2-3 days.
    • If the corners of the mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment like Vaseline. There may be a slight elevation of temperature for 24-48 hours. If temperature continues, notify our office.
    • If immediate dentures have been inserted, sore spots may develop. In most cases, your dentist will see you within 24-48 hours after surgery and make the necessary adjustments to relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.
 
     

In case of problems

If you should have any problems such as excessive bleeding, pain, or difficulty in opening your mouth, call our office immediately for further instructions or additional treatment.

Remember your follow-up visit

It is often advisable to return for a postoperative visit to make certain healing is progressing satisfactorily. In the meantime, maintain a healthful diet, observe rules for proper oral hygiene, and call our office if you have any questions