Oral surgery and extractions

Oral surgery covers the procedures that involve working on the tissue or the bone of the mouth. The most common is the removal of a tooth, known as an extraction, and within those, the removal of wisdom teeth.

Taking a tooth out is always the last option. It is considered when the tooth can no longer be saved, when it is damaging the teeth around it, or when the treatment plan calls for it, for example in orthodontics.

At Higienista Oral every surgical procedure starts with an assessment: an X-ray, a review of your medical history and the medication you take, and an explanation of what will be done and why.

Simple and surgical extractions

Simple extraction. The tooth has erupted and can be gripped directly. Under local anaesthetic it is loosened and removed; it is usually a short procedure with a straightforward recovery.

Surgical extraction. This is used when the tooth is impacted, that is, it has not come through, when it is partly covered by gum or bone, or when it is fractured at root level. It involves raising a small gum flap, sometimes removing a little bone or dividing the tooth into sections so it can be taken out without force, and finishing with stitches.

Oral surgery also includes other procedures: removing retained roots, removing cysts or lesions, taking biopsies, releasing frenums, exposing impacted teeth for orthodontics and preparing the site before an implant.

Wisdom teeth: why they are removed

Wisdom teeth come through between late adolescence and the first years of adulthood, by which point there is very little room left in the jaw. When there is not enough space, they stay impacted or come through in a poor position.

Removal is recommended when:

• There are repeated episodes of swelling or infection of the gum covering them.
• They are pushing against or damaging the neighbouring molar, or causing decay in it because the area cannot be cleaned.
• The X-ray shows a cyst or resorption of the adjacent tooth.
• They cause recurring pain or make hygiene in that area difficult.

Not every wisdom tooth has to come out. If they have erupted in a good position, meet an opposing tooth and you can clean them properly, they can be kept under observation with periodic X-rays.

What to expect after surgery

The procedure is carried out under local anaesthetic, and pain management afterwards is planned in advance, with the instructions and medication your dentist prescribes. Over the first 48 to 72 hours you can expect:

• Swelling of the cheek, usually greatest on the second day and settling after that.
• Discomfort that is controlled with the prescribed painkillers.
• Some bleeding or pink-tinged saliva during the first day.
• Difficulty opening the mouth fully for a few days, especially with lower wisdom teeth.
• Sometimes bruising on the skin of the cheek or neck.

If stitches were placed, they are removed at a follow-up visit unless they are the dissolving kind. That visit is also used to check how healing is progressing.

Recovery instructions

• Bite firmly on the gauze for the time you were told, and change it if it becomes soaked.
• Apply cold compresses to the outside of the cheek on the first day, in intervals.
• Eat soft foods, cold or lukewarm. Avoid anything hot, hard or spicy.
• Do not use a straw, do not spit forcefully and do not rinse on the first day: the suction can dislodge the clot protecting the wound.
• Do not smoke or drink alcohol while the area is healing.
• From the next day, rinse gently with warm salt water after meals.
• Brush your other teeth as normal and avoid the surgical site for the first few days.
• Rest for the remainder of the day, avoid strenuous exercise for around 48 hours and sleep with your head slightly raised.

Let us know if the pain increases on the third or fourth day instead of easing, if there is bleeding that will not stop, or if you have a fever or a persistent bad taste: this may be a dry socket, and it can be treated.

If a wisdom tooth is troubling you, or you have been told a tooth needs to come out, book an assessment at Higienista Oral. With the X-ray we explain whether it really needs removing, what the procedure would involve and what the alternatives are. Call 0312 4869987, message WhatsApp on 0312 4869987, or email penaerika4872@gmail.com.