Wisdom Tooth Extraction Dentist in Dwarka, New Delhi

THE MAXILLOFACIAL SURGEON: A SPECIALIST DENTIST

Maxillofacial surgeons are specialist dentists who are certified to perform surgery on teeth, jawbones, and the face. They are trained to treat disorders, diseases, injuries, and abnormalities in these parts of the body. It is their responsibility to correct facial deformities.

The aspiring surgeon’s academic trajectory

Before becoming a maxillofacial surgeon, this oral health specialist must have the same education as a general dentist; that is, a Bachelor of Dental Surgery (BDS) degree. Only then can they begin their post-graduation studies in oral and maxillofacial surgery (MDS); which is spread over a period of three years, mostly in a hospital-based surgical environment.

The maxillofacial surgeon’s role and responsibilities

An oral and maxillofacial surgeon focuses strictly on performing dental surgical procedures in the most efficient and aseptic way. These procedures include simple and complicated teeth extractions (including wisdom teeth), dental implant placement, repair of broken bones in the jaws and face, removal of cysts and tumors of the jaws, soft tissue biopsies, jaw realignment surgery to correct bite discrepancies, and cosmetic and TMJ surgeries.

General dentist versus Oral and Maxillofacial Surgeon

Any dental surgery procedure performed occasionally by a general dentist is performed routinely by an oral surgeon.  This translates into better outcomes. For instance, the results of a recent survey published in the Journal of the American Dental Association (JADA) suggest that dental implant survival and success rates performed by maxillofacial surgeons are higher than the same procedures performed by general dentists. From their in-depth surgical training background, oral surgeons are also exposed to a wide range of complications that may arise from performing the various dental surgical procedures.  While a general dentist may feel comfortable performing a dental surgery procedure on you, the same dentist may not feel comfortable managing what complications may arise from that procedure.  An oral surgeon will mostly, if not always, be able to manage the complications that arise from a surgery he or she performs.

When Is Tooth Extraction Necessary?

In many cases, you can repair teeth that are broken or damaged by decay with a filling, crown, or other dental treatment. Sometimes, though, the damage is too severe to repair, so your dentist will recommend extraction.

Here are some other reasons tooth extraction might be necessary:

• Decay or infection has reached deep into the tooth
• Trauma or injury
• There isn’t enough room for all the teeth in your mouth
• Baby teeth don’t fall out in time for the permanent teeth to come in
• Orthodontic treatment might require tooth extraction to create room for the teeth as they move into place
• Wisdom teeth, also called third molars, are often extracted either before or after they come in

Preparation

Before removing a tooth, your dentist will thoroughly review your medical and dental history and take the appropriate X-rays. X-rays reveal the length, shape, and position of the tooth and surrounding bone. From this information, your dentist can determine the best way to remove the tooth. Before removal during a simple extraction, they will numb the area around your tooth using a local anesthetic. However, during a more complicated removal, called a surgical extraction, your oral surgeon might administer intravenous (IV) anesthesia, which can range from conscious sedation to general anesthesia, which will put you to sleep. If this is the case, arrange for someone to drive you home after the procedure and stay with you until the effects wear off.

Tooth Extraction Process

There are two types of extractions you might have:

1. A simple extraction is the removal of a tooth that is visible in your mouth. During a simple extraction, your dentist will numb the tooth and gum tissue and loosen the tooth with an instrument called an elevator before removing it with dental forceps.

2. A surgical extraction is a more complex procedure used for a tooth that may have broken off at the gum line or has not come into the mouth yet. During a surgical extraction, the oral surgeon will make a small incision (cut) into your gum and remove the underlying tooth.

After the Extraction

The most important thing to keep up with after a tooth extraction is keeping the area clean and preventing infection. Immediately following the procedure, your dentist might ask you to bite down gently on a piece of dry, sterile gauze, which you should keep in place for up to 30 to 45 minutes to limit bleeding, while clotting takes place. Your dentist will provide you with detailed aftercare instructions, but for 24 hours following your extraction, you shouldn’t smoke, rinse your mouth vigorously or clean the teeth next to the extraction site. You can expect a certain amount of pain and discomfort following an extraction. In some cases, your dentist will recommend a pain killer or prescribe one for you. It might help to apply an ice pack (only on the day of the procedure) to your cheek to reduce swelling. You should also limit strenuous activity, as well as avoid hot liquids and not drink through a straw. Under normal circumstances, discomfort should lessen within three days to two weeks. However, if you experience prolonged or severe pain, swelling, bleeding, or fever, call your dentist immediately. Whether you’re a seasoned pro or a tooth extraction newbie, your best bet for a successful and uncomplicated procedure is to follow your dentist’s recommendations carefully before and after the procedure. Tooth extraction makes room for something better and can help keep your smile healthy and confident.

COMMON COMPLICATIONS AFTER TOOTH EXTRACTION

1. Dry Socket (Alveolar Osteitis)

Overview

A dry socket (alveolar osteitis) is a painful dental condition that sometimes happens after you have a permanent adult tooth extracted. Dry socket is when the blood clot at the site of the tooth extraction fails to develop, or it dislodges or dissolves before the wound has healed. Normally, a blood clot forms at the site of tooth extraction. This blood clot serves as a protective layer over the underlying bone and nerve endings in the empty tooth socket. The clot also provides the foundation for the growth of new bone and for the development of soft tissue over the clot. Exposure of the underlying bone and nerves results in intense pain, not only in the socket but also along the nerves radiating to the side of your face. The socket becomes inflamed and may fill with food debris, adding to the pain. If you develop a dry socket, the pain usually begins two to three days after your tooth is removed. Dry socket is the most common complication following tooth extractions, such as the removal of third molars (wisdom teeth). Over-the-counter medications alone won’t be enough to treat dry socket pain. Your oral surgeon can offer treatments to relieve your pain.

Symptoms

Signs and symptoms of dry socket may include:

• Severe pain within a few days after a tooth extraction
• Partial or total loss of the blood clot at the tooth extraction site, which you may notice as an empty-looking (dry) socket
• Visible bone in the socket
• Pain that radiates from the socket to your ear, eye, temple, or neck on the same side of your face as the extraction
• Bad breath or a foul odor coming from your mouth
• Unpleasant taste in your mouth

When to see a doctor

A certain degree of pain and discomfort is normal after tooth extraction. However, you should be able to manage normal pain with the pain reliever prescribed by your dentist or oral surgeon, and the pain should lessen with time. If you develop new or worsening pain in the days after your tooth extraction, contact your dentist or oral surgeon immediately.

Causes

The precise cause of dry socket remains the subject of study. Researchers suspect that certain issues may be involved, such as:

• Bacterial contamination of the socket
• Trauma at the surgical site from a difficult extraction, as with an impacted wisdom tooth 

Risk factors

Factors that can increase your risk of developing dry socket include:

• Smoking and tobacco use. Chemicals in cigarettes or other forms of tobacco may prevent or slow healing and contaminate the wound site. The act of sucking on a cigarette may physically dislodge the blood clot prematurely.
• Oral contraceptives. High estrogen levels from oral contraceptives may disrupt normal healing processes and increase the risk of dry socket.
• Improper at-home care. Failure to follow home-care guidelines and poor oral hygiene may increase the risk of dry sockets.
• Improper at-home care. Failure to follow home-care guidelines and poor oral hygiene may increase the risk of dry sockets.
• Having dry socket in the past. If you’ve had a dry socket in the past, you’re more likely to develop it after another extraction.
• Tooth or gum infection. Current or previous infections around the extracted tooth increase the risk of dry socket. 

Complications

A painful, dry socket rarely results in infection or serious complications. However, potential complications may include delayed healing of or infection in the socket or progression to chronic bone infection (osteomyelitis).

Prevention

What you can do before surgery

You can take these steps to help prevent dry socket:

• Seek an oral surgeon with experience in tooth extractions.
• If applicable, try to stop smoking before your extraction because smoking and using other tobacco products increase your risk of dry socket. Consider talking to your doctor or dentist about a program to help you quit permanently.
• Talk to your oral surgeon about any prescription or over-the-counter medications or supplements you’re taking, as they may interfere with blood clotting.

What your oral surgeon may do

Your oral surgeon will take a number of steps to ensure proper healing of the socket and to prevent dry socket. These steps may include recommending one or more of these medications, which may help prevent dry socket:

• Antibacterial mouthwashes or gels immediately before and after surgery
• Oral antibiotics, particularly if you have a compromised immune system
• Antiseptic solutions applied to the wound
• Medicated dressings applied after surgery

What you can do after surgery

You’ll receive instructions about what to expect during the healing process after tooth extraction and how to care for the wound. Proper at-home care after tooth extraction helps promote healing and prevent damage to the wound. These instructions will likely address the following issues, which can help prevent dry socket:

Activity. After your surgery, plan to rest for the remainder of the day. Follow your oral surgeon’s recommendations about when to resume normal activities and how
long to avoid rigorous exercise and sports that might result in dislodging the blood clot in the socket.

Pain management. Put cold packs on the outside of your face on the first day after extraction to help decrease pain and swelling. Take pain medications as prescribed.

Beverages. Drink lots of water after the surgery. Avoid alcoholic, caffeinated, carbonated, or hot beverages for as long as your oral surgeon recommends. Don’t drink with a straw for at least a week because the sucking action may dislodge the blood clot in the socket.

Food. Eat only soft foods, such as yogurt, applesauce, porridge, khichdi, rice, etc for the first day. Be careful with hot and cold liquids or biting your cheek until the anesthesia wears off. Start eating semisoft foods when you can tolerate them. Avoid chewing on the surgery side of your mouth.

Cleaning your mouth. After surgery, you may gently rinse your mouth and brush your teeth, but avoid the extraction site for the first 24 hours. After the first 24
hours, gently rinse your mouth with lukewarm water and salt several times a day for a week. Follow the instructions of your oral surgeon.

Tobacco use. If you smoke or use tobacco, don’t do so for at least 48 hours after surgery and as long as you can after that. Any use of tobacco products after oral surgery can delay healing and increase the risk of complications.

2. Pain and Swelling

Pain and swelling are pretty typical after tooth extractions, especially within the first one to three days following your tooth/teeth removal. Your surgeon may recommend over-the-counter pain medications or prescription pain medicine. If you’re feeling severe pain or feeling moderate pain after a few days, contact your dentist’s office. They may ask you to come in for an examination.

3. Limited Mouth Opening

After a lengthy procedure like tooth extraction, you may experience temporary trismus, or restriction, or discomfort opening your mouth. If jaw stiffness or trismus is prolonged, your dentist can prescribe a treatment such as heat therapy, pain medications, muscle relaxants, or jaw opening devices.

4. Excessive Bleeding

Bleeding within the first 8—12 hours after extraction is normal because it takes time for a blood clot to form over the extraction site. Your oral surgeon will give you instructions to help minimize bleeding, including avoiding smoking, having soft foods to eat, etc.

5. Lip Numbness

Lip numbness is rare, but it’s possible. Your wisdom teeth are close to the inferior alveolar nerve in the jaw. If the nerve becomes damaged during the procedure, it can lead to numbness in the lips or jaw. This numbness is usually temporary, but it can be permanent if nerve damage is severe. Most wisdom teeth extractions do not have this complication, however. Your surgeon will discuss with you possible post-teeth extraction complications and their recommendations for reducing risk, including taking care of your extraction site after the procedure to ensure proper healing. Follow their aftercare instructions and contact their office if you are concerned about a side effect or complication of your tooth removal.

Frequently Asked Questions

Is tooth extraction painful?

Our tooth extraction procedures are designed to be as painless as possible. Local anesthesia is used to numb the area, ensuring minimal discomfort during the extraction.

How long does it take to recover after a tooth extraction?

The recovery time can vary depending on the complexity of the extraction. Generally, most patients can resume normal activities within a day or two and experience complete healing within a few weeks.

Are there any alternatives to tooth extraction?

In some cases, alternatives like root canals or dental crowns may save a damaged tooth. Our dentists will evaluate your condition and discuss all available options with you.

Can I eat normally after a tooth extraction?

It’s advisable to stick to a soft diet for a few days after a tooth extraction. Our team will provide you with specific dietary instructions to promote healing.

What precautions should I take after a tooth extraction?

It’s essential to follow post-extraction care instructions, including keeping the extraction site clean, avoiding smoking or using straws, and taking prescribed pain medications as directed.