Category Archives: Extractions

Seeing Sedation Dentist for Extractions- Will I choke on Gauze?

I’m scheduled to see the sedation dentist to have my wisdom teeth extracted in three weeks. I just had my initial consultation and x-rays and they went over most of the instructions with me.  They also sent a sheet home with me that had post-op instructions and it talked about using gauze after the extractions are done. I’m a little worried, since this is a sedation dentist and all… is there a possibility that I could fall asleep and choke on the gauze or, worse yet, choke on it just because I’m not mentally with it after? Is the gauze absolutely necessary or are there alternatives?

Thanks,

Julia in Nebraska

Dear Julia,

The gauze is only needed while you’re actively bleeding. The pressure helps stop it and will help protect the blood clot as it forms. The clot is important because it protects the socket. Without it, your bone is exposed and that can be a very uncomfortable experience. So, you really want to do everything you can to protect the area and promote healing right after the tooth extractions. Gauze is a great choice because it’s gentle, absorbent, and can be changed out easily. The gauze you’ll receive from the sedation dentist will also be sterilized, so you don’t introduce bacteria into the socket.  In other words, the gauze is a huge benefit that you don’t want to overlook.

You will be groggy after you leave the sedation dentist and you’ll probably want to sleep off the meds. Even still, it’s highly unlikely that you’ll have an issue with the gauze. You should have a responsible adult with you after surgery and that person should stay with you until the meds are out of your system. You can talk to that person in advance about your concerns and make sure that they understand the importance of their job. They really do need to look out for you and also make sure you’re not up and walking around while you’re still disoriented. They can help keep an eye on how you’re doing with your gauze, too. You shouldn’t lay down with it in and you’ll need to change it out about every 45 minutes until it’s only light pink when you’re supposed to be ready for a change. At that point, you can take it out without worry. This could happen as little as one hour after surgery, or about the time you’re getting home, or it could be about five hours later.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Sensitivity after a tooth was pulled.

I had a tooth extraction done to remove a wisdom tooth. All went well, I didn’t think it was really that big a deal. Well, at least as big of deal as my wife was building it up to be. Anyway, a couple weeks have passed and the other day I noticed it was kind of achy near the extraction site. I had just exerted a lot of energy from starting out my workout for the first time since the procedure. Now, it seems that anytime warm food or drink comes near the area, it is very sensitive. Do I need to be concerned?

-Paul in Illinois

Paul,

It is not uncommon for their to be some aches after physical exertion. But you should not be experiencing discomfort or sensitivity to heat.

Usually, when a patient complains of sensitivity to temperature near the tooth extraction site, it is nine times out of ten, the tooth right next to it that is reacting. Sometimes, the root of the tooth near the site will become exposed and you may begin to notice it. Sensitivity to cold, as long as it’s mild, isn’t usually anything to be concerned about. All that to be said, it’s always a good idea to contact the dentist and explain what is happening. It could be a minor irritation from the recent procedure.

But if the tooth is having trouble tolerating heat, the pulp inside of the tooth could be dying. Usually, a toothache will be the outcome and eventually a root canal may be required to save the tooth. Your dentist will be able to check things out and see if there is cause for concern. Thank you for your question. Hopefully it turns out to be nothing serious.

This post is sponsored by Cleveland dentist Hylan Dental Care.

My gums won’t stop bleeding. Help!

It has been almost a decade now since my wisdom teeth were extracted. But I have had extreme sensitivity around those areas ever since the extractions. If I start to brush over the area of the gums where the teeth once were, my toothbrush is red by the time I’m done. I hate going to the dentist because they are so rough. And when they look back there and begin poking around, the bleeding occurs. But I have had it checked out and was told everything was normal.

But how can it be normal if that area bleeds if I brush back there?  I’m sick of dancing around that area after almost ten years.

– Betsy in Indiana

Betsy,

It wouldn’t hurt to go back into the dentist to have everything re-evaluated by another dentist. And it sounds like going to the dentist isn’t on your top ten list. So instead of letting the dentist poke around back there and then dealing with the discomfort, talk to him or her prior to the exam. If they know your are anxious, they can be sure to use gentle dentistry techniques. A little communication and understanding by both parties goes a long way during an exam.

But since it has been quite some time since those wisdom teeth extractions, the questions needs to be asked how often the area is brushed. Good oral hygiene means twice per day. But since you state, “if” you brush, it leaves the impression it may not occur daily. Therefore, the bleeding may ironically be a result of the lack of brushing.

If the area isn’t brushed regularly, plaque and bacteria can build up on that teeth closest to the area. This makes the gums inflamed and even the slightest touch at that point will cause irritation and possible bleeding. So brushing (even if you see blood) is the way to remedy the situation.

The bleeding is highly unlikely due to any issue with the old wisdom teeth. After ten years those extractions sites should be completely healed. The bone has had time to reshape and the tissues should serve as if the wisdom teeth were never even there.

So, look for a gentle dentist in your area if you would like a second opinion to rule out any gum disease. In the meantime, try increasing the frequency of brushing at home.

Good luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.

My face is numb after wisdom teeth extractions.

My dentist told me that I wouldn’t need sedation for my wisdom teeth extractions. But I was pretty freaked out about the whole thing. So we decided to use sedation dentistry to keep me calm. Everything went well at the appointment. But it’s been several weeks that have passed and now I feel numb in my lip and chin. I even have this random tingling sensation and twitching. What is going on? When I called my dentist, he acted like it was no big deal and told me it’s normal. It doesn’t sound or feel normal to me! Have you heard of it?

– Jessica in Oregon

Jessica,

Actually numbness after the extraction of wisdom teeth is a possible risk of the surgery. The numbness you are experiencing is not from the oral sedation. There is a good possibility your dentist informed you of the potential for side effects prior to the surgery. The technical term is  called paresthesia, defined as an altered feeling or sensation. This is likely occurring due to to a nerve located in your lower jawbone. It may have been irritated, bruised, or inflamed at the time of the extractions.

The numbness subsides for most patients that experience paresthesia, anywhere from a few days to a few months following the surgery. For a small percentage it doesn’t return to normal. The tingling you mentioned is an encouraging sign. But definitely keep in touch with your dentist to inform him of the symptoms and let him know if it continues or gets worse.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Am I too old to have my wisdom teeth extracted?

I was involved in a dental emergency several years ago where they removed my top two wisdom teeth. But since then, I haven’t had the others removed and now I am in my low thirties. Am I too old to have them extracted now? Am I at a higher risk of my jaw breaking or having any other complications? I didn’t realize at the time I would need to have the others out because no one ever seemed like I needed to. But now they are starting to bother me, so I think they need to be removed. Any advice you have would be appreciated!

– Katherine in Texas

Katherine,

On average, wisdom teeth are extracted between the ages of 18-25. But you are not “too old” to have them removed. If you are experiencing discomfort, there is a possibility that the tooth or teeth is infected which means it needs they need to be removed. And this needs to be addressed sooner than later, so it doesn’t turn into a serious dental emergency. In some cases, if a tooth infection is ignored, it can turn deadly. The infection can spread to other areas of the body.

Although it would have been ideal to have them extracted years ago, you shouldn’t have to worry about any jaw complications. At 40, the risk increases for jaw damage. The oral surgeon will still have you signing paperwork to remove liability from their practice, but the risk of anything serious occurring during the extraction process is considerably low.

While the oral surgeon is performing the tooth extractions, it would be beneficial to have them all out at once. Then it will be done, the infection will be removed, and you can move on. Again, if they are bothering you, act now. Don’t let this fester into an emergency situation.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Sedation dentistry and dentures.

I’m helping my dad look around because he is in need of dentures. Do you know if he will be put to sleep when they pull his remaining teeth? Also, are the dentures placed at that same appointment?

– Becky in Texas

Becky,

Sedation dentistry is used during tooth extractions when an individual is getting dentures. And all of the teeth will be removed during that same visit. Options for sedation are typically oral sedation which involves take a pill prior to the appointment or some offices offer IV sedation. You should talk to the different dentists about which method they use because some dentists are not certified for IV sedation.

In regard to your question about the denture placement procedure. There are some variances in placing dentures. One of the most common types of denture is called an immediate denture which is placed at the same time as the teeth are removed. Many people like the fact that they will leave the office the same day with new teeth and not have to go toothless for any amount of time. An immediate denture also helps reduce swelling and bleeding after the extractions. Immediate dentures cost a little more than the placement of traditional dentures because there are more follow-up visits involved. The immediate denture will need to be adjusted as the individual begins to heal. As for a traditional denture, they don’t actually get placed in the mouth for up to eight weeks after the extractions have taken place. Many people don’t like that about them, but overall the fit can be better than the immediate denture. This is because over those weeks your body is healing and the tissue shrinks. Therefore, the immediate denture sometimes feels loose because a softer temporary lining is used. Typically it will be six months to completely heal, at which time a permanent denture lining needs to be done.

There are many options beyond dentures available for people that are missing all of their teeth. Be sure to discuss all of the options, as well as the pros and cons of dentures. Many patients experience problems with dentures, like they move around while they are eating and talking, and over time can cause painful sores. Facial collapse is also a bone loss condition that causes the jawbone to shrink and makes it difficult to continue wearing a denture. Dental implants prevent facial collapse and can also be used to secure a denture. Again, just make sure you talk through all the options to find the right solution for your father.

Best of luck.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Possible malpractice? The tooth roots are still there after an extraction.

Over a year ago now, my husband had two tooth extractions. He was having some issues and when we returned to the dentist today, the discovery was made that the tooth roots were both still there. How does this happen? Have you ever heard of this? We are wondering if this is a possible malpractice suit? We asked the dentist if the roots would be okay or if they had to be removed and he said they need to be out. Do we trust this guy?

– Natalie in Idaho

Natalie,

This is difficult to assess without having seen your husband’s specific case, x-rays, or notes from the file. There have been tooth extraction cases where a small fragment of the tooth or bone chip, or the tip of the root remains in tact in the socket of the tooth. It is not unheard of in cases where the tooth to be extracted is very decayed or fractured. If the fragment is not infected it is possible for it to remain in the jaw. This may also be the best way to approach this situation if the procedure is difficult and may cause other issues like nerve damage. The oral surgeon may be able to better make recommendations for you and your husband. In other instances, the small fragments of bone or tooth material can actually work themselves out. But if it is down deep into the socket, it will need to be surgically extracted to avoid possible infection. The root section of the tooth that you are referring to is surrounded by ligaments. This may also complicate things.

Not sure if you have a malpractice suite, but it sounds like a case worthy of a second opinion and assessment from an expert implant dentist or oral surgeon. If this situation is left unaddressed the possibility remains for infection as mentioned earlier, or possible cyst or lesion to form around the impacted roots.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Eruption of Wisdom Teeth

I am a 19 year old girl and my wisdom teeth still haven’t came in. How old are you when they do? Does everyone get them? My mouth is to small for my teeth already. Would that be the problem?

Thanks, Kari in North Carolina

Dear Kari,

Not all people develop wisdom teeth, however many people have them. About 35% of the population never develop wisdom teeth. Wisdom teeth start to form in the jaw bone around the ages of nine and ten. As wisdom teeth roots develop, usually between the ages of 15 and 20, this is the time to have them surgically removed in order to make ones recovery easier, as well as to prevent crowding of the teeth, infection, pain, and decay of nearby teeth or in the wisdom tooth itself. Usually between the ages of 15 and 25 is when people start to develop problems with their wisdom teeth.

Due to the fact that your mouth is so small and if you have your wisdom teeth they will probably never erupt fully and will only cause problems like the ones we mentioned in the first paragraph. Most peoples jaws are too small for the proper eruption of wisdom teeth and become impacted which means they do not erupt completely. In order to determine if you have wisdom teeth you will need to have your dental professional take a dental x-ray called a panorex (see below) as well as complete an exam for proper diagnosis. By looking at the image below you can see the wisdom teeth which are the very last teeth on top and bottom. Look closely at the wisdom teeth on the bottom they are not fully erupted and will most likely never erupt completely.

We recommend you visit your dental professional for an evaluation to determine if your wisdom teeth are present in the jawbone. They will be able determine if they are indeed there and offer you the best advise on what your next steps are. You may have to have teeth extractions so they don’t interfere with your existing teeth.

Panorex

This post is sponsored by Cleveland dentist Hylan Dental Care.

Problem with shifting after an extraction

I had to have one of my top molars removed. It has been about a month or so and now I’m noticing that my front tooth looks like it has moved. I think it is really ugly. How did this happen?

– Jim in Pennsylvania

Jim,

After a tooth extraction, the bone will begin to recede in the area around it. When our teeth are unbalanced they can shift around in a reaction to the procedure. You will typically see this happen within the first few years after you have had the tooth out. Over time the shifting will subside. The exact movement of the teeth varies from patient to patient. Sometimes it is not noticeable at all and other times it is very visible. Typically you see this if someone is missing a tooth. The tooth surrounding the site will move into the empty space. That is why a dental implant is an ideal treatment because it helps to prevent the shifting and it also stimulates the bone so it doesn’t resorb.

Occlusion is the study of how your teeth come together and our bite varies when we are eating or swallowing, or even when we sleep it can be different. So the shifting will only take place as long as your personal occlusion will allow.

Again, it is worth mentioning the importance of replacing your missing tooth to prevent shifting and occlusion problems. It sounds like your teeth are shifting quickly so it would be a good idea to seek treatment to replace the tooth soon. There are affordable dental implant options if budget is a major deciding factor for you. Make sure you see an implant dentist that has reputable credentials because there is a lot of dental malpractice in this area. Cheap dental implants aren’t always better because faulty materials or cutting corners can be much more expensive in the long run.

Hopefully this was helpful in answering your question.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Waiting period between extraction and dental bridge.

Hello,

One of my upper molars was extracted. Right after the tooth extraction, the dentist set the bridge right on top of the area. There was no time between when the extraction took place and when the bridge was placed. I was told by someone that the area should have had pressure applied to it to avoid a blood cot. Do you know if my dentist did something wrong?

– Jordan from Minnesota

Jordan

It is always difficult to make specific recommendations without having seen you in person. Although, it sounds as if everything has worked out okay. So in all likelihood your dentist probably did the right thing.

Even though you did not decipher whether or not the bridge was a permanent dental bridge or if it was just the temporary. Either way, usually there is some pressure applied to the tooth extraction site before placement. Although, for some patients there is actually very little bleeding and within a few minutes it has subsided. The pressure is a technique that is used if the dentist isn’t going to be monitoring it right after the extraction.

One of the benefits in having the dental bridge placed right away is that there is no time for any of the surrounding teeth to move. Sometimes if there is significant time that passes where there is no tooth in that area, the teeth can shift around and cause bite problem or other issues.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Related link: dental implant vs bridge