HeresHowtoAvoidDrySocketAfterToothExtractionSurgery

Surgical tooth extraction is a fairly routine procedure with few complications. But one rare complication called dry socket does affect a small number of patients. Dry socket, which derives its name from its appearance, can be quite painful. Fortunately, though, it doesn't pose a danger to oral health.

Normally after a surgical extraction, a blood clot forms in the empty socket. This is nature's way of protecting the underlying bone and nerves from various stimuli in the mouth as well as protecting the area. Sometimes, though, the clot fails to form or only forms partially (almost exclusively in lower wisdom teeth), exposing the sensitive tissues beneath the socket.

Patients begin to notice the painful effects from a dry socket about three or four days after surgery, which then can persist for one to three more days. Besides dull or throbbing pain, people may also experience a foul odor or taste in their mouth.

People who smoke, women taking oral contraceptives or those performing any activity that puts pressure on the surgical site are more likely to develop dry socket. Of the latter, one of the most common ways to develop dry socket is vigorous brushing of the site too soon after surgery, which can damage a forming blood clot.

Surgeons do take steps to reduce the likelihood of a dry socket by minimizing trauma to the site during surgery, avoiding bacterial contamination and suturing the area. You can also decrease your chances of developing a dry socket by avoiding the following for the first day or so after surgery:

  • brushing the surgical area (if advised by your surgeon);
  • rinsing too aggressively;
  • drinking through a straw or consuming hot liquid;
  • smoking.

If a dry socket does develop, see your dentist as soon as possible. Dentists can treat the site with a medicated dressing and relieve the pain substantially. The dressing will need to be changed every few days until the pain has decreased significantly, and then left in place to facilitate faster healing.

While dry sockets do heal and won't permanently damage the area, it can be quite uncomfortable while it lasts. Taking precautions can prevent it—and seeing a dentist promptly if it occurs can greatly reduce your discomfort.

If you would like more information on oral surgery, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dry Socket: A Painful but Not Dangerous Complication of Oral Surgery.”

By Dr. Dulat
March 13, 2020
Category: Oral Health
Tags: dental injuries  
TakeTheseStepstoSaveaKnocked-OutTooth

Even though teeth are resilient, they're not indestructible. An accidental collision involving the face could damage teeth, even knocking a tooth completely out of its socket.

At first, it might seem like the end of the line for that particular tooth. But it doesn't have to be—if you know what to do. But you'll have to act quickly: The longer the tooth is out of its socket, the less chance it will survive long-term.

Here are the steps you should take to save a knocked-out tooth.

Find the tooth. It's important that you locate the missing tooth quickly. When you do, don't handle it by the root end: It still contains delicate periodontal cells that are essential if the tooth is going to rejoin with the ligaments and bone. Use clean water to rinse off any dirt or debris.

Reinsert the tooth. Holding it by the crown and not the root, reinsert the tooth into its empty socket, hopefully within an hour (the faster the better). You want to make sure it's good and snug, so apply a little force when you do this. Place some clean gauze or cloth between the tooth and its opposite on the other jaw, then have the person bite down and hold it in place.

Get immediate dental care. It's preferable to find a dentist as soon as possible (if not, then the nearest emergency medical facility). The dentist will x-ray the tooth to make sure it's positioned properly, and may adjust it further if necessary. They may also splint the tooth to adjacent teeth to help stabilize it until it fully reattaches with the jaw.

Again, time is of the essence—the quicker you can perform the above steps, the better the tooth's chances. Any delay could jeopardize the tooth's ability to reattach, or it could shorten its lifespan.

You can also get guidance on treating a knocked-out tooth and other dental emergencies with a free mobile app developed by the International Association of Dental Traumatology (IADT). Just look in your Android or IOS app store for ToothSOS.

If you would like more information on what to do during a dental emergency, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “When a Tooth is Knocked Out.”

NHLIronManKeithYandleSuffersDentalTraumaonIce

Professional Hockey player Keith Yandle is the current NHL “iron man”—that is, he has earned the distinction of playing in the most consecutive games. On November 23, Yandle was in the first period of his 820th consecutive game when a flying puck knocked out or broke nine of his front teeth. He returned third period to play the rest of the game, reinforcing hockey players’ reputation for toughness. Since talking was uncomfortable, he texted sportswriter George Richards the following day: “Skating around with exposed roots in your mouth is not the best.”

We agree with Yandle wholeheartedly. What we don’t agree with is waiting even one day to seek treatment after serious dental trauma. It was only on the following day that Yandle went to the dentist. And after not missing a game in over 10 years, Yandle wasn’t going to let a hiccup like losing, breaking or cracking nearly a third of his teeth interfere with his iron man streak. He was back on the ice later that day to play his 821st game.

As dentists, we don’t award points for toughing it out. If anything, we give points for saving teeth—and that means getting to the dentist as soon as possible after suffering dental trauma and following these tips:

  • If a tooth is knocked loose or pushed deeper into the socket, don’t force the tooth back into position.
  • If you crack a tooth, rinse your mouth but don’t wiggle the tooth or bite down on it.
  • If you chip or break a tooth, save the tooth fragment and store it in milk or saliva. You can keep it against the inside of your cheek (not recommend for small children who are at greater risk of swallowing the tooth).
  • If the entire tooth comes out, pick up the tooth without touching the root end. Gently rinse it off and store it in milk or saliva. You can try to push the tooth back into the socket yourself, but many people feel uneasy about doing this. The important thing is to not let the tooth dry out and to contact us immediately. Go to the hospital if you cannot get to the dental office.

Although keeping natural teeth for life is our goal, sometimes the unexpected happens. If a tooth cannot be saved after injury or if a damaged tooth must be extracted, there are excellent tooth replacement options available. With today’s advanced dental implant technology, it is possible to have replacement teeth that are indistinguishable from your natural teeth—in terms of both look and function.

And always wear a mouthguard when playing contact sports! A custom mouthguard absorbs some of the forces of impact to help protect you against severe dental injury.

If you would like more information about how to protect against or treat dental trauma or about replacing teeth with dental implants, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dental Implants: A Tooth-Replacement Method That Rarely Fails” and “The Field-Side Guide to Dental Injuries.”

4ThingstoDotoKeepYourChildsDentalDevelopmentonTrack

When you’re expecting a new baby, there’s a lot to prepare: outfitting the nursery, stocking up on diapers or choosing a pediatrician. It’s also not too early to consider how to protect your new child’s dental development.

From birth through adolescence, a child’s mouth goes through a whirlwind of growth. Hopefully, it all follows a normal track, but detours can arise like tooth decay or bite problems.

Here are 4 things you can do to keep your child’s dental development on track.

Start oral hygiene before teeth. Daily oral hygiene is essential toward helping your child avoid tooth decay. And don’t wait for teeth to come in—begin wiping their gums with a clean, damp cloth right after nursing. When teeth do appear, switch to brushing with just a smear of toothpaste and then add flossing as more teeth come in.

Begin regular dental visits. The American Dental Association recommends pediatric dental visits around the first birthday. The possibility of tooth decay becomes a concern around this time as the primary teeth are steadily erupting. Starting earlier rather than later may also help your child adjust to the routine of dental visits that they’ll most likely carry on as they get older.

Control their sugar consumption. Because sugar is a prime food source for disease-causing bacteria, you should keep your child’s sugar consumption as controlled as possible. For example, don’t put a baby to bed with a bottle filled with a sugary liquid (including juice and breast milk)—the constant presence of the liquid during nap time encourages bacterial growth and acid production.

Get an orthodontic evaluation. While we often associate orthodontic treatment with the teen years, it may be possible to head off bite problems earlier. So, see an orthodontist for a bite evaluation when your child is around age 6. If there are signs of a developing problem, certain techniques could help stop or slow them from getting worse, helping you avoid extensive and expensive treatment later.

With a newborn coming, you and your family have a lot on your plate. Be sure, though, not to forget making plans for keeping their teeth and gums healthy.

If you would like more information on dental care for your child, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Age One Dental Visit.”

StopBiteProblemsEarlyWithInterceptiveOrthodontics

Every year many parents learn their “tweenager” or teenager needs their bite corrected, often with specialized orthodontics. Imagine, though, if these families could go back in time to when their child’s poor bite was just developing to stop or slow it from forming.

Time travel may still be science fiction, but the approach suggested isn’t. It’s called interceptive orthodontics, a group of techniques and procedures performed during the early stages of jaw development. The focus is usually on getting abnormal jaw growth back on track, enough so that a poor bite won’t form.

The upper jaw, for example, may be growing too narrow, reducing the amount of available space for tooth eruption. If it isn’t corrected, teeth can erupt out of position. To correct it, an orthodontist places a palatal expander in the roof of the child’s mouth (palate). The appliance applies gentle pressure against the inside of the teeth, which stimulates the jaws to develop wider.

The expander works because of a separation in the bones at the center of the palate, which later fuse around puberty. The pressure applied from the expander keeps this gap slightly open; the body then continues to fill the widening expansion with bone, enough over time to widen the jaw. If you wait until puberty, the gap has already fused, and it would have to be reopened surgically to use this technique. Ideally, then, a palatal expander should be employed at a young age.

Not all interceptive techniques are this extensive—some, like a space maintainer, are quite simple. If a primary (baby) tooth is lost prematurely, teeth next to the empty space tend to drift into it and cause the intended permanent tooth to erupt out of place due to a lack of space. To prevent this an orthodontist places a small wire loop within the space to prevent other teeth from moving into it.

These are but two examples of the many methods for stopping or slowing a developing bite problem. To achieve the best outcome, they need to be well-timed. Be sure, then, to have your child undergo an orthodontic evaluation around age 6. If an interceptive orthodontic approach is needed, it could eliminate the need for more extensive—and expensive—treatment later.

If you would like more information on treatments to get ahead of bite problems, please contact us or schedule an appointment for a consultation.





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