Dental surgery – what is it?
Generally, surgical treatment is associated with active interference within the hard and soft tissues in the patient’s mouth. For most of patients dental surgeon is associated primarily with tooth extraction, but this specialty is much more advanced and includes the treatment of pathological changes in the jaw and mandible, as well as changes or incorrect construction of the gums and mucous membrane. In dentistry, dental surgery is linked to postoperative aesthetics – “atraumatic” methods used to ensure fast healing without scars and to significantly improve the patient’s appearance.
Dental surgery – types of treatments
The basic treatments are so-called alveolar surgery, ie extractions of teeth unsuitable for treatment, surgical removal of the eighth teeth, so-called third molars (“teeth of wisdom”), retained teeth. The typical treatment includes subsequent bones and gums formation to ensure the best healing and – which is extremely important – maintaining the correct bone volume, which naturally tends to disappear after removing the teeth. The more bones remain, the better the implants stabilization or the movable prosthesis maintenance. In the case of bone deficiency, there are some methods of its reconstruction with augmentation materials, which we also do in our clinic. After extraction, the implantologist or prosthetist takes care of the patient to plan further treatment.
An important part of dental surgery are soft tissue treatments: treatment of gum hypertrophy, removal of mucous cysts or frenula correction (mainly upper lip). The dental surgeon deals also with the hypertrophic and pre-cancerous lesions removal. In our clinic we use lasers for surgical procedures on soft tissues, which significantly shortens the procedure time, minimizes bleeding and ensures quick, painless healing.
In the surgery office we treat also cases of abscesses in the face and neck, which often have origin from the tooth. In the treatment of abscesses, it is necessary to operate (abscess incision) with antibiotic therapy. It is usually advisable to remove the tooth.
For dental surgery, cooperation with other specialists is very important, because it allows to quickly obtain satisfactory results. Plastic surgery within the gums, increasing gum width, covering the recession (exposed teeth necks) or regeneration of bones and gums in the interdental spaces requires cooperation of a surgeon with a periodontologist. Joint surgical and orthodontic treatment is a chance to bring the teeth into the line of occlusion (after surgery) and to reduce crowding by planned extractions because of orthodontic indications. The cooperation with the implantologist and the prosthetist is based on the procedures which increase the volume of the alveolar bone in case of its disappearance, which facilitates further treatment with prosthetic restorations.
Dental surgery – the course of the procedure
After collecting a detailed interview, which is extremely important in dental surgery due to possible complications and the impact of general diseases and medications taken by the patient on the entire procedure, the doctor presents a treatment plan and waits for patient’s agreement. Each surgical procedure carries the risk of complications, usually easy to supply, but the patient must be aware of them and strictly follow the doctor’s instructions. Surgical treatment usually starts with local anesthesia, which eliminates any pain and allows the surgeon work comfortably. The time of each procedure is different and depends on general and local factors. After the procedure, the patient receives a list of recommendations from the doctor.
It is necessary to follow those recommendations to ensure proper healing and prevent uncomfortable symptoms (see below). Typically, to ensure better healing, absorbable or non-absorbable sutures are assumed, depending on the physician’s decision. In the case of non-absorbable sutures, the patient must report for the next visit (usually about a week after the surgery) to remove them. This visit also involves controlling the healing process.
Dental surgery – indications and contraindications
Surgical treatment is strictly conditioned by the range of indications, which, however, have changed in recent years due to the significant progress of endodontic and periodontological treatment. Nowadays it is possible to maintain the dead but properly treated teeth in the oral cavity and to regenerate bone surrounding the teeth and preventing their loosening and falling out.
Indications for extraction:
– teeth unsuitable for conservative and prosthetic treatment, with a significant tissue loss,
– longitudinal cracked teeth (so-called vertical root fracture),
– teeth which roots are surrounded by extensive lesions in the bone (visible on the X-ray),
– very loose tooth with a significant loss of the surrounding bone,
– recurrent periodontal abscess,
– third molar teeth (wisdom teeth) – detained in the bone, improperly located, causing pain or simple irrelevant to bite,
– additional, supernumerary teeth (appear as a result of developmental disorders),
– orthodontic indications.
Indications for gum surgery:
– overgrown gums (eg as a result of treatment with cyclosporin, calcium inhibitors, etc.),
– exposed tooth necks (recessions),
– exposed roots in molars.
Contraindications can be divided into general and local ones. General ones concern patient’s diseases and are usually relative, a procedure can be performed after appropriate preparation of the patient by the physician treating the systemic disease. Diabetes, blood diseases, or taking of anticoagulants (the treatment and prophylaxis of thromboembolism and its effects, such as myocardial infarction) are the most common general contraindications as they can seriously affect healing process. The most important local contraindication to remove teeth is surrounding them tumour mass. There are also strict rules of surgical procedure if the patient undergoes chemotherapy or radiotherapy, but those treatments are not contraindication to the extraction with appropriate precautions.
Dental surgery – location
If you are interested in performing the removal of wisdom teeth or other surgery, please report to our dental office located at street Ks. P. Wawrzyniaka 36a (Krzyki) in Wrocław.
Dental surgery – frequently asked questions
How long does the treatment take?
A simple extraction of a loose tooth may take a few minutes, but the removal of a third molar deeply retained in the bone, with complicated roots position – even over an hour. An impact on the duration of the procedure have the individual conditions that the doctor finds in the patient’s mouth. Sometimes, despite the use of up-to-date technologies, we cannot predict the complications that arise during the procedure. Each surgical procedure should be carried out from the beginning to the end. The doctor will always put the patient’s good above the quick and careless operation. It should be realized that there are no simple extractions – in surgery, each procedure carries a risk of complications that an experienced doctor can adequately react to.
Is the procedure painful?
The times when dental treatment was inseparably associated with pain have passed. Currently, before each surgery (and not only) local anesthesia is used to eliminate the problem of pain, ensuring peace and comfort for both the patient and the doctor. Of course, during extraction, the patient may feel the touch of the tools, which is natural – only the nerves responsible for the pain are “turned off”.
What happens if I do not follow the doctor's instructions after removing the tooth?
Thera are 2 – 3 days after each extraction which are crucial, because then take place the most important phases of wound healing. However, for your own safety, you should follow the doctor’s instructions for a week after the surgery due to the individual predispositions. One of the quite frequent and extremely unpleasant complications is the total loss of a blood clot that causes dry socket caused by smoking cigarettes directly or within the next days after the procedure. The reason for the formation of a dry socket can also be drinking drinks through a straw or too vigorously rinsing the mouth after brushing your teeth, as well as intense physical activity. It is manifested by sharp pain at the wound, the dark, stinking masses coming of the alveolar and the lack of healing. Treatment is burdensome and consists of repeated rinsing dry socket with an antibiotic in a dentist’s office for at least a few consecutive days.