The first person to have historically used anaesthesia to perform surgery was a dentist!
William Thomas Green Morton was the first dentist to use anaesthesia to achieve a painless tooth extraction on September 30th 1846. He used ether as an anaesthetic agent in his own dental office. Then, on October 16, 1846, Morton participated in a surgery where Dr. John Collins Warren used ether as anaesthesia on a patient at Massachusetts General Hospital to remove a tumour in the neck without pain. Following this procedure, the news spread out globally and Morton convinced the medical world of the importance of performing surgical procedures without pain.
Your dentist said that you need to remove your wisdom teeth? Don’t panic, lots of people have to go through this procedure. But knowing what to expect after the surgery can help you calm down and recover more easily.
Your dentist has, or will explain all that, but let’s go through the recovery instructions in details:
Eat a light meal an hour or two before your appointment. Do you go to your appointment with an empty stomach, and do not eat a very heavy meal if you will have intravenous sedation.
Make sure you have a couple of days off after your appointment to rest after the surgery.
If you took medications or if the dentist used sedation, make sure there is someone who will drive you home after.
After the procedure, leave the gauze in your mouth and bite on it for pressure, do this for at least 30 minutes or the time that your mouth bleeds.
If the bleeding persists for more the 30 minutes, or if it starts again later in the evening, use more gauze, or bite down on a wet tea bag which works even better. Tannic acid found in tea helps reduce bleeding. It is normal if you wake up the following day and that your saliva is reddish from blood.
For the first 24 hours, eat soft foods that are not too warm nor too cold.
Rinse with warm water and sea salt, but starting 24 hours after your wisdom teeth have been removed, not the same day. The recipe is 1 teaspoon of sea salt in 1 glass (250 ml) of warm water.
Use ice the first 24 hours on your face to reduce the swelling. If you do not have ice, use bags with frozen vegetables instead. If the procedure was difficult, swelling will occur and you might also see colour change on the skin.
Have a couple of pillows under your head when sleeping. This will help reduce the swelling.
Take your antibiotics and pain killers as prescribed by your dentist.
Do not smoke for 48 to 72 hours! Smoking introduces toxins to the extraction site and can also dislodge the clots, which can cause dry socket.
Do not use a straw to sip on liquids, as the pressure caused from the sipping can also dislodge clots and lead to dry socket.
Do not spit, as the pressure can also dislodge the clots. If there is blood in your mouth, let it flow down your mouth and then wipe your lips.
Do not play sports for 24 to 48 hours.
Do not use mouthwash for 24 hours.
After one week, you should feel much better. Your gums will slowly get back to normal, and some people might feel like it’s totally healed. But put in mind the total healing time takes about 3 months, and during that time food can be stuck in the sockets and you need to rinse with salted water to clean them.
Dr Nimatt Pertick is an oral and maxillofacial surgeon practicing in Laval, Canada. He takes great care of his patients, and is a top practitioner in his domain. I refer to him all my patients needing implants, even if he practices about 50 kilometres from my clinic.
What might happen if you leave a cavity in your mouth without treating it? Tooth decay is like an infection. It is made of harmful microscopic bugs that use sugar to attack teeth. With time this creates a little hole in a tooth, and if not repaired with a filling, the cavity continues to grow.
If a cavity is not treated it can destroy a good part of the tooth, making it hard to be rapaired with a conventional filling. If a lot of the tooth is gone, only a crown can fix it.
If the decay’s micro-organisms reach the pulp chamber, where the nerve and blood vessels are located, then the pulp becomes irritated and infected. This can eventually lead to an abscess which can be very painful. Only a root canal can fix a tooth when its pulp is infected, and a crown is then probably needed as a final restoration.
There are also situations where a tooth is so much destroyed by a cavity that nothing can be done to fix it, not even a root canal and a crown. In that case the tooth would sadly need to be extracted.
People can lose their teeth for many reasons. But the long term consequences can be very bad for your health and for your overall well-being. Knowing those consequences might help you realize how important it is to take care of your teeth in order to keep them healthy and not to eventually have to extract them.
Here’s a list of tooth loss consequences:
You might develop speech problems as it might be hard to pronounce some letters if you are missing too many teeth.
Avoiding certain foods because having less teeth might produce chewing problems.
Avoiding going out in public because if your missing teeth are showing, you might be embarrassed to show your smile.
Because of the way your smile looks, you might develop anxiety and self-consciousness.
Stiff jaws because with fewer teeth it’s harder to chew on foods and there is more stress expressed in your jaws.
Other teeth might become weak because there are fewer teeth to use when you eat.
Other teeth might move, or incline because there is nothing to stop them. This condition might induce periodontal disease and possible tooth loss.
You might develop nutrition problems because you cannot eat all types of foods.
One of the greatest dentists I have known is Dr Marie-Claude Michaud. She and I know each other very well because not only we had done our dental studies together at university, but we have also worked together for many years.
Marie-Claude and I got our dentist diplomas in 1999. She continued studying by doing a year of residency while I worked on opening a new office. During her residency year, she became very acquainted with surgery dental extractions, including wisdom teeth removal, and this still remains her best asset! She offers the best care for her patients and clearly explains all different options that they have before starting treatments.
Her lovely personality puts anybody at ease and her work is perfect. If you get her on a cheerful day, she will even make you laugh!
By the way, did I mention that Marie-Claude is my own dentist!
What if you have just had a tooth extracted and wondering if you can have a glass of wine, or even a beer? Or you might have had your tooth extraction a week ago, and although it feels pretty comfortable in your mouth, you still wonder if you can go out with friends and have shooters!
The first few days after an extraction, it feels uncomfortable to eat or drink anything. Therefore alcohol might not be a good choice of beverage. Some people might argue that alcohol disinfects the extraction site, but rinsing with water and salt is a better idea. It is not officially forbidden to have alcohol after any tooth surgery… unless you are taking medication such as pain killers or antibiotics.
Some of these drugs can become toxic if alcohol is taken during the same period. It is therefore important not to have alcohol if any medication is taken after tooth extraction, depending on the prescribed period, which is usually from seven to ten days.
Can a tooth abscess really fracture a tooth? Of course, if it’s left there for a long time! A tooth abscess that has originated from a tooth is caused by a big cavity that has reached the pulp chamber. When the abscess is big and painful, there is a good chance that the cavity is also huge and compromises the integrity of the tooth. If it is not treated, the tooth might break apart to a point that no treatment can restore it, eventually needing to be extracted. If the fracture is not too big, the tooth might be restored by a root canal and a crown.
An abscess might also originate from the gums and not from a tooth itself. In that case, gum disease must be treated in order to eliminate the abscess. Daily oral hygiene care, including brushing and flossing, are very important to prevent gum disease.
An abscess is made of infection, and whether it originates from the gums or from a tooth, it is a bad thing to have in the mouth because the bacteria can enter your body and reach other organs. This can complicate diseases such as diabetes and caridiovascular disease.
Depending of how big the abscess is, usually prior to any treatments, antibiotic medication should be taken to control it. But put in mind that the antibiotic effect is only temporary and permanent treatment should be done.
Smoking is very bad for your health, and especially after your dentist has removed a tooth. Ideally, if you need to smoke, you must wait 48 to 72 hours after the surgery. If someone tells you to wait only 4 hours, do it at your own risk!
The reason you must wait is that smoking can slow down the healing process in your mouth, and even cause serious complications. The smoke has chemical toxins that not only harm your lungs but also your surgery site. Also, the suction done when smoking can dislodge the blood cloth from the socket it is in.
One major complication is called dry socket. It is a very painful condition around the tooth extraction site, which can cause bad smell and limit how big your open your mouth. It usually happens 3-4 days after the surgery. If you do nothing, it will eventually go away, but if you see a dentist, he can put a desensitizing drug to make it go faster.
Sometimes accidents happen where a front tooth falls out completely after shock, without fracturing itself. This situation is serious and can cause stress, if it happens to us, or if it happens to our child. In these cases it is possible to put the tooth to where it was, but we must proceed immediately.
Here are the instructions to follow:
A tooth that fell out, and which maintained its whole structure without any major fracture must be re-implanted within 60 minutes after the accident for having the best chances to remain in position. This applies to adult teeth only and not for deciduous teeth.
The best option is to re-implant the tooth at the accident site. The tooth should be placed by an adult, either by the person who lost his tooth, or by another adult if it is a child who has suffered from the accident.
It is important that the tooth is placed in its exact position, so it does not move when the patient bites his teeth together.
If the tooth is dirty, it is important that the patient cleans it with his own saliva by putting it in his mouth. It should then be removed from the mouth and spit all the debris. By spitting hard, you can remove the blood clot that would have formed in the hole where the tooth was located, making the re-implantation of the tooth easier to do.
The more quickly this is done; the better will be the chances of success.
If for some reason the tooth cannot be placed in its right position, then it must be brought the dentist as soon as possible. The tooth can be kept in the mouth of the patient if it is an adult. If it’s a kid that had the accident, he or she may swallow the tooth; it is therefore better to keep it in a cup of milk, or in a saline solution (one cup of water mixed with half teaspoon of salt). The patient and the tooth must be taken to the dentist as soon as possible.
By following these instructions there are good chances that the tooth remains in the mouth for a lifetime. There are risks that it may need a root canal later, or it might need to be extracted and replaced by an implant, a bridge or a partial.
Following dental extraction, which includes the removal of wisdom teeth, a lot of people who are smokers may ask themselves when can they start smoking again.
After tooth extraction, a blood clot slowly forms in the hole left in the bone by the removed tooth. This blood cloth is the initial phase of the healing process. The blood cloth’s formation can be slowed down when a person smokes, either from the suction done during the smoking action, or from the chemical toxins that come from a cigarette. This can lead to complications such as a dry socket, which is a temporary and very painful condition that occurs when the blood cloth forms slowly.
It is therefore recommended to wait at least 48 to 72 hours before smoking after a dental extraction. Smoking is very bad for someone’s health and stopping completely is mostly recommended.