Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There will usually be a metal or rubber chain protruding through the gums and attached to the arch wire of your braces. Please take care to avoid heavy contact with the chain during eating or brushing. It is not uncommon for the chain to become loose or detached from the tooth. If this happens please keep the chain and bracket handy and call our office immediately.
Usually there will be sutures (stitches) placed to reapproximate the gingiva at the surgical sites. The sutures we place are usually resorbable and do not need to be removed. Please avoid tampering with the sutures, allow 7-10 days for sutures to dissolve. Occasionally sutures may break and fall out sooner than anticipated, this is not cause for alarm simply keep the area clean, healing typically progresses as normal.
Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding can be controlled by biting on a moistened gauze pad placed under pressure directly over the bleeding wound for 30 to 60 minutes. If bleeding continues profusely, please call for further instructions. Avoid the use of straws for 2-3 days.
Swelling is a normal occurrence after surgery. To minimize swelling apply an icepack, or towel filled with ice, on the face in the area of surgery. Apply the ice 20 mins on and 20 mins off at a time, as much as possible, for the first 24 hours.
Drink plenty of fluids. Avoid hot liquids or hard foods. Soft food and liquids should be eaten on the day of surgery and for 2-3 days. Return to a normal diet as soon as possible unless otherwise directed.
Antibiotics are sometimes necessary after exposure of an impacted tooth, especially when bone is removed or the tooth is luxated (loosened). If prescribed, antibiotics should be taken as directed to help prevent infection.
TEETH-IN-AN-HOUR™ is a revolutionary concept providing patients with fully functioning teeth on dental implants in a single procedure that takes about an hour. This technology was developed by Nobel Biocare and utilizes collaboration between both the restorative doctor and the oral surgeon. This merging of knowledge and experience achieves not only increased safety, but also a more precise implant placement. In addition, the fabrication of a final prosthesis is completed prior to the surgery. The computer-guided implant surgery is done in an arthroscopic fashion without requiring any flap reflection. This benefits the patient in that there is less postoperative discomfort, less swelling, and less bruising. Patients can often resume their normal activities the next day.
The process begins when a CT scan is taken of the patient’s jaw bone. This CT scan allows for the generation of a three-dimensional model of the jaw bone that can then be used with virtual software to plan the implant placement without the presence of the patient. The results are a more accurate implant placement and less chair time for the patient.
An Implant Supported Overdenture is a contemporary restoration that has revolutionized the way surgeons and dentists think of replacing a full set of teeth. Standard dentures are unsecured prostheses with inherent limitations. Most often, dentures are painful, inconvenient and unstable. Such dentures can make chewing foods difficult, limiting the foods that you once enjoyed. Modern dentistry can help with implant supported dentures.
Scientifically proven and documented. Implant Supported Overdentures have had good clinical outcomes from decade long studies with favorable results.
Although many patients have no problem wearing an upper denture, some people find it difficult to wear and eat with lower dentures. Several implant-supported replacement options are available if you are missing all of your lower teeth.
One option is to have two implants placed in your lower jaw and a denture made that snaps onto these implants. This option allows your lower denture to be more stable while chewing than without implants. However, there will still be movement of your lower denture, and sore spots will occur if any food particles, especially seeds, are caught under it. As with all removable replacement teeth, you still will need periodic appointments for denture adjustment.
Another option involves placing four to six implants, depending on your jaw size or shape, into your lower jaw. After healing is complete, the implants are connected with a custom-made support bar. Your denture will be made with special internal retention clips that attach onto the support bar, enabling the denture to snap firmly into place. This is called an “overdenture.” The advantage of this option is that it is much more stable than the first option and allows very little denture movement. Your denture is still removable for easy cleaning and maintenance.
A third option involves placing five or more implants in your jaw and attaching a permanent denture. Your denture is held in place by screws or clasps that secure it to the support posts or bar. It doesn’t touch the gum tissue, which allows you to clean under the denture without removing it. This denture will replace all your missing lower teeth and will not be removed except at maintenance visits. Although cleaning under your denture without removing it is more
time consuming and requires more dexterity, many patients who want a permanent denture prefer this option.
The final option is to have all your teeth individually replaced so that they will appear to be growing out of your gum tissue and will most closely resemble the appearance of your natural teeth. This option usually requires eight or more implants. Separate abutments or support posts for each one of these implants will be made and crowns for each missing tooth will be placed.
The teeth are often joined together. Overall, this is the most costly option, because it requires the most implants and individual replacement tooth fabrication. Your replacement options may also be limited by the current size and shape of your jawbone.
A similar range of treatment options is also available for your upper jaw. However, because the bone is not as hard as that in the lower jaw, people often need more implants to support their new replacement teeth. Depending upon the number of implants to be placed, it may be possible to eliminate the need for covering the roof of your mouth with a complete denture. This option allows you to fully taste your food and gives you a better sense of its temperature.
Your denture will feel more natural. You have the option of a removable or fixed denture. Sinus grafting may be performed in the upper jaw to replace bone height strength and support prior to implant placement.
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A small amount of bleeding is to be expected multiple extractions. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 – 45 minutes. If bleeding continues, bite on a moistened black tea bag for 30 minutes. The tannic acid in the black tea helps to form a clot by contracting blood vessels. If bleeding persists, call our office immediately. If you were instructed to wear an immediate denture/ prosthesis after extractions please do not remove the immediate denture unless the bleeding is severe. Expect some oozing around the sides of the denture.
Use ice packs (externally) on the cheek near the surgical site. Apply ice for the first 24 hours only. Starting the following day you may use a warm wet rag against the face to help further minimize discomfort and swelling.
For mild discomfort you may use Tylenol, or any similar medication; two tablets every 3-4 hours. Two to four tablets of Ibuprofen (Advil or Motrin) can be taken every 6 hours. Care should be taken not to exceed the daily max dose indicated on the bottle.
For severe pain, use the prescriptions given to you. If the pain does not begin to subside after 3 days, or increases after 3 days, please call our office. If an antibiotic has been prescribed, please take as prescribed till completed. If you are allergic to any medication please do not take it, if allergy develops unexpectedly please stop medications and call our office immediately.
Drink plenty of fluids. If many teeth have been extracted, the volume lost at this time needs to be replaced. Drink at least six glasses of liquid the first day.
Do not rinse your mouth or brush your other teeth for the first day, or while there is bleeding. After the first day, use a warm salt water rinse following meals to flush out particles of food and debris that may lodge in the operated area. (One teaspoon of salt in one glass of warm water). If you were instructed to wear a denture, you way remove it after 48 hrs. Please rinse the denture and clean it with an antibacterial solution at which point it can be replaced, this is to be done 3-4 times a day especially after meals starting 48 hrs after surgery.
Restrict your diet to liquids and soft foods that are comfortable for you to eat. As the wounds heal, you will be able to resume your normal diet.
The removal of many teeth at one time is quite different from the extraction of just one or two teeth. Because the bone typically must be shaved and smoothed for patient comfort and optimal healing. The following conditions may occur, all of which are considered normal:
If immediate dentures have been inserted, sore spots may develop. In most cases, your dentist will see you within 24-48 hours after surgery to make the necessary adjustments and relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process. Please call our office if severe soreness or tenderness develops.
TMJ (temporomandibular joint) disorders are a family of problems related to your jaw joint . If you have had symptoms like pain or a “clicking” sound, you’ll be glad to know that these problems are more easily diagnosed and treated than they were in the past. These symptoms occur when the joints of the jaw and the chewing muscles do not work together correctly. TMJ stands for temporomandibular joint, which is the name for each joint (right and left) that connects your jaw to your skull. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.
No one treatment can resolve TMJ disorders completely and treatment takes time to become effective. Dr. Egolum can help you have a healthier, more comfortable jaw.
TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disk, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, clicking, or grating noise when you open your mouth, or trouble opening your mouth wide.
The more times you answered “yes”, the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.
There are various treatment options that Dr. Egolum can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, Dr. Egolum will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care combined with professional care.
The initial goals are to relieve the muscle spasms and joint pain. This is usually accomplished with a pain reliever, anti-inflammatory, or muscle relaxant. Steroids can be injected directly into the joints to reduce pain and inflammation. Self-care treatments can often be effective as well and include:
Stress management techniques such as biofeedback or physical therapy may also be recommended, as well as a temporary, clear plastic appliance known as a splint. A splint (or night guard) fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. There are different types of appliances used for different purposes. A night guard helps you stop clenching or grinding your teeth and reduces muscle tension at night. It also helps to protect the cartilage and joint surfaces. An anterior positioning appliance moves your jaw forward, relieves pressure on parts of your jaw, and aids in disk repositioning. It may be worn 23 hours/day to help your jaw heal. An orthotic stabilization appliance is worn 23 hours/day, or just at night, to move your jaw into proper position.
Appliances also help protect tooth wear.
If your TMJ disorder has caused problems with how your teeth fit together you may need treatment such as bite adjustment (equilibration), orthodontics with or without jaw reconstruction, or restorative dental work. Surgical options, such as arthroscopy and open joint repair restructuring, are sometimes needed, but are reserved for severe cases. Dr. Egolum does not consider TMJ surgery unless the jaw can’t open, is dislocated and non-reducible, has severe degeneration, or the patient has undergone appliance treatment unsuccessfully.