After tooth extraction

Premise

After the extraction of a tooth, the patient's speed of recovery is heavily conditioned by the complexity of the intervention and by the compliance with some precautionary rules, which are very important to reduce the risk of complications.

We begin, therefore, to analyze in detail which risks and complications can follow a dental extraction intervention. Subsequently, we will try to list a series of precious precautions to be taken into consideration to avoid the risk of running into unpleasant problems after a dental extraction.

Risks after a tooth extraction

Whether it is a wisdom tooth or a canine, it matters little: the risks that occur after the extraction of a tooth are almost the same.

First of all it is good to remember that a healthy tooth requiring extraction for reasons of misalignment or dental malocclusion - typical wisdom teeth condition - faces fewer dangers or post-surgery complications than a tooth severely damaged by deep caries, pulpits, granulomas, dental abscesses or whatever. Also possible morbid conditions can heavily affect the post-dental extraction course: patients affected by systemic pathologies (eg diabetes, autoimmune diseases, chronic renal failure etc.), as well as subjects undergoing chemo / radiotherapy or who have to take corticosteroid drugs, can present considerable recovery difficulties after the extraction of a tooth.

Inevitably, after the avulsion of a tooth, the patient experiences an unpleasant sensation of swelling and gum pain, often accompanied by a slight bleeding which should resolve within the 24 hours following the operation. Within certain limits, these side effects can be defined as "normal". Let us remember that, although it is relatively simple, dental avulsion always remains a surgical operation in all respects, so it is understandable how the organism can react after the forced "removal" of an integral part of the body.

If the general rules of post-extraction prophylaxis are not respected, the clinical profile of the patient can dangerously degenerate. In this sense, the most worrying post-surgery complications are dental infections such as:

• Alveolite: alveolus infection (the bone cavity where the tooth roots are housed)
• Dental abscess: accumulation of bacteria, white blood cells, plasma and cellular debris (pus) confined to the tissues surrounding a tooth
• Dental granuloma: chronic inflammation of the root apex and surrounding tissues
• Dental cyst: rounded cavities that progressively expand in the bone, destroying it. This is a typical complication after extraction of an included wisdom tooth

Among the possible complications resulting from dental extraction we must not forget the temporary loss of sensitivity of the lip and tongue to the side where the operation was performed.

Prevent dental infections

Before a tooth is extracted, the doctor or specialist surgeon must communicate to the patient all the risks and complications that could cause such an intervention. As mentioned several times, compliance with the advice suggested by the doctor and the observance of certain oral hygiene rules can undoubtedly help to minimize the risk of acute pain, infections or other post-extraction complications. In the table, some general suggestions are summarized.

What to do after a tooth extraction ...	Tips
... to prevent pain after the first 24 hours after dental extraction	Take medications with pain-relieving and anti-inflammatory action before the effect of anesthesia wears off. Ibuprofen (eg Brufen, Moment) is particularly indicated for keeping pain at bay. Place an ice bag (wrapped on a soft cloth) on the outside of the jaw, in line with the site of the intervention. Remove the ice after 10 minutes and apply it again after another ten minutes Prefer a mainly liquid-semi-solid diet. Avoid gummy and hard foods.
... to prevent or limit bleeding immediately after tooth extraction	Hold an absorbent gauze over the tooth extraction site for at least 30-60 minutes, without removing it or touching it with your fingers Sleeping with your head raised on a couple of pillows: doing so you can calm pain and gum bleeding after a tooth extraction Check the degree of gingival bleeding only 30 minutes after placing the sterile gauze on the wound left by the tooth extraction When necessary, gently blow the nose to avoid strain that favors gingival bleeding Do not take drugs containing salicylates (eg acetylsalicylic acid)
... to prevent pain in the days following extraction	Take an antibiotic as a precaution or in case of proven infection: follow the instructions given by your doctor. The antibiotic (eg Metronidazole, Amoxicillin) can only be taken with a prescription It is possible to support the normal hygiene of the mouth with rinses of water and salt (dissolve a pinch of salt in a cup of warm water). Do not swallow Take drugs with pain-relieving and anti-inflammatory action (NSAIDs)
... prevent infections	Gently rinse the mouth with disinfectant mouthwashes (eg chlorhexidine 0.2%) only after 12-24 hours after dental extraction. Continue rinsing for at least two weeks after surgery Proceed with normal oral hygiene with extreme delicacy at the dental extraction site (do not force with the toothbrush, prefer soft bristles). Do not use the electric toothbrush. Stop smoking Do not suck at the extraction site: such behavior slows down recovery times
... promote recovery and speed up healing	Avoid driving immediately after extraction: it is advisable to be accompanied by a family member or friend, in particular if the tooth extraction procedure has been invasive or complicated (eg tooth included) An adequate rest in the days following the extraction favors complete recovery in less time Not smoking Don't drink alcohol Do not use an electric toothbrush or a hard bristle manual Do not chew gum or gum in the 3 days after tooth extraction Do not play sports or other heavy physical activities in the three days after a tooth extraction Do not suck at the extraction site: such behavior expands wound healing times
... if the pain persists	Contact the dental office if the pain persists even 3 days after the dental procedure Take a painkiller
... if the bleeding does not stop	Keep calm Bite a sterile gauze pad vigorously, keeping it pressed at the site of the operation Apply ice packs externally Gently remove any blood clots in the mouth, respecting the indications suggested by the surgeon to the letter
... in the presence of fever	Take antipyretic drugs (eg paracetamol) in doses set by your doctor Contact the dentist immediately if your body temperature exceeds 39 ° C and you are unable to lower with medication

Diet: what to eat and what to avoid

Also nutrition influences the recovery of the patient subjected to a tooth extraction. In fact, after the operation, it is strongly recommended to follow a light, balanced and water-rich diet. In particular, in the 24-36 hours following avulsion, we suggest a mainly liquid or semi-solid diet, therefore consisting of soft foods such as mashed potatoes, lukewarm soups, lukewarm soups, smoothies, minced or pureed meat, baby food, puddings, meatballs, fish boiled etc .. The residues of solid food, in fact, tend to get stuck in the sores on the gum - still painful and not completely healed - left by the intervention. Caging in these wounds, the bacteria, fond of carbohydrates and food, wedge into the injured gingiva, giving rise to a series of even serious dental infections.

In conclusion, it is good to reiterate that the observance of these precious suggestions is extremely important for the purposes of prophylaxis against infections or complications after a dental extraction intervention.