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People undergo oral surgery for a number of different oral- and tooth-related problems, including impacted, infected or abscessed teeth, or problems that cause inflammation. Oral surgery can involve anything from a root canal and similar treatments to the total extraction of a tooth or multiple teeth.

These procedures are designed to eradicate infection, but on occasion, complications occur, and this may cause other types of infection that require further medical attention. The human body has naturally occurring bacteria; some of which are beneficial, but some bacteria have the potential to be harmful. When the body's immune system is compromised either because of chronic illness (such as diabetes, or other conditions that lower resistance,) or surgery, the potential for infection increases.

What to Expect Following Oral Surgery

During the first few hours following surgery you will most likely be numb and should use caution, especially when eating. You will also be given pain medicine along with the suggestion that you not wait until you are in intense pain to take the medication.

Since you won't be able to brush your teeth in the area where the surgery was performed, you may be given a prescription medication to use as a mouth rinse. Gargling with warm saltwater will reduce swelling and help minimize pain. Be careful about what you eat for at least the first 24 hours; Dr. Theodotou and our team advise sticking to soft foods such as Jello®, yogurt, smoothies, or soups.

Reasons for Concern

Post oral surgery infection is a rare complication and typically happens most often with people whose immune systems are compromised or those who are diabetic. A possible indication of infection following the surgery is bleeding that is present 24 or more hours following the surgery. Some residual blood is natural during the first few hours following surgery, but it subsides and bleeding should no longer be a concern. Although there may be some swelling following oral surgery, this should also subside, and ice can help with that.

Possible Symptoms of Infection

• Throbbing pain that doesn't respond to pain medication indicates a serious problem.
• Many people develop a fever following surgery, but should return to normal by the next day. If you have a low-grade fever that persists, or increases, contact Dr. Theodotou immediately.
• Increased swelling to the gums, jaw, or face is often indicative of infection, and it generally gets worse as the infection progresses. Seek prompt medical attention.
• Any oozing discharge such as pus is always indicative of an infection and requires treatment.

If you are a patient with compromised immune system or medical problems for which an infection would be serious, an antibiotic will usually be prescribed. The natural presence of bacteria in the mouth increases the likelihood that bacteria could enter exposed areas. That is why it is so important that only sterile gauze pads be placed in the mouth, and that you gargle with warm saltwater and any other antibacterial gargle that has been prescribed. The presence of any or all of the above problems indicates a possible infection, and you should contact Dr. Theodotou or our team at Oral and Maxillofacial Surgery of Coastal Georgia.

Dental implants are a marvel! They look just like your natural teeth, and, even better, they function just like your natural teeth. So, when you’re planning on a dental implant after an extraction, you want to make sure that your implant has the best chance of success—and we do, too. That’s why we might recommend a socket preservation procedure, where socket grafting takes place immediately after your extraction.

What is a socket graft, and what does it “preserve”? Let’s take a closer look.

Socket Preservation—A Logical Choice After Extraction

You’ve decided on a dental implant for some excellent reasons.

• A missing tooth can change the appearance of your smile.
• Your remaining teeth might shift to fill the empty space, causing alignment and bite problems.
• A lost tooth affects the amount, shape, and health of the bone surrounding your teeth.

No one wants to lose a tooth, but sometimes, due to injury or decay, an extraction is the only choice for your oral health. Seeing an oral and maxillofacial surgeon is especially important for complex extractions, when you have impacted or fractured teeth, roots close to nerves, or other complications which require surgical treatment.

After your tooth is extracted, if the socket bone holding the tooth is perfectly healthy, we might be able to place an implant post in the socket right away.

But often, even with a simple extraction, bone needs time to heal before placing an implant post, and you risk losing the bone size and density you need to make a future implant possible. How can you lose bone? That’s an unfortunate consequence of losing teeth. Teeth are important not just because they let us eat comfortably—they also help maintain bone health.

Without the stimulation of biting and chewing, the bone beneath the teeth begins a process called resorption. As older cells are absorbed back into the body, new bone cells aren’t produced as quickly to replace them. The alveolar bone, the thick ridge of the jaw which holds our sockets, shrinks in size. As the bone gets smaller, gum tissue shrinks around it, causing a sunken spot where your tooth used to be.

For a dental implant to anchor successfully in the jawbone, you need healthy bone that is high enough, wide enough, and dense enough to hold the implant post securely as it fuses with the bone.

A socket graft at the time of extraction provides two important benefits: grafting material fills the empty socket immediately, preserving the bone and gum area around it, and the graft material acts as scaffolding for new bone growth, creating a firm, dense foundation for your implant.

Grafting materials are gradually and safely absorbed as your new, healthy bone tissue replaces them. The result, after several months of healing, is an alveolar ridge with normal height and width and with the density needed to anchor an implant successfully.

The Grafting Procedure

Grafting material comes in different forms, including allografts (made from donor bone), synthetic grafts (made from synthetic materials which function like bone tissue), and autografts (bone taken from your own body). Growth factors may also be included in the grafting material to encourage new cell growth. Dr. Theodotou will recommend the type of graft which will work best for you.

A socket preservation procedure will frequently involve the following steps:

• Local anesthesia to numb the area before your extraction. You might choose sedation options as well, which we’re happy to discuss with you in advance.
• Careful cleaning of the site after the tooth is extracted.
• Filling the empty socket with bone grafting material.
• Placing a barrier or membrane over the graft to protect it as it heals.
• Suturing the surrounding gum tissue.

Aftercare Treatment

Aftercare treatment for a socket graft is a lot like the treatment for a tooth extraction. You’ll need to be careful around the graft area for several days as it heals, and we’ll give you specific instructions for your recovery. Normally, these may include:

• Don’t disturb or touch the area. Even pulling on lips or mouth to look at the site can put stress on your sutures.
• Immediately after the procedure, we can give you suggestions for reducing swelling and managing any pain you might be feeling.
• We’ll let you know when and how to rinse your mouth clean and when you can return to brushing. And no spitting!
• Eat carefully. We might recommend a liquid diet for a few days before transitioning to bland and cool soft foods. We’ll let you know the best diet for the period after your surgery. Don’t use a straw for your liquid diet, because suction can interfere with the wound.
• Treat yourself carefully for a few days by avoiding strenuous activities, including workouts.
• Don’t smoke. Smoking interferes with the healing process, and the suction involved does your graft no favors either.
• Visit our Pooler office for follow up appointments as recommended. We’ll monitor your healing, and give you a timeline for your future implant.

Preserving your socket now instead of repairing it later has many advantages. Immediate placement of a graft protects bone size and density, eliminates the need for a potential bone grafting procedure in the future, and makes it possible for you to enjoy the natural look and feel of a dental implant as soon as possible. If you’ve scheduled an extraction with us, let’s discuss why socket preservation might be your best path to an efficient, timely, and successful dental implant.

As with any surgery, post-procedure care is of utmost importance after getting periodontal surgery. Bleeding, pain, swelling, and other sensations are common and should be expected to a degree. This can manifest as small amounts of blood in your saliva, pain after anesthesia wears off, and swelling around the lips and cheeks. However, these symptoms should start improving after a several days.

Below you'll find recommendations from Dr. Theodotou on what you should do to make your post-procedure experience as quick and painless as possible:

Don't smoke - After your surgery you should definitely not smoke. Smoking will inhibit your body's ability to heal the surgical site.

Don't drink alcohol - If you are taking prescription or over-the-counter pain relievers, don't drink alcohol. And it is a good idea in general to avoid alcohol after surgery, since excess alcohol consumption suppresses immune system function and slows the healing process.

Take pain medication as prescribed or an alternative - Pain is to be expected for at least the first week after your procedure. If you choose to take the prescription medication that is prescribed to you, do so as directed. However some patients have found over-the-counter pain medication works for them. You may also consider natural herbs instead of pharmacological solutions. Try turmeric, arnica, or white willow bark (which is what aspirin is derived from, so the same warnings for aspirin apply to white willow bark.)

Eating with your surgical site in mind - It is best to chew on the other side of your mouth for the first several days so as not to irritate the surgical site. Avoid overly cold or hot foods as well. Softer foods like mashed potatoes, oatmeal, and fruit will be more comfortable to chew.

Avoid brushing the surgical site - You can start brushing and flossing your teeth the day after the procedure but avoid the surgical site.

Don't rinse for the first 24 hours - After the first day has passed you can rinse with a mild mouthwash to keep your mouth, dressing, and surgical site clean.

We're here to answer any questions you have after your procedure and will help you as best we can. Pay special attention to any excessive bleeding or discomfort. Contact our Pooler office immediately if you have tried addressing the issue on your own but are still having trouble.

Sometimes, despite our best care, we lose a tooth. If it is a front tooth, it will probably be a high priority for replacement. But if a missing tooth doesn’t show when we smile, what’s the hurry? Let’s look at the reasons why prompt replacement with an implant is always a good idea, no matter which tooth is involved.

1. Appearance

Implants look like natural, individual teeth, but that is not the only aesthetic reason to replace a lost tooth. Without some type of tooth replacement, missing teeth can eventually affect the structure of our jawbones and change our facial appearance. Cheeks, lips, profiles—all are impacted by the changes in our bones resulting from tooth loss.

1. Better Bite

Nature abhors a vacuum, and so do our teeth. When a space is left by a missing tooth, the teeth around the area can shift position, affecting the even pattern of our bite. And without a tooth to keep it in place, a tooth above or below the missing one might begin to grow longer to fill the void in your bite. This lengthening, in turn, can cause even more bite problems.

1. Chewing

With the loss of only a single tooth, there is a negative impact on the remaining teeth. More pressure is placed on the other teeth in order to chew properly, front teeth not meant for chewing might be used for that purpose, or food is not chewed as thoroughly as it should be. The first two problems are not healthy for our teeth, and the last one is not healthy for digestion!

1. Don’t Delay

Changes in bite and chewing problems probably won’t happen overnight, so is putting off the process really a big deal? It can be! Time is not on our side when a tooth is lost. The bone tissue which supports our teeth needs the stimulation of biting and chewing to stay healthy. Without that stimulation, the bone area under the missing tooth gradually shrinks. If there is not enough bone area left, you might need surgical bone grafting to achieve the right bone height to hold an implant, or it could lead to the impossibility of placing an implant at all.

1. Expense

Replacing a lost tooth quickly requires less restoration of the gums and bone in the future and prevents other serious problems from developing.

We could continue through the alphabet, but instead, come talk to Dr. Theodotou about all the reasons a tooth implant might be your best option. Oral surgeons have years of advanced surgical training, and specialize in the diagnosis and treatment of medical conditions in the face, mouth, and jaw. Whether you have already lost a tooth, or if you have an extraction scheduled at our Pooler office, we are uniquely qualified to recommend the best treatment plan to ensure your smile is beautiful, healthy, and complete!