Tooth extraction is the most common minor surgery performed in dentistry, but sometimes it can lead to accidents, undue damage and pain, and in severe cases, life-threatening. Therefore, it requires both physical and psychological preparation before tooth extraction. Many patients have anxiety and fear about tooth extraction, avoiding it because of nervousness and fear, or failing to cooperate with the dentist during the extraction process, or even fainting.
Everyone should know the following precautions before tooth extraction.
Tooth extraction is contraindicated in any of the following cases.
(1) If the patient is accompanied by other systemic diseases, especially hypertension, coronary heart disease, etc., serious complications may arise as a result, and even life threatening. It is recommended that in addition to effective control of systemic diseases and physical condition meeting the requirements for tooth extraction, great attention should be paid to the mental preparation and psychological tolerance of the patient. Those with severe cardiovascular disease and high blood pressure above 180/100 mmHg.
Patients with heart disease in general can have their teeth extracted as long as they do not show signs of cardiac insufficiency (such as shortness of breath with slight activity or lying down). However, when extracting teeth, it should be done as follows: do not add epinephrine to the anesthetic to avoid tachycardia and induce heart failure; complete anesthesia and gentle movements to minimize adverse irritation, bleeding or injury; anti-infection prophylaxis should be given before and after tooth extraction, because the resistance of heart disease patients is reduced and they are more prone to co-infection than normal people.
(2) Bleeding diseases: Patients with hemophilia and primary thrombocytopenic purpura, for example, have a tendency to bleed because of the disorder of coagulation process in their bodies. The bleeding is difficult to stop after extraction and can cause hemorrhage and life-threatening. As for patients with leukemia, since they are highly susceptible to infection, the incision after tooth extraction can also become a focus of infection, which can lead to serious systemic infection and is difficult to control. Therefore, when these patients suffer from dental disease, they should be treated conservatively and tooth extraction is contraindicated.
(3) Menstruation, pregnancy and lactation: Women should in principle avoid tooth extraction during menstruation, because compensatory bleeding may occur in the alveoli during menstruation. However, the extraction of loose teeth during menstruation does not affect the patient much. Some “deep-rooted” teeth, such as obstructed teeth or buried teeth, should be extracted after menstruation.
According to some data, it is most appropriate for women to have their teeth extracted around the 10th day of their menstrual cycle, when the wound heals faster and bacterial infection is less likely to occur. Some people believe that no tooth extraction should be performed during pregnancy because it may lead to miscarriage. However, a lot of clinical practice shows that tooth extraction during the third to seventh month of pregnancy is safer and has no adverse effects on pregnancy.
The following points should also be noted for tooth extraction during this period.
① Intramuscular injection of progesterone 10 mg on the day before and on the day of tooth extraction.
(ii) Epinephrine must not be added to the anesthetic for tooth extraction.
③Anesthesia must be complete and the pain relief effect should be good. For patients with a history of habitual miscarriage or habitual premature birth, tooth extraction is prohibited during pregnancy. Dental extraction is completely allowed during breastfeeding. Some people say that tooth extraction during this period will interrupt or reduce milk production. This statement is not scientific. Clinical practice shows that there is no effect on lactation.
However, do not take antibacterial drugs; the drugs and their metabolites can have an effect on the baby through the breast milk possibly. During taking contraceptive pills, the pills can increase fibrinolysis in the body, so that the wound can not form a good blood clot, and germs can easily take advantage of the situation to cause infection and affect wound healing.
(4) Severe liver and kidney function damage extremely active liver disease. For example, chronic hepatitis and cirrhosis, due to poor liver function, the content of prothrombin and fibrinogen, which are involved in the coagulation process, is reduced and there is a tendency to bleed, and the wounds after tooth extraction will bleed more than once. Therefore, appropriate amount of vitamin K should be supplemented before tooth extraction for such patients to promote prothrombinogen synthesis to supplement the deficiency of fibrinogen in order to avoid accidents.
(5) Tooth extraction should be avoided in malignant tumors and during episodes of psychosis.
(6) Before the symptoms of diabetes are controlled.
(7) Tooth extraction should not be performed after strenuous exercise, labor, or after drinking alcohol.
(8) Those who have a history of allergy to procaine anesthetics (some can be changed to acupressure or needle anesthesia).
(9) Patients with inflammatory period of cold and flu also need to be cautious in tooth extraction.
Precautions for tooth extraction are.
I. Preparation on the day of tooth extraction:
(1) It is better for women not to have their teeth extracted in time for their regular holidays, there will be more bleeding. There will be more chances of infection.
(2) Try to avoid the high incidence of cold in spring and autumn.
(3) As for whether to go for extraction in the morning or in the afternoon. It depends on the situation.
If it is a difficult tooth extraction, it is recommended to come to me at 8:00 am. The physical energy of both the doctor and the patient is good in the morning. The observation time after the extraction is also longer.
If the extraction is not very difficult and the tooth to be extracted has a history of recurrent inflammation, it is recommended to come in the afternoon.
The anesthetic is not absorbed well and it may be painful to extract such a tooth. People are less sensitive to pain in the afternoon.
(4) If the extraction is expected to be difficult or the tooth to be extracted is inflamed. Or if you are afraid of pain. You can take an anti-inflammatory medicine and painkiller half an hour before the extraction.
(5) Before tooth extraction, eat a little something, not on an empty stomach, don’t eat too much, don’t eat too greasy food. Drink water properly. If you eat too little, your resistance will be weak, and if you eat too much, you may get nauseous and even vomit during the extraction process. That would be a problem. It is easy to get infected. Then rinse and brush your teeth clean.
(6) Patients with high blood pressure should have their blood pressure tested at the nurse’s office.
Before tooth extraction, you must be mentally relaxed, increase your self-confidence and maintain emotional stability, and if necessary, extract teeth under conscious sedation and cardiac monitoring, which can greatly improve safety if you operate with the dentist in a comfortable and relaxed situation.
Before tooth extraction. Be sure to tell the dentist about your current general condition and mental status. If you have a history of heart disease, hypertension, diabetes, blood disease, hepatitis, kidney disease, hyperthyroidism, malignant tumor, mental disorders and other systemic diseases, you should suspend tooth extraction; women suffering from menstruation or pregnancy who are taking anticoagulant medication for a long time must pay more attention.
Second, what should we pay attention to after tooth extraction.
(1) First of all, the most crucial thing is that after tooth extraction, it is important to calm down and listen carefully to the doctor’s explanation.
(2) It is better not to eat for two hours, and to eat soft food on the same day, with warm and cold, and chew on the other side.
(3) Do not rinse your mouth and do not spit much on that day to prevent bleeding or infection. Do not repeatedly suck and spit out blood clots because of the smell of blood in the mouth, which will not heal the trauma.
(4) Do not brush your teeth on the same day. Because about 24 hours after tooth extraction, the local fibroblasts just extend and grow from the alveolar bone wall to the blood clot, and gradually make the blood clot mechanized and become strong and solid. If you rush to rinse and brush your teeth, it is possible to rinse and brush off the blood clot and cause rebleeding, or cause “dry socket” with unbearable pain due to emptying of the tooth socket, which prolongs the healing time. Care should also be taken not to lick the wound with tongue or suck the wound with force to prevent infection caused by wound injury or dislodge the blood clot on the wound, which will affect the clotting process and cause continuous bleeding.
(5) Within 1 week after tooth extraction, it is normal to have blood in the mouth and water; if there is more than bleeding, go to the hospital for examination.
(6) Try to exercise less and talk less on the day of tooth extraction. Avoid smoking, alcohol and spicy food.
(7) If there are sutures in the mouth when the tooth is extracted, the sutures can generally be removed only after 4~5 days.
(8) After tooth extraction, bite the sterilized cotton ball or gauze pressed on the wound to compress the wound and help stop bleeding, and stick to it for 60 minutes before spitting it out, and do not bite too tightly or bite for too long. This is because the blood in the wound after tooth extraction can form a blood clot only after half an hour. If you spit out the cotton ball or gauze in advance, bleeding will easily occur.
(9) Generally, tooth extraction can be done without oral conventional antimicrobial agents, and it is normal to have a slight fever after a difficult tooth extraction. If wisdom teeth or traumatic teeth are extracted, oral antibiotics must be taken, and intravenous antibiotics can be infused if the symptoms are aggravated.
(10) Teeth should be set in time (except for blocked teeth) 2 to 3 months after tooth extraction to avoid the backing up of neighboring teeth.
(11) Do not touch the wound with your fingers after tooth extraction because they are covered with a large number of pathogenic microorganisms, which can easily cause infection of the extraction wound and also destroy the formed blood clot.
What are the possible problems of tooth extraction? What are the chances of occurrence? What are the technical problems of the doctor? What are the normal reactions?
1. Infection after tooth extraction
Minor infection: 70% chance of occurrence.
After tooth extraction, especially wisdom tooth extraction, it is normal to have a little pain and slight swelling, which usually does not affect your image and normal study and work. Take oral anti-inflammatory drugs and painkillers for three days, usually fenbutrazol and tinidazole.
Moderate infection: 10% chance of occurrence
Significant facial swelling and severe pain after wisdom tooth extraction is not an accident. As long as the pain is lighter than the day before, you will usually be fine. You can increase the dose of anti-inflammatory drugs or even infusion for a few days. You can rest for a day or two. If it is not lighter than a day or even worse after the third day, please go back to the doctor promptly.
Severe infection: 3% chance of occurrence
Severe swelling, severe pain and restriction of mouth opening after wisdom tooth extraction, you must consult a doctor at this time.
2. Bleeding
The bleeding will stop the next morning in 80% of the cases. If there is a small amount of bleeding, you can eat some ice-cream and freeze it to stop the bleeding, but if there is a lot of bleeding, you should go back to the doctor for treatment in time.
3. Broken tooth roots during tooth extraction.
I would like to make a special mention of this issue, if your tooth has not been inflamed. If the remaining root is less than one third of the total length of the root, it is not necessary to remove it. It is not necessary to get it out.
If it is not easy to do so, don’t do it. Forcing it out is more damaging than leaving it unplugged!
It can be absorbed on its own.
4, pulling the wisdom tooth above, when the anesthetic can not close the eyes and rapid local swelling.
Chance of occurrence: less than 3%.
Please believe that this is not medical malpractice. It is an accident. There will be no after-effects.
The inability to close the eyes will recover on its own after the anesthetic wears off, within about 2 – 3 hours.
The local swelling will generally return to normal in about two weeks. During this period, the local skin generally goes through a process of red – dark red – yellow – normal. Such an evolutionary process.
5, consent form there are many provisions: what soft tissue damage, what alveolar bone damage, what oral maxillary sinus traffic, and the patient’s friends most worried about infection with hepatitis B, infection with AIDS, etc., these are not impossible. But the possibility is very small and very small.