surgery
We also offer surgery at our practice in The Hague. On this page we tell you everything about the different procedures.
Pulling tooth or molar
If a tooth or molar is severely affected or damaged, the extraction of this tooth or molar may be the only remedy. The extraction of a tooth or molar is also called extracting or an extraction. The dentist can perform the treatment himself or, if necessary, refer you to an oral surgeon.
When is a tooth extracted?
A tooth or molar is extracted when it is no longer possible to keep it. This can be due to, for example, a serious gum disease as a result of which the molar is no longer fixed in the jaw bone, a tooth has been damaged too much by tooth decay, or a tooth has broken off to such an extent that it can no longer be repaired due to an (accident) fall.
Wisdom teeth can cause problems if they are partially below the gumline, become inflamed or grow crooked. It may also be necessary to pull molars if there is a lack of space. This often coincides with braces treatment.
Therapy
Before the treatment, a photo is first taken. The dentist can then see how the roots run and whether there is, for example, a risk that the tooth will break off. He will also see whether he can perform the treatment himself or whether he will refer you to an oral surgeon. You will of course be well anesthetized before the extraction of the tooth. The dentist first pries the tooth loose a little and then the tooth is pulled out. Sometimes the dentist splits the molar first and the molar is removed in parts. The dentist may find it necessary to suture the wound.
First days after tooth extraction
You should not eat or drink food that is too hot until the anesthetic has worn off. Try to limit smoking or drinking alcohol to a minimum the first day after the procedure. In addition, it is important to leave the blood clot that forms alone. This blood clot protects the bone.
In the first two to three days, the wound may swell slightly and feel uncomfortable. You can then take painkillers for the pain. Ask your dentist about this.
Cleaning your mouth after tooth extraction
Do not clean the place where the tooth was extracted for the first 6 hours after extraction. Brush your other teeth as you normally would and gently near the wound.
Severe pain can indicate an inflamed tooth cavity. If you feel severe pain two days after the tooth has been removed, it could be that the blood clot has dislodged or dissolved or that food particles have entered the cavity. It is important that you see your dentist.
Risks
Tooth extraction is a common treatment, but not always without risks. The dentist will assess the risks in advance and determine whether he can perform the treatment himself or whether a referral is necessary. For example, if the root tips are close to the nerve, it can be damaged (irreparably). During a treatment, things can also turn out differently than expected. The dentist will then stop the treatment and refer you to the oral surgeon. It also sometimes happens that an opening from the oral cavity to the paranasal sinus (antrum perforation) has developed after pulling. In that case, too, you will be referred to the oral surgeon who will close the resulting opening again.
Always follow the dentist's instructions after treatment. You may feel small pieces of bone sticking out after the treatment. This can't hurt. The dentist can remove this if necessary. In case of bleeding that will not stop, fever, severe pain or swelling, always contact your dentist.
Alternatives
The extraction of a tooth usually only happens when there is no other option.
Source: KNMT
flap surgery
Usually periodontitis can be cured, but sometimes the pockets are very deep or difficult to reach. Flap surgery may then be necessary to properly clean these places.
When do you need flap surgery?
Flap surgery may be necessary in persistent cases of periodontitis. In most cases, periodontitis can be cured by the combination of good oral hygiene and comprehensive gum treatment. It is possible that very deep or hard-to-reach pockets do not respond sufficiently to the treatment. To be able to properly clean these places, it is necessary to perform a flap operation.
Therapy
In a flap operation, the gums are loosened and moved to the side under local anaesthetic. Then the inflamed tissue is removed. The jawbone and the roots of the teeth and molars are then clearly visible and accessible. This allows the dentist to properly remove the plaque and tartar that are left behind after the dental cleaning. Where necessary, the (often jagged) edge of the affected jawbone is also touched up.
The sutures and dressing are removed one to two weeks after the flap surgery. A week later, the wound is usually healed. Because there is no more plaque and tartar on the teeth after the flap operation, the inflammation disappears and the healthy gums attach themselves to the teeth.
Risks
Both after extensive gum treatment and after flap surgery, the gums may recede somewhat. This makes the teeth appear 'longer' and can (temporarily) become more sensitive to heat, cold or oral hygiene treatments.
Alternatives
Pulling tooth or molar
Source: NVvP
Root point surgery (apex resection)
The roots of your tooth or molar are firmly in the jawbone. Root canals are located in the roots. The canal is filled with pulp that consists of connective tissue, nerve fibers and blood vessels. If your tooth is inflamed, the dentist will perform a root canal treatment. If root canal treatment is not possible or desired, root tip surgery (apex resection) can be performed.
When do you need root tip surgery?
If you have already had a root canal treatment and there is an infection again, you can choose to have a root canal treatment performed again. If this is not possible or the chance that this treatment will be successful is small, root tip surgery can be performed.
Therapy
During an apex resection, the practitioner makes a small cut in the anesthetized gums and opens it slightly. He then drills through the bone to the tip of the root with a small drill and cleans the root. Often a piece of the root tip is also removed. Then he fills the end of the root canal with a small filling. In this way, the channel is closed, preventing new infections in the future. When the practitioner is ready, he sutures the gums.
Risks
When the anesthetic wears off, you may experience some discomfort from the wound. This pain can be treated well with painkillers. In addition, your cheek may become thick after surgery. Cooling the cheek with ice reduces the swelling. The symptoms generally go away after three to four days. If the complaints persist, please contact your practitioner. Removing the root tip and the inflammation creates a hole in the jawbone. This closed after a few months.
In case of bleeding that will not stop, fever, severe pain or swelling, always contact your dentist.
Alternatives
- Root canal treatment
- Pulling tooth or molar
Source: KNMT
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- info@mondzorg-valerius.nl
- +31 0 70 870 1466
- Valeriusstraat 25, 2517 HM The Hague