questions & answersquestions & answers

What are dental caries?

Dental caries is the most common chronic disease of early childhood and the leading cause of tooth loss in adults. Dental caries (tooth decay) is the result of a specific bacterial infection that impacts the entire mouth. Two bacterial species have been implicated in dental caries, lactobacillus sp. and streptococcus mutans. These bacteria are transmitted in saliva and can be passed from one individual to the next. Recent studies suggest that 75% of these infections occur between the 19 and 24 months age.

How do bacteria cause tooth decay?

Our teeth are constantly being damaged and repaired. Damage occurs as acids in the mouth dissolve the minerals necessary to make up the tooth. We call this process de-mineralization. The process of repair, called re-mineralization, occurs as minerals present in your food and water, tooth paste and mouth rinses, and saliva recombine with your tooth to repair areas damaged by acids. De-mineralization and re-mineralization are in a constant tug of war where anything that shifts the balance in favor of damage will result in dental caries. Once de-mineralization has weakened the structure of the tooth enough, the tooth crumbles in forming a cavity. At this point bacteria may enter the tooth and cause further infection of the tooth.

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What things put me at risk of having Dental Caries?

There are three important influences that effect whether you are at risk of having dental caries:

  1. Your individual susceptibility, for example:
    1. Do you have a healthy immune system that can fight s.mutans or lactobacilli? – Did you know that your saliva has antibodies and other proteins that kill bacteria?
    2. Can your saliva block the actions of acid on tooth structure? – Fact, some people are better able to neutralize acids in our foods and those acids produced by bacteria.
    3. Medications and overall health – Did you know: that one of the most common side effects to medications is reduced saliva production? Less saliva means more bacteria and more damage from their acids! With increasing age and some diseases, like diabetes and sjogrens syndrome, we also experience decreased saliva production!
  2. Diet
    1. Foods higher in simple carbohydrates are easier for s. mutans to produce acid from! The more frequently you ingest food high in sugar the more damage (de-mineralization).
    2. The faster foods are removed from the mouth the less chance bacteria have to produce acid. Did you know: at night your body produces less saliva? Less saliva means food is not washed away and leads to prolonged damage to teeth! Remember to brush if you have a bed time snack!
  3. The right…or wrong stuff! (good vs bad bacteria)
    1. Everyone has bacteria in the mouth. Some bacteria help contribute to our overall health by killing harmful bacteria.
    2. S. mutans must be present to develop dental caries. Without this bacteria present, caries are not seen. Something to consider: Although brushing and daily flossing are necessary to promote good oral health they cannot remove 100% of the bacteria around your teeth. Since it takes very few of these bad bacteria to cause cavities, even for the best brushers and flossers this may not be enough to prevent dental caries.

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How much bleeding is normal?

Some blood will ooze from the area of surgery and is normal. You may find a blood stain on your pillow in the morning, so it is advisable to use an old pillowcase the first night.

Do not spit or suck thick fluids through a straw, because this promotes bleeding.

If bleeding begins again, place a small gauze pack directly over the tooth socket and bite firmly for 60 minutes. An unused tea bag is an excellent alternative. Keep your head elevated with several pillows or sit in a lounge chair.

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Do I need pain killers?

Some discomfort is normal after surgery. It can be controlled but not eliminated by taking pain pills your dentist has prescribed. Take your pain pills with a whole glass of water and with a small amount of food if the pills cause nausea, do not drive and drink alcohol if you take Tylenol #3 or prescription pain pills.

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What can I drink and eat? what should I avoid eating?

It is important to drink a large volume of fluids. Do not drink thick fluids through a straw, because this may promote bleeding.

Eat normal regular meals as soon as possible after surgery. Cold, soft food such as ice cream or yogurt may be the most comfortable for the first day.

We encourage good nutrition and vitamin supplementation following surgery to promote favourable healing. Softer foods such as soups, pastas, yogurt, pudding, fish or eggs should be eaten the first day or two after surgery.

Try to avoid foods with small seeds (such as poppy seeds, sesame seeds, raspberries) for a few days following surgery.

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How do I keep my mouth clean after surgery?

Do not rinse your mouth or brush your teeth for the first 8 hours after surgery. After that, rinse gently with warm salt water (1/2 teaspoon of salt in 8oz of warm water) every 4 hours. Brush your teeth gently, but avoid the area of surgery.

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How long does the swelling last and what can I do to ease the pain?

Swelling after surgery is a normal body reaction. It reaches its maximum about 48 hours after surgery and usually lasts 4 to 6 days. Applying ice packs over the area of surgery for the first 12 hours helps control swelling and may help the area to be more comfortable.

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How long after before I can start exercising?

Avoid strenuous activity for 12 hours after your surgery.

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Should I be worried about the bruising?

Mild bruising in the area of your surgery is a normal response in some people and should not be a cause for alarm. It will disappear in seven to 14 days.

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My jaw is very stiff and I cannot open it very much. Is this normal?

After surgery you may experience jaw muscle stiffness and limited opening of your mouth, This is normal and will improve in five to ten days.

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Do I need to schedule an appointment to remove my stitches?

Sutures used in our office are dissolve on their own. There is no need to have them removed.

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What kinds of post-op problems should I call the office?

  • You experience excessive discomfort that you cannot control with your pain pills.
  • You have bleeding that you cannot control by biting on gauze.
  • You have increased swelling after the third day following your surgery.
  • You feel that you have a fever.
  • You have any questions.

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What medications should I use?

  • IBUPROFEN (Advil, Motrin): DO NOT USE IF ALLERGIC TO ASPIRIN OR IF YOU ARE A SEVERE ASTHMATIC.
    • We recommend two tablets (400mg) every four hours for the first day of surgery and one tablet in the morning & evening for 3 days after surgery. Ibuprofen is an excellent anti-inflammatory and a good pain reducer. DO NOT exceed 3200mg (maximum adult dose) in one 24 hour period.
  • TYLENOL 3 (optional): is a strong pain reducer with contains codeine. You should not operate a motor vehicle after taking codeine for at least 6-8 hours. USE AS DIRECTED.
    NOTE: Codeine may promote constipation
    • DO NOT EXCEED 12 ‘Tylenol 3’ tablets in one 24 hour period.
  • CHLORHEXIDINE RINSE (optional): use one capful three times a day. Swish for 30 to 60 seconds the spit remaining rinse into the sink. Discontinue after 14 days.
  • SALT WATER RINSE: Mix 1 teaspoon salt to 8oz. warm water and rinse for 10 seconds. Repeat 2-3 x per/day

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can I smoke?

Recent studies have indicated that tobacco smoke delays soft tissue healing! The toxic constituents of cigarette smoke—particularly nicotine, carbon monoxide and hydrogen cyanide—suggest potential mechanisms that may undermine timely healing;

  • Smoking causes blood vessels to tighten up. This decreases blood flow to the healing area. With less blood, its harder for damaged tissues to get the nutrients and oxygen they need to heal properly.
  • Smoking decreases the level of oxygen in the blood. Healing tissues need plenty of oxygen, but they don't get if you're a smoker.
  • Smoking decreases the formation of collagen. Collagen is the main protein in connective tissue that is needed for a wound to heal properly.
  • Smoking increases scar tissue formation. By limiting the migration of fibroblasts – the most common type of cell found in connective tissue – to the wounded area. This leads to an accumulation of these cells at the edge of the wound.
  • Smoking increases the level of hydrogen cyanide in the bloodstream. This makes it harder for chemicals in the body to transport oxygen from cell to cell – an action that is necessary for healing.

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