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Frequently Asked Questions
Before Treatment
Patients with certain heart valve/wall defects, recent angioplasty/stent surgery and recent total knee/hip replacements might need antibiotic coverage before certain dental procedures. The stents, valve/wall defects and prosthetic joints can harbor the oral bacteria entering their blood stream during certain dental procedures.
The same goes for patients with ESRD (End stage renal disease), lower CD4 cell counts and uncontrolled diabetics. The antibiotic prophylaxis can prevent bacteremia in such cases.
Dr. Patel will take a detailed medical history and prescribe such antibiotcs for prophylaxis in consultation with your physician.
Patients might be taking one or more blood thinners such as Warfarin, Coumadin, Aspirin, Clopidogrel (Plavix), Apixaban (Eliquis), Dabigatran (Pradaxa), Edoxaban (Savaysa), Rivaroxaban (Xarelto).
Patients should not stop their blood thinner regimen without consultation with the prescribing physician. Stopping these without consulting with the physician can lead to untowards complications like heart attack or stroke.
Our office will transmit a clearance to the physician’s office to get the physician’s recommendations.
Patients with low bone density/osteoporosis (typically females above the age of 45) might be taking medicines such as Alendronate (Fosamax), Denosumab (prolia), Ibandronate or Risedronate. These medicines interfere with the natural healing process in the bone and can lead to severe jaw infections after extractions. Radiation of the head and neck for cancer/tumors can hinder bone healing as well.
Patients taking osteoporosis medications or undergoing radiation therapy currently or within past 6 months would be referred out to the Oral Surgeon who would be better equipped to treat any ensuing complications.
After Treatment
Cleaning of the root canals may cause soreness around the root areas. The patient will be prescribed pain medication to prevent this soreness.
If you experience swelling or ulceration in the region please contact our office immediately. This might be from your tissue comming in contact with irrigation medicament.
Bleeding after tooth extraction usually stops within an hour post surgery when pressure is applied on the site with a moist gauze pack. A blood clot forms during this time. The blood clot plays a major role the healing process. The clot acts as a scaffold and has all the ingredients for successful healing. The clot is very weakly bound in the socket during the first 24 hours and can be easily dislodged by smoking/sucking/blowing/spitting. This can lead to a very painful condition known as “Dry socket”, which essentially means the bone at the bottom of the socket is now open to all kinds of contaminants. Dry-socket is a very common complication associated with smoking within 72 hours of extractions. Contact our office immediately if you experience excruciating pain and foul odor after extractions.
Sometimes oozing of blood may continue past the first hour. Biting on a moist tea bag might help stop the oozing.
Other FAQ's
Food particles can easily build up between the tooth and gums because of insufficient or improper brushing. This build up is called tartar or plaque.
The plaque harbors bacteria that are harmful to the gum tissue. The body will mount it’s defense against these bacteria.
The defense includes increased blood supply to the gums so the blood cells can counter the bacteria and its toxins. This increased blood supply to the gums manifests as bleeding of gums from brushing. This inflammation and bleeding gums are a manifestation of gingivitis.
If the bacterial assault continues the body might not be able to counter sufficiently. The toxins from the bacteria will then start destruction of the gum attachemnt and bone tissue under it. This is called loss of periodontal/gum tissue support. At this stage the disease has progressed in to periodontitis. The loss of gum attachment results in gum tissue pockets around teeth. These are safe havens for the bacteria to further colonize and proliferate. The deep pockets become inaccessible to regular brushing and, can accumulate more tartar and bacteria which can cause bad breath.
A deep cleaning/scaling root planing are recommended at this stage to remove tartar and diseased tissue from under the gums. An escalated cleaning regimen might be recommended to prevent build up. In certain cases a gum surgery might be recommended to clean inaccessible areas, graft bone tissue and to get rid of the deep gum pocketing.
