Oral Surgery And Oral
Dr shabeel pn
• Includes: The diagnostic and surgical
treatment of diseases, injuries, and
defects involving both the junctional and
the esthetic aspects of the hard and soft
tissues of the oral and maxillofacial
Types of Oral Surgery
• Impacted tooth removal
• Cysts, tumors
• Dental implant placement
• Maxillofacial prosthetics
• Immediate denture
• Facial esthetics
• Cleft lip/ palate
• TMJ disorders
• Salivary Gland Obstruction
• Have the client use a soft tooth brush with a simple brushing
• Give instructions of prosthesis care.
• Recommend what to include and not include in the diet.
• Promotion of healing
Protein, vitamin A, C, and Riboflavin
• Tissue resistance
Diet variation including all food groups
• Provide instruction sheets for clients to take home.
• When instructing about diet, explain in quantity or servings.
• Explain procedures for anasthesia and surgery
• Explain alcohol and medication restrictions
• Some medications will interfere with the anasthetic and other drugs
provided during or after the treatment
• Assess whether the client will need transportation to and
from the appt. ie. when sedation is used…
• Tell them to get a good nights rest the night before.
• Wear loose and comfortable clothing.
• Ask to remove contact lenses or any prosthesis.
• Explain the number of hours before surgery the client
should stop their intake of food and liquid.
• If bleeding persists, place a gauze pad or cold wet tea bag over the area for
½ hr. Bite firmly!
• Don’t rinse for 24 hours.
• After 24 hours rinse with warm salt water after brushing and every 2 hours.
• Brush more thoroughly but avoid area of surgery.
• Get at least 8 – 10 hours of rest each night.
• Avoid strenuous exercise for the first 24 hours.
• Don’t smoke for 24 hours.
• Use a pain relieving medication prescribed by the dentist.
• Apply ice pack 15 min on and 15 min off.
• Include phone number the client can call after hours in case of
• Do not suck from a straw for 24 hours
• Indications for a Liquid Diet
• Jaws wired together
• All clients who have a condition that makes it hard
to open their mouth
• Indications for a Soft Diet
• Client with no appliance or with a single appliance
• Client who has been maintained on liquid diet
throughout the treatment period.
Diet Planning Hints
• This is for the client who isn’t hospitalized
• Provide instruction sheets
• Explain nutritional needs in servings
• Show ways to vary the diet
• Suggest the limitation of cariogenic foods
• Reduce the bacteria count
• Makes post-surgical infection less likely
• Reduce inflammation
• Will lessen bleeding during surgery
• Promotes healing
• Remove calculus
• Prevents interference with the placement of surgical instruments
• Prevents the breaking off of calculus
• Instruct the client in personal oral care
• Interpret dentists directions
• Motivate the client who will have remaining teeth
• Prevents further tooth loss
• A complete debridement should be scheduled for a few weeks after
surgery to insure the prevention of infection and assess tiissues.
• The DH or DA may participate in suture
removal, irrigation of the sockets, and
other post surgical procedures when the
client returns for his/her follow up.
• Maintain a clear surgical field
• Observe vital signs
• Reassure the client and help them to relax
• Provide pre/post operative instructions
• Make follow up call
• DA MUST ASK IF THE CLIENT HAS TAKEN
PRE MEDS IF REQUIRED!!!
Holistic Approaches to OS
• Apply annatto after tooth extraction or gum surgery.
• Drink catnip tea or take in capsules to help you relax
before dental treatment
• Use chamomile as a poultice for pain and swelling.
• Soak a washcloth in warm comfrey tea and use as a
compress to relieve the pain of jaw and tooth fractures.
• St. John's wort is given to people for neuralgic pains
after tooth extractions.
• Use the fresh tops of shepherd's purse to help stop
bleeding after tooth extraction
Use of Magnets can:
• Acceleration of growth of new cells (speeding up
wound healing processes)
• Suppression of pain (analgesic effect)
• Suppression of inflammation
• Widening of blood vessels
• Improving tissue flexibility
• Eliminating swelling
• Strengthening immunity
• Stimulating and stabilizing bone tissues
• Dramatic improvements in effectiveness of
prescription medication and supplemental
nutrients, vitamins and minerals
Infections related to Oral Surgery
• An inflammation of
the bone marrow that
produces pus and
affects the calcified
components of bone.
• 1. acute periapical infection
3. acute periodontal lesions
4. trauma-fractures and extraction of
5. acute infection of the maxillary sinus
How is it Diagnosed?
• Complete blood count
• Erythrocyte sedimentation rate
• C-reactive protein
• Needle aspiration or bone biopsy
• Radionuclide bone scans
• CAT scans
Signs and Symptoms
• severe pain
• regional lymphadenopathy
• soreness of the involved teeth
• if the infection involves the mandibular canal, a
paresthesia of the lip is common
• On radiographs:
decreased density of trabeculae
• multiple small radiolucent areas become
• sequestra - irregular calcified areas separate from
Tx of Osteomyelitis
• Teeth should be extracted only when necessary
and antibiotics should be given prior to and
following the surgical procedure.
• Massive doses of antibiotics, usually one of the
penicillin drugs, are given for at least six weeks.
• A surgeon may perform a bone biopsy to see if
an abscess has formed on the bone. If an
abscess is found, antibiotics are given and
surgery is performed to remove the abscess.
• If pus has formed, it is sometimes necessary to
drain the bone by drilling holes in it.
• Restrict the movement of the area as
much as possible.
• Monitored blood tests and x-rays.
Holistic Tx of Osteomyelitis
• Hepar sulphuris – pain, swelling, infection
• Chamomile -pain and swelling
• Witch Hazel – helps fight infections and
• Inflammation of the gingiva around a
partially erupted tooth.
• Resulting from debris accumulating under
the flap of tissue.
• Or from constant contact between the flap
and the tooth in the opposing arch.
• Usually occurs in teenagers and young
• Usually affects the
Signs & Symptoms
• Pain when chewing
• Bad taste
• Swelling in the neck and in the area of the tooth
• Partially erupted tooth
• Red inflammed tissue around the partially erupted tooth
• Pain when touched
• Enlarged lymph nodes
• Irrigate under the flap of tissue with warm saline
• Gently clean with a scaler
• Instruct the client to rinse with warm saline
solution every 2 hours
• Surgical removal of the flap after antibiotic
• Third molar extraction
• Dandelion is useful for treating abscesses in the mouth
• Combined with myrrh and licorice root, echinacea is
excellent for the treatment of abscesses in the mouth.
• Rub eucalyptus oil or evening primrose on sore, inflamed
gums for temporary relief
• Use a horsetail mouthwash to relieve mouth and gum
• Red clover ointment can treat abscesses.
• For pain and inflammation around wisdom teeth,
Belladonna is often given for throbbing pains and Hepar
sulph to promote expulsion of pus.
Other Oral Infections
What is Oral Thrush?
• It is an infection in the oral
cavity of yeast fungus, Candida
albicans. It affects the
mucous membranes of the
mouth. It causes white
patched in the mouth that can
be very painful and make
swallowing and chewing
• Thrush effecting the
mouth and throat is also
known as oropharyngeal
How do you get Thrush?
• Thrush also known as Candida, does not
become a problem until the natural flora of the
mouth is disturbed, favoring candida over the
other microorganisms of the oral cavity.
• This disturbance of the oral cavity can be caused
by a number of factors such as, taking
antibiotics, or chemotherapy. Systemic
problems can also cause an imbalance; diabetes,
malnutrition, drug abuse, or immune deficiencies
such as AIDS or deficiencies related to old age.
• Those who have dentures that do not fit
well can suffer from breaks in the mucous
membranes of the oral cavity. This can
act as a gateway for candida. Those who
have suffered from this problem show
evidence of it when they have moist, pale
pink spots on their lips. These spots are
known as angular chelitis. This is a clear
indication of candida infection.
Symptoms of Thrush
• White cream coloured or yellow slightly
raised spots in the mouth.
• When the creamy substance is scraped
away wounds will be present and will
• A burning sensation may be felt in the
mouth and throat area.
• Get the main condition that caused the thrush
• Anti-fungal drugs will have to be either sucked
on or a liquid that must be held in the mouth
before swallowing to eliminate the fungus.
• If it spreads or becomes complicated, systemic
treatment in the form of tablet or injection may
Coping with the Symptoms of
• Thrush can make the
mouth very sensitive,
this can make oral
hygiene very difficult
• Use an extra soft
• It is also helpful to
rinse with a diluted
solution of 3%
Foods to Avoid if you have Thrush
• Yeast- breads, crackers, pastries
• Fruit Juices- canned, bottled or frozen
• Coffee and Tea- Regular, instant, decaffeinated. Herbal teas are tolerated
• Caffeine- anything containing caffeine
• Dairy or Dairy Containing Products
• Black Pepper- hard to digest. Cayenne pepper is a recommended
alternative as it promotes digestion.
• Any type of mushroom
• Pickled and smoked meats, including sausages, hot dogs, corned beef,
pastrami, and ham.
• Condiments, Sauces, and Vinegar-Containing Foods
• Dried, candied fruits.
• Leftovers, best to eat fresh foods due to mold growth.
• Vegetables and Legumes
• Fish/Shell fish, meat, poultry
• Whole grains
• Fruits – avoid for 3 months then reintroduce 1 at a time on an
• Seeds such as pumpkin, sesame and sunflower
• Non grain such as Amaranth, buckwheat and quinoa
• Butters (almond, sesame and sunflower)
• Fats (Butters or unrefined oils
• Herpes simplex is a common and usually mild
• A virus causes herpes
• Causes cold sores or fever blisters on the mouth
• Once introduced to the body it will live there for
• Often with periodic symptoms or no symptoms
• Can take 4-6 weeks
to heal fully
• May cause small
pimples or blisters
which will eventually
crust over and scab
• May cause flu like
swollen glands in
lymph nodes in the
head and neck region
How often will it occur? Why?
• depends upon the HSV type and how long the
infection has resided in the body
• prolonged exposure to strong sunlight can
trigger oral herpes
• individuals will discover what triggers outbreaks
in their own bodies
• people who experience a strong initial outbreak
can expect to have several recurrences a year
How is it Spread?
• Skin to skin contact
• if you have a “cold sore” and kiss
someone, the virus will be transferred to
• if you have a “cold sore” and have oral
sex, your partner will get genital herpes
• no treatment or medication that will cure herpes
but there is some to control it
• 3 most common meds: Acyclovir (Zovirax),
Valacyclovir (Valtrex) and Famciclovir (Famvir)
• Episodic therapy means taking the medication
only during an outbreak to speed up the healing
• Suppressive therapy means taking antiviral
• Whole olive leaves can be boiled in water or treated with
wine to make a remedy
• carbohydrates from red marine algae is a low-cost, high
potential, broad spectrum antiviral agent
• As a mild antiseptic, Sage will help heal coldsores
• Rub tea tree oil directly on cold sores to promote healing
• Use a salve made of thyme, myrrh, and goldenseal to
treat oral herpes
• A mouthwash made from violet soothes coldsores
• Capsicum, Dulcamara, Kali muriaticum, Kreosotum, and
Upas tiente all assist tin the relief of oral herpes.