An Experienced Dentist Serving Pembroke, ON & Area
Dr. Bruce Harle is an experienced dentist in Pembroke, Ontario who provides a full range of surgical services, including tooth extractions and gum surgery, bone grafting procedures, placement of dental implants, and the removal of diseased tissue from the mouth.
For more information about the surgical services we offer, please click on any of the following headings:
Tooth Extractions / Third Molars
More often referred to as “wisdom teeth”, third molars are the last teeth to develop, typically erupting during the teen or young adult ages. Some patients may not have enough room in their mouth to accommodate the growth of third molars, which can cause problems when those teeth attempt to erupt. Cramped for space, these teeth may become impacted (trapped in the jawbone and gums) and attempt to grow in different directions, requiring removal to prevent potential problems. Even if the patient doesn’t notice any symptoms, an impacted wisdom tooth can put your other teeth at risk for damage.
Because removal is more easily accomplished while the teeth are still developing, wisdom teeth should be removed as early as possible. Extraction is much more difficult and uncomfortable when the tooth has achieved full density and the roots are fully developed.
While some wisdom teeth can be extracted in the office using local anaesthetic, most patients prefer to have them removed under IV sedation or general anaesthetic. The type and duration of surgery required will depend on how developed your wisdom teeth are, as well as their position.
Bone grafting is a process that assists your body in regenerating bone lost to tooth decay. Bone loss can be caused by a number of factors, including:
- Loss of a Tooth
- Localized Infection
- Gum Disease
Once one or more teeth have been lost, the surrounding area of jawbone will begin to shrink in both height and width. Bone grafting is used to prepare a site for a dental implant(s) or prosthesis that is used to replace a missing tooth or teeth and to achieve a functional and aesthetically pleasing result. Bone grafting is also effective in helping to preserve teeth that have experienced bone loss as a result of gum disease. The graft material is intended to restore lost bone by acting as a scaffold and promoting new growth of your own bone during the healing process.
Acting quickly to replace lost teeth before significant changes in the bone can occur can greatly reduce the risk of further bone loss. If you're not ready to replace your teeth at the time they are lost or removed, a ridge preservation procedure may provide a solution.
Ridge preservation is a procedure that provides stabilization and preservation of the existing bone in that area where a tooth has been extracted. It is recommended that ridge preservation be completed at the time the tooth is removed as the future placement of dental implants or dental prostheses can become more costly, more invasive and time consuming with the passage of time.
The most common reasons to have a tooth extracted include:
- Irreparable Tooth Decay
- Cracked or Broken Tooth
- Advanced Gum Disease
Ridge preservation is effective in minimizing the amount of bone loss that occurs between the time a tooth is removed and an implant or prosthesis is put in place. The graft material acts as a scaffold, promoting new growth of your own bone.
Soft Tissue (Gum) Grafting
Soft tissue (gum) grafting offers an effective solution for patients who need to repair or recreate gum tissue that has been lost to infection or disease. Thick, healthy gum tissue is more resistant to the effects of recession, easier to brush, and a critical part of maintaining a healthy gum line and mouth. Healthy gum tissue plays an important role in achieving aesthetically pleasing results after restorative and implant dentistry. Patients who have gum recession that has left the root of a tooth exposed will benefit from soft tissue grafting, as it covers and protects the root of the tooth, preventing further deterioration of the gums while improving the appearance of your smile.
Gum recession is associated with:
- Aggressive brushing
- Gum disease
- Gum tissue that is naturally thin
- Tooth loss
- Destructive oral habits (use of toothpick, grinding of teeth)
Here are some suggestions to help maintain your gum line and the health of your gums:
- Use a soft toothbrush
- Avoid abrasive toothpastes
- Ask your dentist or dental hygienist to advise you on proper oral hygiene techniques
- Control and/or treatment of destructive habits
Some of the benefits provided by soft tissue grafting include:
- Prevention or reduction of sensitivity
- Protection from future cavities
- Symmetry in your gum line, creating an improved smile
- Creation of a more suitable environment (thicker gum tissue) for implant and or crown and bridge placement
What to Expect after Tooth Removal or Other Oral Surgery
Most patients report some pain, bleeding and swelling after oral surgery; however, proper care will help your mouth heal quickly and cleanly.
It is normal to feel some pain after the anaesthetic has worn off and for the 24 – 72 hours after surgery, and some soreness or discomfort may last for as much as 3 to 5 days. The amount of discomfort that is experienced varies, depending upon each individual’s personal tolerance for pain and what type of operation was performed.
Bleeding typically occurs for the first couple of hours after surgery and the affected area may continue to ooze for up to 24 hours. Blood combines with saliva in your mouth and this can make it look like you are bleeding more than you really are. Swelling is a common aftereffect of surgery and can include your face, depending on what type of surgery was performed. Swelling generally increases for 72 hours after surgery and may last for 5 – 7 days. Once the swelling starts to abate, you may notice facial bruising, which may last for up to 10 days after your surgery. After certain surgeries your jaw muscles may be sore, making it difficult to open your mouth for up to 7 – 10 days.
- Using FIRM AND CONSTANT PRESSURE, bite down on the gauze pad until frank bleeding has stopped; change the gauze pad as needed every 30 – 60 minutes. (It is normal for the saliva to be lightly streaked with blood for about 1 day.)
- DO NOT rinse your mouth within the first 24 hours after surgery. After a full day, you may rinse your mouth "gently" with warm water, saltwater, or diluted mouthwash.
- DO NOT spit or expectorate vigorously.
- DO NOT exert or strain yourself (sports or heavy activity) for the first 48 hours following surgery. Rest and keep your head elevated.
- DO NOT drink alcohol or carbonated beverages for 48 hours following surgery.
- REFRAIN from drinking through a straw.
- REFRAIN from smoking for 48 hours after surgery.
- Lukewarm or cold liquids are okay after the bleeding has stopped. AVOID hot liquids for 24 hours after surgery.
- A SOFT DIET that avoids spicy or acidic foods is recommended for the first 48 hours after surgery.
- Cold compresses may be applied extra-orally to relieve discomfort (10-20 minutes on, 10-20 minutes off) for the first 24 hours after surgery. Warm compresses may be used in the same fashion starting the second day after surgery, but should not be used in the first 24 hours.
- Massage jaw muscles gently if they are sore or if you are having difficulty opening your mouth. Maintain your normal liquid intake and use liquid meal replacements such as Ensure® if chewing solids is difficult.
- Take prescriptions as advised.
- Brush and floss your teeth as usual, doing your best not to disturb the wound.