Oral Surgery And Oral InfectionsPresentation Transcript
Oral Surgery And Oral Infections By: Terri and Premlata
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 regions.
Types of Oral Surgery
Impacted tooth removal
Dental implant placement
Cleft lip/ palate
Salivary Gland Obstruction
Have the client use a soft tooth brush with a simple brushing technique.
Give instructions of prosthesis care.
Recommend what to include and not include in the diet.
Promotion of healing
Protein, vitamin A, C, and Riboflavin
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 complications.
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
Will lessen bleeding during surgery
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
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 2. pericoronitis 3. acute periodontal lesions 4. trauma-fractures and extraction of teeth 5. acute infection of the maxillary sinus
How is it Diagnosed?
Complete blood count
Erythrocyte sedimentation rate
Needle aspiration or bone biopsy
Radionuclide bone scans
Signs and Symptoms
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 apparent
sequestra - irregular calcified areas separate from remaining bone
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 cleanses mouth
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 adults.
Usually affects the mandibular third molars.
Signs & Symptoms
Pain when chewing
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 solution.
Gently clean with a scaler
Instruct the client to rinse with warm saline solution every 2 hours
Surgical removal of the flap after antibiotic therapy
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 infections.
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 difficult.
Thrush effecting the mouth and throat is also known as oropharyngeal candidiasis
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 bleed slightly.
A burning sensation may be felt in the mouth and throat area.
Get the main condition that caused the thrush under control.
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 be needed.
Coping with the Symptoms of Thrush
Thrush can make the mouth very sensitive, this can make oral hygiene very difficult to maintain.
Use an extra soft toothbrush.
It is also helpful to rinse with a diluted solution of 3% hydrogen peroxide.
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
Fruits – avoid for 3 months then reintroduce 1 at a time on an empty stomach
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 infection
A virus causes herpes
Causes cold sores or fever blisters on the mouth and face
Once introduced to the body it will live there for a lifetime
Often with periodic symptoms or no symptoms at all
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 symptoms; fever, 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 that person
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 process
Suppressive therapy means taking antiviral medication daily
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.