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Root Amputations Post-Op Instructions

As part of normal healing a root amputation site forms a blood clot. The clot goes through a series of steps called organizing in the first 24 hours of healing after a tooth is extracted. If the clot is dislodged or lost during this period, the healing must start over and you can develop a dry socket. The dry socket is characterized by severe pain. Most healing is uneventful, but spitting, vigorous rinsing and smoking all place you at high risk for losing the clot. We recommend that you keep the gauze in place for 45 minutes after the extraction and then refrain from spitting, vigorous rinsing and smoking for the first 24-48 hours after a tooth is extracted. Gentle rinsing with salt water followed by letting the water run out of your mouth over the sink is fine. If you experience enough bleeding that you feel you need to spit, we recommend that you place another moistened piece of gauze or a black tea bag over the extraction site and bite for another 45 minutes.

We generally use a special suturing technique during a root amputation that can sometimes start to unwind as healing progresses. When this happens, it is not a large concern but can become annoying as the sutures unwind. The loops in the suture that are unwinding or the areas that are hanging can be cut back with clean manicure scissors if you feel comfortable, or you can contact the office to have the sutures removed earlier than scheduled. This early loosening usually means things are healing well and the sutures are no longer necessary.

Very rarely, a small sharp area of bone can poke through the gums. This is called a sequestrum and occurs when gums are very thin and the bone becomes sharp during the remodeling that occurs with this type of surgery. The sequestrum will usually take care of itself. It will usually heal by the gums growing back over the bone or by the small piece working its way out. Unfortunately, this can take several months and the area can be uncomfortable while it is healing. If you suspect that you have one of these areas and it is very uncomfortable, contact our office to have the sequestrum removed or recontoured.

It is quite normal after a root amputation for the roots of the teeth to be sensitive to changes in temperature and sometimes anything that touches the roots of the teeth. During the procedure, the remaining roots are cleaned very well, making them prone to developing sensitivity. The sensitivity will not harm the teeth and is usually only temporary, but the time it takes to subside can vary from a few days to even a year or two. Plaque accumulations can aggravate this sensitivity, so you should continue to brush normally and use a salt water rinse or over the counter rinse like Peroxyl to help keep the area clean. If the sensitivity is severe or does not seem to be resolving, a prescription fluoride toothpaste or gel can be phoned in to a pharmacy to help with the sensitivity.

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