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Precautions before and after tooth extraction which people are not suitable for tooth extraction

4hw.org: many people have pulled out their teeth. Many people think it's as easy to pull out teeth as injection. In fact, in China, tooth extraction is generally not recognized and never faced up to. In fact, tooth extraction is an operation. According to the various complex situations of the mouth, tooth extraction is also explained by comparison. The complicated tooth extraction is no less than one operation. Let's see what kind of tooth extraction is The question needs to be noted, which kind of people are not suitable for tooth extraction?

Because tooth extraction can cause local tissue damage, bleeding, swelling, pain and other reactions, but also can lead to blood pressure, temperature, pulse fluctuations, so we must be careful. We should pay special attention to the patients with cardiovascular disease and blood disease, otherwise it will bring serious consequences. Tooth loss can cause alveolar bone atrophy, displacement or elongation of adjacent and opposite teeth, resulting in masticatory disturbance. Loss of anterior teeth directly affects pronunciation and appearance. Premature loss of primary teeth in children can cause deformity of tooth and jaw development. Therefore, we must strictly grasp the indications of tooth extraction. Only when the teeth have adverse effects on health, but can not be treated and preserved with effective methods, the extraction can be considered.

Pay attention to problems

1. The gauze or cotton ball on the wound after tooth extraction can only be vomited after about half an hour to 45 minutes. If there is saliva on the gauze, please swallow it normally. If the gauze is still slightly oozed, the gauze needs to be kept for 1 hour. If it is still invalid, please contact the doctor again. A small amount of blood in saliva within 24 hours is normal. Don't panic if the saliva is a little bloody, but if the blood keeps appearing, please contact the doctor.

2. After tooth extraction, you can take a half lying position to rest. Do not lie on your back. Do not take a hot bath immediately to avoid bleeding from the wound.

3. You can eat only 2 hours after tooth extraction. You can eat liquid or semi liquid instead of hard or overheated food It must be noted that the soft food should be burst out after 2 hours; the food should not be overheated, and the extraction side chewing should be avoided. Otherwise, if the above points are not paid attention to before the blood clot is fully mechanized, it will cause blood clot damage and bleeding.

4. Do not do strenuous exercise or heavy physical labor on the day of tooth extraction. Do not drink, play musical instruments, suck or rinse.

5. After the disappearance of anesthetic, there is slight pain in the tooth extraction wound. Generally, it is not necessary to take medicine. If there is fever, severe pain, swelling or a large amount of bleeding, you should see a doctor in time.

6. In addition to the third molars and supernumerary teeth, the dentures should be installed in adults after extraction. About 2 months after extraction, the dentures can be installed in hospitals or dental clinics.

7. After tooth extraction, the tooth extraction wound is full of fresh blood. Blood clot will be formed in about 15 minutes to close the wound. So the correct gauze bite time is 30 minutes. Neither too early nor too late. The blood clot is not formed in advance, and the bleeding is not stopped; the blood clot and gauze are coagulated later, and they are taken out together when the gauze is taken out, and bleeding again. At the same time, it is emphasized to take out rather than spit out the gauze. The latter often destroys blood clots due to excessive force.

Indication

① all kinds of dental diseases can not be cured and preserved.

② all kinds of dislocated teeth, impacted teeth and embedded teeth have symptoms.

③ pathogenic teeth or diseased teeth causing other diseases.

(4) the last dislocated tooth without opposite occlusion.

Antimicrobial application

One to two days after tooth extraction, it is normal that there is slight pain in the wound. If the pain is aggravated, there may be infection. The common complications are acute cellulitis and osteomyelitis of jaw. It was mainly caused by Staphylococcus aureus and hemolytic streptococcus, followed by Streptococcus pneumoniae, Escherichia coli and Clostridium. Putrefactive necrotizing cellulitis is a kind of mixed infection caused by anaerobic bacteria, which is rare. Antibiotics should be used against pathogenic bacteria. The commonly used drugs in clinic are sulfanilamide, penicillin, kanamycin, gentamicin, etc. Kanamycin is used to treat penicillin resistant Staphylococcus aureus, Escherichia coli or Proteus infection, but it may cause damage to the auditory nerve and kidney, so the course of treatment should not be too long (generally 7-10 days). Gentamicin has a similar effect to kanamycin, but less toxicity.

Contraindication

If the patient suffers from blood disease, cardiovascular disease, hyperthyroidism, diabetes, hepatorenal disease and acute infectious disease, or has local acute inflammation, malignant tumor and radiotherapy, tooth extraction can make the condition worse and endanger life and health. Therefore, the teeth should not be extracted in the acute stage. In the stable period, preventive measures should also be taken and teeth should be extracted carefully. Women's teeth should be extracted carefully during menstruation. Operation steps: disinfection, local anesthesia, separation of gums, extraction or extraction of teeth, examination of wounds, bite roll. But complex teeth or embedded teeth must be split or drilled, or cut to remove bone and other complex operations. Complications: bleeding, infection, alveolar pain, dry socket, fracture, numbness of lower lip, mandibular joint injury, etc. should be treated by a dentist in time.

1. Cardiovascular disease patients

There are severe cardiovascular disease and hypertension in 180 / 100 mmHg or more. General heart disease patients, as long as there is no performance of cardiac dysfunction (such as slight activity or lying flat when panic shortness of breath), can extract teeth. But when pulling out teeth, it should be done as follows: do not add adrenaline in the anesthetic to avoid tachycardia and induce heart failure; anesthesia is complete and action is light, so as to minimize adverse stimulation, bleeding or injury; anti infection prevention treatment should be given before and after tooth extraction, because the resistance of patients with heart disease is reduced, and it is easier to combine infection with normal people.

2. Patients with hypertension

In patients with haemorrhagic diseases such as hemophilia and idiopathic thrombocytopenic purpura, there is an obstacle in the process of coagulation, so they tend to bleed. It is difficult to stop bleeding after tooth extraction, which may cause massive bleeding and lead to life risk. However, in leukemia patients, because of the high incidence of infection, the wound after tooth extraction can also become an infection focus, which leads to serious systemic infection and is difficult to control. Therefore, these patients should be treated conservatively and should not be extracted.

3. Menstruation

In principle, women should avoid tooth extraction during menstruation, because there may be compensatory bleeding in the alveolus during menstruation. But in the menstrual period, the loose teeth were removed, which had little effect on the patients. Some 'ingrained' teeth, such as impacted or embedded teeth, should be removed after menstruation. According to some data, it is most suitable for women to have their teeth extracted on the 10th day of their menstrual cycle. At this time, the wound healing is faster and bacterial infection is less likely to occur.

4. Pregnancy

Some people think that teeth can not be extracted during pregnancy, because it may lead to abortion. However, a large number of clinical practice shows that it is safe to extract teeth at 3-7 months of pregnancy, and there is no adverse effect on pregnancy. During this period, we should pay attention to the following points.

① on the day before and on the day of tooth extraction, 10 mg progesterone was injected into the muscle.

② adrenaline should not be added to the anaesthetic for tooth extraction.

③ anesthesia must be complete and the analgesic effect is good. For patients with habitual abortion or habitual preterm birth, tooth extraction is prohibited during pregnancy.

5. Lactation

During lactation, teeth can be extracted completely. It is said that tooth extraction in this period will interrupt or reduce the secretion of milk. This is unscientific. Clinical practice shows that it has no effect on milk secretion. But don't take antibiotics, drugs and their metabolites can have an impact on babies through milk.

6. Patients with liver and kidney function diseases

For example, in chronic hepatitis and cirrhosis, due to the poor liver function, the content of prothrombin and fibrinogen involved in the coagulation process is reduced, and there is a tendency of bleeding. The wound after tooth extraction will bleed more than once. Therefore, it is necessary to supplement vitamin K to promote prothrombin synthesis and fibrinogen deficiency before tooth extraction, so as to avoid accidents. The following points should also be noted.

① the extraction of teeth should be avoided in the stage of malignant tumor and psychosis.

② before diabetes symptoms were controlled.

③ after strenuous exercise and labor, it is not suitable to extract teeth after drinking alcohol.

(4) patients with allergic history of procaine (some can be changed to finger pressure and acupuncture anesthesia).

⑤ it is also necessary to be cautious in extraction of teeth in patients with inflammation of cold.

7. Hyperthyroidism

This kind of patients can be due to infection, surgery, anxiety thyroid crisis, the serious can cause failure or even death, so should not be rashly extracted teeth. If it is necessary to pull out the teeth, a detailed examination should be carried out to ensure that the basic metabolism is below + 20%, and the pulse is below 100 times per minute. Epinephrine vasoconstrictors are not added to the anesthetics. Antibiotics should be taken before and after the operation.

8. Acute infectious diseases

Pernicious anemia, serious tuberculosis, malnutrition, and excessive fatigue can reduce the body's resistance, delay wound healing, and combine infection, so tooth extraction should be postponed.

9. Patients with organic and functional neurological diseases

It may cause disease attack due to operation. If tooth extraction is necessary, the operation can only be carried out after consultation and treatment by neurophysician, and sedative should be given before operation.

10. Ulcerative lesions of oral mucosa

Such as acute gingivitis, stomatitis, etc. should be postponed tooth extraction.