Sewn the cheek to the gum after tooth extraction - ProfiMed

The eruption of wisdom teeth is a natural process, which for some goes unnoticed and painlessly, while for others it causes a lot of trouble. For example, when a wisdom tooth grows into the cheek. The symptoms of this pathology will be described below with photographs and advice from specialists. You cannot let the situation take its course, otherwise unpleasant consequences may arise, deterioration of well-being and the condition of neighboring teeth.

Regardless of a person’s actions, his hygienic culture, lifestyle and health, each dental unit has its own direction of growth and its own characteristics. Pathologies usually arise due to genetic and natural predisposition, which are practically not amenable to any influence.

View full version: The lower impacted 8 has been removed. The pain does not go away for 7 days. Complication?

Hello, dear consultants!
I am 39 years old. On February 27, I removed the lower right 8, which was hidden under the gum; only a small tip emerged. I turned to the surgeon because... 4 days before this, the gum above the wisdom tooth turned red and was very painful. The removal operation lasted 40 minutes, they cut the tooth out of bone tissue, it was difficult to get it out, the tooth did not want to part with me.:bn: The tooth had fused roots and was large in size. The gum was sewn up, and the cheek was also sewn to the gum with two stitches. They prescribed Nimesil, Ciprolet, Suprastin. It didn’t bleed for long; the next day there was no more blood. On the second day, the mouth practically did not open; swelling appeared, which crawled onto the neck on the third day. And a bruise on my cheekbone. Also on the second day a putrid smell appeared. After 7 days: 1) the pain is still very strong, I am on strong painkillers (ketorol in injections, because I can’t take Nimesil, I feel nauseous and then vomit), it started shooting in the back of the head, in the ear area, it hurts very much in the area swollen lymph node. 2) there is still a strong putrid odor; when you press on the outside of the gum, a liquid (not blood, not pus) with a terrible smell is released. Visually, the sutured wound looks quite normal, not swollen, the mouth opens more or less (by 2 fingers), the pain intensifies when chewing, even with painkillers. During this week I visited my surgeon twice, as he asked, described my complaints to him, after the examinations the doctor said that everything was fine, such pain was my individual characteristic, he didn’t say anything about the smell at all. Today I'm going to remove the stitches, maybe I should ask to take the picture again? Questions that torment me: - Is it normal that the pain does not subside in intensity for a week? Considering that the wounds on me, including those in the oral cavity, previously healed very quickly (there was an operation to resect a cyst in the front tooth, everything healed and did not hurt in 1.5 days), can a strong putrid odor be present during normal healing? — what else can be checked, what pictures should be taken to exclude complications that the doctor may not see visually? — why is the cheek sewn to the gum? will it fuse with the gum now? I really wouldn’t want to, because... I bite this cheek all the time anyway.

Thank you very much in advance for your help! :ax:

Alveolitis can develop even under the sutures. The clot decomposes and such a smell appears. You need to remove the sutures and see what’s inside the hole. Then tactics depend on the situation. In one thing, the cheek will return to its previous position)))

Thanks for the quick response! :ab:It turns out that normally there should be no smell under any circumstances? I maintain good hygiene, don’t use my fingers, now I brush my teeth and tongue as much as I can, 3 times a day. I rinse lightly with chamomile and just water. Besides alveolitis, what else could cause such a smell? This cannot be from the lymph node under the jaw (it hurts and is swollen, edematous), for example? In any case, the smell is not normal?

Today I’ll ask everything again when I’m examined by a doctor. But somehow I don’t like that the doctor is happy with everything, given the presence of a terrible smell and such strong, unrelenting pain. Ugh. wall:

There is sometimes a slight odor. During these periods there should not be such intense pain that indicates an inflammatory process in the socket. The l/node has nothing to do with the smell. Let the doctor carefully examine the socket and go in with a stroker. From the outside it may even be quite decent. Because it’s under the seams. And here’s what’s inside.

Thank you! I'll write back in the evening after the inspection. :ab:

Dentistry. Clear and Accessible.

The best blog about dentistry and dental implants

Here comes the New Year, 2011. I congratulate all my friends on this holiday and wish that 2011 was even better than 2010. With all my heart I want to thank everyone who showed interest in my modest LiveJournal and actively participated in discussions, asked questions, and wrote comments. I hope next year it will become even more interesting and useful. Thank you everybody! Today we will touch on a very relevant topic - what to do before and after tooth extraction. It would seem that this is the most common operation in the world, everything here has been studied and researched for a long time, but... Oddly enough, it is this that causes the most negativity and the largest number of complications in modern surgical dentistry is associated with it.

In this post, we will discuss how to set yourself up for tooth extraction and prepare for it, what recommendations you need to follow after the operation and what their meaning is. And at the end of this post you will find a reminder in MS-Word format that you can print and use to inform patients or yourself.

And this is just part of a collection of the strangest teeth I've ever had to remove.

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That's right, that's how it is. In addition to tooth movement, another serious problem arises - atrophy of the bone and soft tissue in the area of the extracted tooth. Therefore, it is better not to delay implantation.

I think that nothing too serious will happen in six months. But the sooner you start prosthetics, the easier (and cheaper) it will be.

If you have any questions, write or call.

Best regards, Stanislav Vasiliev.

Hello. In any case, you should definitely consult your doctor. Did they give you any recommendations or warn you about possible problems?

Don’t be afraid to push the doctor with or without reason. The doctor is responsible for you while you are being treated by him.

Hello. Surely there is a better doctor in your city than me. You just don't know him yet.

I wish you to find your doctor as soon as possible. If you need help, write. Always happy to help, at least with advice.

Lantrat

Hello Stanislav. I have a question about a tooth that was not removed but treated. On the lower jaw on the right (6ka) a filling fell out, the next day I went to the clinic, they took a picture, as it turned out one of the walls of the tooth had broken off, the nerves in this tooth had already been removed a long time ago 5 years ago and it did not bother or hurt in any way, the doctor cleaned it I checked the canals with a needle, there was no pain, I put some kind of putty in, I told him to check for leaks, they told me to come back in a couple of days, if it didn’t bother me, he would put a filling, the tooth didn’t bother me, they started putting a permanent filling, I went through the canals with a needle again, no pain there were no sensations at all, I began to fill the canals, and at this time, during the filling of the canal, a rather sharp pain passed, which immediately subsided, the tooth was filled, the tooth did not bother me at all all day, but by the evening it began to hurt, the pain intensifies with pressure, it has already passed The pain does not subside for 3 days, there is almost no particular pain when pressing, but the tooth itself, without any influence on it, “aches” without letting up day and night for 4 days. This is fine? what could it be? Maybe the doctor touched something to me there when filling the canals when I felt pain, because before that the tooth had not bothered me at all for many years under the old filling that fell out. Will this go away on its own or should I see a doctor?

What happens to the gum after removal?

The intervention associated with the operation requires sutures. After all, it is often impossible to remove a tooth that sits deep in the gum without surgical manipulation. The gums react quite sensitively to such things, they can become inflamed and almost always bleed.

If a wisdom tooth is to be removed, it is often necessary to cut a section of the gum and then apply stitches to quickly heal the wound. The gum is a mucous membrane, it covers the processes next to the lower and upper jaws, and is located directly next to the teeth.

What does a hole in the gum look like after wisdom tooth removal?

After the dentist removes or simply pulls out a tooth, the gums become more sensitive and easily vulnerable to various microbes. For many people with periodontal disease , the gums are generally very irritated, and the slightest intervention leads to severe bleeding, purulent discharge and an unpleasant burning sensation.

Read also: It hurts to swallow after wisdom tooth removal

Symptoms that require immediate consultation with a dentist

Often, all symptoms develop atypically. Deterioration of the condition may indicate the presence of pathology.

Signs of the development of the disease after tooth extraction are the following:

continuous bleeding from the socket for 24 hours;
spreading swelling on both cheeks with a pronounced effect;
nausea and vomiting;
severe throbbing pain that increases over time;
a rise in body temperature to 40 degrees, which is not reduced by antipyretic drugs with repeated use;
the appearance of purulent discharge from the socket;
presence of a strong unpleasant odor from the mouth;
difficulty breathing and cough;
severe headache, general fatigue and weakness.

If the gums pulsate after tooth extraction, this is a clear manifestation of pathology. This is usually observed with pulpitis. But it happens that during an operation, a large number of nerve endings or even an entire branch are injured. Of course, this is not neuritis, but the symptoms are quite acute and painful.

It is important to understand that only a dentist can competently and quickly get rid of any problem. There is no need to delay visiting the doctor. Self-medication usually leads to longer exposure to traditional methods, as well as complications that lead to the loss of one or more teeth.

bezzubov.su

When to apply sutures after tooth extraction

Sutures are applied in several cases:

If the gums begin to bleed heavily, the bleeding does not stop, purulent inflammation or severe pain in the tissue area appears.
If wisdom teeth or distant teeth that require surgical intervention are removed. Sometimes the process is complicated by the fact that the tooth is subject to severe decay and there is a risk of infection.

It is important to understand that this procedure requires constant monitoring by a specialist. Often people neglect weekly examinations, which leads to complications. But a competent doctor will never prescribe an operation without checking the pictures.

Today, even a wisdom tooth is removed if indicated; it was previously believed that its appearance in itself was a negative factor. A wisdom tooth is removed in the following cases:

If it interferes with other teeth. When a tooth begins to grow incorrectly, it pushes its neighbors apart, which can lead to complications.
If a tooth rots, caries has formed on it.
If a tooth bleeds, it comes out slowly and causes severe discomfort to the person.
If a tooth grows into the gum, it injures it, which leads to constant bleeding.

Sutures after wisdom tooth removal

If there are indications for removal, then they will medically indicate to you the need for “extraction of third molars” - a complex type of operation performed by dental surgeons . In order to remove the “tooth eight” you need to cut the fabric, and you cannot do without seams.

Sutures promote rapid tissue healing, help cope with the loss of blood clots, and avoid infection. When you visit a free clinic, you will receive regular stitches, which will be removed after a week. But during treatment in a modern clinic, they will offer to sew up the hole with self-absorbable material .

They are divided into two types:

Simple synthetic . It is made from a substance that dissolves in the mouth after about a month. Does not cause inflammation, promotes rapid wound healing, and protects against infection.
Catgut. This remedy dissolves in two weeks, the breakdown occurs without any harm to the body.

There are problematic and advanced cases that require additional medical intervention. If, after suturing, blue swelling appears near the wound, and then it turns brown, and a little later a white film forms, then the sutures will have to be removed - pus has appeared.

The wound was infected, which means it needs to be treated with a special solution and then stitched again. Inflammation is a fairly rare phenomenon. It occurs if hygiene measures are not followed.

Therefore, carefully monitor how the treatment is progressing. Do not put your hands in your mouth, do not pick or scratch the suture site, wash food thoroughly before eating, and pay attention to the heat treatment of foods. to drink alcohol or eat too fatty or rough foods during the period of suturing . It is also undesirable to touch the wound with your tongue or touch it in general.

If all procedures go without complications, the stitches will be removed in a week, the wound will resolve, and you will forget about the unpleasant period after the operation.

Sutures to prevent bleeding

As we have already written, all people have different perceptions of surgical intervention. When a tooth is removed, the gums often bleed, but in a normal situation the bleeding goes away quickly. If a person has indications for suturing, this means that the specialist recommends avoiding complications. For people with bleeding gums and periodontal disease, complications can be quite significant.

For example, if damaged, some dirt may get into the wound, which will lead to suppuration, which means that the treatment will not take a week, but a month or more. Usually, after a tooth is removed, the wound is thoroughly washed, a special drug is injected that will numb it, and stitches are applied.

After a week, the doctor checks how the wound is healing. If blood periodically continues to bother the patient, then he is entitled to special treatment - drugs are prescribed, a special ointment is prescribed.

After a week, the doctor checks how the wound is healing.

It is important to understand what causes excessive bleeding after the wound is sutured. If it is brownish-brown, and a blue tint appears near the seams, turning into a white film with yellow veins, then you need to urgently visit a doctor . The sutures will have to be removed and anti-inflammatory treatment prescribed.

Usually, to prevent bleeding, the gums are sutured with simple synthetic sutures; if the patient has the opportunity to visit a modern high-quality clinic, then he can count on sutures that dissolve within two weeks. They are completely safe for the body and hypoallergenic, and most importantly, they practically do not bother the patient.

Read also: In what cases is a tooth pulled out?

Ways to eliminate the pain reaction

All medications are prescribed individually. The doctor selects treatment methods only after examining and establishing the cause of the problem. However, some aspects of pain management are suitable for everyone.

They are as follows:

Immediately after surgery, it is recommended to apply a cold compress to the cheek. If ice is used, it should be applied through a thin cloth. It is necessary to observe the time regime and not to overcool the well.
Start rinsing on the second or third day after surgery. The best antiseptic solution is regular baking soda and salt. To prepare it, take half a teaspoon of these components and thoroughly dissolve it in boiled water at room temperature. Rinse 3-4 times a day, especially after meals.
If there is an inflammatory process, the doctor must start antibacterial drugs. Amoxiclav, Sumamed, Biseptol have a good effect. These medications are taken even after all symptoms have subsided. It is important to follow the course prescribed by the doctor.
At home, if throbbing pain occurs, antiseptic irrigation and oral baths are indicated. The most commonly used are Chlorhexidine, Miramistin, Rivanol, Rotocan, Stomatofit, Iodinol. The price of the drugs is insignificant, but their high effectiveness has been proven in practice many times.
If the unpleasant sensation increases, painkillers such as Analgin, Diclofenac, Ketanov are indicated. You should not use antispasmodic drugs, as they have a completely different effect and are not able to help in this situation.

Antiseptic solutions for rinsing the mouth during inflammation of the socket
To prevent the development of a pain reaction, it is necessary to adhere to the following recommendations:

after tamponade of the hole, the gauze pad must be kept in the oral cavity for half an hour;
do not eat for 3-4 hours;
it is necessary to keep the blood clot in the socket and protect it in every possible way for about a day after extraction;
It is forbidden to apply dry heat to the cheek, take a bath, visit a sauna, or use hot antiseptic solutions;
for three days you should not eat spicy, too sour, salty or hard foods;
avoid hypothermia of the wound if removal occurred in winter;
You should not use alternative medicine to relieve pain, as they can lead to purulent complications;
hot drinks and alcohol are prohibited;
Avoid contact of the wound surface with household items.

It is important to follow all dentist recommendations for oral care. After the tooth is removed from the alveolar process, traditional cleaning can be carried out two days later.

If the pain reaction increases, you should not take painkillers endlessly. It is better to contact your dentist for help as soon as possible, and do not use any medications, including analgesics, during the next few hours of your visit. During this period, only the application of cold to the area where the operation is performed is allowed.

Sometimes it happens that after surgery the gums pulsate and the tooth that is located next to the removed one hurts. The reason for this manifestation could be injury to the pulp tissue in the “neighboring” tooth, if its roots were located very close to the roots of the exposed unit.

As a result, the vascular-nerve bundle of fibers that enter through the apical foramen in the area of the root apexes and nourish the pulp tissue is damaged. In this case, the tooth will have to be opened and treated according to the type of acute pulpitis.

Recommendations for oral care after surgery

After applying stitches, you must follow a number of rules:

Do not pick at the wound again, do not touch it with your hands or tongue
Don't eat too fatty foods
It is better to give up solid foods - apples, nuts, seeds
Do not try to remove stitches yourself
Rinse your mouth with Rotokan solution and other means prescribed by your doctor.
It is recommended to brush your teeth with a new toothbrush
It is not recommended to use dental floss near the suture site.
Don't drink alcohol
Do not use medications that thin the blood
Do not drink coloring or too hot drinks - coffee, black tea, lemonade, soda
Do not try to stop the bleeding if intense bleeding occurs using self-prescribed medications. It is better to go to a 24-hour dental clinic or call a doctor at home.

How to sew up the gum after tooth extraction

If you have experienced tooth extraction surgery and didn't have your gums stitched afterwards, then you are in luck. In particularly difficult situations, such as the removal of wisdom teeth or surgery due to dental diseases of the oral cavity, the doctor has to resort to applying sutures (stitches) to the operated area.

The procedure is not pleasant, but it is not painful or dangerous, since the modern world uses innovative technologies using various painkillers. But depending on the complexity of the clinical case, operations can be of varying degrees of complexity using different types of sutures.

Continuous suture after molar extraction

Treatment options

What to do to relieve pain and swelling of the cheek after tooth extraction? At home you can try the following options:

On days 1-2, it is recommended to place an ice pack on your cheek for 10-20 minutes, taking a break for half an hour. This cycle must be repeated continuously for the first 12-24 hours after dental surgery. Cold application should be performed periodically, since prolonged use can cause compensatory vasodilation.
After a couple of days, cold compresses are replaced with warm, damp ones. Apply them for a maximum of 30 minutes. Heat has a vasodilating effect and increases blood circulation, thereby promoting healing.
Anti-inflammatory drugs. Corticosteroids are effective in reducing swelling, but they have many adverse side effects and should not be used unless absolutely necessary.

These methods will be effective if there are no complications. Otherwise, the doctor may perform a second operation to remove the remaining bone tissue, rinse with an antiseptic, or prescribe antibiotics, depending on the cause of the swelling.

Stitch types

There are generally two types of suture materials used by dentists. The difference between them is that one type “resolves” (dissolves), the other does not.

Seams that dissolve

Slit stitches (absorbent stitches) have the advantage that they do not need to be removed. Your body breaks them down and gets rid of them. Such sutures will easily dissolve without damaging the gums. Doctors often use these stitches, as they say: why injure the wound by removing stitches if they can disappear on their own.

These types of sutures are sometimes called "catgut" sutures or simply "gut" sutures.

Historically they were made from sheep intestines. Modern medicine also uses various synthetic materials.

Catgut thread dissolves on its own

How long does it take for them to dissolve?

The time taken for disintegration depends on the type of material. Intestinal sutures remain intact for 5-7 days, chronic treatment lasts about 9-14 days. Some synthetic materials can last for a couple of weeks.

Seams that don't dissolve

In comparison, insoluble (non-absorbable) sutures are made from materials that the body cannot break down and destroy. These include silk, polyester and nylon.

When should they be taken out? Insoluble stitches should be removed. This procedure is usually scheduled somewhere between 7 and 10 days after they were originally placed. The date when to remove the sutures should be determined individually by your doctor.

Hole after tooth extraction

Removing stitches

Removing your sutures from your gums is usually an easy, quick and painless process.

When should they be removed? In most cases, your dentist will schedule a follow-up appointment for you on the same day of your oral surgery.

The timing of this appointment may vary (and is at the dentist's discretion), but sutures are usually removed somewhere between 7 and 10 days after their initial placement.

How are stitches removed?

The process of removing seams is quite simple.

Your dentist will use small scissors and secure the suture thread.
Then, grab one of the loose ends (the end that has the knot) with dental tweezers and pull the floss out of the gum tissue.
There is no need for anesthesia.

How will you feel

At the beginning of the process, you may feel a firm tug on each stitch as your dentist grabs it with his tweezers so he can cut it off.

When he grabs the knotted end and pulls it through your gums, it is unlikely that you will feel anything.

Suturing after wisdom tooth removal

Read also: Painkillers for tooth extraction

Immediate complications

When removing a wisdom tooth, the consequences are divided into two types: intraoperative, which arose during the procedure or immediately after it, and early, which appeared in a short time after the end of the operation. Most often in dental practice, a mechanically broken wisdom tooth occurs in its crown part or in the root area.

In 50% of cases, the cause is carious damage to the hard tissues of the molar, due to which they soften and cannot withstand pressure. Additional factors are the anatomical features of the underlying alveolar arch and the likely complex shape of the roots, aggravating the applied loads.

In the remaining half of cases, the main role is played by the iatrogenic factor – a consequence of a medical error:

placing the cheeks of the forceps used regardless of the axis of the tooth;
inadequate depth of advancement of the forceps;
turning the tool too sharply in the process of dislocating the figure eight;
unprofessional use of elevators at the final stage of the operation.

The remains of the root system in the hole must be removed, since their presence there can provoke the onset of an inflammatory process in the periodontium or alveolus. To do this, use special root tongs or burs to fragment them. If the roots remaining in the hole cannot be immediately removed (due to the patient’s condition or the shape of the roots), the intervention must be stopped and the prepared area sutured (with the insertion of turunda combined with triiodomethane).

The patient will need one to two weeks of physical therapy and a course of anti-inflammatory medications before continuing the removal process again.

Important! Among the complications after tooth extraction, the likelihood of a fracture of the adjacent crown, on which the surgeon pressed too hard with the elevator when creating a fulcrum, is noted. Such a tooth will also need to be removed, and if it is dislocated, it will need to be realigned and a splinting bracket applied to it for the next 20-30 days.

Consequences of wisdom tooth removal may include inadvertent pushing of molar roots into the soft periodontal tissues caused by pathological loss of alveolar lingual wall tissue (or iatrogenic interference). In such a situation, the roots penetrate the mucous membrane in the area of the lingual-maxillary groove, and if they can be palpated, then after dissecting the mucosa, the surgeon removes them.

Otherwise, you will have to resort to x-rays in two projections or computed tomography to localize the displaced root. If it has advanced into the area under the tongue or lower jaw, its extraction is carried out in a hospital setting.

A wisdom tooth that requires removal often leads to such unpleasant consequences as injury to the gums or other soft tissues of the mouth, which occurs through the fault of the dentist. This happens in two cases: either with incomplete separation of the periodontal ligaments between the neck of the figure eight and the gum, or with the “blind” application of forceps around the molar. To avoid the problem, it is recommended to peel off the gum tissue to the middle of the adjacent crowns.

Note! An unpleasant development of events is tissue rupture followed by bleeding, which can only be eliminated by suturing. The crushed periodontal area will need to be cut off, and the tissue in the area of the rupture will need to be brought together and sutured.

Other complications after wisdom tooth removal are less common, but are more traumatic for the patient:

the pressure of the cheeks of the elevator on the edges of the tooth socket can provoke the breaking off of a small section of the alveolar process, which is removed along with the molar. Most often, the event does not affect the healing process, but if the broken element does not separate with the tooth, it must be removed purposefully, and the edges of the fracture must be smoothed. In severe cases, the posterior portion of the alveolus breaks down along with the maxillary tubercle - it should be removed, and the wound should be sutured and packed;
dislocation of the maxillary joint is likely (especially in older people), which occurs during the removal of the lower “eights” with the mouth wide open and great pressure from the surgeon. It is easy to diagnose a dislocation for the reason that the patient cannot close his jaws, and it is reduced in the standard way in such cases;
a fracture of the lower jaw is a rare occurrence resulting from a combination of several factors: excessive external pressure and the pathological condition of the bone tissue. Among the diseases that increase the risk of fracture are various cysts and neoplasms, osteomyelitis and osteoporosis.

Effect of stitches on wound healing

When sutures are applied, they have a certain effect, which determines the healing of the gums.

The main purpose of stitches is to stabilize moving soft tissues.
They also help to minimize the distance between wound parts. Their presence helps strengthen the wound.
Overall, they help create a more unprecedented and predictable treatment process and outcome.
They can help minimize wound bleeding. When sutures are placed into the extraction site, they create compression on the soft tissue. This pressure can help minimize post-operative bleeding.

Sutures have an inhibitory effect on wound healing. This is probably something you didn't know about seams. They actually tend to inhibit wound healing.

Your body treats the suture material as a foreign object. And as a result, its presence causes inflammation and a “foreign body” reaction. This interferes with the progress of the wound healing process (at least to some extent).

Catgut suturing after recession surgery

This means that stitches should only be placed for a good reason. And if those reasons don't exist, you'll actually be better off without them.

Dental valves

Some extraction procedures, such as wisdom teeth removal, require the creation of a flap (flap) in the gum tissue. After the wisdom tooth is removed, a valve is attached in its place using sutures. The basic premise of using a valve during surgery is that the wound will heal faster and easier than a torn, injured area of gum tissue.

Applying a flap to the gum

When not to panic

Why does my cheek swell after tooth extraction? Swelling is a normal reaction of the body, which indicates adequate wound healing. It is more likely to appear if the gums were already inflamed and infected before the extraction procedure. As a rule, this happens in advanced cases when a visit to the dentist has been postponed for a long time.

“Normal” swelling develops on the first day after surgery and reaches a maximum on day 2. At the same time, its degree is moderate, there is no severe pain and temperature rise above 38 0. Then it gradually goes away by day 6-7 (with heavy extraction, recovery takes 10-14 days). This phenomenon should not cause alarm. But persistent or excessive swelling is already a pathology.

In many patients, swelling intensifies in the morning, after waking up, and then gradually subsides during the day.

The level and duration of swelling is directly dependent on the degree of tissue injury. If the wound is large, then the cheek will swell more after treatment of the tooth. It is especially difficult to pull out wisdom teeth, as well as dystopic and impacted (not fully erupted) elements of the dentition. Removing them requires a lot of effort; sometimes you have to literally gouge out the remains of bone tissue, so swelling is difficult to avoid.

Please note: it is more difficult for people with diseases of the cardiovascular system to undergo surgery, so they quite often experience situations like “a tooth was pulled out and a swollen cheek.”

The procedure for applying a flap to the gums

Here is the process a dentist uses to “set” a flap when performing a dental extraction surgery.

First, he will need to use a local anesthetic ("Novocaine") to numb your gums in the area where the flap will be created.
He will then use a scalpel to cut all the way through the gum tissue down to the bone. (This is called creating a “full-thickness mucoperiosteal flap,” which indicates that all layers of soft tissue covering the bone will be cut.)
The gums will become numb and you will not feel any pain. However, you will feel the pressure of the scalpel as it makes the cuts.
Once the gum has been cut, your dentist will open it up a bit. Here's how he'll do it: Where your gums and teeth meet, your dentist will insert a tissue "lift" (a hand-held tool that looks like a flat-blade screwdriver, only the blade is rounded and smooth). As the elevator rotates, the gums will gradually open up.
After this, the surface of the bone will be completely exposed. Your dentist can now perform any dental procedure (bone removal or tooth sectioning).
Finally, he will move the gum back into place to stitch it up.

Types of suturing

The suturing pattern your dentist uses will depend on the size and need for wound closure. There are two types of seams.

Interrupted seams

Probably the most common is for the dentist to place "broken" stitches. This means that each one is hosted and linked independently. And if one falls away, the integrity of the other stitches is not compromised. This procedure is called suturing.

Continuous seams

In comparison, "continuous" stitches involve repeatedly threading a single line of suture material through secured fabric, with all stitches secured with the same knot.

The process of applying such sutures can be faster. But if any part of the suture material fails or breaks, this leads to a violation of the integrity of the entire structure.