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Tooth extraction
Jan 19, 2000

Dear Dr. Reznik. I need one of my teeth to be extracted some time soon (top left 7) and I wonder if a) I should be worried about any complications, b) should I notify my dentist about my new HIV status, and c) any other relevant advise would be highly appreciated. Many thanks, Anna

Response from Dr. Reznik

Dear Anna:

There is a great deal of scientific information available which shows that people living with HIV infection and AIDS do NOT have any more complications following dental surgery than those who are HIV negative. We perform over 100 extractions a month at the Oral Health Center and completely agree with the scientific data. So I would not worry about any complications if you follow the post operative instructions given at the time of the procedure.

Should you inform your dentist about your new diagnosis? The answer would be yes. An accurate, comprehensive medical history would assist your dental health care professional in the provision of the best care for you. Whereas it is true that general dentistry, including simple extractions such as you have described, does not differ for people living with HIV disease, you may be on medications that will he/she needs to be aware of. Also, dentists can play an important role in your overall well-being if they are aware of your medical status. A well trained dental professional can look for candidiasis (thrush), HPV, etc and play an important role in the management of these and other conditions. Your dentist should be a valuable part of your healthcare team.

The following are Post Operative Instructions from the HIVdent Internet Project which are located at the following URL: http://www.hivdent.org/_peag/faq-Instos.htm

1. Leave the gauze in your mouth in place for at least 30 minutes. Keep a firm but steady pressure on the gauze and when you remove it, remove it GENTLY without disturbing the blood clot.

2. Place an ice bag or a COLD towel on your face over the operated area from 4-6 hours. This will help prevent excess swelling. The earlier this is started the more effective it will be. You may remove the cold pack 15 minutes every hour it necessary for your comfort.

3. Do not rinse your mouth today. Rinsing may dislodge the blood clot and interrupt the normal process of healing. You are encouraged however, to drink(swallow) fluids today.

4. Spit as little as possible. (Blood cannot clot if you are constantly spitting it out.) If abnormal bleeding occurs, fold a sponge, wet it, place it over the socket and bite down for 30 minutes with even pressure. If abnormal bleeding persists, don't hesitate to call.

5. On the day following surgery rinse your mouth GENTLY after each meal with WARM salt water (1/2 teaspoon of salt in a glass of warm water). This should also be done at bedtime. It should be emphasized that this rinsing be done gently. Rinsing with a mouth wash four times per day is also recommended. In addition, DISCONTINUE ICE, and start warm heat (warm moist towels) to the operative area.

6. Follow your own inclinations as to diet, but for your own comfort soft foods or liquids are indicated for the first 24-48 hours. Keep up your food intake and drink plenty of fluids.

7. The teeth should be given their usual care except in the region of surgery.

8. Please carefully follow the directions on any prescriptions you may have been given. 9. Occasionally there is numbness following a difficult extraction. This numbness may last for several weeks or longer, but is almost always temporary.

10. Small pieces of bone may work their way out through the gum following an extraction. This normal and usually requires no treatment.

11. If suture removal is necessary, please be advised that this is a painless process. Please be sure you make an appointment for a postoperative checkup.

Take care!

DR


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