It’s safe to assume that very few (if any) oral surgeons would employ a dental hygienist. On the other hand, many referring dentists who send their patients to an extraction specialist do employ the services of a hygienist. Fact of the matter is, numerous patients referred to oral surgeons pose unique challenges as far as teeth removal and postprocedural healing expectations. Good examples would be the teen referred for impacted wisdom teeth extractions, the elderly patient with multiple root fractures, and the patient with ultra-poor home care, which led to the eventual breakdown of tissue health and the need for a removable partial. At times, we may forget the oral surgeon only sees our patient once or twice. This places the specialist in a challenging situation to build rapport. We have the opportunity as a hygienist from the referring dental office to assist the oral surgeon by becoming a link through which our education will help promote a smooth healing process of our now-mutual patient.
We anticipate the healing of those referred patients. We sit chairside and think, “Won’t it be great to have those unsightly root tips out?” or “After the patient has that third molar removed, I can access the distal of Tooth No. 31 with ease!” These are the folks in need of hygiene services. After all, healing occurs best when the oral environment is primed by performing bacterial removal measures.
Try developing a leaflet to give to patients seeking a specialist who reinforces care of the wound site and offers home care catered to their needs. Perhaps set up an in-office visit or a phone conversation between you and the oral surgeon’s office to discuss how your hygiene services would encourage the patient’s home care and the healing process. Granted, oral surgeons want patients to heal from the services they perform using their specific recommendations. Although most postoperative recommendations are very similar, request a copy of the oral surgeon’s postsurgical home-care recommendations to become familiar with his/her individualized protocol. This will avoid confusion later at home and reassure your patient of the seamless care between your office and the specialist’s.
After surgery, when your patients are dealing with mouth soreness, home care may be affected or neglected. Generally, this oral maintenance dilemma is short-term; however, modifications in regular routine will provide comfort. Useful products are available to promote care and healing of wound sites. Why not make available recommended (specialized) products in a care bag just for the patient going to the oral surgeon? Hygienists know the products and are familiar with their use and positive results.
Tenderness from having extractions may make opening the mouth challenging and reaching posterior areas to deplaque even more difficult. Emphasize to the patient that the healing process is slowed when the tissues are dealing with a barrage of proliferating bacteria. The usual home care the patient is accustomed to may not be advised. Alternative measures can help ensure that wound sites are kept clean. Try a smaller head toothbrush which fits easily into the area. Sunstar Butler has introduced a delicate postsurgical brush. The patient will appreciate the ultra-soft bristles which can be used gently during the crucial healing process.
Common swelling or bruising where the tooth was removed makes caring for adjacent teeth a challenge. Harmful bacteria may contribute to healing delays and mouth odors, and become trapped by flaps of tissue and sutures. Perhaps the patient would do well with mouthrinses formulated to soothe and promote healing as a front-line defense when brushing is tricky during the days following extractions.
Mouthrinses are a welcome product when delicately swished (no vigorous spitting) for needed freshening after the first 24 hours or as indicated by the specialist. Slight odors at the surgical site (not always indicating infection) may nag the patient. Advise patients to use products that do not contain alcohol to avoid any stinging sensations, an unwelcome postoperative issue. Healing and halitosis are both concerns for the patient after surgery. Biotene mouth products by Laclede are ultra-kind to tissues because they are mild in flavor and are antibacterial using natural enzymes.
Avoid adopting the attitude, “This patient has neglected his/her mouth, so let’s not deal with him/her anymore; just send this patient to the surgeon.”
These folks are just the sort your hygienist can assist through education and home-care modification. Help make the process of an extraction more soothing by assembling and recommending comforting products.
By establishing a professional protocol from office to office, your patient will feel the caring touch your office provides ... and then your place will become the office where patients want to be referred.
Karen Kaiser, RDH
Ms. Kaiser has been in the dental field since 1986. She graduated from St. Louis, Mo., Forest Park hygiene program in 1994 and practices in Illinois at the Center for Contemporary Dentistry. Ms. Kaiser authors articles, presents, and can be reached at At Your Fingertips: [email protected].
