Dental work while on Reclast

Hi Holly. Oops, no you won’t need to be under general anesthesia for those extractions. It is done with a local anesthetic such Lidocaine or Carbocaine. Sorry for the confusion. Anesthesia was a typo…should have been anesthetic.

As for questions, from what you’ve said about your remaining teeth these should be simple extractions and the consultation with the oral surgeon will be pretty straight forward about the procedure. You’ve had other teeth extracted so I don’t think this will much different than your previous experiences

Occasionally, when there will be an immediate denture, there can be some sutures placed to make sure the gum tissue heals smoothly. So you an ask if there will be sutures.

You could ask if you need any prophylactic antibiotics but again, that may not be necessary in this case.
I think the best bet is to go ahead with the consultation so you can hear what the oral surgeon has to say. You have a great dental team. And I’m here if you some clarification. ☺️

Dear Lori,
Thank you !
I am so lucky to have you to help me and to keep me grounded, and respond to my questions. I worry. So you are a huge help.
Holly

Dear Lori,
It has been a long journey to actually get to the consultation with the oral surgeon about having my remaining four upper teeth extracted. I have been returning to the dentist to have fillings and then a permanent crown inserted today. I have an appointment with the oral surgeon tomorrow and the dentist gave me the denture to give him. I am wondering what questions I need to ask the oral surgeon. I will be making the appointment for the extractions when I see him tomorrow. The dentist did not give me any instructions except that I will need to have the denture inserted immediately after the extractions. I was wanting a more detailed explanation of what will happen, but it seems you are the only one who actually anticipates what I will need to know. Should I be buying adhesive cream to keep in the denture ? Does it stay in for 48 hours? The dentist(who was recommended as a denture specialist) did not give me any instructions except to have the denture inserted immediately and then make an appointment to see him for 48 hours after this. I will ask if I will need sutures and or an antibiotic (I only know to ask this, because you told me about it). I have been focused on trying to get my lower teeth in as good shape as possible before the extractions, but I now need to shift my attention to the extraction.
Any help with my appointment tomorrow would be wonderful. It is not until 3pm.EST. I know this is short notice.
Thank you so very much,
Holly

Hi Holly. Phew…ok. You’re getting so close, let’s get you to that finish line without anxiety. ☺️

Obviously, I can’t know for sure what your oral surgeon will say, however from having assisted with this procedure over the years, basically this is what will happen at that extraction appointment.
Also, from discussions we’ve had, I’m assuming these teeth have lost a significant amount of bone support around them so they should be easy to remove.

At the extraction appointment, you’ll have local anesthetic injected around the teeth. Since you’ve had this done before none of this will be new for you. The difference this time is that you won’t be biting on gauze when you leave the dental office. You will now have your denture in place.

Depending on your oral surgeon’s instructions you’ll most likely be told to keep your denture in place for 24 hours. Do not remove it. The denture acts to stop any bleeding and also to limit any swelling that might take place.

Usually after 24 hours you may take it out only to brush your lower teeth and to GENTLY, I can’t stress that enough, Gently let water swish across the upper and also brush and rinse the inside of the denture and then place it back in.

****Remember to put water in your sink basin so if the denture slips from your hand, the water will break the fall…not the denture! ***

Usually after 48 hours you can leave the denture out at night. No hard swishing or drinking through a straw for about a week unless your oral surgeon says it’s ok. Foods will be limited to soft things for a while. Again, I’m sure your doctor will give you a print out.
Oh, you can also do a quick internet search. Immediate Denture Placement…that will give you a ton of relevant information. I was going to post a site but they’re all from dental clinics and I’m not sure about the domain issues. I read several and the information was spot on.

The first 24 hours don’t be surprised if there is pink tinged saliva. You might also find you have a lot of saliva…this is temporary over the next few days after insertion. You might want to keep paper towels handy to spit into.

Don’t do any adhesive for a while! Ask your doctor when to start using that, if you even need it. As your tissue heals it will shrink and conform. After a reasonable time your dentist may opt to do a reline for you. I think we talked about that. It’s basically just putting a new, custom fitted layer of plastic back into the palate portion of the denture so that you may not even need adhesive. But if you do, there are good adhesives on the market that really grab those dentures and leave them fitting comfortably.

These are just the basics…
~Ask if you need sutures
~Do you need prophylactic antibiotics
~Will you need to rinse with a special mouthrinse to reduce bacteria
~Ask the doctor how long you need to keep the denture in place initially.
~When can you eat with the denture
~When can you start swishing with salt water to keep the extraction sites clean.
~What should you look for as an indication of infection
~When can you use adhesive if you need it
~Who do you call if you’re in pain and you feel something isn’t right
~How to care for the denture…though this may be more information gotten from the dentist who will do the followup for the denture itself.
~You can talk to that doctor and ask about relining the denture when necessary.

I hope this helps! You’ll find out a lot of info with your consultation tomorrow. If you need clarification, I’ll be here!
Sending a hug! Lori

Dear Lori,
You are absolutely amazing !!!!!!!
Thank you so very much for your response. I feel so much better now that I have the information that you sent ! I have written questions out, asked questions, pleaded with the staff to please tell me what they are doing before they do it and no one has responded with the clarity and empathy that you express. Thank you !
With your expertise, I will make it to the finish line with very little anxiety !
I so appreciate your timely response. I will keep you updated.
Bless you !
Holly

Hi Holly, Not sure I’m amazing…though I have a sticker on my bathroom mirror that says I am. 😅 But I try to be helpful wherever I can, so I’m very happy that I’ve been able to give you useful information for your dental issues.

You shouldn’t have to beg staff for information. That makes me sad! Our office wasn’t that way at all so it’s easy to just assume everyone would want to make sure their patients were well informed. I’ll continue you to do my best to help you out. Good luck today! 🌷

Dear Lori,
Again, Thank you so very much for responding and all of your VERY helpful information. I have copies of your response for myself and the oral surgeon to bring with me today. I think I have neglected to mention that I have COPD and use an inhaler. I have to rinse my mouth each day after I use the inhaler so I do not get a recurrence of thrush. You did walk me through how to deal with thrush and thanks to you I have been Thrush free for months now. I will ask the oral surgeon if I can continue to rinse my mouth each day from day one. I have been told that wearing dentures also makes you prone to getting thrush. Thank you again. I also have PFT Pulmonary function tests scheduled for May 1st. I wonder if I should post pone the dentures until after these tests. Thank you again.
I will let you know how today goes !
Hugs and blessings

Dear Lori,
I keep looking for the black box to connect to you and I do not see it, so I am just continuing to write here. I typed up a list of questions from the information that you sent and gave a copy to the oral surgeon. I asked that he go over each question. For the most part, he said he would have to wait and see how things went before he decided on the action. He did say I will need stitches (dissolvable ones), no antibiotics before hand, just continue using the paradontax mouthwash that I have been using. Keep the denture in for 24 hours, then gently rinse and replace it, Make an apt with the dentist for 48 hours after the extraction and for one week with himself and at that point they will know if I am healing as I should. He left most of the decisions to be decided by the dentist after the procedure. Also, in order to line up the apt's when both doctors would be available and not close to my pulmonary function test everything is delayed to June 17th for the extraction. I'm not thrilled about this, but both drs. are going to be out of town at times and that date was the only time when they will both be here. I did want to tell you which teeth I am having extracted. Upper (6,8,9 and 10). These are the remaining teeth on upper jaw. I am concerned that no matter how gentle I am bright red bleeding occurs between tooth 8 and 9. He said that this was because of decay, and to just stay away from those teeth. This is confusing to me, but he said just don't worry about it. It takes me a while to absorb what is said at these visits, so I am sure I will be sending you more questions. Also I will google Immediate Denture Placement. I guess I will just try to look at this as more time to educate my self, with your help, and prepare for the denture. Thank you again ! I really appreciate your support!
Holly

Good morning, Holly! At the bottom of my reply there should be a little blue oval that says Reply. Click there and it will open a box for you to type your message into that will then have my name imbedded. When you’re finished typing, look under the box and now you’ll see the black oval that says Reply. You’re doing great. I’m always on the lookout anyway, even if my name isn’t attached.

Oh gosh, I’m sorry for that delay of a couple months. How disappointing! Now that you’ve gotten this far you just want to get on with the show! Well, you’re all set to go now…the denture is made and waiting won’t have any impact except to test your patience. 😉

It’s normal that your dentist will resume your care after the oral surgeon (OS) does the extractions. In our office, we did the extractions along with making the dentures. But there are offices where the dentist refers all extractions out to the oral surgeon. The teeth you mentioned should be simple extractions, meaning non-surgical because they should slip out easily.
The sutures will be used to close the open tissue over the tooth sockets in the bone. This helps the tissue to heal less ragged so there will be a smoothness to the area where the denture will be sitting on the bony ridge of your upper jaw.

When you return to your dentist the 2nd day, he’ll remove the denture, check the tissue and make sure there is healing taking place. He will ask if you have any areas that feel sore inside. He can trim away plastic that might be pressing too firmly in the roof of your mouth or up under your lips. Not going to lie…it’s going to feel like a mouthful! But plastic can be trimmed away if the denture feels ‘too thick or full’ behind your lips or creates sore spots on the tissue anywhere. Don’t be afraid to speak up!

Remember, when the dentist constructed the denture, he did it from the study models where he had to remove the plaster teeth to imitate your mouth after the extractions.
So he had no way of actually trying the denture in your mouth in its completed stage to make sure it had a custom fit.
Once the final teeth in your mouth are removed, he can do some fine tuning to make it more comfy for you. If you recall, I also mentioned about several weeks down the road where the denture may feel too sloppy from tissue/bone shrinkage and remodeling. That’s when you can use adhesive or, if your doctor feels enough time has lapsed, he can do that reline technique. We’ll talk about that when the time comes.

You can still brush those teeth on top, even if the gums bleed. You’re not doing any damage. There’s a lot of inflammation around those teeth so they will continue to bleed until the extractions take place. Then healing can begin. You’re doing everything right and I can picture everything your dental teams are doing for you. ☺️ It’s all very standard and you’re going to have a great smile soon enough.

I’m glad you didn’t have to cancel your PFT. Get that out of the way… Wishing you well with the outcome! This was the first year, out of the last 5, that I didn’t need a PFT as part of my followup appts!

Again, I’m sorry to hear about the delay in excitement for you! It’s like having to wait for presents on a holiday or birthday!

Dear Lori,
I have been re-reading all of your advice while I am waiting for my denture work to continue, and I noticed that you mentioned PFT. I have severe COPD and I am very frustrated that I have not been able to get an inhaler that I appear to be able to take, without itching. I do use Levalbuterol 2 puffs a day which does help slightly, but I wish I could find one that did not warn about making you more prone to infections, and did not contain steroids. Do you know of an inhaler that is very safe to use? Maybe I should start a new category on the Mayo Clinic site. I am hoping to get some answers when I go in for my PFT.
Thanks !
I hope you are able to enjoy Spring !