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Curettage is a procedure that is performed only in the dental office and only by a professional doctor. The procedure itself is associated with the disinfection of the tooth recess, which remains after the tooth is removed. This can be both the elimination of abscess foci, and disinfection and cleaning of fragments and remaining particles of a seal that has collapsed. The procedure must be done so that inflammation does not occur due to the fact that there is a foreign body in the oral cavity. Cleaning the alveolar socket after complete tooth extraction significantly helps the wound healing process after the operation.
What is curettage of the hole?
Often, the hole is cleaned immediately after the tooth has been removed. But if there is a need, then they can do it again in a few days, only there should be medical indications for this. Usually, a second intervention is necessary when the inflammatory process begins again in the hole, which means that the wound was infected.
In addition, there may be another reason for performing a procedure such as curettage – this is if there is no so-called dry socket effect. In order for the wound to heal as quickly as possible, it is necessary that a blood clot appear in the hole. Thanks to this, clotted blood can protect the open wound from various bacteria and infections.
Sometimes such a clot may simply not form due to the patient’s special illness, which is due to the fact that the blood does not clot well. And it is precisely in order to avoid any infection that the dentist is forced to carry out curettage. In the event that the inflammation was not eliminated in time, everything can develop into a serious disease – osteomyelitis of the bones.
If the patient has not undergone such a procedure, then he needs to inspect the hole every day and consult a doctor at the slightest suspicion of inflammation.
Symptoms may be:
- Constant pain.
- Inflammation of the gums.
- Pain when eating.
- Temperature.
The dentist will immediately clean the canals and treat the inflammatory foci.
In the course of work, the doctor will remove all tissues on which the disease has already developed and thus accelerate the healing process.
What are the types of curettage?
Such an operation has several types, everything will depend on how difficult the situation is.
The first method of curettage is closed
The closed method of curettage is performed at the very initial stages of periodontitis and at the first stages of periodontal disease, only in such cases it is allowed to carry out this type of operation.
Even with this operation, it is important that the depth of the pocket is not more than five millimeters. Closed cleaning is carried out by the doctor almost “blindly”, since even a small inflammation of the gums will not give a chance to look under it. Such procedures are carried out very carefully and carefully so as not to cause any harm to the patient, healthy teeth and tissues that grow near the site of inflammation.
One of the main varieties of the closed type of operation is the vacuum cleaning of pockets. For this method, a curette is used, also attached to the apparatus, which creates the vacuum effect.
When using this method, all particles that have already exfoliated are immediately removed and do not remain on the walls of the pocket. Using this method, the risk of any complications in the postoperative period is significantly reduced.
The second way is open curettage
Such an operation consists in the fact that an open (direct) surgical intervention is performed, it is used only when the inflammatory process is already underway and the size of the gingival recess is more than five millimeters. Using a tool such as a scalpel, the surgeon opens the focus of inflammation, and then separates some of the gum from the tooth itself. After that, with a curettage spoon, the already bare roots of the tooth are cleaned from stone deposits and tissue that has died.
After that, the roots are completely polished with a special nozzle.
Then it is necessary to treat the pocket with various antiseptics that are used in dentistry. After the pocket has been “secured”, drugs are placed in it that will affect the structure and mineralization of the bone part of the entire tooth.
After all procedures with the periodontal tissue, the mucosal flap is repatriated back. Also, the interdental papillae are sewn together, and as the last step, a universal bandage is applied, which will reliably protect the operated gum from microbes and excess objects entering the open wound.
There are times when a bandage that is impregnated with antiseptic and anti-inflammatory drugs may not be applied. This practice is used if the patient has severe bleeding from the gum, which has just been operated on, in order to avoid the formation of a hematoma and the consequences that may appear after. The whole process after the operation is completely under the control of the doctor, ten days after complete healing, the sutures are removed.
In addition, curettage of the gums, as well as curettage of the hole, is used in the complex treatment of periodontal disease. Surgical intervention is necessary only in the most severe and advanced cases.
Positive and negative aspects of curettage
One of the main positive aspects of curettage is the relatively low cost of the procedure: 200 rubles will be charged for one cleaning of a closed pocket, and 2 rubles for an open method. In addition, it is possible to completely restore bone tissue, and in this case, an osteopreparation plays a significant role.
The gum pockets are also completely removed and all microorganisms that can cause pain are removed. After curettage, the teeth sit much tighter in their sockets, so the percentage of tooth mobility decreases.
Disadvantages:
- a small percentage of effectiveness in periodontal disease;
- sometimes an expensive method;
- open type surgery takes too long, it can take at least 2 hours to process seven teeth;
- the specialist who will carry out all the procedures must have a high category and be a pro in this field;
- if a person gets to an inexperienced doctor, he can expect damage to the mucous membrane and minor wounds.
Who carries out such procedures?
Such procedures can be performed by a dental surgeon and a surgeon. If the dentist does not have an education in the field of surgery (dental), then he cannot perform any of the above operations.
Such manipulations can be carried out using mechanical instruments or using ultrasound. Most dental clinics today practice the use of ultrasound. In this case, the procedure will give a greater percentage of effectiveness, moreover, quickly and without pain.
In order to be sure that the disease will not return during treatment, the root of the tooth is polished without fail. Thus, the tooth enamel becomes smoother, and tartar will not build up. And then the doctor will prescribe medications that will disinfect the oral cavity, and the gums will be able to reject any bacteria.
Contraindications to the procedure
The procedure is not carried out in this case, if the patient has gingival fibromatosis, doctors categorically prohibit any manipulations with curettage. Also, it is not carried out even when there are contraindications of the surgeon or the possibility of complications.
If the patient has infections in the oral cavity – this can be a sore throat, acute respiratory infections, influenza, etc., and the presence of purulent discharge, and deep planting of bone pockets;
In addition, sometimes there are cases when the patient has thin gums, such a procedure can bring a lot of damage to the gums and bleeding. And the procedure is not done even with high tooth mobility.
Recommendations
In order to somehow alleviate the patient’s condition, you can do cold compresses. Then the inflammatory processes slow down significantly and eventually pass completely.
If you have had an open type of curettage, then it is best to drink water through a tube for the first hours, so you will protect yourself from possible bleeding. Of course, you can not drink hot water and eat hot food until the tissues are completely healed. Take the antiseptic medicines that your doctor prescribes for you every day.
Period after surgery
As after any complex operation, there is a rehabilitation period after curettage. When a universal bandage is applied to the gum, then you should understand that it will not be possible to brush your teeth and even carry out a normal mouth rinse. And the first few days you should only take liquid food.
As soon as you remove the bandage, you will need to do a couple of procedures at home so that the wounds heal faster. Standardly, this is treatment with drugs so that the infection does not get in and with those means that will help the wound heal faster. You must understand that wound care at home is very important.
After the curettage is completed, in a few months you will need to go to the doctor to see how the healing process is going and how successful the operation was.