Sore no more

July 1, 2005
For many teenagers, summer vacation means a welcome break from the school year, traveling with family, and time for dental care.

For many teenagers, summer vacation means a welcome break from the school year, traveling with family, and time for dental care. When teenagers come in for scheduled recare appointments and say, “It kind of hurts way back there,” hygienists generally respond with, “Have you had your wisdom teeth removed yet?”

The realization that these teeth may need to be removed is not a pleasant one. Since some classmates may have recently undergone removal of impacted teeth, these teens may be misguided as to what they can truly expect. They have seen the swollen cheeks, bruising, and discomfort that others have endured following a difficult surgical extraction. For some of your patients, having teeth surgically removed may even be the first time they’ll experience a sedation procedure - being “put under.”

Even though surgical extractions come with innate unpleasantries, there are soothing products available to these young people to ease their discomfort.

When my own daughter had her third molars extracted, I called in the product cavalry to offer relief. I also realized that teens referred from general practices might not be aware of these products, which could significantly ease their discomfort after surgery.

A care kit of such soothing products could easily be compiled and distributed to your patients at the time of such referrals. Not only would your patients have much appreciated relief at their fingertips, but such a thoughtful care package can also enhance and help build your practice.

When my daughter and I arrived home, I dutifully reviewed the post-operative instructions provided by the oral surgeon’s office. I quickly comprehended that the instructions lacked product recommendations for care of the sore tissue. Rinsing with salt water was the extent of the recommendations.

So much more might have been included, prompting me to write this article. Care of the new extraction site was certainly the primary concern, but what about the rest of the mouth?

In my daughter’s case, she wasn’t interested in her usual home care regimen, because of the possibility of disturbing the site. As a matter of fact, she even lacked motivation to brush her unaffected teeth, because of the pain medication she was taking. For the first few days following extractions, the jaw hurt even when opened as a result of the manipulation required to retrieve those wedged third molars. Regular methods for toothbrushing may be temporarily interrupted due to generalized tenderness.

The initial cleaning method that worked best for my daughter was a gentle swish of mouthrinse. Realizing her mouth had undergone trauma, we chose a soothing rinse from Laclede. Biotene mouthrinse has a gentle antibacterial and alcohol-free formula that soothed her oral tissue without stinging.

For the first week, my daughter complained not only of a constant and horrific sense of taste, but was also plagued by bad breath. After an extraction, the tissue turns gray and sutures will easily accumulate plaque. The natural oral flora of the mouth has been disturbed and amassing bacteria are unwelcome during the healing process. Also, the sites will commonly seep and mix blood products with saliva. Biotene offers a gentle way to alleviate the bloody taste and offer freshness. The natural enzymes found in Biotene boost the healing response and flow into the areas that cannot be brushed. We also found that the Biotene mouthrinse neutralized mouth odors and offered a freshening benefit that my teen fully appreciated.

To help surgical wounds heal, consider recommending Rincinol P.R.N. by Butler Sunstar. This product provided the care my daughter’s tissues needed during the crucial healing stage. Rincinol P.R.N. contains natural healing enzymes, but in a thicker gel consistency than mouthwash. Rincinol, as its name suggests, is rinsed or gently swished, and then expectorated. The product provides relief to sutures and tender sites for several hours after application, all without a traumatizing application process. The product is clear and forms a healing barrier which can be applied as often as needed for comfort. When my daughter complained of a dry mouth, this product actually hydrated the tissue and offered even further relief.

Once the initial soreness subsides, a toothbrush may be reintroduced to maneuver carefully around the teeth.. We turned once again to Sunstar Butler. The GUM delicate, post-surgical toothbrush was an obvious selection. The ultra soft bristles of the surgical brush are perfect for sensitive tissues. The brush works well for post-op care, even when the opening is restricted.

We also turned again to the Laclede line of products, using the Biotene paste during the healing stage. My daughter felt it was less harsh than her everyday toothpaste. Because Biotene does not contain the detergent sodium lauryl sulfate, my daughter’s mouth was not as foamy, and she could better visualize the areas she needed to reach.

Biotene products are well known for xerostomia care and relief. The gentle formulas do not dry tissues and actually stimulate salivary flow, which alone provides helpful healing enzymes, thereby promoting tissue health and hydration.

One of the most annoying consequences of wisdom tooth removal is the crater left in its wake. This area easily packs with food and becomes tender when the debris is not thoroughly removed. However, disturbing a healing clot should be avoided to prevent the development of a painful dry socket. When it is deemed safe to begin more vigorous bacterial removal, a tool that comfortably fits this posterior crevice is called for. The Sulcabrush is angled to tuck behind the second molar and gently stimulate food debris removal. A Sulcabrush can also be dipped into the Rincinol P.R.N. for site-specific delivery.

For many teenagers, the extraction of wisdom teeth is practically a rite of passage to adulthood. Before handing a teen a referral slip for oral surgery, consider the advice you may offer them. During the critical post-extraction period, products are available to soothe, hydrate, and assist in the healing process. Recommend or dispense trusted products and help your patients be sore no more.

The author did not receive compensation for products mentioned. For more information visit, and

Karen Kaiser, RDH, graduated from St. Louis’ Forest Park dental hygiene program in 1994 and currently practices at the Center for Contemporary Dentistry in Columbia, Ill. She has written several articles for RDH and other publications, sits on dental hygiene panels, and is an evaluator for Clinical Research Associates. She can be contacted at [email protected].