Tooth 4.7 Removed - Healing time?

[Norwegian Cave Diver]

I had my 4.7 tooth (lower right side - tooth just in front of the wisdom tooth) removed on December 7th. Dentist filled in the root area with fake bone material so I can have an implant installed some day in the future. Follow up appointment on December 21st. Dentist told me that the gum was doing well. No infection. Healing as expected. He also showed me a picture and to my surprise there is a area that has a hole exposing the fake bone material. He says this is ok and the gum will continue to close up. Told him I have a dive trip booked leaving January 17th for two weeks. He has booked another follow up appointment for January 16 - day before we fly to look at the gum and tell me if it has closed up. That would be 6 full weeks from the tooth removal to landing in Roatan. Hoping that is enough time for the gum to close up. Anybody have a similar experience? I would expect that diving with an opening still there and diving up to 4 ATA would be a problem. Any dentists out there with your professional opinions? Thanks

 

[Flotsam]

Not a medical professional.... But I had a molar removed in August and prepped for an implant with bone graft, as well. I think the only potential problem was suction disloging the blood clot from the tooth removal, but that was only for the first couple weeks. I dove about 3-4 weeks after with no problem, and my gum was still closing up too. But it was just a couple days diving, not repeated dives like you have scheduled. I don't think it's an issue, but you could call to the dentist with your question and hopefully they can get you an answer sooner than your follow up. There is a prescription mouthwash you might have been given, maybe continuing that after dives will help prevent any problem...

 

[Norwegian Cave Diver]

Thanks. Glad to hear you were diving so soon after your dental work. I do have the prescription mouth wash. Will bring that on the trip. Good idea. Thanks. I’m more concerned about 4 ATA and an open wound and getting bubbles forming in the area. Not sure if that is possible but hoping a dentist/diver checks my posting. Will likely send DAN the question also. Thanks again for your posting.

 

[lionfish-eater]

I also had a molar removed and prepared the same way last Friday. Mine was sutured closed however.
I discussed my concern but the doctor was not dive savvy. I explained the issues and we determined there were a few areas of concern.
First is comfort of the mouthpiece for an hour or more multiple times per day. You need to check the feel and maybe modify it or get one that can be molded to fit.
The second and more important concern is the possibility of trapped air pockets in the replacement bone material. There is a potential for reverse squeeze on ascent from compressed air that is trapped in the pores of the material. He didn't think there is a high probability that this would happen.
He thought 30 days after surgery was reasonable before diving.

I am also concerned about the antibiotic treatment killing all the good bacteria in my gut. I am looking at different options for replacement from youghert to kombuca or tablets.

I left out the obvious concern for infection from seawater. Use the mouthwash immediately after every dive.

 

[Taath]

Not a dental professional, however, earlier this year I had an unplanned removal of the same molar and the wisdom tooth (while awake, ouch). I had a trip to San Carlos, Mexico a week later.

Did 6 dives including one to with just over 5 ATAs of pressure. Definitely a little sore and the dry air was uncomfortable, but everything healed up okay otherwise and no complications.

Your mileage may vary....

 

[Tool Belt]

As a retired dentist my main concerns would include primary closure of the site and concomitant reattachment of any attached gingiva. Given that your dentist is not dive savvy I would present it that your concern is with a possible Subcutaneous Emphysema ( the trapping of gas/air in soft tissue that is most often iatrogenic in origin stemming from the bleed air of a highspeed handpiece.) If your doc sees no possibility of that.....no worries.

 

[jonhall]

Had impacted wisdom tooth pulled Dec. 11. Went to Dr. today for checkup and while gently blowing through my nose as he held it closed, we could hear air escape through a small hole that hasn't closed up. So now I must go in 2 weeks to see him again, 2 days before leaving to dive in Cabo San Lucas. Asked Dr. about diving and he told me I could dive and if the hole had not closed before leaving, we would address it after my trip. My biggest concern was doing the Valsalva maneuver to equalize. He indicated it shouldn't be an issue, but I will double check that also.

I left out the obvious concern for infection from seawater. Use the mouthwash immediately after every dive

One of my directions to follow after the surgery was to not use commercial mouthwash that often contains alcohol as it may irritate the wound (but to use warm salt water to rinse 4-5 days after). Didn't think to ask if I could now use mouthwash with the small hole there (is that still a wound?), so I will ask him next time. I've only had one beer since the surgery due to that alcohol warning!!

 

[Duke Dive Medicine]

I'd listen to the retired dentist. Be careful with foods that could irritate the area, irrigate and care for the open area as directed and you will probably be healed up by then, but depending on underlying health issues, your mileage may vary.

Best regards,
DDM