My First Ever Surgery (Dental Surgery)

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Today’s the fourth day after I had my first dental surgery. I have pending blog posts about my previous beauty boxes, but I was in pain for days already and I couldn’t think of blogging about it yet. Since this is my first ever surgery, I would want to share with everyone how it went.

(If you’re faint-hearted please skip some of the photos or just don’t read the blog.) 🤢

I’m a dentistry student and a licensed dental hygienist by profession. I have experienced most of what dentist does to their patients like oral prophylaxis (scaling & polishing), tooth filling or tooth restoration (“pasta” in Tagalog), received different methods of local anesthesia administration, and underwent root canal therapy (RCT). So, I know how to explain it to my own patients or to family and friends.

However, I have never been subjected to any dental surgery like extractions, apicoectomy (removal of cyst at the end of your tooth), third molar removal, etc. So, explaining the procedure and post-operative care to patients (or even to family & friends) are all based on what was taught in school by dentists/instructors, experiences of colleagues, what we usually observe, and partially on what I read on cases posted over the internet.

Not until last June 09, 2017 – my first ever dental surgery materialized. I underwent a dental surgery called APICOECTOMY. After that day, I can now relate to my future patients and share my experience – what will happen during the procedure and post-operative care.

 

What is Apicoectomy?

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Apicoectomy is a surgical procedure for people who have an infection in the root of their tooth. It usually includes removing a part of your root tip and a lesion (i.e. cyst), if present.

 

Why do I need to undergo Apicoectomy?

A series of failed events led to my current condition – having a periapical cyst. I’m one of those kids who loves to eat candies at school. Let’s be real, we don’t believe how our parents tell us to stop eating sweets because it will destroy our teeth. 🤤 My parents won’t allow us (my siblings and I) to eat chips and sweets at home, but we’re able to enjoy eating those at school. I brush my teeth two to three times a day, but was lazy to floss. Since I don’t floss, I developed a small cavity in between my two front teeth in high school and have it fixed by a dentist.

Two years after having my teeth restored, I spotted a pimple-like bump in my gums (just above my two front teeth). Since I was already in my pre-dentistry course, I seek advice from a student clinician (someone from a higher batch). She took a radiograph of my teeth and told me I needed to undergo root canal therapy. I couldn’t find the old photo of my radiograph, but it shows tiny radiolucency (black) at the root of my two front teeth. I have seen a similar photo over the internet, but mine was smaller. (See photo below)

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On 2010, I had my root canal therapy done. The dentist said, one factor why my restoration failed was failure to completely seal my teeth – which is why bacteria could still enter my teeth and have caused infection inside my two teeth.

Unfortunately, my root canal treated teeth failed too. On 2015, I asked one of my classmate to take a radiograph of my two front teeth, since I can feel something’s not right. And bam! There’s a reinfection. Look at the photo, it has radiolucent part again – which disappeared weeks after my root canal therapy. Looking at the photo, it was bigger and much rounded this time.

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At that time, I already suspected I have a cyst – due to its circumscribed form. But since I’m busy – I’ll be graduating that year and will be taking the board exam – I was not able to have it checked.

On November 2016, I started working in GAOC. As part of the training, we were taught how to operate different X-ray apparatus like Panoramic, TMJ Radiograph, and CT Scan. Upon reviewing my own CT Scan taken by another trainee, I said to myself, “sh*t! I have cyst!”. I’ve been down for a few days…I couldn’t accept I had it despite having a good oral hygiene. 😥

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Dentists, who were my co-workers at that time, told me that reinfection was caused by inadequate seal – again! The root canal material was not able to fully seal my canal, thus, having bacteria to pass through (AGAIN!!!). Sigh! 😪

This time, I decided to have my dental treatment done by a dentist who specializes in Endodontics and Surgery. Dr. Rey Estrella, a dentist from GAOC and NUVODENTAL, studied my case and we discussed all the possible treatment plan. We decided to re-treat my teeth and do another session of root canal therapy to properly seal my teeth. After root canal therapy, we had the lesion under observation to see if it will subside or become smaller. If after a few weeks the size would stay the same or bigger, I will undergo surgery.

Weeks after root canal therapy, the lesion was still there; so, we decided to proceed with the surgery.

 

What happened during the day of surgery?

  1. Latest radiograph was taken before the surgery proper.
  2. Topical anesthesia was applied prior to administration of local anesthesia
  3. Local anesthesia was administered – Supraperiosteal + Nasopalatine Nerve Block
  4. Surgical drapes was placed over me. 19238540_1352291474820523_1264821092_o
  5. Incision was made to retract the gum and expose bone.
  6. Bone was drilled until the lesion was exposed.
  7. The lesion (cyst) was suctioned and the site was cleaned further. Here’s a photo of the hole after the cyst was removed.
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  8. Part of my root tip was cut and sealed again to prevent reinfection.
  9. Collaplug Absorbable Collagen was placed in the hole to promote proper healing of bone and prevent gums to collapse.
  10. Retracted tissue was placed back and stitched to keep it in place.
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How was the procedure?

I can tolerate the pain of inserting a needle in any part of my gums (I’ve been anesthetized before), but I couldn’t endure the pain of a Nasopalatine Nerve Block – the type of local anesthesia technique that inserts needle in the palatal area (roof of the mouth). It was just so painful. 😩

Once in a while, I bawled for pain in areas that are not so numb. I’m so glad I have my boyfriend was with me inside the operating room…he massaged my hands and legs to keep me calm during the procedure. I couldn’t imagine being operated without him while I’m extremely agitated. Knowing you have a hand to hold on too while you’re scared, made me calm a bit.

I tried to be relaxed during the procedure but the anxiety level was so high —actually not with pain, but with the thought that I’m in a surgical operation. I’m so glad I decided to have my surgery done by a great surgeon dentist. Kudos to the whole dental team. 💕

The Recovery  

I would be lying if I’d say I’m perfectly fine. The day after the surgery, I felt so wretched. After the anesthesia wore off, it seems like none of the pain killers were working. Since the incision was located between my gums and lip (labial vestibule), it was so hard to open my mouth, speak, and chew. Try to open your mouth, look how your upper lip was being pulled downward – the reason why I can’t open my mouth and chew.

Today’s day 4 and I’m upset. I can only eat congee, sloppy lasagna from Pizza Hut, Jollibee’s mashed potato, and bananas. My family and close friends know how an unsatisfied stomach turns me into a woeful creature. I have too many cravings in one day and I don’t like eating congee for days – almost three times a day! I don’t feel satisfied eating congee which makes me hungry few hours after eating. It feels awful not to eat what I usually do. I just can’t wait to finally get over this. 😫😓

Another thing is how hard it is to brush teeth. Since I can’t open my mouth properly, it’s even harder to place the brush inside my mouth. Post-operative care also instructs me to avoid spitting and no gargling motion. I end up flushing glasses of water into my mouth and let it overflow. In exchange of gargling, moving my head from side to side was even harder – whenever I do this, it feels like gravity is pulling something on my surgery site which feels weird.

Here’s a photo of me today. Look how my right cheeks look swollen and fuller than my left cheek. The right wing or alar of my nose is also swollen. My left cheek was a little bit swollen too, but not as much as my right cheek. My cheeks are bony and usually looks like V-shaped (almost like my left side on this photo).

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Not eating what I want, unable to talk much, uneasy sleeping position, discomfort – all of this makes me grumpy most of the time. I feel irritated with simple things and I just want to eat pizza and steak! I don’t want congee anymore!

But one thing’s for sure: I have learned a lot from this operation. I’ve learned how I can deal with future patients who will undergo the same surgery I had and give them proper post-operative instructions (the way I experienced it). I guess, I should just be thankful the cyst was finally removed and hope for faster recovery.

I should have listened to my parents and avoided eating too much sweets when I was younger. Currently, I make sure my 2-year old nephew would be restricted to sweets as well. And as early as now, I educate my sister on how she can brush my nephew’s teeth properly.

I just can’t wait to finally be back in my normal self 😷

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