Gingival retraction goal materials methods. Gingival retraction is an unpleasant but necessary dental procedure. Why is gum detachment performed?

Gingival retraction products are used in all areas of dentistry - in therapy, surgery and orthopedics. It is also used in pediatric dentistry for the treatment permanent teeth. Retraction cords and other means of gum retraction are great helpers during dental treatment. They must be used in cases where the work of the dentist is close to the gum.

What is gum retraction and what is the purpose of it?

Gingival retraction is a temporary expansion of the periodontal sulcus. It must be carried out in the following cases:

when it is necessary to protect the gum from injury during treatment and other diseases. The risk of injury to the gingival margin appears during treatment and caries of the interdental spaces;
retraction is performed if it is necessary to stop bleeding in the treatment of caries. It is very important that blood does not get on filling material, otherwise it will not hold well;
gum retraction is necessary when hygiene procedures in the cervical region, for example, the removal of tartar by ultrasound. Retraction is needed to have access to all dental deposits;
during orthopedic treatment when trying on crowns or, as well as during the removal of impressions, retraction is indispensable;
During tooth whitening, you also need to protect the gums. The whitening gel should not come into contact with the gum tissue, so as not to burn them.

Basic gum retraction methods

There are 3 methods of gingival retraction that are used in modern dentistry:

Surgical. The dentist removes the overgrown gum tissue with a scalpel or special electrical devices. This method is used very rarely, only in cases where without surgical intervention cannot be dispensed with.
Chemical method. It is also not used as often, as many patients are allergic to chemicals. Used mainly pastes and gels containing kaolin and aluminum oxide. It is necessary to monitor the duration of the paste on the gum to avoid burns.
The mechanical method is the most common. Usually, when asked by the patient, gum retraction, what it is, the dentist answers that it is the placement of a thread under the gum. Basically, in therapeutic dentistry use threads various kinds. Less commonly used copper rings. The complexity of using rings is due to the fact that it is necessary to choose a ring that exactly matches the size of the neck of the tooth. This procedure is quite painful, so it is performed under local anesthesia.

Types of retraction threads

There are 3 types of retraction threads:

Cotton. They are soft and have good absorbent properties. The liquid they are soaked in helps stop bleeding.
Fabric tubes. Their absorbent properties are the same as those of cotton threads, but due to their structure, they hold better.
Threads not impregnated with liquid. Such threads are used to treat those patients who are contraindicated in the use of chemicals. For example, if there is an allergy to the components of the solution. Persons suffering from cardiovascular diseases are contraindicated in adrenaline, which is present in the composition of the liquid.

In addition to the traditional gum retraction with threads and rings, there are new methods, for example, the use of a laser. Contraindications to the use of this method are still poorly understood. The laser is rarely used for retraction, because this method of treatment is very expensive.

Gingival retraction during impression taking

In orthopedic dentistry, retraction pastes are most commonly used. With the help of such a paste, it is possible to retract the gums with little or no injury. Usually such pastes are used before taking an impression to make orthopedic construction. But in the treatment of caries, it is not recommended to use it, because working time its no more than 5 minutes. Such pastes do not require the use of local anesthesia. When the paste is in the gingival sulcus, it has constant pressure on her. The gum is retracted, and conditions are created for taking an excellent impression.

Stages of setting the retraction thread

On the video of gum retraction you can see all the stages of this procedure.

The method of gum retraction with a thread:

The doctor examines the periodontal sulcus with an instrument, measures the depth to which he then puts the thread.
After that, the doctor makes a local infiltration anesthesia.
The thread is being prepared. Sometimes the doctor wets the thread with hemostatic fluid just before setting. He cuts off a piece of thread desired length(the rest of the thread in the box also remains sterile), processes it in solution. The thread is ready to use.
The doctor inserts the thread to a shallow depth if the patient does not have pain, the setting is carried out further. If the patient complains of pain, anesthesia is added.
After the doctor is convinced that the thread is placed at the required depth, he proceeds to further treatment.
After carrying out all the necessary medical manipulations, the dentist picks up the tip of the thread with a sharp instrument, and then carefully pulls it out with tweezers.

Choice suitable remedy for gingival retraction depends entirely on the clinical case. Properly selected and installed retraction means greatly improves the quality of the doctor's work. The dentist will not have to re-fill or remake the impression, because everything will be done with high quality the first time.

Soft tissue management

Tissue retraction

mechanical retraction

Surgical retraction

Retraction paste

Combination of methods

conclusions

The success of a quality impression lies in the details and precision of the process. One of these is the soft tissue retraction procedure. To do this, clinicians can use different approaches and materials. Retraction methods can be classified into mechanical, chemomechanical, surgical, paste-based, or a combination of algorithms. Each of these methods has its own advantages and disadvantages, which must be considered in different clinical situations. Careful retraction provides Better conditions for fixing crowns and prostheses, and therefore for their more predictable functioning in the long term.

The transfer of the entire necessary information through an impression from the clinic to the laboratory. The doctor should check the impression carefully beforehand to minimize the risk. possible violations in future. In 2005, one study found that approximately 89% of all impressions received were less than perfect. The quality of the current depends on the choice suitable material, adequate implementation of the algorithm for obtaining and ensuring the necessary retraction of soft tissues.

Soft tissue management

Even those impressions that at first glance seem perfect, when carefully examined, may show certain flaws, such as bleeding defects in the area of bleeding and tissue overlap, which limit the penetration of the material. The use of digital scanning techniques is still not widespread enough and is characterized by its own nuances in work. Thanks to close communication with the technicians, the doctor can avoid many potential errors associated with the peculiarities of the preparation of the teeth or registration of their bite. In one study, 50.7% of impressions were found to have pores or stretch marks at the finish line of the preparation, 44% of the impression material did not sufficiently illuminate the margin, and 40.4% of the impressions showed air bubbles at the finish line. . An article in the Journal of the American Dental Association (JADA) showed a similar distribution of errors in impression taking, noting that the marginal area of the preparation had the highest error rate. These statistics justify the need for the clinician to analyze the quality of the impression before it reaches the laboratory - thus preventing a huge number of complications of further prosthetic rehabilitation.

Tissue retraction

Tissue retraction is one of the main factors affecting the quality of the impression. Retraction is essentially a displacement of the tissues of the free gingival margin down and out. Thus, it is possible to fully visualize the finishing line of the preparation. Under such conditions, the impression material can also freely flow into the desired area without fear of contact with blood or other oral fluids.

The gingival retraction material must meet three criteria:

it should be effective both for the retraction procedure itself and for achieving tissue hemostasis, since the preparation area often extends below the gingival margin;
the material should not cause any systemic effects, such as increased frequency heart rate;
most importantly, the use of retraction material should not result in irreversible soft tissue damage.

Many materials have been used for retraction over the years. However, often when the patient returns for the final fixation of the crown, the doctor can sometimes note damage to the gum tissue. Sometimes the gingiva is simply noticeably reduced in size, exposing the edges of the preparation, and thus compromising future esthetic results. Therefore, it is very important to understand how to effectively retract soft tissues without damaging them. Suitable for this 5 different ways: mechanical, chemical-mechanical, surgical, retraction paste and any combination of these methods.

mechanical retraction

To perform mechanical retraction, one of three approaches can be used: placement of a rubber dam; installation of copper tape, which is already a thing of the past; and installation of a cotton retraction thread.

The retraction cord may be monofilament, twisted, or braided. After can consist of one or even several filaments. The sizes can also be different: 000 (thinnest), 00, 0, 1, 2 and 3 (thickest). The thread can also be impregnated with various chemical agents, such as adrenaline (epinephrine). Smaller sizes of thread are used mainly in the double thread technique, during which the doctor first lays a thin one and then a thicker one on top of it. This procedure can take up to 5 minutes or more. The pressure during the installation of the retraction thread is slightly higher than the pressure that is applied during probing. However, this should be dosed, since it can provoke the destruction of the epithelial attachment.

The advantage of using a retraction cord is that it can accurately and quite clearly separate the soft tissue from the preparation area, thus providing access for the impression material. When using the two strand technique, the thinner strand (lower strand) can be left in place while the impression is being taken. To pack the suture, the clinician only needs the suture itself and a packer tool. The disadvantages of this retraction method are presented potential risk epithelial attachment injury, the occurrence of certain pain(for the relief of which it may be necessary to carry out local anesthesia). This procedure is also manual-sensitive and requires some experience on the part of the doctor. Photo 1-5 shows the stages of packing the floss into the gingival sulcus, and its further removal.

Photo 1. Installation of the retraction cord and tissue separation.

Photo 2. Prepared tooth.

Photo 3. Packing of the retraction cord.

Photo 4. Packing of the retraction cord.

Photo 5. Retraction of the gums after packing the floss.

Chemical-mechanical retraction

Chemical-mechanical retraction combines chemical action different materials with retraction cord pressure. Roughly speaking, the cord is pre-moistened with a certain substance. The most commonly used as such is zinc chloride. Previously used sulfuric acid and trichloroacetic acid. The most commonly used chemicals today remain hemostatic astringents such as aluminum chloride, aluminum sulfate, and ferrous sulfate, as well as the vasoconstrictor epinephrine. The cord can be immersed in one of these chemical solutions to moisturize and then packaged for a hemostatic effect. Caution should be exercised when using epinephrine as it exhibits systemic action in the form of tachycardia, rapid breathing, increased pressure and the development of anxiety. Adrenaline should be used judiciously and should not be used in patients with high blood pressure, cardiovascular disease, diabetes, or hyperthyroidism. Adrenaline is also contraindicated in patients taking beta-blockers.

Surgical retraction

Among the methods of surgical retraction, it is worth highlighting: gingival curettage, electrosurgery and laser retraction.

Curettage of the gums is carried out diamond bur to form an adequate gingival margin. Thus it is possible to remove a part epithelial tissue at the final stage of preparation. As a rule, from the vestibular side in the frontal area, the clinician enters with a burr slightly below the level of the gums in order to hide the edge of the crown. Since burs are relatively small instruments, removing the edge of soft tissues at the final phase of hard tissue reduction is as easy as shelling pears. In this way, a clear visualization of the intervention area can be achieved without any retraction thread.

Electrosurgical intervention, which, in fact, is the excision of soft tissues with an electrode, involves the use of a high-frequency generator or radio transmitter, in which a high-frequency electricity. This allows you to control the volume of soft tissue reduction by the working end of the electrode on which the high density current and the temperature rises rapidly. The electrode is extremely thin, almost needle-like. Thus, it is possible to recreate a clear visualization of the workspace. Benefits of using electrosurgery for correct execution lie in the fact that it is possible to avoid bleeding, and healing takes place under by primary tension. The disadvantage of electrosurgical retraction is the specific odor that can result from the “melting” of the tissue. This effect is not always correctly perceived by the patient. At inadequate application electrocoagulator can cause loss bone tissue. Therefore, with a thin bone profile, this method should not be used at all.

The third method of surgical retraction is to use a laser. Both diode and neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers provide hemostasis during soft tissue reduction. Their use often eliminates the need for an anesthetic, as the level of subjective discomfort is kept to a minimum. However, as with electrosurgery, an unpleasant odor can occur due to the “melting” of the soft tissues.

Retraction paste

The use of a retraction paste (e.g. DryZ, Parkell; Expasyl, Kerr Dental; Traxodent, Premier Dental) is unique method, which is characterized huge amount benefits. The structure of the paste usually consists of kaolin, clay and aluminum chloride, which provide hemostasis. The author believes that special outlet caps should be used to achieve optimal results. The advantage of using retraction paste is that it effectively provides hemostasis due to aluminum chloride, which absorbs fluid in the sulcus. In addition, tissue injury is avoided, and the paste is easily washed out. This method is also less labor intensive, simply opening the paste, inserting the cap into the furrow and squeezing out the material.

Retraction paste can also be used in clinical situations other than impressions, such as when restoring with composites or during the cementation of crowns. For example, when restoring a Class V defect, the gum is often subject to bleeding, and the use of a paste can save the clinician from undesirable complications in the work. The disadvantages of using the paste are related to the fact that it is necessary to ensure the dryness of the working field before installing it. That is, if the tissue is already bleeding, then before applying the paste, you must first ensure maximum hemostasis. In some cases, the tip of the dosing cap is too large for the narrow sulcus, making it difficult to “push” the pastes into the limited space of the gingival sulcus. This method is also somewhat more expensive than all the others. The author recommends using retractable caps (e.g. ROEKO Comprecap, Coltene; Premier Retraction Caps, Premier Dental; GingiCap, Centrix) to achieve optimal level retractions. The cap absorbs a noticeable amount of moisture, and biting allows the paste to be pressed into the space necessary for retraction, thereby providing hemostasis. Photos 6-9 show examples of the use of the retraction paste and cap.

Photo 6. View after completion of tooth preparation.

Photo 7. Packing of retraction paste.

Photo 8. Installing the retraction cap.

Photo 9. Clean dry edge prepared for impression taking.

After the preparation of the tooth (photo 6), there was some bleeding. After applying the retraction paste (photo 7), the bleeding decreased, but did not completely disappear. Therefore, the doctor asked the patient to bite on the retraction cap to completely stop the bleeding (Figure 8). The retention time of the retraction cap in the mouth depends on the dynamics of bleeding. Photo 9 shows the resulting print. In this clinical case the cap was held in the mouth for 2-3 minutes instead of 1-2 minutes due to progressive bleeding. Photos 10-12 show the final impressions after using only the retraction paste. Photo 10 shows that the clinician was able to get the paste quite deep, given the level of the exposed tissues.

Photo 10-12. View of the impression after using the retraction paste.

Combination of methods

Any of the above methods can be used in conjunction with another to achieve maximum hemostasis and tissue retraction. An example of a combined method is first packing the thread, then packing the paste, and the cap on top of everything. Alternatively, a diode laser could be used before the cord and retraction paste were placed in the sulcus. Regardless of the method or combination of methods, ultimate goal is to obtain an excellent impression, from which the technician will later make a suitable crown. Technology is recreating new conditions for the work of doctors. So, for example, a doctor can use a scanning procedure and refuse analog impressions. In this case, however, it is also necessary to ensure the absolute dryness of the working field in order to avoid changes in the design of the drawing on the computer.

A new word in retraction - simple, fast, painless, complete absence bleeding.

Gingival retraction is a set of measures aimed at temporarily expanding the periodontal sulcus in the vertical and horizontal direction by pushing and reducing the volume of gum tissue, as well as stopping or preventing bleeding, reducing the release of gingival fluid. When prosthetics and restoration, several methods of gum retraction are used: mechanical (retraction threads, rings, pastes); chemical (epinephrine, aluminum chloride, aluminum sulfate, etc.); surgical (surgical scalpel, electro-surgical devices, rotary instruments); combined (combination of the above methods). Most often, impregnated retraction threads are used. Threads are made of various materials, have different diameters and impregnation. The doctor can choose the necessary thread for each specific clinical situation. Despite the popularity of this method, there is Great chance periodontal tissue injury. In the process of laying the thread and later, inflammation of the gingival mucosa and damage to the circular ligament of the tooth are possible. This injury can occur even with the initial measurement of the sulcus and careful insertion, which can lead to gingival recession, periodontal pockets, etc. in the future. For patients with periodontal diseases, this type of retraction is contraindicated. The use of chemical components for vasoconstriction is also a risk for the category of patients with diseases of cardio-vascular system. This type retractions are also recommended under local anesthesia. And, of course, with prosthetics a large number teeth retraction of the gums with the help of a thread takes a lot of time. We present to your attention new preparations for retraction of the gingival margin:

"Exposyl" (Kerr)
GingiTrac (Centrix)
"Magic FoamCord" (Coltene/Whaledent)

expasyl– an innovative atraumatic method of gum retraction. Replaces traditional, often painful for the patient, procedures. Quick and easy to apply, does not cause discomfort and guarantees excellent access to the cervical margin. After removing the material, a clean operating field remains. Expasyl is ideal for taking impressions without trauma to the epithelium. The most efficient retraction system on the market. Characteristics:

Hemostatic action
No anesthesia required
Gingival retraction lasts from 30 seconds to 2 minutes
Open and dry sulcus provides excellent access to the cervical margin
Autoclavable Dispenser Gun (134˚C)

Paste "GingiTrac" created on the basis of silicone, contains a soft, natural astringent - a means of stopping bleeding and suppressing secretion. GingiTrac is packaged in non-standard cartridges, which requires the mandatory purchase of the entire set, which includes a special gun, GingiMatrix - silicone for creating a key, GingiCap - foam caps, mixers and cannulas. Working time - 5 minutes. Easily removed mechanically. The action of the paste is effective and does not require additional flush areas of retraction after removal of the paste.

Retraction is the name of a dental procedure. This is a gentle pulling of the edge of the gum tissue to expose the root zone of the teeth. So the dentist gets access to the tissues of the tooth, usually hidden by the mucosa. Retraction is carried out for cleaning tartar, prosthetics, and treatment of dental diseases.

Expert opinion

Biryukov Andrey Anatolievich

doctor implantologist orthopedic surgeon Graduated from the Crimean Medical Institute. institute in 1991. Specialization in therapeutic, surgical and orthopedic dentistry including implantology and prosthetics on implants.

Ask an expert

I think that you can still save a lot on visits to the dentist. Of course I'm talking about dental care. After all, if you carefully look after them, then the treatment really may not reach the point - it will not be required. Microcracks and small caries on the teeth can be removed with ordinary toothpaste. How? The so-called filling paste. For myself, I single out Denta Seal. Try it too.

Indications for use

Such situations will become indications for gum retraction:

it is necessary to stop the bleeding when filling the tooth, the ingress of saliva / blood violates the characteristics of the filling, which will affect its properties;
you need to protect the gum during treatment. Therapy cervical caries, cleaning the gaps between the teeth increase the risk of soft tissue injury. To minimize the risks, gum retraction is performed;
while cleaning the enamel from tartar, it is necessary to process those areas that are hidden under the edge of the gum;
when whitening enamel, so that the product used does not get on the gum;
during the fitting of dental crowns, veneers, during the taking of casts, orthopedic treatment.

Methods of carrying out

Dentists use one of existing species retractions - mechanical, chemical, surgical. If necessary, the methods are combined.

Mechanical retraction is performed using caps, threads, rings. The procedure is carried out quickly, under local anesthesia. Use special threads with impregnation. To control the depth of the groove between the tooth and the gum, the doctor uses special devices.

The mechanical method is not suitable when prosthetics of two or more teeth are performed. There is a risk of trauma to the gums, getting fragments of the retraction thread into the restored tooth. During the procedure, special threads of 2 types are used:

twisted. They are characterized by low strength, break up into fibers;
wicker. Durable, do not leave marks on casts;
knitted. Protect gums during tooth preparation.

The threads are impregnated with drugs that have analgesic, vasoconstrictive, and hemostatic properties.

The paste is applied with a syringe or gun

Chemical retraction is the use of solutions, gels that reduce the periodontium. Some remedies include adrenaline and are used in the treatment of heart problems. Means used in chemical retraction:

epinephrine. It has a vasoconstrictor, their volume decreases;
aluminum sulfate. Has an astringent, water-repellent effect;
ferrous sulfate constricts blood vessels, stops bleeding. It is not used in the treatment of anterior teeth, it gives the enamel a dark shade;
zinc chloride gives an astringent effect;
aluminum chloride is used when the gums are inflamed or damaged.

The procedure is carried out as follows:

paste, gel are applied with a gun / syringe, pressed down with a plastic crown;
after a while, the paste is removed, the remnants are washed off.

The procedure is performed under local anesthesia with a scalpel.

If the transferred funds are not removed in time, it threatens chemical burn. Chemical substances– allergens, which should be taken into account when treating people with a tendency to allergies. Another disadvantage of the method is considered a small period of time that is given to the doctor for manipulation.

Surgical retraction is indicated if the gum tissue has grown so large that other techniques are not possible. The dentist performs local anesthesia, works with a scalpel or a laser beam.

Dentists resort to combined methods. Perform immediately mechanical and chemical retraction. After the procedure, the doctor gives advice to the patient on how to avoid complications. After dental intervention, you need to refrain from eating for a couple of hours, after retraction - it is better not to eat for 6 hours, refuse hot drinks.

Do you get nervous before visiting the dentist?

YesNot

The first days after the procedure, it is not recommended to visit the pool, sauna. This minimizes the risk of tissue infection. The teeth begin to be brushed with a soft-bristled brush so as not to damage the mucous membrane. On the recommendation of a doctor, healing / anesthetic dental gels and ointments are used.

Prevention measures

After retraction, complications are possible, which is associated with the lack of professionalism of the doctor, low immunity patient, non-compliance with recommendations for care oral cavity. Among possible complications note:

appearance of periodontal pockets. If a patient has periodontitis, periodontal disease, then retraction is contraindicated for him;
exposure of the roots of the teeth. A complication occurs if the thread is placed too deep. Therefore, before the procedure, the doctor studies how the periodontal sulcus is arranged in a particular patient, and only after that performs manipulations.

The rate of healing / restoration of the gums depends on several significant factors:

Professional qualities of a dentist. overlay healing gel, packing threads, competent resection of the gums - these actions require caution from the doctor, a certain degree of skill.
The level of the patient's immunity. If a defensive forces the body is weakened, it is difficult for him to cope with inflammatory processes. Before retraction, it is recommended to conduct a course of vitamin therapy lasting 6 days.
Correctness, regularity of oral care.

Proper care of the gums after retraction involves refraining from hot drinks, food for 6-8 hours after the manipulation. After eating, the mouth is rinsed with decoctions of herbs or a solution of furacilin.

Use a soft-bristled toothbrush to clean your teeth toothpaste from those recommended by the doctor. Special gels (Dental, Solcoseryl) will help reduce pain. Antibiotics are rarely prescribed - only if the doctor sees that inflammation may be activated. If all medical prescriptions are followed, the risk of complications is minimized.

Gingival retraction is a dental manipulation, the essence of which is the short-term exposure of the neck and root of the tooth.

Thus, there is a decrease in the level of the gums. The purpose of this manipulation is to carefully detach the impressions before. Retraction is also used for carious cavity mouth and front (in some cases).

Why is gum detachment performed?

Retraction is carried out in such cases:

Protection of teeth during. Since when the whitening gel comes into contact with the tissues of the gums, a burn may occur.
Protecting gums from damage during treatment. The probability of damage to the gingival margin arises during the treatment of the area of the interdental lumen.
Orthopedic treatment with a fit or .
Stop bleeding during.
Holding hygiene measures in the cervical area. For example, it could be . When applying retraction, access to all dental layers is opened.

Methods used

To date, gum retraction is carried out using four methods:

AT recent times new methods of retraction began to appear, using diode lasers. This method is painless and absolutely safe. On the whole, this procedure best done with painkillers.

For successful gingival retraction, the dentist must accurately determine the width and depth of the gingival recess and select appropriately sized retraction cords. Up to four threads at a time are allowed, otherwise chemical burns may occur.

Necessary equipment and materials

When carrying out retraction, special threads are most often used. According to their structure, they can be cotton or linen (in most cases, dentists use cotton threads).

According to the manufacturing method, the threads can be:

braided- have sufficient hardness and do not have defibration;
twisted- when packing into the gingival sulcus, rapid defibration occurs;
knitted- have the appearance of histogenic nodular tubes with a high absorption capacity.

Threads can be produced both with impregnation (vasoconstrictor, hemostatic) and without it. Threads without impregnation (impregnation) are used in the presence of periodontal diseases. The following chemicals are used as impregnation:

adrenaline hydrochloride. it vasoconstrictor, due to which qualitative homeostasis is carried out and the size of tissues decreases. Exactly this powerful tool used to exfoliate the gums. This homeostatic is prohibited for use in patients with arterial hypertension.
ferrous sulfate. Produced in the form of gels and essences. Experts advise not to use this remedy in combination with epinephrine hydrochloride. It also cannot be used for aesthetic restoration of anterior teeth.
aluminum chloride. Has a hemostatic effect. The tool is produced in the form of gels, solutions and pastes.
aluminum sulfate. Sold in the form of essences and used to impregnate threads.

In most cases, Retrac, MagicFoam Cord and Expasyl pastes are used to separate the gums from the teeth.

They are injected into the gingival sulcus from a syringe, and after hardening, chemical and mechanical retraction occurs.

Disposable single doses are used for the preparation impression.

What retraction threads are used in dentistry:

Consequences and complications

The very first complication that can occur after retraction is inflammatory process in the work area. If the dentogingival margin is very thin, then it is best not to retract the gums. mechanical method. It is also possible to form defective pockets. When retracting the gums, it is carried out in special occasions because it can only exacerbate the situation.

Retraction can lead to consequences such as exposure of the roots of the teeth. This problem occurs due to excessively deep packing of the retraction threads.

To prevent various complications, before the procedure it is necessary to set the depth of the gingival recess. When using gels and pastes, you must first conduct an allergy test and check the gums for inflammatory processes.

To prevent any of the above consequences from occurring after the intervention, hot drinks and food should not be consumed for the first six to eight hours after the manipulation. The toothbrush should have soft bristles.

You can also use medicinal pastes With healing properties. To reduce pain and eliminate swelling, you can use special gels (Dental, etc.).