DENTAL CYSTS
WHAT IS A DENTAL CYST?
A dental cyst is a sac-like structure that can form in the soft tissues in the mouth or in the jaw bones. There are many different types of cysts. Whilst most cysts are benign, almost all cysts will require treatment to prevent them from increasing in size and causing further symptoms.
WHAT DOES A CYST FEEL/LOOK LIKE?
Your dentist may notice a lump or swelling looks different to the normal appearance of the tissues of the mouth. Many of these lumps or swellings cannot be diagnosed by examination only. Many of these lumps and swellings also look similar.
Alternatively, you may notice a swelling inside the mouth, facial swelling, pain and/or an altered sensation to the affected area. You may also notice that teeth in the affected area become loose.
WHAT INVESTIGATIONS WILL I NEED BEFORE MY TREATMENT?
You will need an x-ray before your surgery.
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A 2D x-ray will show the position, size and shape of the cyst.
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A 3D scan will also be required. The 3D scan will provide greater detail of the shape of the cyst and its relationship with teeth and nerves that are close to the area.
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Depending on the position of the cyst, you may also be referred for an ultrasound scan in order to provide further information about the structure of the cyst.
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Your x-rays/scans will be reported on by a radiologist in order to provide the best indication as to what the cyst is.
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This will ensure that your treatment is planned appropriately according to the type of cyst.
HOW WILL MY CYST BE REMOVED?
Before I remove your cyst, I will apply numbing injections in the gums around the affected area. I will then leave this for 5 minutes for the anaesthetic to work.
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I will check that the anaesthetic has worked by pressing around the affected area using a dental probe. At this point, you will feel pressure but you should not feel pain. If you feel pain, I will leave more time for the anaesthetic to work or apply more anaesthetic depending on what you can feel.
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Your surgery will only start when you are happy that you are numb. The gums will be opened with a small incision. The cyst will then be identified and pushed out.
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Once your cyst has been removed, the surgical site will be cleaned out and flushed with sterile water. The opening in the gums will be closed with stitches. The stitches will dissolve 10 - 14 days after your surgery.
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WILL I BE AWAKE DURING MY SURGERY?
Cyst removals are performed under local anaesthetic or intravenous conscious sedation.
Treatment under local anaesthesia only numbs the gums around the tooth. You will be awake throughout your treatment, but you should not feel any pain or discomfort.
Intravenous conscious sedation is administered through a vein in your arm or hand. However, this is not the same as a general anaesthetic which will put you completely to 'sleep'. Instead, intravenous conscious sedation will reduce your awareness of the procedure. The treating team will still be able to speak with you and identify if you are feeling discomfort.
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During your consultation I will discuss the advantages and disadvantages of treatment under both local anaesthetic and intravenous sedation at greater length.
WHAT WILL MY RECOVERY TIME BE AFTER MY CYST REMOVAL?
You may experience pain, swelling and bruising after your cyst removal.
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Pain usually worsens over the first 3 days after surgery. This may take up to a further 10 days to stop, with daily gradual improvements. Provided that you have no allergies, intolerances or reasons why you cannot take them, the following painkillers are advised:
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Paracetamol 1g every 6 hours for 7 days
Ibuprofen 400mg every 8 hours for 7 days
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I will confirm with you which are best in your case.
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Swelling usually worsens over the first 3 days after swelling. This may take up to a further 10 days to disappear, with daily gradual improvements. You may use an ice-pack applied to the outside of the face for 15 minutes in the morning and in the evening to help to reduce the swelling.
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Bruising after a cyst removal is common. This will usually resolve with any swelling that you may experience.
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You will also require antibiotics after your surgery, which I will prescribe depending on which is most appropriate.
WHAT CAN I EAT AFTER MY CYST REMOVAL?
Immediately after your surgery while you are still numb, avoid hot food and drink to prevent burning yourself without realising.
Once the local anaesthetic has worn off, you will find a soft diet for the first 3 days after surgery more comfortable. If you feel that you can return to a normal diet you may do so.
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Avoid small grains and pieces that may get caught in the extraction socket for 5 days after your surgery.
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Avoid alcohol for the first 48 hours after your surgery.
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Avoid smoking for at least 72 hours after your surgery - the longer you are able to stop smoking the lower the chances of infection.
CAN I BRUSH MY TEETH AFTER MY CYST REMOVAL?
You should return to toothbrushing as soon as possible after your cyst removal. Ideally you should start on the same evening as your cyst removal.
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You should not mouthwash with saltwater or mouth wash for the first 48 hours after your surgery. After this, when using rinsing your mouth, ensure that it is a gentle rinse only for the following 5 days.
DO I NEED A REVIEW AFTER MY CYST REMOVAL?
Once your cyst has been removed, the sample will be sent to a laboratory for examination under a microscope.
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On average, the biopsy results take approximately 4 weeks to return.
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Once the biopsy results have been received, a review in practice or a telephone review will be arranged to discuss the findings of the results and arrange further treatment if necessary.
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You will then likely need further review for follow-up x-rays to confirm the area is healing. I will advise this depending on the type of cyst that has been treated.
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ARE THERE ANY OTHER TREATMENT OPTIONS?
Cyst surgery can be complex and in some instances treatment under general anaesthetic may be more appropriate. If so, you may require a referral to hospital for this surgery.
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I will discuss this with you in greater detail during your consultation.
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