Postoperative Extraction Instructions

Day of Surgery

FIRST HOUR

After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. That’s why we ask you to bite firmly on a gauze pad for 30- 45 minutes after the appointment. If the bleeding or oozing still persists, place another gauze pad and bite firmly for another 30 minutes. You may have to do this several times.

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EXERCISE CARE

Do not disturb the surgical area today. Do not rinse vigorously or probe the area with any objects or your fingers. You may brush your teeth gently. Do not smoke for at least 5-6 days, since it is very detrimental to healing. Do not go to bed with gauze in your mouth. Before you go to bed, remove all gauze from your mouth to avoid swallowing.

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Steady Bleeding

Bleeding should never be severe. If it is, it usually means that the packs are between your teeth rather than exerting pressure on the surgical areas. Try positioning fresh packs over the surgical areas. If bleeding persists or becomes heavy you may substitute a tea bag (soaked in warm water, squeezed damp-dry and wrapped in moist gauze) for 20-30 minutes. If bleeding still remains uncontrolled, please call our office.

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Oozing

Intermittent bleeding or oozing is normal for the first 24 hours. Packs should be removed prior to eating or drinking anything. If bleeding continues, repack the surgical area by placing fresh gauze over the surgical site and biting down firmly for 30-60 minutes. Once bleeding has stopped, gauze packs will not be needed.

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Swelling

Often there is some swelling associated with the surgery. You can reduce this by holding a cold pack or ice bag wrapped in a towel firmly to the face or cheek over the surgical site. This should be applied 20 minutes on and 20 minutes off during the first 36 hours. After 36 hours, it is best to switch from ice to moist heat, placing it to the same areas. The greatest swelling occurs 2-3 days after surgery. After that time it should gradually decrease. Keep head elevated on at least 2 pillows at all times for the first 3 days after surgery.

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Pain

Unfortunately, some oral surgery procedures cause discomfort. The doctor may prescribe pain medication. Always have food in stomach before taking any pain medication. Pain medication must be taken within 2 hours after discharge. This will manage the discomfort better. The effects of pain medicines vary widely among individuals. If you do not achieve adequate relief, you may add Ibuprofen (Motrin). Some people may even require more pain pills during early stages (but that may add to the risk of upset stomach). Remember that the most severe discomfort usually occurs within the first six hours after the numbness wears off. Afterward your need for pain medication should lessen.

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Nausea

Nausea after surgery may be the result of swallowed blood, pain medications and /or the after effects of the anesthesia. Reduce nausea by always having food in stomach before taking each pill, followed by drinking a large volume of clear fluids. Try to keep drinking clear fluids and minimize the pain medication if vomiting persists. Ibuprofen or Tylenol can be taken to help with pain control if nausea is present.

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Diet

Do not use straws or drink carbonated beverages for 4-5 days. Avoid hot and/or spicy foods. The first days’ diet should consist of cold, soft foods (pudding, yogurt, milk shakes, etc.) Avoid foods like nuts, sunflower seeds, popcorn, etc. for 4-5 days so that they will not get lodged into the surgical sites. You may proceed to a soft diet the second day. Proceed with diet as you feel comfortable. If you are diabetic, maintain your normal eating habits as much as possible and follow instructions for your insulin given by your physician or by our doctor. Muscle spasms and restricted opening may occur. Use warm moist heat, stretching, and massage.

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Instructions for the Second and Third Days

Brushing

Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing of all areas, but please make every effort to clean your teeth within the bounds of comfort.

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Mouth Rinses

Keeping your mouth clean after surgery is essential. Use one-quarter teaspoon of salt dissolved in a 8-ounce glass of water and gently rinse with portions of the solution. Repeat as often as you like, but at least two or three times a day for the next five days. If food gets trapped in the surgical sites, please rinse gently. Using water pik or disturbing surgical sites increases chances of dry sockets.

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Sharp Edges

Sharp edges felt with your tongue are probably the bony walls of your jaw, which originally support the teeth. Occasionally small slivers of bone may come out during the first week or two after surgery. They are not pieces of tooth and, if necessary, we will remove them. Please call the office if you are concerned.

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Sinus Exposure

Upper premolar and molar roots can be near or protruding into the maxillary sinus. If exposure of the sinus membrane occurs after extraction of a tooth, then you must not blow your nose for two (2) weeks after the extraction.

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Overall Recovery

Normal healing after tooth extraction should be as follows: The fist day of surgery is usually the most uncomfortable and there is some degree of swelling and stiffness. The second day you will usually be more comfortable and although maximum swelling occurs on this day, you can usually begin a more substantial diet. The third day, swelling and discomfit will max. If a dry socket occurs (loss of blood clot from the socket, usually in the 3rd to 5th day), there is usually noticeable, distinct, persistent throbbing pain in the jaw, often radiating toward the ear and possibly causing other teeth to ache, you will have a foul taste in your mouth and bad breath. If this occurs please contact our office so we can help you.

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