Surgical Instructions

After Tooth Extraction

 

Care of the mouth after surgery has an important effect on healing.  Unnecessary pain and the complications of swelling, such as jaw restriction, or infection can be minimized if the instructions are followed carefully.

BLEEDING:
The gauze packs placed after surgery should be removed after 30 minutes. Some bleeding is expected. For continued bleeding, replace with moistened gauze or moistened tea bag over the area every 30 minutes until the gauze comes out pinkish in color. Bite down firmly with constant pressure. 
PAIN & INFECTION CONTROL: 
It is important that you do not take pain medicine on an empty stomach. This could result in nausea. Mild discomfort can be expected for up to 14 days. However, if pain intensifies after several days, call our office.

a.     PAIN: 

                                                              i.       For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every six hours or Ibuprofen (Motrin or Advil) two to four 200mg tablets may be taken every six hours.

                                                             ii.      For severe pain, take the prescribed medication as directed. While you are taking this medication, do not drive or operate machinery and avoid alcoholic beverages.

b.     ANTIBIOTICS:  If you have been given antibiotics, take the medication as directed. They are given to help prevent infection.

If you have any reaction to these medications, such as hives, rash, nausea or vomiting, STOP taking them and call our office.

DIET:
A cool, soft diet with increased fluid intake is recommended for 48 hours after your procedure. Examples of acceptable foods are milkshakes/smoothies, ice cream, yogurt, pudding/jello, soup, mashed potatoes, soft casseroles, and pastas. AVOID HOT FOODS, CARBONATED BEVERAGES and DO NOT USE STRAWS.  After several days you may resume your normal diet.  However, crunchy, nutty and foods with seeds should not be eaten for one week after surgery.
SWELLING: 
Apply ice packs to the outside of your jaws immediately upon your return home. Packs should be used in a 20 minutes ON and five (5) minutes OFF cycle while you are awake for the first 48 hours.   When resting, keep your head elevated. Swelling or jaw stiffness may continue and are no cause for alarm.  You may also notice skin discoloration or bruising.  These are normal reactions and should resolve in 7-14 days.  If they do not, call our office.
ORAL HYGEINE:
Do not rinse your mouth or brush your teeth for 24 hours. After 24 hours you may brush gently but avoid the surgical site(s). The day after surgery you may begin using warm salt water rinses after eating and at bedtime. Dissolve ½ teaspoon salt in a cup of warm water and gently rinse. This will help to keep the areas clean and promote healing.
NAUSEA:
Try sipping one ounce of NON-carbonated soda every hour for 5-6 hours.  This can be followed by mild tea or clear soups/broth. If you feel the nausea may be related to the prescription medication, stop taking them and call our office. 
FATIGUE:     
Avoid overfatigue. Go to bed early and get adequate rest. Maintain a low level of activity for several days.
IMMEDIATE DENTURE PLACEMENT:
If an immediate denture has been placed, do not remove them for 24 hours. You may then remove them, gently rinse your mouth, wash your dentures and reinsert them. After the first 24 hours, do not wear them at bedtime. You will see your general dentist approximately 48 hours after the extractions for your first denture adjustment.
RETAINERS & PARTIALS:
Can be reinserted 2-4 days after your surgery depending on your comfort level.
SMOKING: 
NO SMOKING for one week after surgery.
I.V. SEDATION:
If you have had this sedation, you must have responsible adult supervision for 24 hours.  Absolutely no driving or operating any kind of machinery is recommended for 24 hours. Bed rest with head elevation is recommended.

The following conditions may occur, all of which are considered normal.

·         The surgical areas will usually swell and may become quite large.

·         Stiffness of the muscles (trismus) may cause temporary difficulty in opening the mouth.

·         You may have a slight earache or a sore throat may develop.

·         Numbness at the corners of the mouth on the side from which the tooth was removed may occur. This is called “paresthesia” and is usually temporary. It may last from a few days to a few weeks.

·         Your other teeth may ache after your procedure. This is called sympathetic pain and is a temporary condition.

·         If the corners of the mouth are stretched, they may crack. Keep your lips moist with cream or ointment.

·         There will usually be a socket (hole) where the tooth was removed. These areas will gradually fill in with new tissue. It is important that you keep these areas clean.  DO NOT use your fingers, tongue or anything else to poke into those areas.

·         A dry socket is when the blood clot is dislodged prematurely from the socket. Symptoms of pain at the surgical site and even pain radiating to the ear may occur three to four days after surgery. Call the office if this occurs.

·         If sutures were used, they will dissolve or fall out in 3-5 days.

·         Occasionally, patients may feel hard or sharp projections in the mouth with their tongue. These are the bony walls that supported the tooth. Sometimes they will be felt months after the extraction and will usually smooth out spontaneously. If they do not, call our office.

·         There may be a slight elevation of temperature for 24-48 hours. If the temperature continues, call our office.

Everyone's case is unique because no two mouths are the same. Even well meaning advice from family and friends can be misleading. If you have any questions or concerns, please call our office and we will be happy to help you.