After Tooth Extraction

Sometimes the after-effects of oral surgery are quite minimal, so not all of the instructions may apply.  Common sense will often dictate what you should do.  However, when in doubt follow these guidelines or call our office for clarification.  Our number is: # 632-5557.  To download and print a copy of these instructions click the following:  Extractions Home Care Instructions

DAY OF SURGERY

FIRST HOUR: Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place.  Do not change them for the first hour unless the bleeding is not controlled.  The packs may be gently removed after one hour.  If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30 minutes.  The gauze may then be changed as necessary (typically every 30 to 45 minutes).  It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning.

EXERCISE CARE:  Do not disturb the surgical area today.  Do NOT rinse vigorously or probe the area with any objects.  You may brush your teeth gently.  PLEASE DO NOT SMOKE for at least 48 hours, since this is very detrimental to healing and may cause a dry socket.

OOZING:  Intermittent bleeding or oozing overnight is normal.  Bleeding may be controlled by placing fresh gauze over the areas and biting on the gauze for 30-45 minutes at a time.

PERSISTENT BLEEDING:  Bleeding should never be severe.  If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs and then holding pressure for 30 minutes.  If bleeding persists or becomes heavy you should try the gauze one more time and then try a moistened tea bag wrapped in moist gauze for 20-30 minutes.  If bleeding remains uncontrolled, please call our office.

SWELLING:  Swelling is often associated with oral surgery.  It can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area.  This should be applied for twenty minutes on and twenty minutes off during the first 24 hours after surgery.  It is not necessary to use ice while you are sleeping.  Your swelling may be increased on the second and third days after surgery.  If you have been prescribed medicine for the control of swelling, be sure to take it as directed. 

PAIN:  Unfortunately most oral surgery is accompanied by some degree of discomfort.  You will usually have a prescription for pain medication.  If you take the first pill before the anesthetic has worn off, you should be able to manage any discomfort better.  Some patients find that stronger pain medicine causes nausea, but if you precede each pain pill with a small amount of food, chances for nausea will be reduced.  The effects of pain medications vary widely among individuals.  You must allow time for your medicine to work.  You must also take the medication on a regular schedule. Remember that the most severe pain is usually within six hours after the local anesthetic wears off; after that your need for medicine should lessen.  If you have been given a prescription for Motrin (ibuprofen) you may take it with Tylenol (acetaminophen).  Both drugs are taken every six hours and can be taken as follows:  if you take Motrin at 12PM, you can take Tylenol at 3PM, Motrin at 6PM, and Tylenol at 9PM.  .  If you find you are taking large amounts of pain medicine at frequent intervals, please call our office.  If you anticipate needing more prescription medication for the weekend, you must call for a refill during weekday business hours.

NAUSEA:  Nausea is not uncommon after surgery.  Sometimes pain medications are the cause.  Nausea can be reduced by preceding each pain pill with a small amount of soft food, and taking the pill with a large volume of water.  Try to keep taking clear fluids and minimize dosing of pain medications, but call us if you do not feel better.

DIET:  Eat any nourishing food that can be taken with comfort.  Avoid extremely hot foods.  Do not use a straw for the first few days after surgery.  It is sometimes advisable, but not absolutely required, to confine the first day’s intake to liquids or soft foods (soups, puddings, yogurt, milk shakes, scrambled eggs, fish etc.)  It is best to avoid foods like nuts, sunflower seeds, popcorn, etc., which may get lodged in the socket areas.  Over the next several days you may gradually progress to solid foods.  It is important not to skip meals!  If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster.  If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.

SHARP EDGES:  If you feel something hard or sharp edges in the surgical areas, it is likely you are feeling the bony walls which once supported the extracted teeth.  Occasionally small slivers of bone may work themselves out during the following week or so after surgery.  If they cause concern or discomfort, please call the office.

SUTURES:   You may have sutures placed in between your teeth.  Sutures placed during surgery will resorb and drop out on their own after approximately 5-14 days.  If they become bothersome, removal can be done at your follow-up visit.           

INSTRUCTIONS FOR THE SECOND AND THIRD DAYS

MOUTH RINSES:  Keeping your mouth clean after surgery is essential.  Please use warm, salt water three times per day, rinsing for 30 seconds each time.  You may also use an over the counter mouth wash, such as Listerine as soon as is it comfortable to do so.  By the third post operative day dip a cotton swab into the solution before rinsing and gently dab the surgical area.

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

HEALING:  Normal healing after tooth extraction should be as follows: The first two days after surgery are generally the most uncomfortable and there is usually some swelling.  On the third day you should be more comfortable and although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be gradual, steady improvement.  If you don’t see continued improvement, please call our office.  If you are given a plastic irrigating syringe, DO NOT use it for the first five days.  Then use it daily according to the instructions until you are certain that the tooth socket has closed completely and that there is no chance of any food particles lodging in the socket.

SYMPTOMS OF INFECTION:  Bright red, hard swelling near surgical site that is increasing rather than decreasing 3-4 days after surgery.  Elevated temperature of 101 degrees or more.  Increasing pain not relieved by medication.  Pus or drainage from the surgical site that may be accompanied by a foul taste or odor.  Should any or all of these symptoms occur, please notify our office immediately.

It is our desire that your recovery be as smooth and pleasant as possible.  Following these instructions will assist you, but if you have questions about your progress during normal office hours, please call our office at 632-5557.  Outside of business hours, the doctor can be reached by calling our office and following the prompts for emergency care.  Calling during office hours will afford a faster response to your question or concern. PLEASE NOTE:  telephone calls for prescription renewals are ONLY accepted during office hours.