After Tooth Removal
Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.
Immediately Following Surgery
o The gauze pad placed over the surgical area should be kept in place for a half hour. Refer to the section on bleeding for more information.
o Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
o Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.
o Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
o Place ice packs to the sides of your face where surgery was performed. Refer to the section on Swelling for an explanation.
CAUTION: If you suddenly sit up or stand from a lying position, you may become dizzy. Make sure you sit up for one minute before standing.
Your case is individual. No two mouths are alike. Do not accept well-intended advice from friends. Discuss your problem with the persons best able to effectively help you: Dr. Henry or your family dentist.
Other information
o If numbness of the lip, chin, or tongue occurs post-operatively there is no cause for alarm. This is usually temporary in nature. If this does occur, call our office.
o A slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Ibuprofen should be taken to reduce the fever.
o You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery and taking pain medications can make you dizzy. You could get light headed when you suddenly stand up. Before standing up, you should sit for one minute and then get up.
o Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls, which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. Henry.
o If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline.
o Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in two to three days.
o Stiffness of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event that will resolve in time.
Bleeding
A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon.
Bleeding may be controlled by placing a gauze pad over the area and biting firmly for 30 minutes. Repeat if necessary for the next 2 to 3 hours. Leave the gauze out at this point if bleeding has reduced to a small amount. A small amount of oozing is normal during the first 24 to 48 hours.
If bleeding continues, bite on a moistened tea bag for 30 minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. Repeat as necessary. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.
Swelling
The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair.
Swelling may not become apparent until the day following surgery and will not reach its maximum until two to three days post-operatively. However, the swelling will be minimized by the use of ice packs for the first 48 hours. The ice packs provided by our office (or bags of frozen peas) should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake (an ace bandage is helpful to keep the ice packs in place). After 48 hours, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.
The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur, call our office.
Discoloration
In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal postoperative
occurrence, which may occur two to three days post-operatively. Moist heat applied to the area may speed the removal of the discoloration.
Pain
Take any pain medication prescribed by our surgeon as directed.
o Begin taking pain medication as the local anesthetic is wearing off, usually three (3) to eight (8) hours after surgery. Prescribed pain medicine may make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages.
o For break-through pain (pain that persists after taking prescription pain medication) you can alternate with ibuprofen (i.e. Motrin, Advil). Do not exceed 600mg of ibuprofen in six (6) hours. Do not take acetaminophen (aspirin, Tylenol).
o Nausea with pain medication may occur but can be reduced by eating food 30 minutes before taking your pain medication. If you do become nauseated, you can also take one-half of your prescribed dose more frequently. If you continue to experience nausea or vomiting, please contact the office.
o Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.
Antibiotics
Antibiotics will be given to help prevent infection. If you have been placed on antibiotics, take the tablets or liquid as directed. It is important to completely finish all of the medication; however, discontinue antibiotic use in the event of a rash or other unfavorable reaction and call our office.
You may find that eating yogurt with live and active cultures will decrease your chances of stomach upset and/or yeast infection while taking antibiotics.
If you are taking birth control pills, please note that antibiotics may make your birth control pills less effective.
Nausea & Vomiting
In the event of nausea and/or vomiting following surgery or medications, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip slowly on Coke, tea, or ginger ale over a 15-minute period. When the nausea subsides, eat something 30 minutes before taking your pain medication or antibiotics. Call the office if you have any questions.
Diet
Do not use straws when drinking from a glass. The sucking motion can dislodge the blood clot and increase your risk for dry socket. Drink lots of liquids after IV sedation to prevent dehydration. At least five to six glasses of liquid should be taken daily.
Avoid hot foods until all bleeding stops. Cold foods often can soothe an uncomfortable area. Milk shakes, yogurt, pudding, Jell-O, and applesauce usually work well. You may advance to normal food as you feel able, but avoid crunchy foods like popcorn and potato chips until gum tissue has healed.
Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. You may eat anything soft by chewing away from the surgical site(s). High calorie, high protein intake is very important. Try not to miss a single meal. You will feel better, have more strength, less discomfort, and
heal faster if you continue to eat.
Sutures
Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures will dissolve on their own.
Oral Hygiene
Good oral hygiene is essential to good healing. You can brush your teeth the night of surgery but rinse gently. No rinsing of any kind should be performed until the day following surgery. The day after surgery, the Peridex should be used twice daily, after breakfast and before bed. Be sure to rinse for at least thirty seconds then spit it out.
Our office may have provided you with an irrigating syringe to flush food and debris out of deep extraction sites. You may begin using the syringe on the fourth day following oral surgery. Fill syringe with lukewarm water and gently flush the extraction sites.
There will be a cavity where the tooth was removed. The cavity will gradually fill in with new tissue over the next month. In the meantime, the area should be kept clean especially after meals.
Dry Socket
A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur 2-3 days following surgery. Call the office if this occurs.
To avoid developing dry socket, follow these guidelines:
o Do not smoke.
o Do not use a straw.
o Do not forcefully spit.
o Do not use the irrigating syringe until the 4th day after surgery. Until you are able to use the syringe, do not eat anything with very small pieces that could become lodged in the extraction site (e.g. small noodles, lentils, etc).
Activity
Reduce physical activity for 2-3 days. Avoid lifting, bending, running, etc to help minimize swelling. Rest and sleep with your head elevated. After 2-3 days, you may resume normal activity as you feel able.
If you are involved in regular exercise, be aware that your normal nourishment intake may be reduced. Exercise may weaken you. If you get light headed, stop exercising.
Dentures & Prostheses
Leave in for the first 24 hours. It is okay to remove the dentures to clean and give your mouth a short rest. Do not remove dentures for an extended period as swelling may prevent you from replacing the denture.
You should see your denture provider during the first week after surgery to check for sore spots. This is a normal part of adjusting to dentures. If you continue to experience problems with denture retention 2-3 months after your surgery, you may want to consider dental implants to help retain your denture. Please call our office if you would like to discuss this option with your surgeon.
Rinse denture with warm salt water or chlorhexidine (Peridex) rinse two times per day, then reinsert. Consult your denture provider for follow up regarding the fit and condition of your denture.
