Post-op Instructions: Extractions
What you should do following extractions and other oral surgery procedures.
A certain amount of bleeding, pain, and swelling is normal. Reduce your activity as much as possible for several hours. Avoid spitting, rinsing, and drinking through a straw for 24 hours. Do not rinse your mouth, or brush your teeth for 24 hours. These activities may hinder formation of a blood clot, which is necessary for proper healing.
Do not be alarmed if your vision is blurred for a time following anesthesia, or if a bruise should appear at the site of an injection. The arm also may be bruised, swollen, and tender to touch due to the IV.
Please follow the simple post-op instructions below to minimize complications and to help ensure prompt recovery.
To control bleeding:
Our doctors and staff will make sure that all active bleeding is controlled before you are discharged. If bleeding should develop soon after you leave our office, keep a steady pressure on the bleeding area by biting firmly on a gauze roll placed directly over the bleeding site for at least 30 minutes. Pressure helps reduce bleeding and permits formation of a clot in the tooth socket.
A certain amount of bleeding is to be expected following surgery:
Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area, and biting firmly for thirty minutes. Repeat if necessary.
If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.
To relieve pain:
For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every three to four hours, or Ibuprofen (Motrin or Advil). 200 mg tablets may be taken every 3-4 hours. Be sure to take pain medication on a full stomach to avoid an upset stomach.
For severe pain, take the tablets prescribed for pain as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile, or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention, and you should call our office.
To minimize 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. The swelling will not become apparent until the day following surgery, and will not reach its maximum until 2-3 days post-operatively.
However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be applied for 20 minutes with 20 minutes off while you are awake. After 48 hours of ice, moist heat should be applied to the area until all swelling is gone.
If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.
Oral hygiene is important:
Twenty-four hours after surgery, rinse mouth gently with a solution of one-half teaspoonful of salt dissolved in a glass of water. Repeat after every meal or snack for seven days. Rinsing is important because it removes food particles and debris from the socket area, and thus, helps prevent infection and promote healing. Also 24 hours after your surgery you can resume your regular tooth brushing, but avoid disturbing the surgical site so as not to loosen or remove the blood clot. Keep your mouth very clean.
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 post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.
If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions. Women please note: Some antibiotics may interfere with the effectiveness of your birth control pills. Please check with your pharmacist.
Nausea and vomiting:
In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour, including the prescribed medicine. You should then sip on soda, tea, or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides, you can begin taking solid foods and the prescribed medicine. If you still continue to experence the nausea and vomiting, call our office at once.
Maintain a proper diet:
After general anesthetic or IV sedation, soft to liquid diet should be taken at first (avoid milk and ice cream for the first 12-18 hours). Do not use straws. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. High calorie, high protein intake is very important. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat. Add solid foods to your diet as soon as they are comfortable to chew.
Caution: If you suddenly sit up or stand from a lying position, you may become dizzy. Therefore, immediately following surgery, if you are lying down, make sure you sit for one minute before standing.
If numbness of the lip, chin, or tongue occurs, there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel it, so be careful. Call our office if you have any questions about this.
Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
You should be careful going from the lying down position to standing, as you were not able to eat or drink prior to surgery, and it is difficult to take fluids, and taking pain medications can make you dizzy. You could get light-headed when you stand up suddenly. Before standing up, you should sit for one minute then get up.
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.
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 2-3 days.
Stiffness of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is normal post-operative event, which will resolve in time.
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 be removed approximately one week after surgery.
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 for instructions.
There will be a cavity where the tooth was removed. The cavity will gradually, over the next month, fill in with the new tissue. In the meantime, the area should be kept clean, especially after meals with salt-water rinses.
Brushing your teeth is okay just being gentle at the surgical sites.
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.
If you are involved in regular exercise, be aware that your normal nourishment intake is reduced, and exercise may weaken you. If you get light-headed stop exercising.
Remember your follow-up visit:
It is often advisable to return for a post-operative visit to make certain healing is progressing satisfactorily. A follow-up visit will be scheduled. In the meantime, maintain a healthful diet, observe rules for proper oral hygiene, and call our office if you feel something is not going right.
Care of mouth after your oral surgery:
- Do not rinse or spit for 24 hours after surgery.
- Keep fingers and tongue away from the socket or surgical area.
- Use ice packs on surgical area (side of face) for the first 24-48 hours; apply ice 20 minutes on – 20 minutes off.
- For mild discomfort, take Tylenol or Ibuprofen every three to four hours.
- For severe pain use the medication prescribed to you.
- Drink plenty of fluids. Do not use a straw.
- If the muscles of the jaw become stiff, you can massage and exercise your jaws. After 24-48 hours, the use of warm, moist heat to the outside of your face over these muscles will help get rid of the stiffness.
- After the first post-operative day, very gently use a warm salt-water rinse following meals for the first week to flush out particles of food and debris, which may lodge in the surgical area. (1/2 teaspoon of salt in a glass of warm water.)
- Diet may consist of soft foods, which can be easily chewed and swallowed. No seeds, nuts, rice, popcorn, etc.
- A certain amount of bleeding is to be expected following surgery. Applying pressure to the surgical area using small rolled gauze for 30-60 minutes controls bleeding. After that time, remove the gauze and then you may eat or drink. If bleeding persists, a moist tea bag should be placed in the area of bleeding and bite firmly for one hour straight. This will aid in clotting blood. Repeat if necessary. If bleeding still persists, call our office.
- We suggest that you do not smoke for at least 5 days after surgery. Nicotine may break down the blood clot and cause a “dry-socket.”