Tooth Extractions After Care
The removal of single or multiple teeth can be straight forward or complicated. Post-operative care is extremely important. Unnecessary pain and the complications of pain and swelling can be minimized with careful adherence to instructions.
Immediately After Surgery
A certain amount of bleeding is to be expected after surgery. Slight bleeding, oozing or redness in the saliva is not uncommon for 24 hours or more. Control excess bleeding by rinsing or wiping any old clots from your mouth and then biting firmly on gauze for 30 minutes; repeating as necessary. If bleeding continues, bite on a moistened tea bag for 30 minutes. The tannic acid in tea helps form a clot by contracting the blood vessels in the area.
The amount of swelling experienced is generally proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon and is the body’s normal reaction to surgery, inflammation and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until two to three days postoperatively. It may be minimized by the use of ice packs applied to the sides of the face where surgery was done. The ice packs should be left on for 20 minutes and then off for 20 minutes for the first 12-24 hours after surgery. After 36 hours, the ice is of no benefit. If swelling or jaw stiffness persists for several days there is no cause for alarm as this is a normal reaction to surgery. 36 hours after surgery, the application of moist heat to the affected area is beneficial in reducing the amount of swelling.
For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every three to four hours. Two to four Ibuprofen (Motrin or Advil) 200mg tablets (400-800 mg) may be taken every six hours. For severe pain, take the medication prescribed as directed (typically narcotic medication). The prescribed narcotic pain medication will make you groggy and slow down your reflexes, so you should not drive a motorized vehicle or work around machinery. Additionally, avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day.
Do not use a straw for the first 24 hours – instead, drink from a glass. You may eat anything soft by chewing away from the surgical site. A high calorie, high protein diet is very important – nourish your body regularly. You should prevent dehydration by drinking fluids regularly. Your food intake will be limited for the first few days, and in turn you should compensate by increasing your fluid intake. Try drinking at least five to six glasses of fluid, and do your best to not miss meals. You will feel better and heal more quickly if you continue to eat.
No rinsing of any kind should be performed until the day after surgery. You may brush your teeth the night of surgery but rinse gently. The day after surgery, you should begin rinsing five to six times a day, especially after eating. Rinse with a salt and warm water solution, made up of ½ tsp salt in 8 oz of warm water.
Discoloration and Bruising
Occasionally, discoloration of the skin follows swelling. The development of black, blue, green or yellow discoloration is due to blood spreading beneath the tissues, and may occur two to three days postoperatively. Moist heat applied to the area may speed up the removal of the discoloration.
If you have been prescribed antibiotics, use as directed. Antibiotics are prescribed to combat and help prevent infection, however, discontinue use if a rash or other unfavorable reaction occurs.
Nausea and Vomiting
If nausea or vomiting occur, do not take anything by mouth, including medication, for at least one hour. You should then sip on clear liquids such as water, tea or ginger ale. You should sip slowly over a 15 minute period. When the nausea subsides, you may begin taking soft foods and medication.
Sutures are placed in the surgical area to minimize postoperative bleeding and to help healing. Dissolvable sutures typically fall out in five to seven days while non dissolvable sutures will require a return visit for removal one to two weeks post surgery. Sometimes the sutures become dislodged, but this is not a cause for alarm – simply remove the suture from your mouth and discard.
A dry socket occurs when the blood clot dislodges prematurely from the tooth socket. Symptoms include pain at the surgical site as well as pain in the ear. This occurs typically 2-3 days after surgery. Call the office if your pain increases significantly during this time. A dry socket is easily treated with medicated packs.
Use common sense. If you exercise regularly and get lightheaded, reduce your exertion or stop. Do not assume upside-down positions for one to two weeks.