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

  • The gauze placed over the surgical area should be kept in place for a half hour then removed and discarded.
  • Vigorous mouth rinsing or touching the wound area following surgery should be avoided as this may initiate bleeding by dislodging the blood clot that has formed.
  • Take your recommended medications for discomfort as soon as you get home and before your local anesthetic wears off. Continue this medication for the first 24 hours as directed.
  • Restrict your activities the day of the surgery and resume normal activities when you feel comfortable.
  • Place ice packs on side of face where surgery was performed.

Bleeding

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.

Swelling

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.

Pain

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.

Diet

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.

Oral Hygiene

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.

Antibiotics

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.
  • If the nausea continues for more than 6 hours, please contact the office.

Other Complications

  • Numbness of the lip, chin or tongue is no cause for alarm. This is usually temporary in nature. Be careful to avoid biting your lip, cheeks or tongue while numb.
  • Slight temperature elevation after surgery is not uncommon. Tylenol or Ibuprofen should be taken to reduce the fever. If the fever persists, contact the office.
  • Be cognizant of lightheadedness. The procedure, lack of fluids and medications can make you dizzy. Sit for a few moments before standing up.
  • Due to stretching during the procedure, the corners of your mouth may dry out and crack. Lips can be kept moist with vaseline or another lip balm.
  • Occasionally, a sore throat and painful swallowing can occur due to muscle inflammation. This usually subsides in 2-3 days.
  • Stiffness of the jaw may cause difficulty in opening your mouth for a few days after surgery. This is normal and usually resolves itself in several days.
  • You may feel bony projections after tooth removal. These usually smooth out on their own. If not they can be removed by Dr. Broering.

Sutures

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.

Dry Socket

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.

Exercise

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.

Remember, your case is individual and no two mouths are alike. Please contact our office if you have any questions or concerns.

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