After Teeth Removal

Post-operative Instructions

Sometimes the after-effects of oral surgery are 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.

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

Intermitten 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 the teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs. If bleeding persists or becomes heavy, you may substitute a tea bag (soaked in very hot water, squeezed damp-dry and wrapped in a 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 20 minutes on and 20 minutes off during the first 24 hours 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 medication causes nausea, but if if you precede each pill with a small amount of food, chances for nausea will be reduced. The effects of pain medications vary widely amoung individuals. If you do not achieve adequate relief at first, you may be able to suppliment each pill with an analgesic such as Asprin or Ibuprofen. Some patients may even require two of the pain pills at one time. Please call our office to discuss changes with taking medication with your oral surgeon. Remember that the most severe pain is usually within 6 hours after the local anesthetic wears off, after that your need for medicine should lessen. If you find you are taking large amounts of pain medication at frequent intervals, please call our office.

Nausea and Vomiting

Nausea is not uncommon after surgery. Sometimes the pain medications are the cause. Preceding each pain pill with a small amount of soft food, and taking the pill with a large volume of water can reduce nausea. Try to keep taking clear fluids and minimize the dosing of pain medications, but call us if you do not feel better. Sips of 7UP or Sprite may help with nausea.

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 pureed foods (soup, pudding, yogurt, milk shakes, ect). It is best to avoid foods like nuts, sunflower seeds, popcorn, ect., 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 oral surgeon.

Sharp Edges

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

Instructions for the Second and Third Days

Mouth Rinses

Keeping your mouth clean after surgery is essential. We recommend using non-alcoholic mouthwashes such as Biotene, Crest Pro Health, Ect. Or you may use ¼ teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, but at least two to three times daily.

Brushing

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

Moist Heat Application

You may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels and heating pad) for 20 minutes on and 20 minutes off to help soothe tender areas. This will also help decrease swelling and stiffness.

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 you can usually being a more substantial diet. The remainder of the post-operative course should be gradual, steady improvement. If you do not see continued improvement, please call our office.
It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if have any questions about your progress, please call our office. If you have an emergency after hours, call our office and follow the prompts to get a hold of the doctor. Calling during office hours will afford a faster response to your question or concern.