Tooth Extraction

POSTOPERATIVE INSTRUCTIONS

Tooth Extraction

Sometimes the after-effects of oral surgery are quite minimal, so not all of these 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 A TOOTH EXTRACTION

FIRST HOUR AFTER A TOOTH EXTRACTION: Bite down firmly on the gauze that has been placed over the surgical areas, making sure it remains in place. Change the gauze every 15-20 minutes to control the bleeding. If active bleeding persists after one hour, place enough new gauze to obtain pressure over the surgical site for another 30-60 minutes. The gauze may be changed as necessary and may be dampened and/or fluffed for more comfortable positioning. Begin using ice packs. Start a liquid diet and prepare to take pain medication and antibiotics if prescribed. Do not drink through a straw, smoke, or spit because these actions will increase the bleeding.

EXERCISE CARE

Do not disturb the surgical area. Do NOT rinse vigorously or probe the area with any objects or your fingers. You may brush your teeth gently. DO NOT SMOKE for at least 48 hours after oral surgery. Frequent spitting should be avoided.

OOZING

Intermittent bleeding or oozing is normal following a tooth extraction or other forms of oral surgery. It may be controlled by placing fresh gauze over the surgical areas and biting down firmly for 30-60 minutes. Blood-tinged saliva is normal for 48 hours after surgery. Frequent spitting should be avoided.

STEADY BLEEDING

Bleeding should never be severe. If it is, it usually means that the packs are being clenched between your teeth rather than exerting their pressure on the surgical areas. Try repositioning fresh packs. If bleeding persists or becomes heavy, you may substitute a tea bag (soaked in water, squeezed damp-dry, and wrapped in moist gauze) for 20-30 minutes. If bleeding remains uncontrolled, please call our office at 863-665-8878.

SWELLING

Extreme swelling can sometimes be associated with oral surgery. Swelling is natural and continues to increase for 48 hours after extensive procedures such as wisdom tooth removal. You can minimize swelling by using a cold pack (e.g. frozen bags of peas) or ice bag wrapped in a towel and applied firmly to the face or cheek adjacent to the surgical area. This should be applied 20 minutes on and 20 minutes off during the first 24/48 hours after surgery. When you see the swelling subsiding after 48 hours, heat can be used 20 minutes on and 20 minutes off to speed your recovery.

MEDICATION

Unfortunately, most oral surgery is accompanied by some degree of discomfort in the days after the procedure. Follow the instructions on your prescription bottle. It may take a full hour before the medication is absorbed and circulated in your blood stream. If you take the first dose before the local anesthetic wears off, you will be more comfortable. Pain medication should not be taken on an empty stomach. The effect of pain medication varies widely among individuals. If you do not get relief, you may supplement each pill with an over-the-counter medication such as aspirin or ibuprofen (Advil, Nuprin, or Motrin). Some people may even require two of the pain pills at one time during early stages of recovery after a tooth extraction.

NAUSEA

Nausea may occur after oral surgery from swallowing blood or taking the narcotic pain medications. Nausea may be reduced by preceding each pill with a small amount of soft food and taking the pill with a large volume of water. Cola drinks stirred to remove carbonation may help with nausea. Call us if any nausea or repeated vomiting persists and we will call in a prescription for nausea and possibly change your pain medication.

DIET

Eat any nourishing food that you can tolerate. The temperature of the food does not matter, but avoid extremely hot foods if your lips and tongue are still numb. It is sometimes advisable, but not required, to confine the first day’s intake to bland liquids or pureed foods (e.g. soups, puddings, yogurt, milkshakes, and liquid diet supplements such as Ensure). Avoid crunchy foods like nuts, sunflower seeds, and popcorn. They may get lodged in the socket areas. Over the next several days, you can progress to solid foods at your own pace. Frequent small servings seem to work best. If you are diabetic, maintain your normal eating habits as much as possible. Follow instructions from your physician regarding your insulin schedule.

Instructions for the 2nd & 3rd day after a tooth extraction (and beyond)

MOUTH RINSES

Keeping your mouth clean after oral surgery is essential. Use one-quarter teaspoon salt dissolved in an 8-ounce glass of warm water to gently rinse your mouth, taking 5 minutes to use the entire glassful. Repeat as often as you like, but at least 2 or 3 times daily for the next 5 days.

BRUSHING

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

DRY SOCKETS

From the 3rd day on, gradual and steady improvement should mark the remainder of the post-operative tooth extraction course. If a DRY SOCKET occurs, loss of the blood clot from the socket usually occurs on the 3rd to 5th day. In this case, there is severe persistent throbbing pain in the jaw, often radiating toward the ear and forward along the jaw to cause other teeth to ache. If you do not see steady improvement after the second post operative day, do not suffer in silence. Call the office and report symptoms so you can be seen as soon as possible.

SHARP EDGES

If you feel sharp edges in the surgical areas with your tongue, you are probably feeling the bony walls that originally supported the teeth. Occasionally, small slivers of bone may work themselves out during the first week or two after oral surgery. If necessary, we will remove them. Please call the office if you are concerned.

INFECTIONS

Infection is rare, but may occur if food or bacteria are trapped under the gum. This can even occur 3-4 weeks following the tooth extraction. If swelling occurs, call our office.
We are here if you need us! It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, please call our office. A twenty-four-hour answering service is available for after-hours contact with a doctor, but calling in during office hours will ensure an even faster response.