After Tooth Extraction
Sometimes the effects following oral surgery are minimal, so not all of these instructions may apply to you. Common sense will often dictate what you should do. However, when in doubt, follow these guidelines or call our office if you need clarification.
Day of Surgery
Immediately Following Surgery: You will leave the office with a piece of gauze placed on the surgical site. Bite down firmly on the gauze until you get home. When you get home, remove the gauze and have something to eat (see Diet). Take a prescription pain medication, if given. Then take one new piece of gauze, folded into a little square, and place it over the surgical area. Change the gauze every 30-40 minutes as needed for active bleeding, which lasts about 2-3 hours after surgery. Remember that every time you take a piece of gauze out of your mouth, there will be blood on it. You will have to look in your mouth to see if you need a new piece of gauze. If there is blood oozing from the socket, or making a pool of blood around the socket, replace the gauze. See below if bleeding persists.
Activity and Wound Care: Do not disturb the surgical site with any objects or your fingers. Do not rinse or spit for 24 hours. Do not use a straw or drink carbonated drinks for 48 hours. You may brush your teeth gently. Do not smoke for at least 72 hours, as this is detrimental to your healing. If sutures are placed, they will fall out on their own in 3-7 days.
Swelling: There is often some swelling associated with having oral surgery. Swelling will peak on the third day after surgery and can take 5 to 7 days to dissipate. You can minimize your swelling by using a cold pack (or anything from the freezer: frozen-peas, etc…) wrapped in a thin towel. Apply the ice pack to the face or cheek adjacent to the surgical site. Do this for twenty minutes on and off, for the first 24 hours. You can also keep your head elevated, even at night if the swelling is severe. If desired, after 24 hours, use a moist heat pack (a damp washcloth, warmed in the microwave works best) twenty minutes on and off for the next 5-7 days.
Pain: Unfortunately, most oral surgery will be accompanied by some degree of discomfort. If you are given a prescription pain medication, take it with food as directed. After the first 24 hours, you can lessen the amount of the prescription medication and start taking ibuprofen (Advil, Motrin, etc). Of course, if you need the prescribed medication longer than 24 hours, continue using it.
Nausea: Nausea is not an uncommon event after oral surgery. Yet, this is usually caused by improper placement of packs (and therefore blood being swallowed) or taking pain medication without eating first. If nausea occurs, try to continue taking clear liquids and reduce pain medication until the nausea passes.
Diet: If you have had a general anesthetic, as soon as you feel ready, begin taking small sips of a clear liquid (water is best). As the small sips are being tolerated (i.e. no nausea is experienced), you can move on to taking larger drinks of clear liquid. If the larger drinks are being tolerated, you can then begin eating soft foods (ice cream, yogurt, soup, Jell-0, pudding, milkshakes, etc…). Do not chew anything hard for 24 hours. Over the next week or so, you will slowly work your way back into your regular diet but avoid foods with small pieces that can get stuck in the tooth socket, such as rich, chips, and nuts until 1 week after surgery. If you have not had a general anesthetic- eat as soon as possible so that you may take your pain medication before the numbness wears off. Do not chew anything hard for 24 hours. You need to eat soft foods such as ice cream, yogurt, soup, Jell-0, pudding, milkshakes, etc. After the first 24 hours, you may work your way back into your regular diet, as you feel comfortable, but avoid foods with small pieces that can get stuck in the tooth socket, such as rich, chips, and nuts until 1 week after surgery.
The Days after Surgery
Oral Hygiene: It is essential that you keep your mouth as clean as possible following surgery. You may gently brush your teeth, being careful around the surgical areas. Soreness and swelling may not permit brushing of all areas, but please make every effort to clean your mouth within your comfort level. After brushing, use one-quarter teaspoon of salt dissolved in an 8-ounce glass of warm water and gently rinse. Repeat this as often as you like, but at least three times a day for the next five days.
Dry Socket: Starting the third day following surgery, gradual, steady improvement should mark the remainder of your post-operative care. If you notice a distinct, persistent, localized pain in your jaw (which is not relieved with pain medication), and a foul odor emanating from your mouth that will not go away, you may have a dry socket (loss of the blood clot from the socket before healing is complete). If you experience these symptoms, please contact our office so you can be seen as soon as possible.
Severe Bleeding: If you experience severe bleeding, follow these instructions: 1. Rinse mouth with cool water and gently wipe away blood clots with a clean piece of gauze or a tissue; 2. Take a large amount of gauze or 2 tea bags moistened with water and place DIRECTLY over bleeding area and close mouth, applying constant pressure; 3. Remain quiet and in a sitting position for 20-30 minutes; 4. Repeat steps 1 through 3 until bleeding is controlled; 5. After these directions have been followed in detail and excessive bleeding persists, you should call our office.
It is our desire that your recovery be as smooth as possible, following these instructions will assist your recovery, but if you have any questions, please feel free to call our office. Calling during office hours may afford you a quicker response, however, a doctor on call can be reached for emergencies by following the prompts at our office number after hours (504-889-9893).