When you leave the office after your surgery visit, there are several things you will need to do. 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. A 24-hour answering service is available to contact a doctor after hours by calling the office number. Calling during office hours will afford a faster response to your question or concern.
GAUZE: 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 45 â€“ 60 minutes). It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning.
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. Take one of the prescription pain pills as soon as you get home. The effects of pain medications vary widely among individuals. If you do not achieve adequate relief at first, you may supplement each pain pill with an analgesic such as Tylenol (Acetaminophen) or Advil (Ibuprofen).
ANTIOBIOTICS: If an antibiotic is prescribed, it should be taken as directed until all are taken.
ICE: Swelling is often associated with oral surgery. It can be minimized by using a cold pack or ice bag 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.
PRECAUTIONS: Do not disturb the surgical area today. Do NOT rinse vigorously or probe the area with any objects. PLEASE DO NOT SMOKE, or drink alcohol for at least 72 hours. This is very detrimental to healing and may cause a dry socket. Do not use any mouthwashes because they may contain alcohol. Do not drink using a straw for at least 24 hours.
DIET: Liquids only until the numbness wears off. (Take care not to bite lip or cheek while numb). Eat any nourishing food that can be taken with comfort. Avoid extremely hot foods. It is sometimes advisable, but not absolutely required, to confine the first day's intake to liquids or pureed foods (soups, puddings, yogurt, milk shakes, etc). It is best to avoid crispy foods like nuts, chips, popcorn, etc., 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 diabetic, maintain your normal eating habits or follow instructions given by your doctor.
OOZING: Intermittent bleeding or oozing overnight is normal. Placing fresh gauze over the areas and biting on the gauze for 30-45 minutes at a time may control bleeding.
PRESISTENT 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 to reposition the packs. If bleeding persists or becomes heavy you may substitute a tea bag (soaked in cold water, squeezed damp-dry and wrapped in a moist gauze) for 20 â€“ 30 minutes. If bleeding remains uncontrolled, please call our office.
NAUSEA: Nausea is not uncommon after surgery. Sometimes pain medications are the cause. Try to keep taking clear fluids and minimize dosing of pain medications. Coca-Cola or 7-Up may help with nausea. If nausea becomes excessive or continues the next day, please call us.
REST: Although strict bed rest is not required, excessive physical exercise, especially lifting, bending over, or straining should be avoided for the first 3-4 days after surgery. Sleeping on 2-3 pillows to avoid additional swelling is suggested.
RINSING: Keeping your mouth clean after surgery is essential. After 24 hours, use Â¼ teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution. Repeat at least two or three times daily.
BRUSHING: Begin oral hygiene, including brushing your teeth, as soon as comfortable after surgery, even on the first day. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.
MOIST HEAT: After 48 hours you may apply a warm, moist compress to the skin over the areas of swelling (wet wash cloth with heating pad or hot water bottle). You may do this continuously. This will also help decrease swelling and stiffness. Make sure it is warm, not hot.
SHARP EDGES: If you feel something hard or sharp edges in the surgical areas, it is likely you are feeling the bony walls, which 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.
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, can usually begin a more substantial diet. The remainder of the post-operative course should be gradual, steady improvement. If you don't see continued improvement, please call our office. If you are given a plastic irrigation syringe, DO NOT use it for the first seven days. Then, if you are pain free, use it according to the instructions until you are certain the tooth socket has closed completely and that there is no chance of any food particles lodging in the socket.
BIRTH CONTROL: Recent medical studies indicate that antibiotics, and possibly analgesics, may interfere with the effectiveness of oral contraceptive.
DRY SOCKET: Our most common post-operative nuisance is the dreaded â€œDry Socket.â€ This is not an infection. After a tooth is removed, a â€œholeâ€ or socket is left in the jawbone where the roots of the tooth used to be present. Normal healing requires the formation and continued presence of a blood clot in that hole. If this clot does not form or dissolves prematurely, then dull throbbing in the jaw or pain radiating to the ear may occur. This pain usually starts to increase the third to the tenth day after the tooth is removed. We would like for you to contact us if this occurs. (We try to be accessible to our patients. We have an answering service, carry a pager, and each of our home phone numbers is listed in the phone book.) A dry socket usually can be turned around by applying medication within the socket. No more shots! Just a short appointment to place the medication will often resolve the discomfort within a few moments.
We know that tobacco, alcohol, or early physical activity after surgery can increase the chances for a dry socket. Sometimes, no matter what you do, a dry socket will develop. We would like for you to avoid one if possible, but we would like to be the second person to know if you develop a problem.