Extractions

POST OPERATIVE INSTRUCTIONS

PLEASE READ AND FOLLOW THESE INSTRUCTIONS CAREFULLY:

The after-effects of oral surgery vary by individual, so not all of these instructions may apply. Please feel free to contact our office at any time should you have any questions, or experience any unusual symptoms following your surgery.

DAY OF SURGERY

Immediately after surgery: Patients who received a sedative anesthetic should return home from the office immediately upon discharge, and lie down with their head elevated until all effects of the anesthesia have disappeared. Anesthesia affects individuals differently; you may feel drowsy for a short period of time or for several hours. You should not operate any mechanical equipment or drive a motor vehicle for at least 12 hours if you feel any residual effect from the anesthesia.

  • DO NOT drive, use appliances or equipment that could be dangerous, such as power tools, stove,    burners, lawn mower and garbage disposals.
  • Watch out for dizziness. Walk slowly and take your time. Sudden changes of position can cause nausea.
  • DO NOT make any important decisions. You may change your mind tomorrow.
  • Discuss any questions you may have with your surgeon.
  • In the case of a medical emergency, call 911.

Oral hygiene and care: Do not disturb the surgical area today. Bite down gently but firmly on the gauze pack that we have placed over the surgical area, making sure the gauze packs remain in place. Change the gauze packs every 20 to 30 minutes or when they become saturated with blood. This is important to allow blood clot formation at the surgery site. You may resume normal tooth brushing the day of surgery. When brushing, be very careful to not disturb the surgical sites. It is imperative to keep your mouth clean, since an accumulation of food or debris may promote infection.

 

Bleeding: Some bleeding is normal, and blood-tinged saliva may be present for 24 hours. Bleeding may be controlled by placing fresh gauze over the surgical area and biting down for 30-45 minutes. You may take the gauze out to eat and then replace fresh gauze if the area is still actively bleeding, bleeding should not be severe. If bleeding persists, the gauze may be clenched between the teeth instead of keeping pressure on the surgery sites, try repositioning the gauze. If after that, bleeding still persists or becomes heavy, substitute a moist tea bag (first soaked in warm water, squeezed dry and wrapped in moist gauze) on the area for 20-30 minutes. If bleeding has not improved or slowed down, please contact our office. 

  • DO NOT spit, drink anything out of a straw, or drink any carbonated beverages for at least 4 days. 
  • DO NOT rinse, vigorously brush your teeth, or use mouth rinses for 5 days following surgery.
  • DO NOT smoke or drink alcohol for 5 days.
  • DO NOT stick anything down into the sockets, or probe the areas with your fingers.

Swelling and Bruising: Swelling is to be expected, and usually reaches its maximum in 48-72 hours. To minimize swelling, cold packs or ice bags wrapped in a towel should be applied to the face adjacent to the surgical area. This should be applied for 20 minutes, then removed for 20 minutes during the first 24 hours after surgery (20 minutes on, 20 minutes off). Bruising may also occur, but should disappear after 7 to 10 days following surgery. Tightness of the jaw muscles may cause difficulty in opening the mouth, this should also disappear within 7 to 10 days. Keep lips moist with cream or Vaseline to prevent cracking or chapping.

Orthodontic Appliances: If you wear orthodontic appliances, replace them immediately after surgery unless otherwise instructed. If these appliances are left out of the mouth for any length of time, it is often difficult or impossible to reinsert them.

Diet: While you are still numb, eat soft, nourishing foods that do not require a lot of chewing. Do not eat anything hot while you are numb. Avoid foods such as nuts, seeds, rice or popcorn that could get lodged in the socket areas. Over the next several days, you may adjust your diet back to normal habits, with the exception of the previous listed items. If you are a diabetic, maintain your normal diet as much as possible and follow your physician’s instructions regarding your insulin schedule.

Pain and Medications: Unfortunately, most oral surgery is accompanied by some degree of discomfort. Take the pain medication that was prescribed for you as directed. The local anesthetic administered with the general anesthetic during your surgery normally has a 3 hour duration, and it may be difficult to control the pain once the medication wears off.

 

Once you get home, prop yourself up on the couch or bed with your head elevated (with at least 2 pillows), or lay back in a recliner. Be sure to eat something soft before the numbness wears off. We also recommend that you begin taking 800mg of ibuprofen every 8 hours around the clock, for the first 5 days after surgery. HOWEVER, If you have been given a Diflunisal prescription, it is very important that you do not take ibuprofen while taking this medication.

 

Take your other medications as prescribed once you are tolerating food and are not nauseated. If you were prescribed an antibiotic and are currently taking oral contraceptives, you should use an alternate form of birth control for the remainder of this cycle and for one complete cycle afterwards.

 

INSTRUCTIONS FOR THE FOLLOWING DAYS:

 

 Oral Hygiene: Keeping your mouth clean is essential after oral surgery. Begin your normal tooth brushing routine as soon as possible after surgery. Soreness and swelling may prevent rigorous brushing of all areas, but make every effort to clean your teeth at your comfort level.

 

 Irrigation Syringe: If needed, you will be given an irrigating syringe. You should begin gently irrigating your lower socket areas on the 5th post-operative day. Use warm water and gently irrigate every time after you eat and before going to bed.

 

Care of Surgical Areas: After the first 24 hours, apply warm compresses to the skin overlying the areas of swelling for 20 minutes, then remove for 20 minutes. This will help reduce swelling and discomfort.

 

OTHER POSSIBLE POST-SURGERY EFFECTS:

 

Dry Sockets: The blood clot on the surgical site may be lost which will cause a dry socket (usually on the 5th or 6th day). There will be a noticeable, distinct, persistent pain in the jaw area, often radiating towards the ear and forward along the jaw which may cause other teeth to ache. If you do not see steady improvement during the first five days after surgery, or if severe pain persists, call the office to report these symptoms.

 

Numbness: Loss of sensation of the lip and chin may occur, usually following lower wisdom teeth removal. This is usually temporary and disappears within a few days or weeks. Occasionally, some numbness may persist for months, due to the close association of the roots of the teeth to the facial nerve.

 

It is our desire that your recovery be as smooth and pleasant as possible. If you have any questions about your progress or any symptoms you are experiencing, please call our office at 469-689-0704.