After Tooth Removal
The removal of any teeth is a surgical procedure; therefore, post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.
Immediately Following Surgery
- The gauze pad placed over the surgical area should be kept in place for 90 minutes, changing it as it gets saturated. Once the bleeding has subsided, the gauze pad should be removed and discarded. Please remember not to eat, drink, or fall asleep with gauze pads in your mouth.
- No rinsing or spitting for the first 24 hours after your procedure. Vigorous mouth rinsing or touching the wound area following surgery should be avoided. Do not drink through a straw, as this may initiate bleeding by causing the blood clot that has formed to become dislodged.
- Take all medications prescribed by your doctor.
- Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
- Place ice packs to the sides of your face where surgery was performed for periods of 20 minutes on and 20 minutes off for the first 48 hours after the procedure. Refer to the section on Swelling for an explanation.
A certain amount of bleeding is to be expected 24 to 48 hours following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing or wiping any old protruding clots from your mouth, then placing a gauze pad directly over the area and biting firmly for 30 minutes, while sitting in a upright position. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for 30 minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. If bleeding does not subside, call for further instructions.
The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the bodys normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until two to three days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two plastic bags filled with ice, or ice packs should be applied to the sides of the face where the surgery was performed for a period of 20 minutes on and 20 minutes off. After 48 hours, ice has no beneficial effect. It may take several days for swelling and jaw stiffenss to completely resolve. Forty-eight hours following surgery, rinsing periodically with warm water is beneficial in reducing the size of the swelling.
Arnica has been used for medical purposes since the 1500s and remains popular today. Microdoses are used to make homeopathic Arnica. Although research studies are conflicting, Arnica has shown to be beneficial in the prevention and treatment of bruising. Follow the dosage instructions on the label.
For mild pain, ibuprofen (i.e. Advil) or acetaminophen (i.e. Tylenol) may be taken. For moderate pain, take the tablets prescribed as directed. If you are taking narcotic pain medicine, do not drive an automobile, work around machinery or make important decisions, as reflexes and judgment are impaired. Avoid alcoholic beverages. Pain or discomfort following surgery should subside with each successive day. If pain persists, it may require attention and you should call the office.
Drink liquids after general anesthesia or IV sedation. Do not use drinking straws for at least 1 week after the procedure. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical site(s). High calorie, high protein intake is very important. Try to maintain a soft and cool to warm diet for the first few days, then resume to your normal diet. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least five to six glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength and heal faster if you continue to eat. Avoid spicy foods, foods that are hot in temperature or crunchy and hard for 24 to 48 hours. Avoid nuts and popcorn for 2 weeks after the procedure.
CAUTION: If you suddenly sit up or stand from a lying position, you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.
Keep the Mouth Clean
No rinsing of any kind should be performed for the first 24 hours following surgery. Warm saltwater mouth rinses can be started the day after your procedure. Avoid brushing your teeth after the surgical procedure and start again the day after. Brush lightly and gently around the surgical area(s) to avoid bleeding and loosening of any stitches.
In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal postoperative occurrence, which may occur two to three days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.
If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection and should be taken until complete. Discontinue antibiotic use in the event of a rash or other unfavorable reaction and call the office. Antibiotics may impair the efficiency of oral contraceptives for the duration of the present cycle.
Nausea & Vomiting
In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on Coke, tea, or ginger ale. You should sip slowly over a 15-minute period. When the nausea subsides, you can begin taking solid foods and the prescribed medicine.
- If numbness of the lip, chin, or tongue persists after 5 hours, please call the office. There is no cause for alarm, as stated before surgery; this numbness is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful.
- A slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
- You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery. Taking pain medications can make you dizzy. You could get light headed when you suddenly stand up. Before standing up, you should sit for one minute and then stand.
- Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls, which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed with a minor procedure.
- If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline.
- Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in two to three days.
- Stiffness (trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event that will resolve in time.
Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures, if not self-resorbable, will be removed approximately one week after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure. So its really nothing to worry about.
The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur, call the office for instructions.
There will be a cavity where the tooth was removed. The cavity will gradually fill in with new tissue over the next few months. In the meantime, the area should be kept clean especially after meals with salt-water rinses or a toothbrush.
Your case is individual. No two mouths are alike. Do not accept well-intended advice from friends. Discuss your problem with the persons best able to effectively help you: Dr. Stein, Dr. Caruso or Dr. Levarek or your family dentist.
Brushing your teeth is okay just be gentle at the surgical sites.
A dry socket is when the blood clot dissolves prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear, head and throat may occur two to three days following surgery. Call the office if this occurs.
Exercising can resume 2 to 3 days after extractions. If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.