Immediately following surgery:
o Bite firmly on the gauze covering the extraction site. Firm pressure can slow the oozing.
o Avoid vigorous rinsing or spitting, as this can dislodge the blood clot that has formed.
o You may have a numb tongue, lip, or cheek for 6-10 hours, so take care not to accidently bite yourself or burn yourself with hot foods/liquids.
o Start taking the pain medications as prescribed when you get home. It’s important to start taking them before the numbing medicine wears off.
o Avoid vigorous activity the day of the procedure and for a couple days after.
o Use ice packs or bags of frozen peas during the first 12 hours over the areas where the surgery was performed
Bleeding:
o Some oozing of blood is expected after a tooth extraction. A small amount makes a lot of saliva look pink/red. To slow the oozing apply FIRM pressure by biting firmly on a gauze folded in a large square or by applying pressure with your finger. You must apply pressure for at least 30 minutes to be effective. You can also moisten a tea bag and wrap gauze around it and then bite down firmly. The tannic acids in the tea can help slow the bleeding.
o The oozing may persist for up to 24 hours. Avoid any strenuous activity as this may worsen bleeding.
o If there is persistent bright red bleeding, then please contact our office.
Pain Management:
o Some discomfort is expected after extraction of teeth. The goal is to minimize the discomfort so that it is tolerable. It is unrealistic to expect zero pain after surgery, but we will work with you to minimize the discomfort as much as possible.
o Consistently taking ibuprofen and Tylenol has been shown to be very effective at controlling pain.
o Very few people actually need to take a narcotic pain medicine. Narcotics have real risks and side effects such as nausea and vomiting, constipation, drowsiness and addiction. However, if there is severe pain that is not well controlled with ibuprofen and Tylenol, then we can prescribe a small amount of prescription pain medication. Take the narcotic pain medication exactly as prescribed to avoid a complication.
o Never exceed the maximum daily dose that is described in the over-the-counter instructions.
o Ice packs the first day can also help reduce the need for pain medication.
Swelling:
o Swelling is normal after surgery. It is normal for swelling to increase for the first 2-3 days after surgery and then reach its peak and start to lessen.
o Ice packs during the first 24 hours can help. You can also keep your head slightly elevated when you sleep. Spending more time sitting upright and on your feet, rather than laying flat will help reduce the swelling. If you sleep all night on one side of your face, it will be more swollen the following day, but should even out during the day when you are upright.
o Sometimes there is bruising that can take days to weeks to resolve.
Diet:
o Eat bland, soft, mushy, and cool or cold foods the first day. Start with clear liquids (water, popsicles, apple juice, tea). It’s important to be well hydrated, so focus on drinking a lot of fluids. Sharp, crunchy foods can hurt the extraction site. Avoid alcoholic drinks and drinks that are carbonated.
o After the numbing medicine wears off, you can slowly advance your diet. Usually, you are back to a normal diet within the first 2-3 days.
o Avoid sucking strongly on a straw (i.e. thick milkshake).
o If you have a lot of nausea and vomiting, then focus on clear liquids and maintaining hydration. If the nausea and upset stomach is persistent, please contact our office. We will prescribe an anti-nausea medication.
Brushing/Rinsing:
o No vigorous rinsing or spitting the day of surgery. Gentle rinses can begin the day after surgery.
o You should brush and floss your teeth and be careful to be gentle in the areas of surgery.
o Gentle saltwater rinses can begin the day after surgery.
o If you were prescribed an antibiotic mouth rinse, use it twice daily for two weeks.
Activity:
o Avoid strenuous activity and exercise for 2-3 days. You can usually return to school or work the day after surgery, but you might be swollen and sore. Some people need a couple days off from work/school.
o You should not drive a car, operate machinery or sign legal documents if you are taking narcotic pain medication.
o You may want to place a towel over your pillow because if you drool at night it could stain your pillowcase/pillow.
Dry Socket and Minimizing Risk:
o A dry socket can occur when the blood clot is dislodged prematurely. It leaves exposed bone that is very painful and usually causes a deep, achy pain that does not respond well to pain medications. It can occur 3-6 days after surgery.
o If you think you have a dry socket you need to call our office and come in to be seen. We can apply dry socket medication to the site, and this usually helps significantly with the discomfort.
o To avoid a dry socket, do not spit vigorously or dislodge the blood clot. Maintain good oral hygiene. Also, do not smoke.
Sutures:
o If sutures were placed at the extraction site, they will dissolve/resorb on their own after about 7-14 days. It’s ok if you accidentally swallow them as they will simply dissolve in your stomach.
Antibiotics:
o Antibiotics are not routinely prescribed for extractions unless there is a significant infection. If you were prescribed an antibiotic, take it as prescribed and complete the whole course. If you develop a rash or other side effect, stop the antibiotic and contact our office.