EXTRACTIONS - POST OPERATIVE INSTRUCTIONS
SINGLE / MULTIPLE / WISDOM TOOTH / IMPACTED TOOTH
Apply cold compresses or ice packs to outside of face in the area of surgery-15 minutes on, 15 minutes off-for 4-6 hours. Do not use after 36 hours. It is not unusual to have post-operative swelling. The swelling that is normally expected is usually proportional to the surgery involved. However, some swelling should be expected, if a difficult extraction has been performed. If it does occur, it will reach its maximum in 48-72 hours, and then it will start to decrease.
The gauze pad placed over the surgical area should be kept in place for an hour. After this time, the gauze pad should be removed and discarded.
Take prescribed antibiotics, if any, as directed until all medication is consumed. Take pain relievers as directed but only as often as is necessary to manage the discomfort. Ideally, pain medication should be taken BEFORE numbness wears off. For light discomfort or moderate pain one or two 200 mg tablets of Ibuprofen (Nurofen, Rupan, Advil, Motrin) should be taken every three to four hours. Do not exceed 2400 mg per 24 hours. In addition you may use a very effective analgesic and antipyretic agent, Acetaminophen (Tylenol Extra Strength, Paracetamol), one or two every six hours. Some medications may cause an upset stomach. Taking these with food will lessen this side-effect.
Do not rinse your mouth for the first 18-24 hours. Begin the use of the prescribed rinse (special mouthwash - chlorhexidine gluconate 0,12% - or warm salt-water) after the first 24 hours and rinse gently after meals and between 6-8 times a day for at least one week.
Fluids should be consumed as soon as possible. It is recommended that you drink 6-8 glasses of water over the remainder of the day following surgery. Avoid using a straw as it may cause a suction, which may loosen clotting, causing bleeding.
Do not brush, floss, rinse and spit the day of extraction, as it can dislodge the clot that has formed in the extraction site.
For the first 24 hours, eat soft, cool foods that can be easily chewed or swallowed. Avoid eating or drinking very hot and very cold foods or liquids (coffee, soup, tea). Avoid sharp, spicy, acidic or chewy foods for several days. Maintain a balanced diet.
Do not raise your lip or pull on the cheek to look at the extraction site. This might tear the sutures(stitches).
A little bleeding or redness in the saliva is normal after the surgery. If worried, place a wet teabag firmly against the area for 30 minutes or longer if necessary. If bleeding continues, please call the office.
Avoid brushing and flossing for the first two days in the surgical area. After 2 days, brush and floss very delicately. Begin to brush the NON-SURGICAL areas the day following surgery. Good oral hygiene is essential to good healing.
Do not smoke, spit, blow your nose, or take any alcoholic beverages for the first 24 hours. These actions may delay healing, increase discomfort, encourage bleeding and cause complications.
Rest quietly with your head elevated for the remainder of the day following surgery. Keep physical activities to a minimum immediately following surgery. Always get up slowing from a reclining position to prevent dizziness. To encourage rapid healing, please REST!
Following any oral surgical procedures, particularly the removal of impacted lower wisdom teeth, difficult or multiple extractions, several undesirable effects may occur:
You may have pain which becomes worse after a few days and does not respond to the medication you are taking. This may indicate an inflammation of the bone socket. It is necessary an appointment for a sedative dressing. Please call the office.
Other teeth on the same side may ache temporarily.
You may have a sore throat or earache for a few days. Pain when swallowing is not uncommon. This will subside in two or three days. If the medication you are taking does not make you comfortable, call the office.
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.
A slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, please notify the office. Acetaminophen (Tylenol Extra Strength, Paracetamol) should be taken to reduce the fever.
A numbness of the lower lip may occur on the same side as the surgery. This should cause you no alarm since it will gradually disappear in time.
During healing you may feel bony edges or small sharp bone fragments in the mouth with your tongue. These are not roots; they are bony walls, which supported the tooth. They usually smooth out spontaneously. If not, they can be removed.
There may be a "hole" in your gum after extraction. This will fill in time with new tissue. Rinse your mouth after meals to keep it clean.
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 or three days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.
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.
Your case is individual. No two pacients are alike. Do not accept well-intended advice from friends. Call the office and discuss your problem with your doctor, the person best able to effectively help you.
The sutures will be removed approximately one week after surgery. Don't worry if they become dislodged. The removal of sutures requires no anesthesia or needles. It takes only one minute or so, and there is no discomfort associated with this procedure.
Please call our office if you have any questions or concerns.