Post Operative Instructions
What you should do following extractions and other oral surgery procedures

A certain amount of bleeding, swelling, and pain is normal. Reduce your activity as much as possible for several hours. Avoid spitting, rinsing, and drinking through a straw for 24 hours. Do not rinse your mouth or brush your teeth for 24 hours. These activities may hinder the formation of a blood clot, which is necessary for proper healing.

To Control Bleeding

The doctor and staff will make sure that all active bleeding is controlled before you are discharged. If bleeding should develop soon after you leave our office, keep a steady pressure on the bleeding area by firmly biting on a gauze roll placed directly over the bleeding site for at least 30 minutes. Pressure helps reduce bleeding and permits formation of a clot in the tooth socket. 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. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.

To Relieve Pain

For moderate pain, one or two tablets of Tylenol may be taken every 3-4 hours or Ibuprofen (Motrin or Advil) 200 mg may be taken every 3-4 hours. Be sure to take pain medication on a full stomach to avoid an upset stomach.
For severe pain take the medication prescribed for pain as directed. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.

To Minimize Swelling

The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of face is not uncommon; this is the body’s normal reaction to surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Ice packs should be applied to the sides of the face where the surgery was performed. Apply ice continuously while you are awake. After 48 hours of ice, moist heat should be applied until the swelling gone.

Oral Hygiene is Important

Twenty-four hours after surgery rinse mouth gently with a solution of one-half teaspoon of salt dissolved in a glass of water. Repeat after every meal or snack for seven days. Rinsing is important because it removes food particles and debris from the socket area and thus helps prevent infection and promote healing. Also, 24 hours after your surgery you can resume normal tooth brushing, but avoid disturbing the surgical site.

Discoloration

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to the blood spreading beneath the tissues. This is a normal post-operative occurrence, which may appear 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.

Maintain a Proper Diet

You may eat anything soft by chewing away from the surgical sites. High calorie, high protein intake is very important. Nourishment should be taken regularly. Your food intake will be limited for the first few days. You should compensate this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat. Add solid foods to your diet as they are comfortable to chew.

Other Complications

If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb you could bite it and not feel it, so be careful.
Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots: they are bony walls which supported the tooth. These projections usually smooth out spontaneously.
Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then be painful. This will subside in 2-3 days.
Stiffness of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.

Sutures

Sutures are placed at the surgery site 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.

In Review

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 our office for instructions.

There will be a cavity where the tooth was removed. The cavity will gradually, over the next month, fill with new tissue. In the meantime, the area should be kept clean especially after meals with salt water rinses.

Brushing your teeth is okay, just be gentle at the surgical sites.

A dry socket is when the clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur 2-3 days following surgery. Call the office if this occurs.

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.

  • Do not spit or rinse for 24 hours after surgery
  • Keep fingers and tongue away from socket or surgical area
  • Use ice packs for first 24-48 hours : 20 minutes on 10 minutes off
  • For mild discomfort take Tylenol or Ibuprofen every 3-4 hours
  • For severe pain use medication prescribed for you
  • Drink plenty of fluids (Do not use straw)
  • If the muscles of the jaw become stiff, you can massage and exercise jaw. After 24-48 hours the use of moist heat to the outside of your face, over these muscles, will help get rid of the stiffness.
  • After the first post-operative day, use a warm salt water rinse following meals for the first week to flush out particles of food and debris, which may lodge in the surgical area. (1/2 teaspoon of salt in a glass of warm water. Mouthwash can be added for a better taste.)
  • Diet may consist of soft foods, which can be easily chewed and swallowed. No seeds, nuts, rice, popcorn, etc.
  • A certain amount of bleeding is to be expected following surgery. Apply pressure to the surgical site using small rolled gauze for 30-60 minutes.
  • After that time remove the gauze and then you may eat or drink. If bleeding persists, a moist tea bag should be placed in the area of the bleeding and bite firmly one hour straight. This will aid in the clotting. If bleeding still persists, call our office.
  • We strongly suggest that you do not smoke for at least 5 days after surgery. Nicotine may break down the blood clot and cause a dry socket.

Feel free to contact us if any doubt arises as to your progress and recovery.