Postoperative care after tooth extractions is very important. Patients who have had either single or multiple teeth extracted should follow these instructions to help minimize complications following surgery.
A certain amount of bleeding is to be expected 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 clots from your mouth, then placing a gauze pad over the area and biting firmly for 30 minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for ten minutes. The tannic acid in the tea bag helps to form a clot by contracting blood vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exertion. If bleeding does not subside, call for further instructions.
The amount of swelling is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes, and sides of face is not uncommon. The swelling will not become apparent until the day following the surgery and will not reach its maximum until two to three days after surgery. However, the swelling may be minimized by the immediate use of ice packs. A baggie filled with ice can be applied to the side of the face where surgery was performed. After 24 hours, ice has no beneficial effect.
If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. When you have reached 36 hours after surgery, the application of moist heat to the sides of the face may be beneficial in reducing swelling.
For moderate pain, ibuprofen (Motrin or Advil), at a dose of two to four 200 mg tablets, may be taken every eight hours. If you are allergic to ibuprofen or have been instructed by another physician not to take it, you should discuss other medications with us. For severe pain, take the tablets prescribed as directed. The prescribed pain medicine will make you groggy. Do not drive or operate machinery and avoid alcoholic beverages while taking this medication.
After general anesthetic or IV sedation, your initial diet should consist of liquids. Do not use straws because the sucking motion can dislodge the blood clot and create more bleeding. You may eat soft food by chewing away from the surgical site. High calorie and high protein intake is very important. At least five to six glasses of liquids should be taken daily.
Brushing your teeth after each meal is essential for faster healing and preventing infection. You can brush your teeth the night of the surgery, but rinse gently. The day after surgery begin rinsing five to six times a day with ½ tsp. salt mixed in 8 oz. of warm water. A plastic, curved tip syringe is used four days after wisdom tooth extractions. Fill the syringe with warm salt water and flush lower extraction sites three times a day (after meals) until gum tissues have completely closed or are no longer trapping food.
Use the curved tip syringe beginning four days after surgery. Take the syringe and place the tip in a cup of warm salt water. While the tip is submerged, pull back on the plunger to fill the syringe. Place the tip of the syringe over the extraction site hole, and flush out the lower extraction sites only.
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 after surgery. Moist heat applied to the area may speed up the removal of the discoloration.
If you have been placed on antibiotics, take them as directed and until finished. Antibiotics are given to help prevent infection. Stop taking antibiotics if you develop a rash or other serious reaction and call the office for instructions.
In the event nausea and/or vomiting occur following surgery, do not take anything by mouth for at least an hour. You should then sip on cola, tea, or ginger ale slowly over a 15-minute period. When nausea or vomiting subside, you may begin with foods and prescribed medicine.
Sutures are placed to minimize postoperative bleeding and to help healing. Sometimes they become dislodged. Just remove the suture from your mouth and discard it. There will be a hole where the tooth was removed. The hole will continue to fill in with new tissue and close within the next several months.
A dry socket starts when the blood clot gets dislodged prematurely from the tooth socket. Smoking, sucking through a straw, or forceful spitting can cause dry socket. If a dry socket occurs, usually five to seven days following surgery, call the office for further instructions.