After Extractions

Care After Tooth Extractions

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.

Immediately Following Surgery

• It is normal to feel thirsty and/or feel awkward swallowing.
• The gauze pad placed over the surgical area should be kept in place for 30 minutes or until saturated. After this time, the gauze pad should be removed and discarded. Repeat as needed to control bleeding.
• Do not continue to use gauze pad once bleeding is minimal.
• You will begin warm salt water rinses the night of your surgery, along with brushing your teeth.
• Take pain medication with food as soon as numbing begins to wear off.
• 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, alternating 20 minutes on and 20 minutes off.
• Avoid smoking, straw use, and forceful spitting for at least one week after surgery.

Bleeding

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.

Swelling

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.

Pain

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.

Diet

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.

Keep the Mouth Clean

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.

Using the Irrigation Syringe

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.

Discoloration

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.

Antibiotics

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.

Nausea and Vomiting

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.

Other Complications

• If you suddenly sit up or stand from a lying position, you may become dizzy. Make sure you sit for one minute before standing.
• If numbness of the lips, chin, or tongue occurs, there is no cause for alarm. This is usually temporary.
• A slight elevation in temperature following surgery is not uncommon.
• Mouth may feel dry or cracked.
• Occasionally patients may feel hard projections in the mouth with the tongue. These are not roots, but bony walls that supported the tooth, and they will smooth over time.
• The corners of your mouth may feel dry or cracked. Your lips should be kept moist with an ointment such as Vaseline.
• It is not uncommon if the throat becomes swollen or feels painful. This should subside in two to three days.
• Stiffness of the jaw may cause difficulty in opening your mouth for a few days following surgery.

Sutures

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.

Dry Socket

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.