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EXTRACTION

 

POST-OPERATIVE INSTRUCTIONS

PLEASE READ INSTRUCTIONS CAREFULLY.

Sometimes the after effects of treatment are quite minimal, so not all of these instructions may apply, common sense will often dictate what you should do.  It is our desire that your recovery be as smooth and pleasant as possible.  Following these instructions will assist you, but if you have questions about your progress, please call the office where you had treatment.  Please try to call during office hours, however, if an emergency exists contact the doctors at home. Calling during office hours will afford a faster response.


DAY OF SURGERY

FIRST HOUR

Bite down gently but firmly on the gauze packs that have been placed over the surgical area, making sure they remain in place.  Do not change them for the first hour unless the bleeding persists after one hour: place enough new gauze to obtain pressure over the surgical site for another 30-60 minutes.  The gauze may be changed as necessary and may be dampened and/or fluffed for a more comfortable positioning.

EXERCISE CARE

Do not disturb the surgical area today.  DO NOT rinse vigorously or probe the area with any objects or your fingers.  You may brush your teeth gently.  DO NOT SMOKE for at least 48 hours, since it is very detrimental to healing.

OOZING

Intermittent bleeding or oozing is normal. It may be controlled by placing fresh gauze over the surgical areas and biting firmly for 30-60 minutes.

STEADY BLEEDING

Bleeding should never be severe.  If it is, it usually means that the packs are being clenched between your teeth rather than exerting pressure on the surgical areas.  Try positioning fresh packs.  If bleeding persists or becomes heavy, you may substitute a tea bag (soaked n hot water, squeezed damp-dry and wrapped in a moist gauze) for 20 or 30 minutes.  If bleeding remains uncontrolled, please call our office.

SWELLING

Often there is some swelling associated with oral surgery.  You can minimize this by using a cold pack or ice bag wrapped in a towel and applied firmly to face or cheek adjacent to the surgical area.  This should be applied 20 minutes on and 20 minutes off during the first 12-24 hours after surgery.  If you have been prescribed medicine for the control of swelling, be sure to take it as directed.  After 24 hours, it is usually best to switch from ice to moist heat to the same areas.

PAIN

Unfortunately,  most oral surgery is accompanied by some degree of discomfort. You may have a prescription for pain medication, and if you take the first dose before the anesthetic has worn off, you will be able to manage any discomfort better.  Effects of pain medicines vary widely among individuals. If you do not achieve adequate relief, you may supplement each dose with an analgesic such as aspirin, ibuprofen, naproxen sodium (Aleve) or acetaminophen. Analgesics with anti-inflammatory effects such as ibuprofen, Aleve and aspirin often give better relief than acetaminophen.  Remember that the most severe discomfort is usually within the first six hours after the anesthetic wears off: after that your need for medicine should lessen.

NAUSEA

Nausea is not an uncommon event after surgery, and it is sometimes caused by stronger pain medicines.  Preceding each pill with a small amount of soft food, then taking the pill with a large volume of water may reduce nausea.  Try to keep taking clear liquids and minimize the pain medication, but call us if you do not feel better or if repeated vomiting is a problem.  Cola drinks that have less carbonation may help with nausea.

DIET

Eat any nourishing food that can be taken with comfort.  Temperature of the food doesn't matter, but avoid extremely hot foods.  It is sometimes advisable, but not required, to confine the first day's intake to bland liquids or pureed foods (creamed soups, puddings, yogurt, milk shakes, etc.). Avoid foods like nuts, sunflower seeds, popcorn, etc., that may get lodged in the socket areas.  Over the next several days you can progress to solid foods at your own pace.  It is important not to skip meals!  If you take nourishment regularly, you will feel better, gain strength, have less discomfort and heal faster.  If you are a diabetic, maintain your normal eating habits as much as possible and follow instructions from us or from your physician regarding your insulin schedule.

SHARP EDGES

If you feel sharp edges in the surgical areas with your tongue, it is probably the bony walls, which originally supported the teeth.  Occasionally small slivers of bone may work themselves out during the first week or two after surgery.  They are not pieces of tooth and, if necessary, we will remove them.  Please call the office if you are concerned. 

INSTRUCTIONS FOR THE SECOND AND THIRD DAYS

MOUTH RINSES

Keeping your mouth clean after treatment will promote better healing.  Use a one-quarter teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful.  Repeat as often as you like, but at least two or three times daily for the next five days. DO NOT rinse with hydrogen peroxide.

BRUSHING

Begin your normal hygiene routine as soon as possible after surgery.  Soreness and swelling may not permit vigorous brushing of all areas, but please make an effort to clean your teeth within the bounds of comfort.

HOT APPLICATIONS

Apply warm compresses to the skin overlying areas of swelling (hot water bottle, moist hot towels, heating pad) for 20 minutes on and 20 minutes off to help soothe those tender areas.  This will also help decrease swelling and stiffness.

DRY SOCKETS

Normal healing after tooth extraction should be as follows: The first day of surgery is usually the most uncomfortable and there is some degree of swelling and stiffness. The second day you will usually be far more comfortable and, although still swollen, you can usually begin a more substantial diet. From the third day on GRADUAL, STEADY IMPROVEMENT should mark the remainder of your post-operative course. If a DRY SOCKET occurs (loss of blood clot from socket, usually on the 3rd and 5th day), there is a noticeable, distinct, persistent throbbing pain in the jaw, often radiating toward the ear and forward along the jaw to cause other teeth to ache.  If you do not see steady improvement during the first few days after surgery, don't suffer needlessly.  Call the office and report symptoms so you can be seen as soon as possible.

SUTURES

If sutures have been placed, you will need to return to our office to have the sutures removed and healing checked in one week.




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