After Tooth Extraction

Post-operative Instructions

We are committed to providing the same quality of care following procedures that began during your initial visit. Please refer to some general postoperative guidelines below and, by all means, call at any hour of any day to report a continuing problem of lingering concern. Please remember to have a responsible adult prepared to stay with and supervise you following your surgery for a minimum of 8 hours after the surgery or until you have fully recovered and can care and maintain for yourself. It is very important that you do not drive, operate heavy or dangerous equipment or perform activities requiring sound judgment and normal reactions for at least 24 hours after any form of sedation, general anesthesia or while taking prescription pain pills or sedatives.

  • Do not disturb the area of surgery. The first stages of healing are aided by placing tissues at rest. Avoid vigorous chewing, excessive spitting, or rinsing as initial healing may be delayed, active bleeding restarted, or infection introduced.

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 fresh gauze over the area and biting firmly for 30 minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag wrapped in gauze for 30 minutes. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. Should active bleeding persist, please call our office for further instructions.

Swelling

The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the bodys normal reaction to surgery and eventual repair. The swelling usually develops the first 12-24 hours following surgery, often increasing on the second and third day. However, the swelling may be minimized by the immediate use of ice packs. Two plastic bags filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on 30-45 minutes every hour while you are awake during the first 24 hours following the surgery, unless you receive special instructions. After 36 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. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.

Pain

For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every three to four hours or ibuprofen (Motrin or Advil) two to four 200 mg tablets may be taken every three to four hours.

For severe pain, take the tablets prescribed as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. Persistent or increasing pain 3 to 4 days following oral surgery may be caused by early loss of the blood clot (dry socket) or infection. If you feel that this may be occurring, please contact us so that we can make you more comfortable.

Diet

Fluid intake is very important! Drink all the fluids you desire: water, milk, milk shakes, egg nog, tea, soda, broth, soups, and juices are good examples. Avoid hot liquids for the first 24 hours following surgery. Avoid using a straw for several days as it may cause the blood clot to dislodge and delay healing. You may eat anything soft by chewing away from the surgical site(s). Soft, cool foods that require little or no chewing are most easily tolerated at this time. We recommend soups, Jello, yogurt, or ice cream. Try to maintain a normal diet. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least five to six 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.

Keep The Mouth Clean

No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the night of surgery but rinse gently. The day after surgery you should begin rinsing at least three times daily with a cup of warm water mixed with a teaspoon of salt. Repeat this step until remaining soreness subsides. Resume brushing remaining teeth and your regular oral hygiene as soon as possible.

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 post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.

Antibiotics

If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions.

Take any regularly scheduled medication (for diabetes, high blood pressure, etc.) on your regular schedule unless advised to do otherwise.

Nausea & Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on Coke, tea, or ginger ale. You should sip slowly over a 15-minute period. When the nausea subsides, you can begin taking solid foods and the prescribed medicine.

Activity

We do not recommend any physical activities the first 48 hours following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.

CAUTION: If you suddenly sit up or stand from a lying position, you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.

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 the sensation. So be careful. Please call our office at (828)327-7867 or (828)433-4499 if you have any questions.
  • A slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
  • You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery. It was also difficult to take fluids. Taking pain medications can make you dizzy. You could get light headed when you suddenly stand up. Before standing up, you should sit for one minute and then get up.
  • Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls, which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by either Drs. Brown or Neuwirth.
  • 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.
  • Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in two to three days.
  • Stiffness (trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This may be relieved by applying a warm, moist towel to the affected side of the face several times a day. This is a normal post-operative event that will resolve in time.

Finally

Do not worry about stitches. These were placed to control bleeding and aid healing. They will dissolve on their own in approximately 5-10 days after surgery.

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 the office for instructions.

Your case is individual. No two mouths are alike. Do not accept well-intended advice from friends. Discuss your problem with the persons best able to effectively help you: Drs. (Brown & Neuwirth) or your family dentist.

Faithful compliance with these instructions will add to your comfort and hasten your recovery.

Drs. Brown & Neuwirth will strive to provide you with the best in anesthetic and surgical care. However, the ultimate success of your operation now depends on correct postoperative management. You have been given specific verbal and written instructions for proper home care.

Be sure to follow these instructions carefully. Only in this way will you avoid the complications which lead to unnecessary discomfort and delayed recovery. Should any undue reactions or complications arise, notify the office immediately.