Carmel Oral Surgeon | Carmel dental care | IN | After Tooth Extraction

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After Tooth Extraction

Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.

Immediately Following Surgery

  • The gauze pad placed over the surgical area should be kept in place for a half hour.  After this time, the gauze pad should be removed and discarded.
  • Vigorous mouth rinsing or touching the surgical site following surgery should be avoided.  This may initiate bleeding by causing the blood clot that has formed to become dislodged.
  • Take the prescribed pain medication as soon as possible.  You will begin to feel discomfort when the local anesthetic starts to wear off.
  • Restrict your activities the day of surgery ansd resume normal activity when you feel comfortable doing so.
  • Place ice packs to the sides of your face where surgery was performed.  Refer to the section on swelling for further details.

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 fifteen to thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.

Swelling / Bruising

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 body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following 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. An ice pack should be applied to the side(s) of the face where surgery was performed. The ice pack(s) should be left on continuously while you are awake. 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, or a heating pad, to the side(s) of the face is beneficial in reducing the size of the swelling.

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 post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.

Rinsing / Hygiene

No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the night of surgery but be very gentle near the surgical area. The day after surgery you should begin rinsing, especially after eating, with an 8oz cup of warm water mixed with a teaspoon of salt.  Brushing you teeth may stimulate some minor bleeding for several days following surgery.

Diet

Do not use straws. Drink from a glass. The sucking motion created when using a straw can cause more bleeding by dislodging the blood clot. You may eat anything soft, but chew away form the surgical sites. High calorie, high protein intake is very important. Nourishment should be taken regularly. 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 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.  Be especially careful of chewing if your tongue or lip is still numb from the anesthetic that was administered.

If you had an IV sedation, start with fluids before advancing your diet.

Medication

For moderate discomfort, up to four tablets of 200mg Ibuprofen (Motrin or Advil) may be taken every 8 hours (so, a total of 800mg every 8 hours).

For severe discomfort, alternate Ibuprofen with the pain medication that was prescribed.  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. After initially increasing over the first few days, discomfort following surgery should subside more and more every day.  If pain persists, it may require attention and you should call the office.

If you have been placed on antibiotics, take 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.

Nausea and 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 fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.  If the symptoms still persist contact Dr. Alderman. 

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. Call Dr. Alderman if you have any questions.
  • 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.
  • Occasionally, patients may feel hard projections in the mouth with their tongue. They are not part of the tooth, they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. Alderman.
  • 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 2-3 days.
  • Stiffness (Trismus) 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.
  • A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain radiating back 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 therefore cause you to feel weak. If you get light headed, stop exercising.  Please wait 48 hours prior to resuming your normal exercise regimen.


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