Surgical Instructions

After Tooth Removal

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. Only replace it for thirty minutes if heavy bleeding continues.
  • Avoid vigorous mouth rinsing or touching the wound following surgery. This may initiate bleeding by dislodging the blood clot.
  • Take the prescribed pain medication as directed when you get home, this will help you stay ahead of the pain. It is recommended that you have food in your stomach prior to taking the prescription medication.
  • 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. Refer to the section on swelling for an explanation.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. To control bleeding, place a gauze pad over the area and bite firmly for thirty minute intervals, repeating only if necessary. If bleeding still 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 bleeding, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.

Swelling

Swelling can occur and is usually proportional to the surgery involved. This is the body's reaction to surgery. The swelling may not become apparent until a day or two following surgery and may not reach its maximum until 2-3 days after surgery. However, the swelling may be minimized by using cold packs. Cold packs should be applied to the sides of the face where surgery was performed. They should be left on for twenty minute intervals while you are awake. Jaw swelling and stiffness can remain for a few days following surgery, this is a normal reaction. Forty-eight hours following surgery, applying moist heat to the sides of the face is beneficial in reducing swelling and stiffness.

Pain

For moderate pain, two or three 200 mg tablets of Ibuprofen (Motrin or Advil) may be taken every 6 hours or one to two tablets of Tylenol or Extra Strength Tylenol may be taken every three to four hours.

For severe pain, take the prescribed medication as directed. The prescribed pain medicine may make you groggy and slow down your reflexes. Do not drive or operate machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more each day. If pain increases, this requires attention and you should call the office.

Diet

After I.V. anesthesia, liquids should be initially taken. Do not use straws because the sucking motion can cause more bleeding by dislodging the blood clot. Avoid hot liquids or food. Do not chew near the surgical sites. High calorie, high protein intake is very important. You should prevent dehydration by taking fluids frequently. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake to at least 8 glasses of liquid each day. You will feel better, have more strength and heal faster if you take adequate nourishment.

You will feel better, have more strength and heal faster if you take adequate nourishment.

Keep the mouth clean.

You can brush your teeth the night of surgery but rinse very gently. The day after surgery you should rinse after eating using a glass of warm water mixed with ¼ teaspoon of salt.

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 and can occur well away from the surgical site. This is a normal post-operative occurrence, which may occur 2-3 days after the surgery. Moist heat applied to the area may speed up the return to normal color.

Antibiotics

Take antibiotics as directed. Antibiotics may be given to help prevent infection. If you are taking birth control pills use an alternative form of contraception for the entire month. Discontinue antibiotic use in the event of a rash, diarrhea or other unfavorable reaction. Call the office for further instruction.

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour, this includes the prescribed medicine. You should then sip on flat Coke or Ginger Ale. You should sip slowly over a fifteen-minute period. If nausea persists call the office for assistance. Tylenol as pain medication may be easiest on your stomach.

Other Complications

  • Numbness of the lip, chin, or tongue can occur after surgery. This is usually temporary in nature. If your lip or tongue is numb, you could accidentally bite it and feel no pain.
  • Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or Ibuprofen can be taken to reduce the fever.
  • Occasionally you could feel hard projections in the mouth with your tongue. These are not roots; they are the bony walls which supported the tooth. These projections usually smooth out with time. If not, they can be reduced by your doctor.
  • If the corners of your mouth become irritated, they should be kept moist with a lubricant.
  • Sore throats and pain when swallowing are not uncommon. This will subside in a few days.
  • Stiffness 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 subside with time.

Finally

  • Sutures are often placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become lost early; this is no cause for alarm. Most often the sutures dissolve by themselves and there is no need for removal.
  • Pain and swelling should gradually subside and disappear. If your post-operative pain or swelling worsens call our office.
  • There will be a space where the tooth was removed. Over the next month the space will gradually fill in with new tissue. In the meantime, the area should be kept clean especially after meals with gentle salt water rinses.
  • Brushing your teeth is okay - just be gentle at the surgical sites.
  • A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of significant pain at the surgical site and even pain to the ear may occur 3 or more days following surgery. Call the office if this occurs.
  • If you are involved in regular exercise, minimize over-exertion until you feel normal and you are eating properly.