After Tooth Extractions
Home Instructions After Tooth Extractions
Special consideration must be given to wounds of the mouth following the removal of teeth or other surgery involving the mouth and jaws. Proper home care is exceedingly important, and our interest in your case does not cease with the completion of the procedure. If any difficulty arises after you leave the office, do not hesitate to contact us.
Patients who receive general anesthesia should return home from the office immediately upon discharge and lie down with the head elevated until all effects of the anesthesia have worn off. Patients should not operate any mechanical equipment and/or drive a motor vehicle for at least 12 hours or longer if there is any residual effect from the anesthesia.
Immediately Following Surgery
- The gauze pad placed over the surgical area should be replaced with a new one every 45 minutes the day of surgery.
- Vigorous mouth rinsing and/or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
- Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic wearing off.
- Restrict your activities (e.g., work or school) 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 a more thorough explanation.
- 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 up for one minute before standing.
To control pain, please take the prescriptions prescribed by the doctor as indicated. If you do not achieve adequate pain relief, you may supplement the prescribed pain medication with Aspirin, Tylenol, Motrin, Advil, or ibuprofen. Do not take any of the aforementioned medications if you are allergic to them or have already been instructed by your doctor not to. Before taking any of these additional medications, please contact the office or page the doctor after hours to determine which additional medication would be appropriate for use.
Taking medication with soft food and a large amount of water will lessen any side effects of nausea or stomach upset. Avoid alcoholic beverages and do not drive or work around machinery while taking prescribed medications. Pain or discomfort following surgery should subside more and more every day. If pain persists or returns, please contact the office.
Be sure to take the prescribed antibiotics as directed to help prevent infection. Avoid alcoholic beverages during your course of antibiotics. If you are on birth control, be sure to use backup contraception as antibiotics may lower the effectiveness of the pill. Discontinue antibiotic use in the event of a rash or any other unfavorable reaction and contact our office immediately. Call the office if you have any questions.
Some oozing of blood is to be expected for the first 24 hours. Gauze has been placed at the surgical site and should be changed every 45 minutes until the bleeding stops. Remove any gauze before eating or drinking. Please remove the gauze prior to going to bed at night as it is considered a choking hazard. You should refrain from the following for at least three days after surgery: spitting, drinking through a straw, and smoking.
Swelling is normal and to be expected, usually reaching a maximum in 48 hours. This is a frequent aftermath of oral surgery and may persist for as long as a week. To minimize swelling, cold packs or an ice bag wrapped in a towel should be applied repeatedly for 20 minutes on and off during the first 24 hours after surgery. After the first 24 hours, the recommendation is to switch from using the cold pack to applying moist heat at 20-minute intervals until the swelling has receded. To achieve this, you may put a wet wash cloth in the microwave for 10–15 seconds. You may also use a heating pad, but be sure to wrap it in a warm cloth so that your skin does not dry out.
Continued proper oral hygiene is imperative. Normal care should be maintained, and in most cases the individual can brush and floss gently the following morning, being careful to avoid excess trauma to the surgical site. If an irrigating syringe was given, start using the syringe over the extraction sites the day after surgery, once a night before bedtime for 6–8 weeks or until the hole closes.
Use half a teaspoon of salt with an 8-oz cup of room-temperature water and rinse after meals for seven days, starting the morning after surgery. Do not use any other mouthwash unless specifically advised. If the doctor has prescribed a mouth rinse (Peridex), use it once at bedtime on the day of surgery and then as follows: once after breakfast, once in the afternoon (approximately 3:00pm), and once before bedtime for seven days after surgery (i.e., every eight hours). Do not eat or drink anything for 30 minutes after the rinse.
Avoid hot liquids or food until the numbness is gone. A soft-food diet should be maintained for 3–5 days following surgery. You may eat anything soft by chewing away from the surgical sites. A high-calorie, high-protein intake is very important. Our staff can provide suggested diet instructions. You should prevent dehydration by taking fluids regularly. At least 5–6 glasses of liquid should be taken daily. Try not to miss any meals; you will feel better, heal faster, and have more strength and less discomfort if you continue to eat.
In some cases, discoloration of the skin follows swelling. The development of black, blue, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal postoperative occurrence that may occur 2–3 days after surgery. Moist heat applied to the area may speed up the removal of the discoloration.
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 water and eat crackers. You should sip slowly over a 15-minute period. When the nausea subsides, you can begin eating again.
Keep physical activities to a minimum immediately following surgery. If you exercise, throbbing or bleeding may occur. Keep in mind that you are probably not taking in normal nourishment. This may weaken you and further limit your ability to exercise. For seven days following surgery, refrain from rigorous activities, exercise, swimming, heavy lifting, and using instruments with mouthpieces.
- If numbness of the lip, chin, or tongue occurs, there is no cause for alarm. As reviewed in your consultation, 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. Call Dr. Gulati if numbness continues six hours or more after surgery.
- A dry socket is when the blood clot gets prematurely dislodged from the tooth socket. Symptoms of pain at the surgical site and even pain near the ear may occur 2–3 days following surgery. Call the office if this occurs.
- 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 tooth roots; they are the bony walls that supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. Gulati.
- 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 medication given during the IV sedation can dry the throat and result in a sore throat. Also, the muscles of the throat swell, and swallowing can become painful. Sucking on ice chips may alleviate some of this discomfort. These symptoms 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 postoperative event that will resolve in time. Applying moist heat and taking anti-inflammatories like Advil, Motrin, and ibuprofen will help. If it does not resolve, please contact the office.
- Sutures are placed in the area of surgery to minimize postoperative bleeding and help healing. They dissolve in time, faster for patients with higher metabolisms. However, sometimes they become dislodged or feel too long. This is no cause for alarm. If they are bothering you, please call our office; Dr. Gulati can trim or remove them for you.
- If immediate dentures have been inserted, sore spots may develop. In most cases, your dentist will see you within 24–48 hours after surgery to make the necessary adjustments and relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.
Your case is unique; no two mouths are alike. Discuss any problems with the trained experts best able to effectively help you: Dr. Gulati or your family dentist. If you have any questions or concerns, please call our office or page Dr. Gulati at the number provided in the home care packet provided to you on the day of your surgery.