after EXTRACTIONS
PLEASE READ THESE INSTRUCTIONS CAREFULLY. Sometimes the aftereffects of oral surgery are quite minimal, so not all of these instructions may apply. Common sense will often dictate what you should do. However, when in doubt, follow these guidelines or call our office at any time for clarification.
INSTRUCTIONS FOR THE DAY OF SURGERY
Bleeding
Bite down gently but firmly on the gauze packs that have been placed over the surgical area(s), making sure they remain in place. Please apply pressure for one hour at a time. Active bleeding may stop as soon as one hour and may persist into the evening. If bleeding is persistent, consider substituting gauze pads for tea bags. Soak the tea bag in water and then squeeze the excess water out. Position it in the same manner as the gauze pads and place one hour of pressure. Once bleeding is controlled gauze pads will not be necessary. If there are any concerns regarding bleeding or any significant bleeding, please contact our office. If there is any continued bleeding from the extraction sites 24 hours after surgery, please contact our office. Bleeding can sometimes be exacerbated by foods with hot temperatures. These should be avoided in the first 24-72 hours after surgery if bleeding is a concern.
Exercise Care
Do not disturb the surgical area today. DO NOT rinse vigorously or probe the area with any objects or your fingers.
Swelling
Often there is some swelling associated with extraction of teeth. You can minimize this by using a cold pack or ice bag wrapped in a towel and applied firmly to the face or cheek adjacent to the surgical area. This should be applied 20 minutes on and 20 minutes off and is recommended to be used for up to the first 72 hours after surgery. It may not be necessary to use ice extensively. This will have to be judged by the patient based on the amount of swelling they encounter. If you have been prescribed medication for the control of swelling, be sure to take it as directed.
Pain
Unfortunately, most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication, and if you take the first pill before the anesthetic has worn off you will be able to manage your discomfort more effectively. Effects of pain medications vary widely among individuals. Remember that the most severe discomfort is usually within the first 6 hours after the anesthetic wears off.
Nausea
Nausea is not an uncommon event after surgery, and it is sometimes caused by strong pain medications as well as anesthesia. Nausea may be alleviated by preceding each pill with a small amount of soft food, then taking the pill with a large volume of water. If you are experiencing nausea, try to keep taking clear fluids and minimize the use of narcotic pain medication. If you have been prescribed an anti-nausea medication, please use as directed on the prescription. Please call our office with any concerns regarding persistent or severe nausea.
Diet
Eat any nourishing food that can be taken comfortably. Foods which are hot (temperature) may result in increased bleeding. It may be advisable to avoid these foods in the first 24-72 hours. It is sometimes advisable, but not required, to confine the first day’s intake to bland liquids or pureed foods such as creamed soups, puddings, yogurt, milkshakes, etc. Please wait until the local anesthetic has worn off before attempting to chew with any force. You may injure your lips or tongue because you can’t feel them.
Sharp Edges
You may feel sharp edges at the surgical site. These are most likely 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.
Brushing
It is ok to brush your teeth on the day of surgery. We generally recommend gentle brushing at the surgical sites.
Smoking
As always, we recommend to abstain from smoking for the overall health of our patients. Smoking can result in painful/delayed healing as well as failure of bone grafting and implants. It is recommended to abstain from smoking for as long as possible prior and after oral surgery.
INSTRUCTIONS FOR AFTER THE FIRST 24 HOURS
Diet
Please chew soft foods for 2-3 days after surgery. We recommend you avoid tough meat, nuts, chips, seeds etc. Ideally chewing will be performed away from the site of surgery if extractions are isolated to one area of the mouth. If extractions have been performed throughout the mouth, chewing can be performed wherever the patient prefers based on comfort. If pain is present with chewing we recommend changing your diet to be even softer or more liquid to aid in your recovery. If food packing in the site of the surgery can be avoided, the post-operative period will likely be more comfortable.
Brushing
Twice daily tooth brushing should continue after surgery. We recommend gentle brushing at the surgical sites for the first week after surgery, but expect that brushing should return to normal after that week.
Rinsing
Rinsing should be very gentle after extractions. Vigorous rinsing can potentially displace the initial blood clot at the tooth sockets. Rinsing will be an important part of oral hygiene after surgery, however, it should be very gentle. If you have been given a prescription mouth rinse, please rinse with it very gently, twice daily, for 1 week. If not, you may use whatever OTC rinse you prefer or you may also use warm salt water as an adjunct. After 1 week, rinsing may become more vigorous.
Straws
The use of straws may also displace the initial blood clot. We recommend the avoidance of straws for 72 hours after surgery.
It is our desire that your recovery is as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress please call our office. PLEASE TRY TO CALL DURING OFFICE HOURS. Calling during office hours will afford a faster response. However, you may call us after hours and an answering service will take your call and contact a doctor.