After the Extraction of Teeth
Post-Operative Instructions for Removal of Teeth
Immediately Following Surgery
- The gauze pad placed over the surgical area should be kept in place for at least 45 minutes with firm, consistent biting pressure. After this time, the gauze pad should be removed and discarded. If the gauze pad was significantly saturated, repeat the process every 45 minutes until only small amounts of red/blood are present. The gauze will not come out completely white.
- Vigorous mouth rinsing 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 pain medications as soon as you have them available to you. Pain control is best achieved by staying ahead of discomfort. Start with over the counter type medications and then use prescribed medications if prescribed/needed.
- Restrict your activities for ay least 24 hours after surgery, then resume normal activity when you feel comfortable.
- Ice packs can help with discomfort. They can be applied to your cheek on the side of surgery for 20 minute intervals as needed (20 mins on, 20 mins off). If ice does not help with discomfort, there is no clear evidence it helps with swelling so you can avoid icing. For swelling and throbbing it is helpful however to try to keep your upper body elevated (30-45 degrees; avoid lying completely flat) whenever you lay down (for the first 3 days).
Excess Bleeding: If bleeding continues, a moistened black tea bag can be used in the same way as the gauze for 30 minutes. If bleeding still persists, call our office immediately. If immediate dentures were inserted and there is excessive bleeding around the dentures please remove them and bite directly on gauze without the dentures in place. You may not be able to comfortably place the dentures back in until the swelling starts to go down, approximately after 48 hours).
Swelling: As mentioned above, the most effective way to prevent swelling is to have your upper body ramped/elevated 30-45 degrees whenever you lay down during the first 48-72 hours after surgery.
Pain: NSAID pain medication (ibuprofen/motrin/advil/aleve) is a mainstay of pain control after surgery. You can take 600 mg of ibuprofen/motrin every 6 hours. For additionally pain control, or if you cannot take NSAID pain medication, you can take 1,000 mg of Acetaminophen/Tylenol every 8 hours. Opiate narcotics are also occasionally prescribed for pain control, these can be used in addition to NSAIDs and Tylenol, however be cognizant of the prescribed narcotic as it may contain Tylenol in it. You should not exceed more than 3,000 mg of Tylenol in 24 hours.
If the pain does not begin to subside in 2 to 3 days, please call our office.
If an antibiotic has been prescribed, finish your antibiotic prescription. If you are having trouble taking the antibiotics, please call the office for instructions.
Diet: After surgery drink plenty of liquids. Do not use straws. The sucking motion can cause more bleeding by dislodging the blood clot. Diet: Initially restrict your diet to liquids and soft foods (scrambled egg/pasta consistency), which are comfortable for you to eat. As the wounds heal, you can advance your diet as tolerated.
Keep the mouth clean: Do not aggressively rinse your mouth for the first post-operative day, or while there is bleeding. You can brush your teeth gently as tolerated. After the first day, use a warm salt water rinse after meals to keep the extraction sites clean. (1/4 teaspoon of salt in a glass of lukewarm water). If you were given a curved tip syringe, do not start using it before the 5th day after your surgery. This syringe is used to gently rinse the lower wisdom tooth sockets after meals and before bedtime. Rinse gently from above the wound. Do not jab it directly into the extraction site.
Activity: Limit vigorous physical activity for 24 hours. This may increase blood pressure and cause re-bleeding. After a day or two, you will feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, or worsening swelling beyond day 3, or a reaction to the medication, call our office immediately.
After Multiple Extractions
The removal of many teeth at one time is quite different than the extraction of one or two teeth. Because the bone sometimes must be shaped and smoothed prior to the insertion of a denture, the following conditions may occur, all of which are considered normal:
- There may be more bleeding and swelling and this is to be expected.
- The area operated on will reach maximum swelling in two to three days.
- Swelling and discoloration around the eyes and cheeks may occur.
- You may have a slight temperature for a day or two. A low grade temperature is normal after surgery.
If Immediate dentures have been inserted, sore spots may develop. In most cases, your dentist or denturist will see you within 24-48 hours after surgery and make the necessary adjustments to relieve any spore spots. Failure to do so may result in severe denture sores, which may prolong the healing process. Your oral surgeon will instruct you on when to wear your new dentures. Generally, patients should leave the dentures in after surgery until they see their dentist or denturist.
Dry socket or alveolar osteitis is a condition where a blood clot either doesn’t form or goes away too soon, leaving the socket walls exposed. This leads to additional pain that is often described as radiating, severe throbbing that can feel like an earache and isn’t alleviated by conventional pain medicine. This isn’t an infection, but does warrant treatment. If pain medicine is helpful, your provider may be able to prescribe additional medicine. Clove oil is the active ingredient in most dry socket dressings and can be purchased at some pharmacies or health food stores. It can be applied multiple times a day with a dropper. There are also dry socket dressings that can be placed at our office, and may require visits to have them changed out. Dry socket symptoms often last 1-2 weeks and do not require additional surgical treatment.
If you have any questions or concerns, please call us at Waterville office of Mid-Maine Oral Surgery Phone Number 207-873-0117. After hours, you will reach our answering service and they will page the doctor and have him call you back.