Postoperative Instructions: Extractions
Sometimes the after-effects of oral surgery are quite minimal, so not all of the instructions below may apply. Common sense will often dictate what you should do. However, when in doubt, follow these guidelines, or call our office for clarification.
DAY OF SURGERY
First Hour
Bite down firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first hour unless soaked with blood. The packs may be gently removed after 1 hour. If active bleeding persists, place enough gauze to obtain pressure over the surgical site for an additional 30 minutes. The gauze may then be changed as necessary (typically every 30 to 45 minutes). It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning. It may take 4-6 hours for the bleeding to slow down; once the gauze is light pink, you may stop using it.
Exercise Care
Do not disturb the surgical area today. Do NOT rinse for 24 hours or probe the area with any objects. Do not brush your teeth for 24 hours. PLEASE DO NOT SMOKE for at least 1 week, since this is very detrimental to healing and may cause dry socket.
Oozing
Intermittent bleeding or oozing overnight is normal. It may be controlled by placing fresh gauze over the areas and gently biting on them for 30 minutes at a time. Remove gauze while eating or sleeping.
Persistent Bleeding
Bleeding should never be severe. If so, it usually means that the packs are being clenched between the teeth only and are not exerting pressure on the surgical area. Try repositioning the packs. If bleeding persists or becomes heavy, you may substitute a tea bag (soaked in warm water, squeezed damp-dry, and wrapped in moist gauze), with firm biting pressure for 20 to 30 minutes. If bleeding remains uncontrolled, please call our office.
Swelling
Swelling is often associated with oral surgery. It often increases for the first 2-3 days. It can be minimized by using a cold pack, ice bag, or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied 20 minutes on and 20 minutes off during the first 24 hours after surgery. If you have been prescribed medicine for the control of swelling, be sure to take it as directed.
Pain
Discomfort after oral surgery is normal. To best manage your discomfort, please take the prescribed pain medications on schedule per the directions provided. Staying on top of a regular schedule will best minimize discomfort after oral surgery. If you are still experiencing significant discomfort despite the medications, please contact our office.
Nausea
Nausea is not uncommon after surgery. Sometimes pain medications are the cause. This can be reduced by preceding each pain pill with a small amount of soft food and taking the medicine with a large volume of water. Try to keep taking clear fluids and minimize the dosing of the pain medication, but call us if you do not feel better. Carbonated soft drinks may help with nausea.
Diet
Eat any nourishing food that can be taken with comfort. AVOID EXTREMELY HOT FOODS. DO NOT USE A STRAW for the first few days after surgery. It is sometimes advisable, but not absolutely required, to confine the first day’s intake to liquids or pureed foods (soups, puddings, yogurt, milkshakes, etc.). It is best to avoid foods like nuts, chips, sunflower seeds, popcorn, etc., that may get lodged in the socket areas. Over the next several days, you may gradually progress to solid foods. It is important not to skip meals. If you take nourishment regularly, you will feel better, gain strength, have less discomfort, and heal faster. If you have diabetes, maintain your normal eating habits, or follow instructions given by your doctor.
Sharp Edges
If you feel something hard or sharp (in the surgical areas) with your tongue, it is likely you are feeling the bony walls that once supported the extracted teeth. Occasionally, small slivers of bone may work themselves out during the following week or so. They are not pieces of teeth that were left in. If they cause concern or discomfort, please call the office.
INSTRUCTIONS FOR THE SECOND AND THIRD DAYS
Mouth Rinses
Keeping your mouth clean after surgery is essential. Use 1 teaspoon of salt dissolved in an 8-ounce glass of warm water and gently rinse with portions of the solution, taking 5 minutes to use the entire glassful. Repeat as often as you like, but at least 2 times daily. If you are given a plastic irrigating syringe, DO NOT use it for the first 5 days; then use it daily according to instructions until you are certain that the tooth socket has closed completely and there is no chance of any food particles lodging into the socket.
Brushing
Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort. Do not use electric toothbrushes for the first week after surgery.
Hot Applications
You may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, heating pad) after 36 hours for 20 minutes on and 20 minutes off to help soothe tender areas. This will also help to decrease swelling and stiffness.
Healing
Normal healing after wisdom tooth surgery should be as follows:
The first 2 days after surgery are generally the most uncomfortable, and there is usually some degree of swelling.
On day 3, you should be more comfortable and, although still swollen, can usually begin a more substantial diet.
The remainder of the post-operative course would be GRADUAL, STEADY IMPROVEMENT. If you don’t see continued improvement, please call our office during business hours so we can assist you.
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 NOTE: Telephone calls for narcotic (pain killer) prescription renewals are ONLY accepted during office hours.