Postoperative Care

Woman Recovering from Surgery

This is a very important part of the treatment following the removal of teeth or other surgical procedures. No matter how skillfully an operation is performed, recovery may be delayed if home care is neglected. Patients frequently consider such operations minor procedures and continue their daily routine rather than making an effort to obtain proper rest. Rest following surgery within the mouth is just as important as that following surgical procedures performed on other parts of the body.

Routine Postoperative Instructions

Bleeding

Some light bleeding (oozing) after dental extractions may be normal and may persist for several days. Light bleeding is best controlled by using pressure. If a piece of gauze was placed over the surgical site by the doctor or his/her assistant, please keep pressure on it for at least 30 minutes to control bleeding. You may need to change the gauze every 30-40 minutes until the bleeding stops.

If heavy or brisk bleeding persists, try using a hot damp gauze (run gauze under hot tap water and squeeze damp) or a warm moist black tea bag wrapped in gauze and placed over the surgery site. Apply constant pressure for 60 minutes. Bleeding beyond this should be brought to the doctor's attention by calling our office.

Swelling

You can expect postoperative swelling following your procedure. How much and to what extent for each individual is unpredictable. The following are general guidelines. Swelling may persist for approximately one week following surgery. It frequently takes up to three days to reach the "maximum" swelling and from that point, your swelling should decrease. Any increase of swelling or discomfort after the first three days should be brought to our attention by calling our office(s). To help control swelling, use cold packs held on the side of the face utilizing a 15 minute on and 15 minute off technique for 24 to 48 hours. Crushed ice in a "ziplock" bag, frozen food packs or commercial cold packs all work well. Be sure to place a thin layer of cloth (kitchen towel, etc.) between the cold object and the skin to avoid frost bite.

Hygiene

The day after surgery, warm salt water should be held as a "soak"-a mouthful at a time over the surgery site. The solution is made by adding 1/2 tsp. of table salt to 8 oz. of water as warm as you can tolerate. The routine should be repeated 3 to 6 times a day for a week. Vigorous "swishing" should be avoided. Resume tooth brushing as soon as comfort allows.

Medication

Your surgeon may prescribe pain medication for you. Pain medication should be taken with a full glass of water or preferably a meal to prevent nausea. If there is no pain, no such medication should be taken. If no relief is obtained after the second scheduled dose of prescribed medication, the doctor may wish to alter the dose or prescribe another type of medication.

Many of today's narcotic pain medications are combination drugs and often contain Tylenol (acetaminophen). Check your prescription to avoid overdose; do not take additional Tylenol with your prescribed pain medication. You may take Tylenol instead of the prescription pain medication.

Over the counter anti-inflammatory medications, such as Advil or Motrin (ibuprofen), 400-800 mg taken every 6 hours, can boost the effectiveness of your prescription pain medication, and can be taken safely with Tylenol containing pain combination drugs. If your doctor has not advised this option you may wish to call for more information. Do not take Advil or Motrin (ibuprofen) or Aleve (naprosyn) if you have had a severe reaction to anti-inflammatories, if you have asthma, or if you have gastric ulcers. Please check with the doctor before taking any anti-inflammatory.

Antibiotics, if prescribed, should be taken until they are gone. Any unusual reaction, especially itching, shortness of breath, swelling of hands or feet, rash, or hives, should immediately be brought to the doctor's attention. All medications should be stopped if such a reaction occurs.

Requests for refills on prescriptions should be accomplished during office hours so that your records can be reviewed by the doctor.

Nausea

Most nausea is a side effect of narcotic prescription pain medications. Should this occur, discontinue your pain medication. Use Advil (ibuprofen) or Tylenol (acetaminophen) for pain. Try flat Coca-Cola (stir out bubbles), soda crackers or even a few Hershey Kisses chocolates. These all help reduce nausea and vomiting. Once your stomach has "settled down" you may resume taking your narcotic pain medication if needed. You may try eating a small amount of chocolate or a small meal or snack before taking your narcotic pain medication.

Diet

Regular nutrition is essential for healing. Please maintain good hydration especially if you fasted and underwent an IV sedation/general anesthetic. The use of a straw should be avoided during the first week after surgery.

Immediately following the surgery please keep to a liquid or soft diet until the "numbness" has resolved. A liquid or soft diet may be necessary for several days following surgery. Powdered or premade dietary supplements may be used to supplement your diet. Resume your normal diet as soon as comfort allows.

Smoking

Smoking delays healing and can contribute to dry sockets (clot loss). The use of all tobacco products should be discontinued for at least the first week after surgery.

General Anesthesia

If general anesthesia was used in the office, a short period of emotional change may occur as an effect of the anesthetic drugs. This passes in a short time.

Helpful Suggestions

Postoperative fever greater than 101 degrees F., after 24 hours, should be brought to the doctors attention.

Dry Sockets, also known as alveolar osteitis, are an inflammation (not an infection) of the bony tooth socket that is the result of the loss of a protective blood clot. The dry socket when it occurs usually happens 3 to 4 days after tooth extraction and the symptoms include a persistent ache or throbbing that radiates to the temple, ear or along the jaw. A foul odor or taste can accompany a dry socket. Dry sockets are self-limiting, but the pain can be relieved by placing a medicated gauze dressing into the extraction site. This may require multiple office visits before the pain subsides completely.

Orthodontic retainers, if applicable, may be re-inserted when comfortable.

For an after hours emergency that does not require the immediate attention of a 911 operator, please call any office number. Please listen carefully to all of the prompts on the voicemail to leave a message. If the doctor on call has not returned your call within one hour, please call again. All other calls such as those for billing questions, making or changing appointments etc. should be placed between 8:00 a.m. and 5:00 p.m. when office staff are present to assist you.

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