Some light bleeding (oozing) after dental extractions may be normal and may persist for several days. Light bleeding on the day of the surgery is best controlled by placing warm, moistened gauze over the surgery site and biting on the gauze for 30-60 minutes at a time.
If heavy bleeding is noted, it usually means that not enough pressure is being placed on the surgical area. Make sure the gauze is overlying the surgical site and not just between the teeth. Sometimes it is difficult to know by feel when you are still numb from surgery, so confirm the gauze placement in a mirror. If brisk bleeding still persists, after repositioning or changing the gauze, try placing a hot damp gauze (run gauze under hot tap water and squeeze damp), or a warm moist tea bag (black tea is best) wrapped in gauze over the surgery site. Apply constant pressure for 60 minutes. Repeat this process until bleeding stops. If bleeding still remains uncontrolled, please contact our office.
Swelling and bruising are natural responses to surgery and can persist for 1-2 weeks following surgery. It frequently takes up to three days to reach the “maximum” swelling and from that point, your swelling should decrease. Any increase in swelling or discomfort after the first three days should be brought to our attention by calling our office. Also, if you take blood thinning medications, non-steroidal anti-inflammatory medications such as aspirin, ibuprofen, naproxen etc., you may have more noticeable bruising postoperatively.
To help control swelling and bruising, use cold packs held on the side of the face utilizing a 20 minute on and 20 minute off technique for the first 24 to 48 hours. Crushed ice in a “ziploc” 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 your skin to avoid frost bite. Elevating your head while sleeping also helps to reduce swelling and bruising.
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. Repeat this routine 3-6 times a day for a week. Vigorous “swishing” should be avoided. Resume tooth brushing as soon as comfort allows. Avoid using a powered toothbrush or Waterpik in the surgical area for a week.
Most oral surgery is accompanied by some degree of discomfort.
Over the counter anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil/Motrin) or naproxen (Aleve) taken in recommended doses helps relieve most pain and swelling associated with oral surgery. They can be taken safely with Tylenol containing pain medication. Do not take NSAIDs if you have had an adverse reaction to them, or have asthma, stomach or kidney problems, take blood thinners or have been instructed not to take them. DO NOT exceed recommended dosage.
Your surgeon may prescribe pain medication for you. If the anti-inflammatory medication (NSAIDs) does not relieve your pain, add a dose of the prescription pain medication in between the anti-inflammatory medication doses. Most narcotic pain medications are combination drugs and often contain Tylenol (acetaminophen). Check your prescription to avoid overdose. You may take a Tylenol instead of the prescription pain medication.
If pain persists in spite of taking pain medications in recommended doses, please call our office. Due to recent changes in federal laws, requests for narcotic or pain killer prescriptions of any sort will only be accepted during our regular office hours. Questions regarding all other prescription medications are best addressed during office hours so that your records can be reviewed by the doctor.
Antibiotics, if prescribed, should be taken until they are gone.
If you notice any unusual reactions such as itching, rash, hives, swelling, shortness of breath or diarrhea, immediately stop taking the medication and contact our office.
Nausea can be a side effect of narcotic pain medications. Pain medication should be taken after a meal with a full glass of water to prevent nausea. Should nausea or vomiting occur, discontinue your prescription pain medication. Use ibuprofen or Tylenol for pain. Try flat Coke (stir out the bubbles), soda crackers or a small amount of soft chocolate to help reduce nausea and vomiting. Once your stomach has “settled down” you may resume taking your narcotic pain medication if needed.
Regular nutrition and ample hydration is essential for healing. Eight glasses of water per day are recommended for the average healthy adult. The use of a straw should be avoided during the first week after surgery. Liquid or soft diet may be necessary for several days following surgery. Powdered dietary supplements may be used to supplement your diet. Do not skip meals. Resume your normal diet as soon as comfort allows.
Use of tobacco and nicotine products (ie. cigarettes, chewing tobacco, nicotine patch/gum) delays healing and contributes to dry socket (clot loss). Do not use these products for at least the first week after surgery.
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.
A. Post-operative fever greater than 101 degrees F, after 24 hours, should be brought to the doctor’s attention.
B. Dry socket, also known as alveolar osteitis, is an inflammation (not an infection) of the bony tooth socket that is believed to be the result of the loss of a protective blood clot. A dry socket, if it occurs, usually begins 3 to 5 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 socket is self-limiting, but if it is very painful can be treated by placing a numbing, medicated dressing into the affected extraction site(s). This medicated dressing will make the surgical site feel better, but will not speed healing, as the site will heal naturally on its own time frame. The medicated dressing placements may require multiple office visits for evaluation/dressing changes.
C. If you notice hard or sharp edges in the surgical areas, you are most likely feeling the bony walls which once supported the extracted teeth. Occasionally, small slivers of bone may work themselves out during the healing process. If they cause concern or discomfort, please call our office.
D. Orthodontic retainers, if applicable, can be reinserted as soon as possible when comfortable.
E. If you were discharged with any additional post-operative instructions (ie. implant care, sinus precautions, etc.) please refer to them as well.
For an after-hours emergency, please call the office number. If the doctor on call has not returned your call in one hour, please call again. All other calls/concerns should be placed during regular office hours when staff is present to assist you.