Tooth Extraction Post-Op Instructions

After any surgical procedure performed in the mouth, one can expect some bleeding, some swelling, some discomfort. Those occurrences will be minimized if these instructions are followed carefully. Sometimes the after effects of oral surgery are minimal, so not all instructions apply. Common sense will often dictate what you should do. However, when in doubt, follow these guidelines or call our office anytime for clarification.

Immediately after the procedure:

  • Bite on folded gauze for at least 60-90 minutes with firm steady pressure.  You will be given extra gauze to change out as necessary.  This will help to minimize bleeding.  If there is still active bleeding after 1 hour, you should continue to bite on gauze or a tea bag for another 30-60 min.  Please keep in mind that some mild oozing and blood-tinged saliva is normal for about 2 days after the procedure.

  • You should take your pain medication before the effects of the local anesthetic (lidocaine) wear off.  This will help with pain control.

  • You may apply ice packs to the outside of face over the surgical areas for the first 24 hours.  This can help with swelling and discomfort.  Alternate 20 minutes on and 10 minutes off.

Diet:

  • You may begin eating after the gauze is removed.  Be sure you can swallow water easily before you try soft foods (ice cream, soup, mashed potatoes, jello, applesauce, pudding, milk shake, etc.)  

  • You should eat a soft diet with nothing hard or chewy for at least 2 days after the procedure

  • Over the next several days, you can progress to solid foods at your own pace.  It is important not to skip meals.  You will feel better if you stay nourished.

  • Avoid hot foods or drinks (helps prevent dry socket)

Beginning 24 hours after the procedure:

  • After the first 24 hours, begin gently rinsing mouth with the prescribed antibiotic (chlorhexidine) rinse 3 times per day

  • Brush teeth carefully avoiding surgical areas (keeping your mouth clean helps prevent infection)

For 7 days after the procedure:

  • You should eat a soft diet for 3 days after the procedure

  • You should avoid strenuous physical activity and sports for 5 days after the procedure

  • Do not spit or suck

  • Do not smoke

  • Do not use a straw

  • Do not use commercial mouthwash

  • Do not use hydrogen peroxide

  • Do not drink carbonated or fizzy beverages

  • The above activities could pull the blood clot out of the socket and lead to a dry socket

  • You may not drive or operate heavy machinery while taking narcotic (opiate) pain medication

Brush your teeth:

  • You should brush your teeth as normal after surgery.  This will help keep your mouth clean and prevent infection.  Be careful brushing around surgical sites.

What you can expect:

  • To see diluted blood in your mouth for up to 7 days

  • Swelling around surgical site (worst on day 2-3)

  • To be sore for at least 4 days (2nd and 3rd days are worst)

  • To have bad breath for several days

  • Tightness and stiffness to the jaw and joint areas (limited mouth opening)

  • If your pain gets worse after 3-5 days, please notify our office

  • Sore throat or pain around the TMJs

Healing:

  • Normal healing after tooth extraction should be as follows: The first two days after surgery are generally the most uncomfortable and there is usually some swelling.  On the third day you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be gradual, steady improvement.  

Nausea:

  • Nausea can be a common side effect of IV anesthesia and oral surgery.  Prescribed pain medication taken on an empty stomach may also cause nausea.  If nauseated, a clear liquid diet (broth, Jell-O, juice, Gatorade) is recommended.  Cutting back on prescribed pain medication and substituting over-the-counter pain medication may help with nausea.  If nausea persists, please contact our office.

Sharp Edges:

  •  If you feel something hard or sharp edges in the surgical areas, it is likely you are feeling the bony walls which once supported the extracted teeth.  Occasionally small slivers of bone may work themselves out during the following week or so.  If they cause concern or discomfort, please call the office.

Stitches (Sutures):

  • Sutures will dissolve or fall out on their own within 5-14 days.  It is OK if the sutures fall out early.  

Medications:

  • Eating something 30 minutes before taking pain medication can reduce the chance of nausea or stomach discomfort

  • NSAIDs such as ibuprofen are best to manage pain and discomfort after oral surgery procedures.  These medications decrease pain and swelling (unlike narcotics).  You should schedule doses of ibuprofen immediately after your extractions (600 mg every 6 hours or 800 mg every 8 hours for an adult) which is a very effective method of pain control.  It is best to take ibuprofen before the local anesthetic (numbness) wears off. 

  • Do not exceed 3200 mg of ibuprofen or 3000 mg of Tylenol per day for adults (please reference bottle for pediatric dosing based on age and weight).

  • Do not take NSAIDs or Tylenol if your doctor has advised against it for medical reasons

  • You may supplement ibuprofen with a narcotic (opiate) pain medication (for severe pain only) and take the narcotic between doses of ibuprofen.  Please note that narcotic pain medications will not help with swelling and have side effects such as drowsiness, addiction, upset stomach, itching, and constipation. 

  • You may not drive or operate heavy machinery while taking narcotic (opiate) pain medication

  • Antibiotics are not needed in most cases.  If you were prescribed an antibiotic, take as directed.

Sedation patients:

  • You can expect to be tired, sleepy, and forgetful on the day of surgery

  • Some people may repeat conversations or feel emotional

  • You should have a family member or friend with you for at least 8 hours after surgery because you may be unsteady on your feet

  • You should rest for the remainder of the day after sedation.  You should not be difficult to arouse

  • Do not drive, drink alcohol, operate machinery, attend children or attempt activities that require an alert mind for at least 24 hours after sedation

Numbness or tingling following tooth extractions:

There is a low risk of numbness and tingling of the chin, lips, gums, tongue, and teeth when lower teeth are extracted. This is due to the close relationship of the nerve to the surgical site of extraction.  If your numbness persists for greater than 24 hours after surgery, you should notify us immediately for a follow up appointment.

 

This rare postoperative occurrence usually resolves itself within a few weeks to months but in rare cases can be permanent.  There is usually a slow change in the return of normal feeling and a decrease in the pattern of numbness or tingling within three months. Careful follow-up is necessary to determine whether or not more treatment or a repair surgery is needed. 

Signs of a dry socket:

  • A dry socket is when the blood clot in the socket dissolves too early.  It is more likely with more difficult extractions and patients who smoke.  You may have a dry socket if you notice a sudden increase in throbbing pain 3-5 days after your extraction which is not relieved by pain medication.  If you notice this, please contact our office for treatment.  

Reasons to notify us immediately:

  • Repeated vomiting

  • Uncontrolled bleeding

  • Fever of 101 or greater

  • Worsening pain or swelling after day 5

  • Persistent numbness beyond 24 hours

  • Skin rashes

  • You should call 911 and/or go to the nearest hospital for any difficulty breathing

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© 2020 Louisiana Oral & Implant Surgery

4720 Lake Street

Lake Charles, LA 70605

(337) 888-4771

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