ACKNOWLEDGEMENT OF INFORMATION
You must inform the doctor of any personal illnesses, allergies and all medications you are currently taking.
Sometimes the after effects of oral surgery are quite minimal, so not all of the instructions may apply. Common sense will often dictate what you should do. However, if you have questions following these guidelines, please call our office at the above number.
First Hour: Bite down gently but 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 the bleeding is not controlled. The packs may be gently removed after one hour. If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30 minutes. The gauze may then be changed as necessary (typically every 30-45 minutes). It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning. If your procedure was done with IV sedation, someone has to stay with you for the first 24 hours. Do no do anything which requires your judgment (working, driving, operating heavy machinery). Take note that the medication given in the IV and the prescribed pain medication can make you feel dizzy and may impair your judgment.
First 5 Days of Care: Do not disturb the surgical area today. DO NOT rinse vigorously or probe the area with any objects or your finger. You may brush your teeth gently. PLEASE, DO NOT SMOKE for 7 days since it is very detrimental to healing and can lead to delayed healing, infection and dry socket. DO NOT drink through a straw or cause any type of suction (i.e. sports bottle with squeeze top, popsicle). No exercise for 1 week.
Gauze: Intermittent bleeding or oozing overnight is normal. Bleeding may be controlled by placing fresh gauze over the areas and biting on the gauze firmly for 45 minutes. You will need to change the gauze every 45 minutes until bleeding stops. You will only use the gauze for the 1st day. On the 2nd and 3rd day, it is normal to have slight amount of bloody saliva, which usually does not require biting down on additional gauze. DO NOT EAT OR SLEEP with the gauze in your mouth.
Persistent Bleeding: Bleeding should never be severe. If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs. If bleeding persists or becomes heavy, you may substitute a tea bag (soaked in very hot water, squeezed damp –dry and wrapped in a moist gauze) for 30 minutes. If bleeding remains uncontrolled, please call our office at the above number.
Swelling: Swelling is often associated with oral surgery. It can be minimized by using a cold pack, ice bag or a bag of frozen vegetables (such as peas) wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied twenty minutes on and 5 minutes off during the first 24 hours after surgery. After 24 hours, switch to alternating cycles of cold and then warm moist heat. You may use hot water bottle, hot moist towels, and heating pad for 20 minutes on and 20 minutes off to help soothe tender areas. This will also help decrease swelling and stiffness. Swelling and pain is usually the worst on the 3rd to 5th days after surgery.
Pain: Unfortunately, most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication. If you take the first pill before the anesthetic has worn off, you should be able to manage any discomfort better. Some patients find that stronger pain medicine causes nausea, but if you precede each pain pill with a small amount of food, it will reduce the chance that nausea will occur. The effects of pain medications vary widely among individuals. If you do not achieve adequate relief at first, you may supplement each pain pill with an analgesic such as aspirin or ibuprofen. Some patients may even require two of the pain pills at one time. Remember that the most severe pain is usually within six hours after the local anesthetic wears off; after that your need for medicine should lessen. If you find you are taking large amounts of pain medicine at frequent intervals, please call our office. If you anticipate needing more prescription medication for the weekend, you must call for a refill during weekday business hours.
Nausea: Nausea is not uncommon after surgery. Sometimes pain medications are the cause. Nausea can be reduced by preceding each
pain pill with a small amount of soft food, and taking the pill with a large volume of water. Try to keep taking clear fluids and minimize dosing of pain medications. Please call us if you do not feel better. (Classic Coca Cola may help with nausea).
Diet: Eat any nourishing food that can be eaten with comfort. Avoid extremely hot foods. Do not use a straw for the first few days after surgery. It is advisable to confine the first seven days to a soft non-chew diet (soups, puddings, yogurt, milk shakes, etc.) and avoiding things like nuts, sunflower seeds, popcorn, etc., which 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 are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.
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.
Mouth Rinse: Keeping your mouth clean after surgery is essential. Use ¼ teaspoon of salt dissolved in an 8 ounce glass of warm water
and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, but at least two or three times daily.
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.
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, although still swollen, you can begin a more substantial diet. The remainder of the post-operative course should be gradual, steady improvement. If you don’t see continued improvement, please call our office.
Syringe: If you are given a plastic curved tip syringe, DO NOT use it for the first five days. You can start using it daily after the first five days. Only use the syringe on lower extraction sites to flush out food particles. Flush out the socket until you are certain there are no food particles lodged in the socket. You can use the Peridex that was prescribed to you or salt water to flush out the socket.
Sutures: If sutures are placed at the extraction site, they are dissolvable and will usually last from three to ten days. They will gradually dissolve and come out on their own. Please do not pick, pull or cut them out yourself. Sutures are sometimes placed between the teeth in front of the surgery site.
It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, please call our office. A 24-hour answering service is available to contact the doctor on call after hours. Calling during office hours will afford a faster response to your question or concern.
PLEASE NOTE: Telephone calls for narcotic (pain killer) prescription renewal is ONLY accepted during office hours.
Directions to follow when taking your medications.
If you were prescribed a Narcotic such as Hydrocodone (or Tramadol 50mg) and Motrin 800mg as your pain medications, you
will alternate these medications every three hours. Take as needed.
• Antibiotics (Clindamycin/Penicillin)
Take one tab every 6 hours until all gone.
Follow the directions on the package.
• Oral Rinse
Peridex is a mouth wash that you start the following day after your surgery. Squish and spit three times a day.
It is important to take all medications with a full glass of water. If you have adverse reaction to any medication, STOP
taking it immediately and call the office.