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Post-operative Instructions: Tooth Extractions (Including Wisdom Tooth Surgery)

Post-Operative Instructions: General Extraction in Atlanta GA

Bleeding

After tooth extractions, it is important for a blood clot to form to stop the bleeding and begin the healing process. That’s why we ask you to bite on a gauze pad after the procedure. Most patients need to apply gauze for the first few hours after a tooth extraction.

For routine cases, including wisdom tooth surgery, our doctors recommend that patients change the gauze packing every 30-40 minutes for the first few hours (typically around 3-4 hours). If you remove the gauze, please be aware that light oozing and bloody saliva is normal throughout the first postoperative day. Productive bleeding (blood that pools up) is not normal, however, and additional pressure should be applied.

If heavy bleeding persists beyond the first 4-5 hours, you may consider biting on a moistened tea bag for 30 minutes to one hour. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited; sit upright and avoid exercise. If bleeding does not subside, call our office for further instructions.

Please avoid hot foods/liquids for the first 24 hours after surgery.

After the blood clot forms, it is important not to disturb or dislodge the developing blood clot as it aids healing. Do not rinse vigorously, create suction by drinking with a straw or forcefully spitting, no smoking throughout the 1st postoperative weekand refrain from drinking alcohol for at least 24 hoursYou may brush your teeth the evening of your surgery, but please do so gently in the area adjacent to the extraction, and please let things fall gently into the sink as opposed to spitting when you are done.

What are Dry Sockets? What You Need to Know

Limit vigorous exercise for the first few days following surgery as this will increase blood pressure and may cause more bleeding from the extraction site.

Diet

Restrict your diet initially to liquids and soft foods that are comfortable for you to eat. We advise patients to start with soft spoonable foods on the day of surgery (things like Jell-O, yogurt, apple sauce, and soup work well); oftentimes by the evening patients can tolerate more substantial foods like well-cooked pasta (macaroni & cheese) and mashed potatoes.  As the wounds heal, you will be able to advance your diet to include more routine foods throughout the first postoperative week.  Most commonly patients can tolerate a regular diet within 7-10 day of the majority of the procedures that we offer.

It is important to remember that you need to drink plenty of fluids. If multiple teeth have been extracted, you may be dehydrated. Drinking at least 6 glasses of water on the first postoperative day is advisable.

Pain & Swelling After Tooth Extractions

After the tooth is extracted, you may feel some pain and experience swelling. Elevating the head when laying down, and application of an ice pack to the affected area will help keep swelling to a minimum. We recommend that patients apply ice as much as they can comfortably tolerate for the first 48 hours after surgery.  Take pain medications as prescribed, as some of the medications we commonly employ are anti-inflammatory. The swelling from tooth extractions usually subsides after 72 hours, but sometimes it can persist for the first 5-7 days. At any point in time, if swelling begins to increase significantly, or if you have a fever or severe discomfort, please contact your doctor immediately.

Use the pain medication as directed. Call the office if the medication doesn’t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of infection are gone. Drink lots of fluid and eat nutritious soft food on the day of the extraction. You can eat normally as soon as you are comfortable.  We advise patients to avoid chips, seeds, or nuts for the first post operative week.

Oral Hygiene

It is important to resume normal dental hygiene as soon as possible. This should include brushing and flossing your teeth after an extraction at least once a day as well as rinsing with warm salt water after meals to prevent food impaction in the socket(s). DO NOT rinse with peroxide, even if diluted. We advise patients to rinse their mouth with either warm salty water or prescribed Peridex™ Oral Rinse (if applicable) at least twice a day during the first week following surgery.  If you were given an irrigation syringe with your discharge paperwork, it is advisable to begin irrigating your surgical site 4 days after the procedure.  It is best to irrigate with either salty water or Peridex™ after your meals up until the extraction sockets close and food no longer packs into the site(s).

Resumption of Normal Activities

Please avoid heavy athletic activity for the first 3-4 days after surgery.  Also please resume these types of activities gently and not at your regular maximum capacity.

Post-Operative Instructions for Simple Extraction
Post-Operative Instructions for Surgical Extraction

Other Complications

If numbness of the lip, chin, or tongue occurs, there is no cause for alarm. These occurrences fortunately are rare, and usually are only temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful. Call Drs. Aiken and Shessel to inform them of this numbness or if you have any questions.

Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol® or ibuprofen should be taken to reduce the fever.

You should be careful going from the lying down position to standing. Taking pain medications can make you dizzy. You could get light-headed when you stand up suddenly. Before standing up, you should sit for one minute, then get up.

Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots or pieces of teeth; they are the bony walls that supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed or smoothed over by Drs. Aiken and Shessel.

If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline®.

Sore throats and pain when swallowing are not uncommon after oral surgery. The muscles get swollen. The normal act of swallowing can then become painful. This should will subside in 2-3 days.  If it does not for any reason, contact the office for additional assistance.

Stiffness (trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event that will resolve in time.  If it persists for more than 1 week please contact the office for additional assistance.

What is a Dry Socket?

A dry socket is technically a phenomenon of bone inflammation at the site of a tooth extraction.  Commonly, this can occur when the blood clot dissolves or gets dislodged prematurely from the tooth socket, leaving exposed bone in the socket. Most commonly (>90% of the time) this occurs with teeth in the lower jaw only.

Symptoms of pain at the surgical site that may radiate to the ear occur 3–4 days following surgery, and usually don’t respond well to oral pain medications. While this can be quite uncomfortable, the good news is that it can typically be easily resolved in the office.  If you think you have a dry socket we encourage our patients to call the office to schedule a  follow up evaluation. Once you are seen in our office, our staff can wash out the affected are and some times a medicated packing can be placed to relieve the discomfort. Ibuprofen and Tylenol together tends to be more effective than taking narcotic pain medications.

Finally

Sutures may be placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged; this is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures will usually dissolve within one week of surgery. If the removal of sutures is required, no anesthesia or needles are required. It takes only a minute or so, and there is no discomfort associated with this procedure, so it’s really nothing to worry about.

The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur, call the office for instructions.

There may be a cavity where the tooth was removed. The cavity will gradually fill in with the new tissue over the next month. In the meantime, the area should be kept clean, especially after meals, with saltwater rinses or a toothbrush. Starting 5 days after the surgery, the Monoject syringe provided should be used to direct water into the lower extraction sockets to remove any food and debris following meals.

Your case is individual; no two mouths are alike. Do not accept well-intended advice from friends. Discuss your problem with the persons best able to effectively help you: Drs. Aiken and Shessel or your family dentist.

Brushing your teeth is okay — just be gentle at the surgical sites.

Emergencies

If you experience heavy bleeding, severe pain, excessive swelling after 3-4 days, or an adverse reaction to a medication, call our office immediately at 470-427-2854 or call 9-1-1.

 

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