Extraction Post-Operative Care Instructions

Post-operative care is important following oral surgery and recovery may be delayed if this care is neglected. Some swelling, stiffness, oozing of blood and discomfort is expected after surgery. It is helpful to have the patient observed by a responsible adult for the duration of the day of the surgery. The following includes our post-operative instructions and events, which may take place following this kind of surgery.

Bleeding: The gauze pad which was placed after surgery acts as a protective dressing and should be left in place 1 hours (2 hours if on any blood thinning medication) with gentle pressure applied. Some oozing is to be expected. If excessive bleeding is noticed, this is not normal. Most often, however, this can be controlled by the use of clean gauze placed directly over the surgical site and held with firm pressure for approximately 1 hour until the bleeding is controlled. If bleeding continues, call the office number at any time (205) 822-7277, or report to the emergency room.

Pain: If it is necessary, you will be provided with a prescription for medication. This can be filled at any drugstore and should be used as directed. Pain may be expected soon after the surgery and will reach its maximum during the first few hours. It is recommended that the prescription be started approximately 1-2 hours after the surgery and continued as directed.

Nausea: If nausea is encountered in the immediate post-operative period, it is often increased by taking the pain medication. Remember not to take the pain medication without something in your stomach. The post-operative nausea may be relieved by taking 1oz. of a carbonated drink such as Ginger Ale every hour for 5-6 hours. This can be followed with mild tea, broth, and soft foods before resuming your regular diet.

Swelling: Swelling and stiffness are to be expected. This swelling may increase over the first 2 days, and then it should start to subside. Swelling can be somewhat controlled by the use of ice and heat as follows:
Ice: Use ice for the first 12-24 hours applying it to the cheeks for 20 minutes and removing it for 20 minutes alternately.
Heat: Swelling and stiffness may be relieved by warm, moist heat applied to the jaws on the 2nd and 3rd days following the surgery.
The stiffness which can sometimes occur will usually be relieved by the heat application, the use of chewing gum at intervals, and gentle stretching exercises beginning the day after surgery.

Nourishment: Nourishment should not be neglected. On the day of surgery, a light diet is recommended (instant breakfast, Jell-O, soups, shakes, ect.). The following day, a soft diet to a regular diet as tolerated may be started. The patient should not use a straw for several, since this may dislodge the blood clot.

Oral Hygiene: Rinsing and spitting should be avoided on the day of surgery. Starting on the day after surgery, frequent gentle rinsing with mild, warm salt water is encouraged. Brushing should be resumed the day of surgery, being careful to avoid the surgical site for the first two days. Good oral hygiene is important to normal wound healing.

Activities: Activities for the first 24 hours should be minimal. Rest quietly with your head elevated. Smoking should be discontinued for at least 3 days. Do not expect to return to work or normal activities immediately. Two to three days rest is recommended and subsequently resuming activities as they are tolerated. Vigorous physical activities and sports should not be resumed until the surgical areas are comfortable, swelling is resolved and a normal diet is possible. Usually contact sports should not be resumed for approximately 1 week post-operatively. Musical wind instruments should not be played for at least 7-10 days after most oral surgery.

Bruising: Depending on the nature of the surgery which was performed and the nature of the person, some discoloration on the face may be seen for 3-5 days after the surgery. If this happens, do not be alarmed.

Numbness: Many times the roots of the lower teeth are adjacent to the nerve in the lower jaw. When the tooth is removed, the nerve may be slightly disturbed which may lead to a numbness of your chin, lower lip, and your lower teeth on that side. This does not occur frequently, but is not uncommon. No one can determine exactly how long this will remain, but it is rarely permanent.

Taste and Odor: After the surgery, a bad taste or odor may occur. This is usually secondary to a lack of appropriate cleaning in the area. Commercial mouthwash may be used along with normal rinsing and brushing.

Uncommon Problems: Many people fear the possibility of a dry socket, which is a very unusual complication. If you have pain, however, that is not relieved by the pain medication or aspirin, this may be the case. If possible, you should return to our office or if the distance is too great, see your local dentist. Pain in the ear, difficulty swallowing, and difficulty opening and closing the jaws are symptoms which can occur with varying frequency, and usually are not significant. Swelling at a later date is uncommon, but if the swelling increases after 5-7 days, please contact our office at (205) 822-7277.

Emergency: If there is any difficulty in breathing, fever, excessive bleeding or any other disturbing problems following the surgery, you should call the office immediately or go to the emergency room.

**Women please note: Some antibiotics may interfere with the effectiveness of your birth control pills. Please check with your pharmacist.