After Tooth Extraction

Post-operative care is very important. Unnecessary pain and complications such as infection and swelling can be minimized if these instructions are followed carefully. If you have questions, do not hesitate to contact our office.

Immediately Following Surgery

  • 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. After this time, the gauze pad should be removed and discarded. The gauze may then be changed as necessary.
  • Vigorous mouth rinsing and/or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
  • If you were sedated, remember to drink water and eat soft food (pudding consistency) within the first 2 hours after surgery to minimize nausea side effects from the pain medications.
  • Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for a more thorough explanation.

Bleeding

  • A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon for the first 24 hours. Bleeding should never be Excessive. Bleeding may be controlled by wiping any old clots from your mouth, then placing a moist gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary.
  • If bleeding continues, bite on a moistened black tea bag wrapped in a moist gauze for thirty minutes. The tannic acid in the black tea helps to form a clot by contracting bleeding vessels.

Swelling

  • The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes, and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate application of ice packs.
  • Start with the ice packs provided, then zip-lock bags filled with ice, or frozen vegetable bags, should be applied to the sides of the face where surgery was performed. The ice packs should be alternating on-off every 20 minutes while you are awake. At night while sleeping for the first 2 nights, we recommend elevating the head with extra 2 pillows or sleep on a recliner.

Pain

  • For moderate pain, one tablet of Tylenol or Extra Strength Tylenol may be taken every 3-4 hours. Ibuprofen (Advil or Motrin) may be taken instead of, or in addition to, Tylenol. Ibuprofen bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken four times daily, not to exceed 3200 mg daily for an adult. Consult our practice for individuals under 18. 
  • For severe pain, the prescribed medication should be taken as directed. Do not take Tylenol with the prescribed medication. You may however, take Ibuprofen as directed above. Do not take any of the above medication if you are allergic to them, or have been instructed by your doctor not to take it. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.
  • If you find that you are taking large amounts of pain medicine at frequent intervals, or if you anticipate needing more prescription medication, please call our office so we can see you. Most pain medications or refills cannot be called-in to the pharmacy. We cannot provide pain medication prescription during the weekends, so if you anticipate needing it, schedule a follow up before the weekend.

Diet

  • After general anesthetic or IV sedation only liquids should initially be consumed. Drink from a glass and do not use straws. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. A high calorie, high protein intake is very important. Our staff can provide suggested diet instructions.
  • Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss any meals. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.
  • It is best to avoid foods like nuts, sunflower seeds, popcorn, etc. which may get lodged in the socket areas.

Keep the mouth clean

  • No rinsing of any kind should be performed until the day following surgery. The day after surgery you should begin rinsing at least 5-6 times a day, especially after eating, with a quarter teaspoon of salt mixed into one cup of warm water. 
  • Start brushing your teeth on the following day. Don’t skip any teeth but just be gentle at the surgical sites. it is normal to notice slight oozing of blood after you brush.
  • Don’t rinse your mouth by puffing the cheeks and swishing aggressively. Instead tilt your head sideways and let the water drool out without aggressive spitting.
  • Do not smoke for at least 3 days. smoking will increase the chance of developing a dry socket which is a painful complication.

Discoloration

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively and lasts for 7-10 days. Heating pad applied to the area may speed up the removal of the discoloration.

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour, including the prescribed medicine. You should then sip on soda, tea, or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.

Other Complications

  • 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.
  • Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. Deragopian.

Finally

Your case is unique, no two mouths are alike. It is our desire that your recovery be as smooth and pleasant as possible. Following these instruction will assist you, but if you have questions about your progress, please call our office. After business hours, you will be directed to an emergency phone number to reach Dr. Deragopian