Care Following Oral Surgery

Please read these instructions carefully. Sometimes, the after-effects of oral surgery are quite minimal, so not all of these instructions may apply. Common sense will often dictate what you should do. However, when in doubt, follow these guidelines or call our office any time for clarification.

 

DAY OF SURGERY

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 being controlled. If active bleeding persists after one hour, place enough new gauze to obtain pressure over the surgical site for another 30-60 minutes. Be sure to rest and not engage in any physical activity as this will increase your blood pressure and stimulate more bleeding. Continue to swallow during this time to ensure that your mouth does not fill with saliva.

 

TAKE SPECIAL CARE

Do not disturb the surgical area today.

Do NOT rinse, spit, or probe the area with any objects or your fingers. You may brush your teeth gently.

DO NOT SMOKE OR DRINK ALCOHOL for at least 72 hours, since they are both very detrimental to healing.

 

OOZING
Continue to bite on the gauze for one hour following surgery. It is normal to have a small amount of blood mixed with saliva for the first day. Intermittent bleeding or oozing is normal. It may be controlled by placing fresh gauze over the surgical area and biting down firmly for 30-60 minutes while lying down. This will help to lower your blood pressure and stop the bleeding.

STEADY BLEEDING
Bleeding should never be severe. If it is, it usually means that the packs are being clenched between your teeth rather than exerting pressure on the surgical areas. Try re-positioning fresh packs. If bleeding persists or becomes heavy, you may substitute a tea bag (soaked in hot water, squeezed damp-dry and wrapped in a moist gauze pad) for 20 or 30 minutes. If bleeding remains uncontrolled, please call our office.

SWELLING & BRUISING
Swelling is a normal part of the healing process. It will usually peak within 48 hours and will gradually subside over 7 to 10 days. You can minimize this by using a cold pack or ice bag wrapped in a towel and applied firmly to face or cheek adjacent to the surgical area. This should be applied 20 minutes on and 20 minutes off for the first 12 to 24 hours after surgery. If you have been prescribed medicine for the control of swelling, be sure to take it as directed. Bruising occurs in some patients and may extend into the neck and chest. Do not be alarmed as this may be the normal course of healing for some patients.

PAIN
You may be given a prescription for pain medication before you leave the office. You should take the medication as prescribed, at regular intervals (usually every four hours). Take the first dose when you feel the “freezing” wearing off. This will ensure that you will have an adequate level of pain relief during the most uncomfortable period. After the first 24 hours, take the medication only as needed for pain. Remember that the most severe discomfort is usually within the first six hours after the local anaesthetic wears off; after that, your need for medicine should lessen.

INFECTION
If there is a possibility of infection, your dentist may prescribe an antibiotic. It is essential that you take these antibiotics until they are gone. This will ensure the least possible chance of infection. Most antibiotics should be taken on an empty stomach, one hour before meals or two hours following a meal. Your pharmacist will confirm the proper way to take the medication prescribed for you.

EXERCISE
We strongly recommend that you not exercise for the first 24 hours following your surgery. Exercise tends to increase your blood pressure which may cause the surgical site to continue to bleed. You can resume your normal exercise routine on the day following surgery.

NAUSEA
Nausea is not an uncommon event after surgery and it is sometimes caused by stronger pain medicines. Nausea may be decreased by eating a small amount of soft food before each pill and then taking the pill with a large amount of water. Try to keep drinking clear fluids and minimize the pain medication, but call us if you do not feel better or if repeated vomiting is a problem. Cola drinks that have less carbonation may help with nausea.

DIET
Eat any nourishing food that can be taken with comfort. Temperature of the food doesn’t matter, but avoid extremely hot foods. It is sometimes advisable, but not required, to confine the first day’s intake to bland liquids or puréed foods (creamed soups, puddings, yogurt, milkshakes, etc.). Avoid foods like nuts, sunflower seeds, popcorn, etc. that may get lodged in the socket areas. Over the next several days, you can progress to solid foods at your own pace. 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 diabetic, maintain your normal eating habits as much as possible and follow instructions from your physician regarding your insulin schedule. Fluid intake should be 2 to 3 litres per day. More fluids are advised in warmer weather.

STITCHES OR SUTURES
Stitches or sutures are used to help keep the surgical site closed, properly position the gum tissue, and encourage healing. In most situations, the stitches or sutures will dissolve on their own in 5 to 7 days.

DENTURE WEAR
Sometimes, we place your new denture immediately after removing your teeth. For the first 24 hours, we do not want you to remove your denture. The swelling following the removal of teeth may make it impossible to put the denture back in place. We will see you soon after the tooth removal appointment to remove your denture and begin making any necessary minor adjustments.

 

 

SECOND AND THIRD DAYS FOLLOWING SURGERY

 

RINSING
Keeping your mouth clean after surgery is essential. On the day of surgery, you should not rinse or spit; however over the next few days, rinse as follows: Use one-quarter 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 for the next five days.

ORAL HYGIENE
Good oral hygiene promotes healing and comfort. Although soreness and swelling may not permit vigorous brushing of all areas, you should maintain your daily routine of brushing in areas away from the sites where the teeth were removed. Resume brushing and flossing of the surgical sites as soon as you can do so comfortably. If you were given an irrigating syringe, start using it on the third day after surgery to keep sockets clean. Fill the syringe with warm water and irrigate any open sockets gently, especially after eating.

WARM COMPRESSES
After 24 hours, it is usually best to switch from ice to warm moist heat on the areas of swelling. Apply warm compresses to the cheek (hot water bottle, moist hot towels, heating pad) for 20 minutes on and 20 minutes off to help soothe those tender areas. This will also help decrease swelling and stiffness.

 

HEALING

Normal healing after tooth extraction should be as follows:
The first day of surgery is usually the most uncomfortable and there is some degree of swelling and stiffness. The second day, you will usually be far more comfortable and, although still swollen, you can usually begin a more substantial diet. From the third day on, GRADUAL, STEADY IMPROVEMENT should mark the remainder of your post-operative course. If a DRY SOCKET occurs (loss of blood clot from socket, usually on the 3rd to 5th day), there will be a noticeable, distinct, persistent throbbing pain in the jaw, often radiating toward the ear and forward along the jaw to cause other teeth to ache. If you experience this, please call the office. Finally, if you do not see gradual improvement during the first few days after surgery, don’t suffer needlessly; call the office to report the symptoms.

 

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 do not hesitate to call our office at (416) 265-1400.