After Extractions and Biopsies
The removal of teeth and/or soft tissue is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.
Immediately Following Surgery
Keep the moist gauze pad placed over the surgical area in place for a half hour. After this time, the gauze pad should be removed and discarded. Repeat with a fresh moist gauze as needed until bleeding has reduced to a slow oozing or stops all together.
Avoid vigorous mouth rinsing, spitting or touching the wound area following surgery for the first 24 hours. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
Do not use a drinking straw for the first 2 days. Smoking is very harmful to the blood clot and should be kept to a minimum.
Take the prescribed pain medications as directed. It is best to avoid taking medications on an empty stomach.
Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for explanation.
A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a cold moist gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. 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 for further instructions.
Swelling after any surgical procedure is normal and usually occurs 24 to 48 hours after surgery, especially after removal of a difficult tooth or a large amount of tissue. 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 after the procedure. Moist heat applied to the area may speed up the removal of the discoloration.
Have all prescriptions filled and take your medications as directed on each prescription bottle. For the most effective pain relief, take your first dose of pain medicine after you get home, before the numbness wears off. Do not operate machinery or drive a car for 24 hours after your surgery if you had IV anethesia (through a needle in your arm) or after taking prescription pain medication. The prescribed pain medicine will make you groggy and will slow down your reflexes. Avoid alcoholic beverages. For moderate discomfort, adults may use Tylenol or Extra-Strength Tylenol, one or two tablets every 3-4 hours. Ibuprofen (Advil, Motrin) 200mg can be taken 2-3 tablets every 6 hours. *NOTE: DO NOT USE IBUPROFEN IF PREGNANT, ALLERGIC TO ASPIRIN OR NON STEROIDAL, ANT-INFLAMMATORY DRUGS, OR CURRENTLY TAKING OTHER BLOOD THINNERS, ASPIRIN, OR NON STEROIDAL ANTI-INFLAMMATORY DRUGS* Pain or discomfort following surgery should subside more and more every day. If pain persists, you may require attention and should call the office.
Antibiotics may be given to help prevent infection. Be sure to take the prescribed antibiotics as directed. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions.
If refills of medication are needed, please make sure to call 24 hours in advance, during office hours, Monday – Friday, after 8 a.m. and before 4:45 p.m. Please plan ahead! You will need to make arrangements to have the prescription picked up at our office.
After general anesthetic or IV sedation, liquids should be taken at first. Do not use a straw, drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away form the surgical sites. High calorie, high protein intake is very important. Nourishment should be taken regularly. Try not to miss a single meal. Frequent fluid intake will help prevent dehydration. Drink at least 5-6 glasses of liquid a day. You will feel better, have more strength, less discomfort, and heal faster.
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 use of ice packs which should be applied to the sides of the face where surgery was performed.
Keep the ice packs on for 30 minutes, then remove them for 30 minutes. Continue to repeat this cycle to help control pain and swelling. After 36 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery the application of moist heat to the sides of the face may help to reduce swelling.
Other Possible Complications After Extractions and/or Biopsies
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 Coke, Sprite/7Up, tea, ginger ale or Gatorade slowly over a fifteen-minute period. When the nausea subsides you can begin eating solid foods and taking your prescribed medicine(s).
Numbness – If numbness of the lip, chin or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb you could bite it and not feel it, so be careful. Should the numbness persist overnight, call our office the next day to make arrangements for a follow up appointment and we can answer any questions about this.
Fever – 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.
Dizziness – You should be careful going from the lying down position to standing. If you stand up suddenly, you could get light-headed. To prevent this, sit for one minute then get up.
Dry/cracked lips – If the corners of your mouth are stretched after surgery, they may dry out and crack. Your lips should be kept moist with a lip balm or Vaseline.
Earache/sore throat – It is normal to experience a slight earache and / or pain when swallowing after surgery. As the muscles near the extraction site get swollen, the normal act of swallowing can then become painful. This will subside in 2-3 days.
Muscle stiffness – The jaw muscles may be stiff making it difficult to open your mouth for a few days following surgery. Eating solid foods or chewing gum may help to relieve muscle tightness. This is a normal post-operative event which will resolve in time.
Worsening pain – With each day, the pain and swelling should gradually subside after surgery. If your postoperative pain or swelling worsens call our office for instructions.
Do not rinse your mouth or brush your teeth after surgery the day of your surgery. The next day you may rinse gently and brush gently. Warm salt water is appropriate to rinse with.
Use one-half teaspoon of salt in a glass of lukewarm water and rinse three or four times each day for five days. Minor bleeding may occur when you brush or rinse during the first week. Do not be alarmed by this.
Alcohol based mouth rinses can be a little hard on the healing tissue and blood clot the first few days. Rather than use them, you may find a sugarless breath mint helps your mouth feel fresher.
Answers to questions you might have as your extraction site heals
Are there stitches that need to be removed? Sutures are sometimes placed to minimize post-operative bleeding and to help healing, however we normally use dissolving stitches, so in most cases, it will not be necessary to return to the office for stitch removal.
What happens to the the cavity or hole where the tooth was removed? The cavity will gradually fill in with new tissue over the next month. In the meantime, the area should be kept clean especially after meals with salt water rinses. An irrigating syringe may be given to you after your surgery to help you keep the surgery site clean, but it should not be used for the first 5-6 days after your procedure.
Is it OK to brush my teeth? Brushing your teeth is okay just be gentle at the surgical sites.
What is a dry socket? A dry socket occurs when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur 5-7 days following surgery. Call the office if this occurs and the doctor may place a medicated dressing in the tooth socket to alleviate your discomfort.
Is it normal to feel something hard in the extraction site? Occasionally, patients may feel hard projections in the extraction site with their tongue. They are not roots, they are the bony walls which supported the tooth. These projections usually smooth out in the healing process. If not, they can be surgically removed by Dr. Tate.
When can I begin regular exercise again? We recommend that you not exercise or participate in any aerobic activities for a few days after your surgery.