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Post-Op Instructions: Tooth Extractions


When teeth are impacted or receive serious injury or trauma, it becomes very important to remove them in what is called a tooth extraction. Some tooth extractions are simple and do not require surgery, whereas others do. To ensure that your mouth heals it is vital that you follow the instructions of the doctor for taking care of the extraction site after you leave our office. By allowing the site to heal properly, you avoid issues like unnecessary pain, infection, and swelling. Below is a guide of the things you should and should not do to ensure that your mouth heals correctly after a surgical removal of a tooth.

Immediately Following Surgery

When we finish with the procedure we will place a piece of gauze over the extraction site. This is to soak up any excess blood that leaks out while the clot is forming in the extraction site. The clot is the most important part of the healing process as it will allow the site to heal without becoming infected.

We will send you home with some extra gauze and suggest that you remove and replace the gauze in your mouth after about 45 minutes. The bleeding should subside after an hour or so.

Things that should be avoided following tooth extraction include:
•  Vigorous mouth rinsing
•  Touching the site with your fingers
•  Touching the site with your tongue
•  Drinking from a straw, or using a sucking motion with your mouth
•  Vigorous physical activities

The goal is to get a good blood clot to form in the extraction site, and all of the above activities put that formation and success of that blood clot at risk.

Take pain medications as they are prescribed to you and as soon as you begin to feel discomfort. As the local anesthetics wear off, the prescribed pain killers will kick in, and you will be able to maintain your comfort level.

Do not engage in rigorous activities that get your blood pumping as this can cause bleeding at the extraction site. Use ice packs to reduce swelling and see the section on “swelling” for further explanation.

Bleeding

Bleeding is something that should be expected following tooth extraction surgery. It’s why we pack the site with gauze pads and recommend they be changed within 30-45 minutes. Even after the clot has formed it is common for the site to bleed slightly, ooze, and remain red in coloration. This is all normal, and part of the healing process. If you find that following surgery you are bleeding excessively, you can try rinsing and then place a new gauze pad over the area and bite firmly for a half hour. If you continue to bleed, please do not hesitate to give us a call at 503-455-4673.

Biting a moistened tea bag can help to stop bleeding at the site as tea has tannic acid that helps to contract bleeding vessels. To discourage further bleeding, sit still and stay calm.

Swelling

Swelling is expected and extremely common after tooth extraction surgeries. Expect the side of the face to swell significantly. This will include the cheek, lips, eyes and sometimes the neck. Swelling is the bodies normal reaction to surgery and will not be apparent until the day after the surgery. Expect swelling to reach its zenith around 2-3 days after the surgery. Swelling can be minimized using a cold compress (either a back full of ice or a frozen gel) wrapped in a towel. Simply apply the cold compress to the swelling and hold it in place for 20-30 minutes at a time. After 36 hours ice won’t have a large impact on the swelling, but it still may feel good. If your swelling or jaw stiffness persists for several days, there is no cause for alarm, this is normal following surgery and can be treated with a warm compress application.

Pain

It is important to gauge how severe the pain is before medicating. For moderate pain or discomfort, an OTC painkiller like Tylenol can treat the problem just fine. Ibuprofen is also quite good at limiting moderate pain. Aspirin should be avoided following surgery as it is a blood thinner and can adversely affect blood clot formation.

For severe pain, take the medications that we prescribe to you following your surgery. Take this medication only as directed and make sure to take care of follow warnings on the labels. Driving heavy equipment, including automobiles, is not advisable and alcohol should be avoided when taking these medications. If the pain is persistent, it could be an issue that requires further assistance; please reach out to us at 503-455-4673.

Diet

After surgery you will be coming off of some anesthesia and general sedation drugs. During the hours directly following surgery, it is important to stay well hydrated by drinking lots of water. While you have sutures in your mouth, it would be wise not to use a straw as the sucking motion that is required to use a straw can cause the blood clot to come loose. While eating is is important to restrict your diet to soft foods and chew with teeth that are not near the surgical site. Eating a healthy diet and stay well hydrated will help you to gain the energy you need to heal quickly. Beware of sitting up or standing up too quickly as you can become lightheaded and dizzy.

Keeping Good Oral Hygiene

Avoid rinsing your mouth out for at least 24 hours after surgery. Brushing your teeth the evening after you have surgery is fine. The days following surgery be sure to rinse your mouth out with warm salt water 5-6 times a day to keep your mouth clean and free from bacteria.

Discoloration

It is common for bruising of the skin to occur following surgery. If you notice that your skin turns black, blue, or slightly yellow, there is no cause for alarm. Moist heat applied to the area for 20 minutes at a time can help to relieve symptoms.

Antibiotics

Anytime you are prescribed antibiotics make sure you take the whole prescription according to the instructions. Antibiotics can help to prevent infection of the surgical site. Call us immediately and discontinue taking antibiotics if a rash appears.

Nausea and Vomiting

If you vomit or feel nauseous after surgery, try to avoid eating or drinking anything for at least an hour, including prescribed medicine. Things that can settle a stomach can be taken after an hour. Tea and ginger ale are great when it comes to stomach issues.

Other Complications

For many patients it can take hours for the numbness of the local anesthetic to wear off. For this reason, you may find that you can’t feel your lips or tongue after the surgery – this is no cause for alarm. Be aware that drinking water will require your utmost attention and effort. Also, try your best not to bite your lip, cheek, or tongue during this time.

It is also common to run a slight fever following surgery – nothing to fret about. Tylenol and Advil can alleviate the symptoms. If your elevated temperatures continue for more than a day or so call us at 503-455-4673.

Care should be taken when standing up following surgery as it is very common to feel lightheaded and dizzy. Falling due to dizziness can cause serious injury and should be avoided at all costs. Taking pain medications can easily cause dizziness as well. For these reasons, take your time when standing up and always make sure you have something nearby to lean on, a wall or chair back can work well.

Sometimes, when probing the extraction site with the tongue, patients will notice bony protrusions. These are not leftover parts of the tooth, or the root – these are the bony walls of the jaw that once supported the tooth. Usually, this will wear away in a short period but if you are bothered by it, just give us a call and we will e more than happy to help.

Make sure to apply lip balm following surgery as your lips will likely be dry and cracked.

A sore throat is common following oral surgery, and will usually subside after 2-3 days. The muscles in the throat become inflamed and require some time and hydration to recover.

The stiffness of the jaw is another common side effect of oral surgery and will resolve itself in only a few days.

Finally

Sutures are placed in the area of the surgery and are designed to dissolve over time. This is convenient because it helps you to avoid having to come back into our office to have them removed. Occasionally you will notice a suture become very loose, in which case, if it is bothersome, it can simply be removed.

Exercise care around the surgical site when brushing, flossing, and eating. Make sure to rinse at least a few times a day with a warm saltwater rinse. It is critical that if you notice swelling or pain that seems out of place or extreme that you give us a call at 503-455-4673 and let us know right away so we can make time to see you.


NOTE: These instructions do not represent the medical advice of our dental office, always refer to your personalized pre or post-op instructions given to you by Dr. Radakovich or call us at 503-455-4673 for dental advice.







503-455-4673

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Providence Professional Plaza
5050 NE Hoyt St, Suite 322
Portland, OR 97213


 

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