POST- OPERATIVE INSTRUCTIONS

Protection of the blood clot and surgical site

Slight bleeding after tooth extraction is normal and may last for several hours. Bite on folded gauze directly over the bleeding area and replace as needed. If there is no active bleeding then leave the gauze out. Lay in a semi-reclined position. Avoid spitting, bending over, sucking through a straw, and rinsing for 24 hours. No strenuous activity or smoking for 48 hours. The blood clot is important for healing.

Rinsing

Rinsing may dislodge the blood clot and interrupt the normal process of healing. Carefully follow these steps in order.

• Day 1 (Day of surgery - first 24 hours after surgery) Do not rinse or brush your teeth. Do not spit.
• Day 2 (24 - 48 hours after surgery)
  1. Brush your teeth, 3 times a day, be gentle around the extraction sites.
  2. Floss.
  3. Begin rinsing gently using a glass of warm salt water (1/2 teaspoon per cup). Repeat rinsing 4 or 5 times a day.
  4. Follow with the chlorhexidine rinse. (continue using until day 7)
• Day 3 (48 - 72 hours after surgery) Same regiments as day 2, however begin rinsing more vigorously.
• Day 4 (72 hours after surgery)
  1. Same regiment as day 2, however now rinse with full force.
  2. Today begin using the curved syringe to irrigate the extraction sites. Use it with the salt water. Pull your cheek out and directly irrigate any food from the socket. Try to put the tip of the syringe a few millimeters into the socket. Do this 4 or 5 times each day.
  3. Continue rinsing and cleaning in this manner for 30 days. (note; you can stop the chlorhexidine at day 7)

  Care of teeth / Cleanliness and healing

  The teeth should be given their usual care. Brush and floss three times a day. A clean mouth will heal faster.

  Swelling / Fever

  An ice pack placed on face will be beneficial to help control swelling. This should be used only on the day of surgery. If extreme swelling occurs or a temperature above 101.5 contact my office.

  Pain

  Some discomfort is normal following oral surgery. If pain medication is prescribed, take only as directed. Often it is beneficial to take the medication after eating to help prevent nausea. Do not drive while using narcotic pain medications.

  No Smoking or Alcohol

  Do not smoke or drink alcohol for 48 hours following oral surgery. This may cause the disruption of healthy blood clot formation and increase in complications including dry sockets, prolonged healing, wound breakdown and post-operative infections.

  Diet

  No hot liquids, acidic foods or drinks for the first 24 hours. Eat something when you feel ready. Cool liquids are best to start but avoid sucking through straws. Then, when the numbness starts to wear off, progress to a soft diet but avoid chewing in the area of the surgery.

  I.V. Injection site

  After having intravenous anesthesia, the arm vein may become hardened and tender. Apply moist heat over the area for one hour three times a day for three days. Contact me if there is no improvement.

  Sharp bony edges/ Dry sockets

  You may feel hard, sharp areas on the surgical site. This is the hard bony wall, which originally supported the tooth. “Dry Socket” is a term usually describing an area where the blood clot has dissolved leaving an exposed bony area which is painful. A “Dry Socket” will usually heal on its own. Pain control is the issue. Try using an anti-inflammatory medicine like ibuprofen in addition to the narcotic pain medicine. If unsuccessful, then this can be treated in our office by placing a medicated dressing in the surgical site.

  Nausea

  Nausea is a normal side effect of narcotic pain medications. If you have severe nausea or vomiting you may need to stop the pain medications or take an additional anti-nausea medication.

  Antibiotics and Contraception

  Contraceptives may be ineffective while taking an antibiotic. Use extra protection if you have been prescribed an antibiotic