Surgical Teeth Extractions Post-Operative Instructions
Proper care after surgery has an important effect on healing. Please read the following instructions carefully.
Immediately After Surgery:
- Bite firmly on the gauze pads covering each surgical site to help stop the bleeding. We will change the gauze before you leave the office. You may need to change the gauze pads once more at home, leaving the gauze in for an additional 30 minutes. Remember to remove the gauze before eating or drinking.
- You may have difficulty feeling your lips, cheeks, and/or tongue due to the numbness from the local anesthetic. This is a temporary feeling and it will wear off within 2-4 hours. Please take care not to bite your lips, cheeks and/or gums.
- Apply ice packs to your face to reduce swelling for the first 48h hours after surgery.
- Take the pain medication as prescribed as soon as possible.
- Do not rinse or spit the day of the surgery, as this may prolong the bleeding.
- Make sure to get lots of rest on the day of the surgery.
Bleeding:
One of the most common concerns after surgery is bleeding. Surgery causes an increase in salivary flow which in addition to the normal oozing of blood may alarm you unnecessarily. Some oozing is normal for 24 to 48 hours following surgery and should not be a concern. It is common for saliva to be slightly blood tinged for several days following surgery.
- Use a piece of gauze (or a moist teabag), folded into a small wad, and place it over the surgical site. The idea is to apply gentle pressure on the surgical site. Apply pressure for at least 20-30 minutes after surgery. The gauze can be changed when it feels saturated. One may need to change the gauze and repeat the previous steps a few times to decrease bleeding. If bleeding is controlled, the gauze is no longer necessary.
- DO NOT rinse your mouth or use a straw for the next 24 hours.
- DO NOT smoke or consume alcohol for the next 24 hours.
- DO NOT perform strenuous activities for the next 3 days.
If you are bleeding excessively, apply firm pressure by folding and placing a gauze pad directly over the surgical site and bite firmly on the gauze for one hour. Excessive bleeding is defined as pooling or dripping of blood out of the surgical sites within 15-20 seconds of removing the gauze. If excess bleeding continues, apply a gauze pad for an additional 30 minutes. If excessive bleeding persists, contact the Oral and Maxillofacial Surgery service at the Montreal General Hospital.
Pain Management
Some amount of discomfort is to be expected following any surgery. Please take the medications as prescribed by your surgeons. It is best to go to the pharmacy immediately after your surgery to fill your prescription. That way you can begin to take the pain medications prior to the local anesthetic (freezing) wearing off.
Infection
- If the surgeon thinks that you will benefit from an antibiotic, you will receive a prescription for one. If prescribed, take as directed. It is important to ensure you finish the full course of the antibiotic.
If you are experiencing nausea you may TEMPORARILY stop taking the antibiotic until the nausea subsides, however you must always restart and finish the antibiotics as directed.
- If any medications cause hives or itching, discontinue them immediately and call the clinic.
Call our office if you notice any signs of infection including:
- Increased pain or swelling after 5 days
- A foul taste or odour in your mouth
- A temperature above 38°C
Swelling
Swelling around the mouth, eyes, and cheeks is a normal reaction to the surgery and usually takes 2-3 days to fully develop. To help prevent swelling:
- Apply ice packs to the cheeks for 20 minutes on and 20 minutes off. Keep your head elevated for first 48 hours after surgery. Use crushed ice in a ziplock bag or a bag of frozen peas bag wrapped in a moist cloth to prevent frostbite.
- After the first 3 days, you can begin using a heating pad or moist heat for relief of swelling, bruising, and stiffness of the jaw. Apply heat 4 times/day for 30 minutes time intervals.
Diet
Try to resume a normal diet after the first 3 days. Initially you may feel more comfortable with a softer diet. Suggested foods are soups, noodles, scrambled eggs, pasta, pudding, yogurt, ice cream, juices, milkshakes, pancakes, and anything soft that you can tolerate. Drink lots of fluids to stay hydrated. Avoid straws as they can dislodge the blood clot cause bleeding. Avoid hard and crunchy foods such as chips that may disturb the surgery site for at least 5 days. No alcoholic beverages should be consumed for at least 24 hours post anaesthetic or as long as you are taking the narcotic pain medications and antibiotics.
Wound Care
If prescribed to you, use the Peridex (Chlorohexidine 0.12%) mouth rinse 2-3 times a day after brushing. Swish for 60 seconds then spit it out. You may also rinse your mouth with a salt-water solution (1/2 tsp salt in 1 cup of water) several times daily.
Sutures (Stitches)
Your sutures will dissolve on their own 1-3 weeks after the surgery. You may notice that they loosen after the swelling of your gum tissue decreases. This is completely normal.
Resuming Activities:
On average most patients will take 1-2 days off from normal activity. You may return to work/school when you feel you are recovered. Do not engage in strenuous activities for 2 weeks following your surgery.
Dry Socket:
After a tooth extraction it is important for a blood clot to form to stop the bleeding and begin the healing process. A dry socket occurs when the blood clot is dislodged from the surgery site exposing the bone and the fine nerve endings. A small percentage of patients may experience a dry socket. Signs of dry socket generally consist of an increase in jaw discomfort 3-6 days after surgery that is not relieved by pain medication. If this happens please call the office. To avoid a dry socket follow these precautions:
- Do not smoke
- Avoid sucking action from smoking, spitting or using straws for first 24 hours.
- Clean the extraction site as described in the wound care section
- Do not rinse your mouth excessively for first 24 hours as it interferes with blood clotting.
Smoking
Do not smoke for at least 3 days following surgery.
Brushing & Rinsing
The day of surgery you may brush your teeth, but try to avoid the surgical site for at least 5 days. Avoid rinsing, or spitting the day of surgery. If you wear a retainer, you may continue to wear it if is comfortable for you to do so.
Bone Chips
Occasionally small chips of bone may appear in the surgical site. This can happen anywhere from a few days to several weeks following surgery. Usually they will eventually fall out by themselves. If they are causing you significant discomfort you can contact our clinic for an appointment.
Numb Lip and Chin
Lip numbness on the side of surgery is known as “paresthesia.” It is most often a temporary condition that will correct itself. It can last a variable length of time. If it lasts greater than 3 weeks please notify the office.
Follow Up Appointments
Generally no follow up is needed for routine extractions unless otherwise specified by the surgeon. The surgeon will let you know if a follow up appointment is necessary and it will be scheduled for you. There is no additional charges for follow up visits.
Emergencies
You may contact us with questions or concerns at 514-934-8397.
In the event of an emergency please contact emergency medical help. You may also contact the oral surgeon on call by calling the hospital operator at 514-934-1934 ext. 53333 and requesting the oral surgeon on call. An on-call oral surgeon is available for emergent issues 24hrs a day 7 days a week.