Post-Op Instructions

Post-Operative Instructions

Taking Care of Yourself Following Routine Dental Extractions

Immediately Following Your Surgery

Please keep light pressure on the extraction site with clean gauze for 1 hour following your procedure. When gauze needs replaced (about every 20-30 minutes), we recommend dampening the new gauze slightly with clean water prior to placement in the mouth. This will help to keep the gauze from sticking to and irritating the site. Please do not chew on the gauze during this time.

Mouth rinsing and/or touching the wound area must be avoided in the first day following surgery. These may initiate further bleeding or dislodge the clot that is essential to proper healing.

It is important to begin your pharmacological regiment as soon after your surgery as possible. Whether you will be using over-the-counter medicine or prescription strength pain control we advise you to begin taking those meds immediately.

One day after your procedure you should begin rinsing very lightly with lukewarm salt water several times a day. Place 1 teaspoon of salt in a tall glass of clean water and swish very gently for 30 seconds for up to a week after surgery. This will help keep the area clean and promote proper healing. It is important that you do not rinse or swish too vigorously as this can disrupt the clot, causing further bleeding and delaying healing. Please do not use any over the counter mouthwash during this period. Your doctor may elect to prescribe a prescription antibiotic rinse to use in place of salt water.

no-smoking

You cannot smoke for 72 hours following tooth removal.

do-not-disturb

Do Not Disturb the Area

The natural healing process following a tooth extraction involves the formation of a fibrous clot. This clot, while similar to a scab you might find during healing elsewhere on the body, is very delicate and must remain undisturbed during the healing process. Vigorous swishing, drinking through a straw and smoking can all dislodge the clot and complicate the healing process. Keep anything sharp (crunchy food, toothpicks, eating utensils) away from the site. The fibrous clot may resemble chewed up food to the untrained eye. Do not, under any circumstance, attempt to clean or remove food from your extraction site. Your body is very effective at naturally cleaning this site out. If any cleaning or rinsing is required, it will be done by your doctor at a subsequent post-op appointment.

If you have any questions, please don’t hesitate to call your dentist. Call 911 if you have an emergency.

Additional Instructions

What Can I Eat?

You may eat anything you are comfortable with immediately following surgery; however, we recommend cool, softer foods for the first 24 hours. If possible, you should chew on the opposite side for a day or two.

We recommend that you avoid any gritty or crunchy foods for 72 hours (granola, potato or tortilla chips etc.) as these foods can poke or damage the clot during chewing and may get stuck in or around the extraction site. Avoid fruit with small seeds like strawberries or kiwi as these may also get stuck in or around the extraction site.

Avoid hot liquids (very hot soups, coffee, tea etc.) for a day or two after surgery as this high temperature can irritate the site and cause pain or swelling in the area. Drink plenty of water and avoid drinking alcohol for 48 hours or while taking any pain medication.

Hygiene

You may resume brushing the evening after your surgery but exercise cation around the area where your tooth or teeth were removed. Please be sure you are using a soft bristled tooth brush and are careful to avoid brushing over the extraction site.

Do not floss the teeth adjacent to the extraction site for 2 weeks following your procedure.

Do not rinse with any hydrogen peroxide or commercial mouth rinses such as Listerine following your surgery. Peroxide can dissolve your clot and promote a post op dry socket. You may rinse very gently with warm salt water starting the day after your extraction.

Bleeding

Bleeding is normal following routine dental extractions. It is not uncommon to notice blood in your saliva in the 24 hours after the procedure. You may even notice a small blood stain on your pillow the morning after your surgery. If bleeding resumes at any point, use the sterile gauze sent home with you, biting to apply steady pressure on the area for 1 hour. If you are out of gauze, a clean, damp folded paper towel or a wet tea bag make great substitutes. Compounds in tea actually aid in new clot formation! If abnormal or excessive bleeding occurs please contact the office or your doctor.

Pain and Swelling

As with any surgical procedure, moderate pain and discomfort may be expected after surgery. All patients respond distinctly to dental procedures and depending on the scope and complications of your extraction, patients may have vastly different post-operative experiences from one another. Swelling, pain and jaw stiffness are normal responses (particularly after extraction of lower teeth) to tooth removal. Taking pain medicine as directed and using ice packs on the outside of the face are effective ways to mitigate pain and swelling after extraction.

It is not uncommon for a patient to notice a spike in pain and inflammation 2-3 days after the procedure. This is normal and is no cause for alarm. Depending on your individual preferences, medical considerations and needs, your doctor may recommend either an over-the-counter or prescription based approach to pain management. Be sure to inform your doctor if you have any drug allergies or medical conditions that affect your ability to take pain medication.

Most prescription pain medication and even some over the counter medications can be irritating to the stomach. We recommend drinking plenty of water and eating a small meal when you take your meds to counteract these irritating side effects.

Pain Control

Over-the-Counter Pain Control

For pain relief take two 500mg Tylenol capsules and three 200 mg Ibuprofen (Advil or Motrin) capsules every 6-8 hours. This combination of acetaminophen (Tylenol) and ibuprofen (Advil or Motrin) is very effective at managing dental related pain. It may be most effective to stagger the dosages of each of the 2 meds as follows:

8:00AM – 600mg ibuprofen (three 200mg capsules)

11:00AM – 1000mg Tylenol (two 500mg capsules)

2:00PM – 600mg ibuprofen (three 200mg capsules)

5:00PM – 1000mg Tylenol (two 500mg capsules)

8:00PM – 600mg ibuprofen (three 200mg capsules)

11:00PM – 1000mg Tylenol (two 500mg capsules)

* Please follow instructions and do not exceed maximum daily dosages for healthy adults

** Alcohol and Tylenol can cause severe liver complications. Do not drink alcohol while taking Tylenol.


Prescription Pain Control

Your doctor may decide that prescription narcotic pain medication is advisable following your surgery. If you have ever had an adverse reaction to narcotic medicine or wish to avoid them, please consult with your doctor. Also, please inform the doctor if you have had substance abuse issues or are currently taking narcotic pain medication for other issues.

Prescription, narcotic pain medications like Norco (Hydrocodone and Acetaminophen) come formulated with Tylenol already mixed in. If given Norco, Vicodin, Percocet or some other variation do not take in combination with additional Tylenol. You may be advised by your doctor to combine the prescription pain medication with a high strength or over the counter ibuprofen based drug (advil, motrin). This combination is safe and can be very effective at managing pain and limiting post-operative swelling.

If given a prescription for Motrin 800mg and Norco 5/325mg you should stagger the doses of the two drugs to maintain effective pain control all day. Refer to the time chart above, substituting Norco (or the prescribed narcotic) into the Tylenol dosage times. Please be advised that taking narcotic pain medication can make you drowsy or loopy. You may not operate machinery or drive while taking these medications. If you must return to work, and cannot take narcotic pain medication while doing so, you can substitute doses of Tylenol during the day and then use a dose of narcotic pain medication in the evening once back at home.

* If you have any questions concerning your pain medication please consult your doctor.

Smoking

Smoking must be discontinued for AT LEAST 72 HOURS FOLLOWING TOOTH REMOVAL. The healing and success of your procedure are greatly affected by tobacco smoke and the many chemicals found in it. Also, the suction action created by your mouth when drawing on a cigarette or pipe can easily dislodge the clot and cause infection, bleeding or greater pain. Smokers who do not discontinue after surgery are at increased risk of developing a painful post-op infection called dry socket. The need for smoking cessation in the days following tooth removal may be the perfect opportunity to begin the process of quitting smoking. If you would like to use this circumstance to quit smoking please consult your doctor for additional tips and recommendations.

Activity

After your procedure try to get plenty of rest; avoiding stress, strenuous activities or exercise for 24 to 48 hours. Keeping blood pressure low during this time will reduce bleeding and aid in the healing process.

Numbness

The local anesthetic used to numb you during the surgery can last for several hours following your tooth removal. Be careful not to bite, chew, pinch or scratch the numb area. In some cases, tooth extractions may cause residual numbness or tingling for an extended period. Please consult your doctor if your numbness lasts longer than 24 hours.

Antibiotics

Very rarely are systemic, oral antibiotics given immediately following a tooth removal. Even when the tooth or surrounding bone was infected, there may be little to no benefit to taking a systemic antibiotic. If, however, you are given an antibiotic please take as directed.

Prescription Rinse

You may be prescribed an antibiotic rinse to use in place of the salt-water rinse recommended above. Chlorhexidine rinse should be used as directed by your doctor. Conventional use of this rinse usually involves rinsing for 30 seconds and spitting twice daily (morning and night).

Follow-up appointment

Your dentist may elect to schedule a 1 week post-op visit to assess the state of the extraction site and the progress of healing.

Please contact your dentist should you experience any of the following:

  • uncontrollable, severe pain
  • excessive or severe bleeding
  • marked fever
  • excessive, warm swelling
  • pain or difficulty swallowing or bleeding