The surgical removal of teeth (single, multiple or impacted) is a serious procedure. Post-operative care is extremely important. Unnecessary pain, infection and swelling can be minimized if the instructions are followed carefully.
If you have any questions about the instructions below, please call the office in which you were seen.
IMPORTANT: If you have Caller Block/Caller ID, be sure to turn it off before calling the service for a return call from our Doctors. Please, be aware that the Doctors often make post-operative calls and would be unable to get through if the Caller Block is on.
- Randolph Office: 973-328-1555
- Flanders Office: 973-598-8423
- Newton Office: 973-383-0700
Immediately Following Surgery
- The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded.
- Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may stimulate bleeding by causing the blood clot that has formed to become dislodged.
- Take the prescribed pain medications as directed by your doctor. This will usually coincide with the local anesthetic wearing off.
- Restrict your activities the day of and day after surgery; resume normal activity when you feel comfortable.
- Place ice packs at the sides of your face where surgery was performed. Refer to the section on swelling for more information.
Bleeding
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 gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened caffeinated tea bag (non herbal) 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 still does not subside, call the office for further instructions.
Swelling
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 may not become apparent until the day following surgery and may not reach its maximum until 2-3 days post-operatively. Swelling may be minimized by the immediate use of ice. A bag filled with ice, ice packs or a bag of frozen peas should be applied to the sides of the face where surgery was performed. The ice packs should be applied twenty minutes on then left off for twenty minutes while you are awake. After 36 hours, ice has no beneficial effect. Keeping your head elevated, either with a few pillows or sleeping in a recliner, will help reduce swelling. Additionally, forty eight hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This may be a normal reaction to surgery. Please contact our office.
Pain
For pain, take the tablets prescribed by your doctor and as directed. For minimal discomfort you may take any over the counter non-aspirin pain reliever such as Tylenol. Some of the prescribed pain medicine may make you groggy and slow down your reflexes. Do not drive an automobile or operate machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more each subsequent day. If pain persists, it may require attention and you should call the office. Please see the section “About your medications” for more information.
Diet
After an oral and maxillofacial procedure, cool clear liquids should be initially ingested. Do not use straws. 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. Refer to the section on suggested diet instructions at the end of the document. Nourishment should be taken regularly. You should prevent dehydration by drinking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss any meals. You will feel better, have more strength, experience less discomfort and heal faster if you continue to eat.
Caution: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.
Oral hygiene
Refrain from rinsing of any kind until the day following surgery. The day after surgery you can brush your teeth but rinse gently. Begin rinsing at least 5-6 times a day especially after eating with a cup of warm water mixed with a teaspoon of salt.
Discoloration
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 post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.
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 coca cola, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine. If symptoms persist please contact the office or the doctor on call.
Smoking
Smoking causes irritation and will delay normal healing. Smoking should be avoided for at least 48 hours after surgery or until sutures have dissolved or removed.
Dry Socket
Healing can be delayed if the blood clot filling the extraction socket dissolves or is washed away, exposing the underlying bone. This can lead to a persistent, deep, throbbing pain. Dry Socket is easily treated with a special medicated dressing. Dry socket is rare but can occur 3-5 days after a tooth extraction. If you suspect you have dry socket, contact the office in which you were seen.
Other Complications
- 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 the sensation. Be careful. Contact the office in which you were seen if you have any questions.
- Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen can be taken to reduce the fever.
- Please be careful standing up quickly from the lying down or sitting position in order to prevent light headedness or fainting. Before standing up, pump your calves, sit for one minute and then get up.
- Occasionally, patients may feel hard projections on the inside of their jaw with their tongue. They are not roots; they are the bony walls, which supported the tooth. These projections usually smooth out spontaneously. If not, they may be removed by your doctor.
- Keep your lips moistened with lip balm or an ointment such as Vaseline, in order to keep the corners of your mouth from drying out or cracking.
- Sore throat and pain when swallowing are not uncommon. The discomfort should subside with in 2-3 days. Warm salt water rinses are helpful.
- Stiffness (Trimus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.
Specific Considerations
- In cases where a denture is placed at the time of extractions (full or partial), the denture should be left in the oral cavity (and not removed) for 24 hours. This will help minimize swelling and bleeding. If the denture should fall out and you are unable to replace it, place the denture in a cup of cool water and contact your dentist the following day. If immediate dentures have been inserted, sore spots may develop. In most cases, your dentist will see you within 24-48 hours after surgery and make the necessary adjustments to relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process. Additionally, you may find that your denture is loose as the tissues heal. This may require an adjustment or relining procedure by your dentist.
- In cases where a bone graft has been placed into the extraction socket for future dental implant placement, care should be taken not to disturb the area. Avoid vigorous rinsing and tooth-brushing the area. It is not uncommon to detect a few granules of bone grafting material in the mouth. If this should occur, dispose of them in the garbage. If they should become excessive, please notify your doctor.
Finally
Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged but this is no cause for alarm. Just remove the suture from your mouth and discard it. In most cases the sutures placed are of the resorbable/dissolving type. If non-resorbable sutures are placed, the sutures will be removed approximately one week after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure.
The pain and swelling typically peak within three days and then should subside gradually following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur after this time period call the office immediately.
There will be a small cavity where the tooth was extracted. The cavity will gradually heal, over the next month, with the new gum tissue. In the mean time, the area should be kept clean especially after meals with salt water rinses or a toothbrush.
Your case is individual, no two mouths are alike. Do not accept well intended advice from friends. Discuss your concerns with our knowledgeable staff or the oral surgeon that treated you.
Brushing your teeth is okay - just be gentle at the surgical sites.
A dry socket is 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 2-3 days following surgery. Call the office if this occurs.
Discontinue exercise following surgery for one week or as instructed by your doctor.
