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Sometimes the after-effects of oral surgical procedures are quite minimal, so not all of the instructions may apply. In addition, every patient's experience will not be exactly the same. When in doubt, follow these guidelines or call our office for clarification. Our number is: (973) 256 – 0103.
DAY OF PROCEDURE:
FIRST HOUR: Bite down gently but firmly on the gauze packs that have been placed over the extraction areas, making sure they remain in place. Do not change them for the first hour. The packs may be gently removed after one hour. If active bleeding (bright red, saturated gauze) persists, place enough new gauze to obtain pressure over the extraction site for another 30 minutes. The gauze may then be changed as necessary (typically every 30 to 45 minutes). When the area is dry, or gauze is pink, use of gauze packs can be discontinued. It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning. Please be sure the gauze packs are placed correctly over the surgical sites. DO NOT SPIT.
EXERCISE CARE: Do not disturb the procedure area today. Do NOT rinse vigorously or probe the area with any objects. You may brush your teeth gently. PLEASE DO NOT SMOKE for at least 48 hours, since this is detrimental to healing. NO SPITTING.
OOZING: Intermittent bleeding or oozing overnight is normal. Bleeding may be controlled by placing fresh gauze over the areas and biting on the gauze for 30-45 minutes at a time.
PERSISTENT BLEEDING: Bleeding should never be severe. If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the extraction areas. Try repositioning the packs. If bleeding persists or becomes heavy you may substitute a tea bag (soaked in very hot water, squeezed damp-dry and wrapped in a moist gauze) for 20 or 30 minutes. If bleeding remains uncontrolled, please call our office.
SWELLING: Swelling is often associated with oral surgical procedures and is often significant. It can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 24 hours after your surgery. Although helpful to minimize swelling, ice packs will not prevent swelling!
PAIN: Dental procedures can often be accompanied by some degree of discomfort. You will usually have a prescription for pain medication. If you take the first pill before the anesthetic has worn off, you should be able to manage any discomfort better. Some patients find that stronger pain medicine causes nausea, but if you precede each pain pill with a small amount of food, chances for nausea will be reduced. The effects of pain medications vary widely among individuals. Please use the pain medication as directed by your doctor. If you find you are taking large amounts of pain medicine at frequent intervals, please call our office. If you anticipate needing more prescription medication for the weekend, we appreciate your making every effort to call for a refill during weekday business hours. In the unlikely situation that you need a prescription over the weekend, please call our emergency number. Also, please be advised that most pain medications cannot be prescribed over the telephone.
NAUSEA: Nausea is not uncommon after oral surgical procedures. Sometimes pain medications are the cause. Nausea can be reduced by preceding each pain pill with a small amount of soft food, and taking the pill with a large volume of water. Try to keep taking clear fluids and minimize dosing of pain medications, but call us if you do not feel better. Classic Coca Cola may help with nausea.
DIET: Eat any nourishing food that can be taken with comfort. Avoid extremely hot foods. Do not use a straw for the first few days after surgery. It is sometimes advisable, but not absolutely required, to confine the first day’s intake to liquids or pureed foods (soups, puddings, yogurt, milk shakes, etc.) It is best to avoid foods like nuts, sunflower seeds, popcorn, etc., which may get lodged in the socket areas. Over the next several days you may gradually progress to solid foods. It is important not to skip meals! If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster. If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.
SHARP EDGES: If you feel something hard or sharp edges in the extraction areas, it is likely you are feeling the bony walls which once supported the extracted teeth. Occasionally small slivers of bone may work themselves out during the following week or so.
INSTRUCTIONS FOR THE SECOND AND THIRD DAYS:
MOUTH RINSES: Keeping your mouth clean after extractions is essential. After 24 hours, you can begin to gently rinse your mouth. Use 1/4 teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, but at least three to four times daily.
BRUSHING: Begin your normal oral hygiene routine as soon as possible after the procedure. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.
HOT APPLICATIONS: After two days, you may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, heating pad) for 20 minutes on and 20 minutes off to help soothe tender areas. This will also help decrease swelling and stiffness.
HEALING: Normal healing after tooth extraction should be as follows: The first two to three days after surgery are generally the most uncomfortable and there is usually swelling. Swelling usually continues to increase for the 48 hours following oral surgical procedures. On the fourth day, you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-procedure course should be gradual, steady improvement. If you don’t see continued improvement, please call our office.
It is our desire at Northeast Oral and Maxillofacial Surgery that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, please call the office. A 24-hour answering service is available to contact the doctor on call after hours. Calling during office hours will afford a faster response to your question or concern. Our telephone number is: