Prescriptions should be filled as soon as possible. Pain medication should be taken before the freezing wears off (in 1 to 2 hours). For wisdom teeth or multiple tooth extractions, you should plan on taking the prescribed pain medications regularly and as prescribed whether needed or not, for the first 24 hours. Antibiotics, if prescribed, must be taken until finished. Avoid Motrin, Aleve, Ibuprofen or Advil if you are taking a blood thinner, have a history of ulcers, bleeding disorders, kidney problems, gout, liver cirrhosis or have an allergy to NSAIDs. Do not take Tylenol if the medication you are prescribed contains acetaminophen such as Tylenol 3s, Percocet, or Tramacet. If you have any concerns about taking Tylenol or Advil please discuss with your family doctor and notify us
You will have received freezing to the surgical area (local anaesthesia). Depending upon the type of local anesthetic used, the freezing sensation can last from 4-12 hours. If the area remains numb for more than 24 hours, please contact the office.
Ice packs should be used for at least the first 24 hours after surgery, or until bedtime, but may be used for up to 3 days, postoperatively if desired. They are to be placed on the face, over the surgical site, alternating for 20 minutes on/20 minutes off. For wisdom teeth extraction, place the packs on the left and/or right lower jaw.
To control initial post-operative bleeding, use tightly rolled gauze packs (shaped like a marble) placed directly on the surgical site(s). Firm, constant pressure will stop all bleeding, and this should be applied by biting down on the firmly rolled-up gauze (you should not be able to bite your teeth together – this means the gauze is applying sufficient pressure to the wound). Gauze packs should be used throughout the day of surgery while awake, being changed no more frequently than once per hour, and must be taken out before sleeping. If there is minimal staining of the gauze 1-2 hours after surgery, you may discontinue the gauze. If there is still moderate bleeding, continue to bite on the gauze as needed. Minor amounts of bleeding or oozing can be expected for the first day of two after the surgery. If vigorous, heavy bleeding leaving large clots occurring 5 hours after surgery, please call the on-call doctor.
Swelling will increase to a maximum 3 days after surgery, and will gradually decrease over the following 5-7 days. Bruising, which is very common, will disappear along with the swelling. Contact our office immediately if the swelling returns after the first week. If you have had a larger procedure done, in order to reduce swelling, try sleeping in a “lazy-boy” – type reclining chair, keeping the head above the heart for the first 3 days. An alternative is to place several books under the mattress of your bed to keep your head elevated.
No rinsing or spitting should be done on the day of surgery. The day after surgery, use a warm saltwater rinse (1 cup of water to¼ tsp of salt) every 2 hours while awake, for the first 3 days, and then every time you eat for the next 2 weeks. If you have had lower wisdom teeth removed, the recovery nurse may have given you a Monoject Syringe at the discretion of the Doctor. This is to be used with salt water, in addition to the above rinsing, every time you eat until the small incision is completely closed (usually ~ 2-4 weeks). In the bathroom, in front of the mirror, standing over the sink, place the tip of the syringe deep inside the extraction socket and flush with the salt water, to ensure that all food is removed appropriately. Let the salt water fall out of your mouth, in the sink. Continue salt-water rinses so long as stitches are still present in your mouth.
You may brush your teeth on the day after surgery. Try to use a soft toothbrush on your teeth, avoiding the gum tissue around the surgical site for the first 2-3 days.
Drink plenty of fluids and eat a soft diet until your normal diet can be resumed. Avoid hot drinks and foods until freezing wears off. Straws should not be used during the first 3 days, as they may increase bleeding, or lead to a dry socket.
If nausea and vomiting should occur after surgery, GravolTM an over-the-counter product, can be taken orally if only nauseous, or suppository form if vomiting should occur. Adult dosage is 50 mg every 6 hours. Try to avoid milk products. Contact our office if nausea persists.
If a narcotic (Tylenol with codeine/Tylenol #3, oxycocet, Percocet, Tramacet, Tramadol) was prescribed for pain control, please note that it can cause constipation. You should start a bowel regimen (Colace, senekot, restoralax) to ensure regular bowel activity.
Most stitches will dissolve and fall out in approximately 1 week. Occasionally, a stitch may fall out within the first day or two following surgery. If this occurs, do not worry – simply make sure to rinse with salt water appropriately. The wound will heal properly in this case. If you have bone grafts placed, your stitches will fall out in 2-3 weeks. Postoperative visit is not needed. Brushing the wound will help speed up the loss of the sutures.
If you have had all your teeth removed, your denture should be left in place following surgery for the first evening. Brush your dentures with a toothbrush and toothpaste, and reinsert them. Do not sleep with your dentures following the first night of post-surgery. If you find it too uncomfortable to reinsert your dentures the next morning, keep them out until the swelling subsides, and then reinsert them. The rinsing instructions above should be followed. NOTE: You should make arrangements to see your dentist or denturist within 2 days after the surgery for any adjustments to be made.
In very few cases, some discomfort may occur at the IV site. Elevating your arm and applying moist heat with a wet face cloth or hot water bottle every ½-hour for 6 to 8 hours, will help alleviate the symptoms.
Exercise should be done in moderation during the recovery period. No strenuous physical activity should be done for the first 5-7 days following your surgery.
OPERATION OF VEHICLES:
If you have received sedation, it is mandatory that you NOT drive a vehicle, operate hazardous machinery, or consume alcohol for at least 24 hours following surgery, especially if drowsiness persists.
Smoking is the number one cause of delayed healing and complications (infection, dry socket, etc.) following oral surgery. Ideally, you should never smoke after your surgery. However, it is recommended that you abstain from smoking at least 5 days after surgery.
A dry socket is where the blood clot has dissolved away in the wound. It is not a dangerous situation, but an uncomfortable one. The causes of dry socket, ranked in order of occurrence, are: smoking; birth control pills; poor oral hygiene/rinsing. If you have a dry socket, it will present as discomfort which increases in severity on postoperative day 5-6. It will occasionally cause discomfort which radiates to the ear, and the side of the head. If this occurs, please call the office as we will need to see you for an evaluation.