The Day of Surgery
Bite down firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Do not change them for the first hour. The packs may be changed after one hour. Replace gauze over the site for another hour. The gauze may then be changed as necessary. Moisten the gauze with cold tap water. Resting with the upper body elevated (recliner) and applying ice packs to the face will also help control the bleeding. It is not necessary to keep gauze in place overnight. *DO NOT RINSE ON THE FIRST DAY*
Do not disturb the surgical area today. Do NOT rinse vigorously or probe the area with any objects. You may brush your teeth gently at the end of the day. PLEASE DO NOT SMOKE for at least 48 hours since this is very detrimental to healing and may cause a dry socket. Do not drive for 24 hours after general anesthesia or while taking narcotic pain medication.
Bleeding should never be severe. If so, it usually means that the packs are only being lightly clenched between teeth and are not exerting pressure on the surgical areas. Try re-positioning the packs and biting down with firm pressure for at least 30 minutes at a time. If bleeding persists, you may replace the gauze with a damp BLACK tea bag. Tannins in black tea have been shown to help with the formation of a blood clot. If bleeding remains uncontrolled, please call our office at (704) 234-7774.
Swelling is often associated with oral surgery. It can be minimized 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 20 minutes on and 20 minutes off during the first 24 hours after surgery. If you have been prescribed medicine to control swelling, be sure to take it as directed and still use ice as above. Keep in mind that post-surgical swelling typically does not “peak” (i.e., reach its maximum extent) until 72 hrs after the procedure and then should begin to taper off and improve after that. Note: Although less frequent, swelling can sometimes be accompanied by bruising of the external face and upper neck. This tends to occur more frequently in lighter-skinned individuals, patients taking blood thinner medications, and the elderly. Bruising will typically self-resolve and become less noticeable in 5-7 days.
Unfortunately, most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication. You should begin taking pain medication before the anesthetic wears off to “stay ahead” of the pain. We highly recommend using Ibuprofen as your first-line pain medication since it acts as both an anti-inflammatory (to counter-act swelling) and a mild pain reliever. Do not underestimate OTC’s effectiveness (over-the-counter) pain relievers – many studies have shown that Ibuprofen and Tylenol, taken in combination and according to a routine, are more effective than narcotic pain meds in relieving and managing post-surgical pain. Click here for Dr. Soung’s recommended “Pain Control Regimen.”
The effects of pain medications vary widely among individuals, so please call us if our recommended pain regimen does not provide adequate relief. Remember that the most severe pain is usually within six hours after the local anesthetic wears off; after that, your need for medicine should lessen. Remember that no pain medication or pain regimen will eliminate 100% of post-surgical pain; some discomfort is expected/normal even after taking pain meds. The goal is to use pain medication to decrease discomfort to a manageable level.
Nausea may occur after surgery. 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 glass of water. Try to keep taking clear fluids and minimize pain medication dosing, but call us if you do not feel better.
Most stitches used in oral surgery are dissolvable and will “resorb” or fall out on their own in 5-7 days after surgery. Some specific procedures or areas of the surgical site may require “longer-acting” sutures that will not dissolve or resorb for several weeks or even non-resorbable sutures that will need to be removed by the surgeon during a post-operative visit to our office.
Start with clear, cool liquids. Avoid extremely hot foods and carbonated beverages. Do not use a straw on the day of surgery. It is sometimes advisable to confine the first day’s intake to liquids or pureed foods (soups, Jell-O, slushy drinks, applesauce, pasta, 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 have diabetes, maintain your normal eating habits or follow instructions given by your doctor.
If you feel something hard or sharp edges in the surgical areas, you are likely feeling the bony walls that once supported the extracted teeth. Occasionally small slivers of bone may work themselves out during the following week or so. If they cause concern or discomfort, please call the office.
Second and Third Days
Keeping your mouth clean after surgery is essential. Use prescription rinse as prescribed. Avoid mouthwash (Scope, Listerine, etc.) for 5 days.
Begin your normal oral hygiene routine soon after surgery. Soreness and swelling may not permit vigorous brushing, so progress as comfort allows.
Normal healing after tooth extraction should be as follows: The first two days after surgery are generally the most uncomfortable, and there is usually some swelling. On the third day, you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be a gradual, steady improvement. If you are given a plastic irrigating syringe, DO NOT use it for the first five days. Use it daily according to the instructions until you are certain the tooth socket has closed completely and there is no chance of any food particles lodging in the socket.