After Your Visit: Tooth Extraction

DAY OF THE SURGERY AND AFTER CARE - IMPLANT/ TEETH EXTRACTIONS/ GUM SURGERY

• MEDICATIONS/ANTIBIOTICS: If you did not receive your prescriptions before the surgery, fill your prescriptions and take your medications as directed. It is recommended that you take a probiotic supplement when antibiotics have been prescribed. Yogurt with lactobacillus and acidophilus milk may also reduce antibiotic-related diarrhea if you are not lactose intolerant. Please call the office to report an allergic reaction to any prescribed drug. If you develop a rash in response to a prescribed drug, you should stop the medication immediately and take Benadryl or an antihistamine.
• FIRST HOUR: Bite down gently but 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 unless the bleeding is not controlled. The packs may be gently removed after one hour. If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30 minutes. The gauze may then be changed as necessary (typically every 30 to 45 minutes). It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning
• DISCOMFORT: Mild to moderate discomfort is a normal part of the healing process and should be anticipated. Take the prescribed pain medication before the anesthetic begins wearing off, not when the pain peaks. Follow label directions for dosage and frequency information. If you are taking a narcotic medication, do not drive. Many patients will take pain medication the day of the surgery and that night. The next day, you may take the prescription medication if you feel it is necessary or you may take Advil, Aleve or Tylenol Extra Strength. Do not take aspirin for 7 days after surgery as this may cause bleeding in the surgical site. Instead of taking narcotic medication you may take 2 tablets of Advil (Ibuprofen 200mg each tablet) and 2 tablets of Tylenol (regular or extra strength) every 4 to 6 hours. This combination has pain relief equivalent to a narcotic without the adverse side effects of nausea, dizziness and constipation. This recommendation only applies if you do not have an allergy or sensitivity to ibuprofen (Advil) and/or acetaminophen (Tylenol).
• SWELLING: Swelling is a normal part of the healing process and can be minimized with ice packs applied gently to the outside of your face and jaw for the first 48 hours after surgery. Repeat the pattern of holding the ice pack on the face in the area of surgery off and on for 10 minutes at a time. Do not press hard or rub the area or you risk disturbing the surgical site. The swelling usually peaks in 48 hours and tapers off after that. Ice packs will help to minimize the swelling. If you do not ice the area, you will have swelling that will taper off after about 3-7 days. This swelling may put pressure on the sutures and the surgical site. You will improve your chances of healing with a better result if you minimize swelling by icing the area, reduce facial expressions and minimize talking for the first two days.
• BLEEDING: A small amount of bleeding or oozing is normal and usually occurs on the day of surgery and sometimes, the following day. This is not a problem. The site will continue to clot and heal. Keep your head slightly elevated for 24 hours. When you lie down tonight, use two pillows to keep your head slightly raised. For the next 24 hours, do not spit, do not swish vigorously and do not drink through a straw because this may initiate bleeding. For the next 24 hours, do not exercise or do anything that increases your heart rate such as strenuous physical activity because this may raise blood pressure and initiate bleeding in your mouth. However, if the surgical site is continuously bleeding and filling up your mouth, you should place a cold, wet teabag in the area and apply continuous pressure by either biting down or applying even finger pressure for 20-60 minutes as needed. If the dressing is in place, use two fingers to apply even pressure on both sides of the dressing. If bleeding reappears uncontrolled, please call Noa Dental at 661-857-7662.
• NAUSEA: Nausea is not uncommon 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 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.
• CLEANLINESS: Do not use an electric toothbrush anywhere in your mouth until your follow-up visit. A manual toothbrush with a small amount of toothpaste may be used for the rest of your mouth as well as floss. Take care not to stretch your cheeks near the surgical site as this might pull on the sutures. Do not brush anywhere in or near the surgical site(s) until you see your doctor for your follow-up visit. Do not rinse for 3 hours after the procedure. After the initial 3 hour period, you may rinse gently with lukewarm salt water but do not spit forcefully. If you have been given a prescription for antiseptic mouthwash, start using it the morning after the surgery and use it twice a day. You may either hold the mouthwash in your mouth for one minute or saturate a cotton ball and GENTLY dab the area with it for one minute. If you use the cotton ball, dab around the biting surfaces of the teeth and allow the mouthwash to seep down onto the gum tissue. Do not rub. The mouthwash will last longer if you use the cotton ball method and it will stay off your tongue if you do not like the taste. Do not use peroxide, Scope or Listerine.
• FOOD: For the first 24 hours, do not eat HOT foods/liquids. Heat may cause an increase in bleeding from the surgical site. Eat a soft diet such as pasta, meatloaf, fish, chicken, cooked vegetables, eggs, smoothies or yogurt. Avoid crunchy foods such as hard breakfast cereal, hard crusted bread, raw vegetables, chips, popcorn or nuts. Chew on the opposite side and cut your food up into small pieces. Eat a balanced diet and maintain adequate fluid intake. Usually you will need to stay on a soft diet for 2-3 weeks but follow the instructions given at the time of surgery.
• SUTURES: Do not tug or remove your sutures. Follow your doctor's orders for your post-operative visits. We use both resorbable and non-resorbable sutures. Your doctor needs to see you for your follow-up to evaluate your healing progress and remove sutures if needed.
• DRESSING: If a periodontal dressing has been placed, do not disturb it. It may come off either partially or completely before your next appointment. The edges might break off periodically. This is not an emergency and you will not need to have it replaced. Do not pull on the sutures if the dressing is lost. If the dressing is still in place at your follow-up visit, we usually remove it at that time.
• REST: Avoid strenuous activity for 1 week and get adequate rest. Absolutely no smoking for at least 48 hours.
• SHARP EDGES: If you feel something hard or sharp edges in the surgical 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. If they cause concern or discomfort, please call the office.

INSTRUCTIONS FOR THE SECOND AND THIRD DAYS

MOUTH RINSES: Keeping your mouth clean after surgery is essential. 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 two or three times daily. You may continue to use prescribed antiseptic mouth rinse 2x a day as instructed. DO NOT use mouth wash such as Listerine, Crest etc. for the first week.

BRUSHING: Begin your normal oral hygiene routine as soon as possible after surgery but do not brush, disturb the surgery area. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

HOT APPLICATIONS: 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 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 gradual, steady improvement. If you don’t see continued improvement, please call our office. Then use it daily according to the instructions until you are certain the tooth socket has closed completely and that there is no chance of any food particles lodging in the socket.

AN EMERGENCY IS:

A) Excessive bleeding occurs, is prolonged and is not controlled with a teabag

B) Severe pain occurs, is prolonged and is not controlled with the medication

C) Marked swelling that is accompanied by fever

Emergency only please Leave a voicemail @ 661-857-7662 (Noa Dental Office)

All other questions, please call during office hours at 661-857-7662.

CALL 911 WHEN ANYTIME YOU THINK YOU MAY NEED IMMEDIATE EMERGENCY CARE

For Example, call if:

• YOU PASSED OUT (LOST CONSCIOUSNESS)
• YOU HAVE DIFFICULTY BREATHING, SWALLOWING/ THROAT TIGHTNESS
• UNCONTROLLABLE FEVER

Before a surgery — preparation

PREPARING FOR SURGERY – IMPLANT/ TEETH EXTRACTION/ GUM SURGERY

• Refrain Tobacco and Alcohol use: as it may delay or inhibit healing process and increase the risk of complications after surgery.
• Disclose medications to your surgeon/ dentist: Certain medication can lead to complications on the surgery and/or recovery. Some medical condition may need a clearance by your physician prior to the dental surgery, so it is important that you consult your medical condition/ history with your dentist in advance.
• Keep your teeth clean: if you are due for the cleaning, please make an appointment to get your teeth cleaned prior to the surgery or practice good oral hygiene at home as incision area can be infected by the oral bacteria.
• Antibiotics/ medications: if your doctor prescribed you antibiotics to start prior to the surgery, please start 2 days prior so the surgery day falls on your day 3 of taking antibiotics. (Take with probiotic supplement is recommended)
• Tips and arrangements: soft foods, ice pack, prescription, transportation ready prior to the surgery so you can go straight home and comfortably rest right after the surgery.

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