Patient instructions: Dental Extractions & Surgery





THE DAY OF DENTAL EXTRACTION / SURGERY

Bleeding 
* Generally we provide a pressure dressing over the extraction / surgery site to help arrest bleeding which is removed before the patient leaves our center. If the patient has been given gauze, change it as directed every 20-30 minutes until active bleeding has subsided (usually 2-3 hours). Make sure to apply good pressure to the gauze.
* You may remove gauze to begin drinking, but return fresh gauze to extraction site(s) if bleeding is still present.
* It is normal to experience light bleeding for up to 24 hours. If there is severe bleeding follow the instructions at the bottom of the form under “Excessive Bleeding”
* Do not smoke, brush your teeth, rinse your mouth or spit.
* Do not drink through a straw.

Excessive bleeding - follow these instructions only if there is excessive bleeding from the extraction / surgery sites:
* Rinse mouth with cool water and gently wipe away blood clots with a clean piece of gauze or a tissue.
* Take a large amount of gauze or 2 tea bags moistened with water and place over bleeding area and close mouth, applying constant pressure.
* Remain quiet and in a sitting position for 20-30 minutes.
* Repeat steps 1 and 3 until bleeding is controlled.
* If these instructions have been followed in detail and excessive bleeding persists, you should call our office.

Swelling
* Ice packs may be used to reduce swelling. Rotate ice pack on and off or side to side every 30 minutes for 24 hours.

Sedation
* If sedated, once home, begin to drink. Start first with clear liquids, and then gradually advance to soup, and soft foods.
* Driving: If sedated do not drive for 24 hours following surgery.

Smoking/Alcohol: Avoid alcohol or smoking today and for a week following surgery.

Numbness: You will probably remain numb for several hours after surgery, so it is recommended that you begin to drink fluids, and take pain medication (over the counter or prescribed) before the anesthetic wears off (or when you begin to feel a tingling sensation). Please don't start chewing food until the numbness has worn off... in order to avoid biting your lips while your lips are numb.

Medications: You may be given any of the following medications:
* Pain medicine: should be taken as needed. You may take ibuprofen (400-600mg every 6 hours) in addition to or instead of your prescription pain medication. While taking prescription medication, do not drive or operate heavy machinery. Be sure to eat something prior to taking pain medicine to reduce nausea.
* Antibiotic: the full course of antibiotic should be taken as directed in order to avoid complications. Be aware that some antibiotics can reduce the contraceptive effect of birth control pills. Please contact your gynecologist or pharmacist if you have concerns.
* Gastric irritation related medications: These are given to patients who develop acidity and gastric discomfort while having antibiotics and painkillers. Please have them as instructed
* Nausea medicine: should be taken as needed. You may take the nausea medication in conjunction with the pain medication to help with discomfort. While taking this medication, do not drive or operate heavy machinery.
* Mouth rinse: use as directed on the bottle.
* Pro-biotics & Vitamin supplements: Probiotics help in restoring the strain of beneficial bacteria (which would have been eliminated by the antibiotics), which aids in the proper digestion of food in the digestive system. They help to restore a more natural balance of gut flora and this will most certainly provide assistance in the reduction or prevention of such common side-effects of antibiotics as nausea, diarrhea, stomach cramps, flatulence, constipation and the like. Often the probiotics are given along with Vitamin suppements  which are often a complex of Vitamin B and folic acid. This combination will help to restore energy to body and will also help the beneficial lactobacillus bacteria to proliferate in your system; vitamin B is food to this type of bacteria.

THE FIRST DAY AFTER SURGERY
* Hygiene: Return to your normal brushing routine, being very careful around extraction site(s).
* Avoid using full-strength mouthwashes for 2 weeks.
* Begin using a warm salt-water rinse (1/4 teaspoon salt in a glass of warm water) every 2-3 hours for 3 days.
* Pain and swelling is normal and expected, and may last for 10-14 days. Don’t be alarmed if the third day is the worst.
* Continue eating soft foods. You may begin to gradually return to your normal diet as tolerated.
* Avoid spicy foods and drinks for 2 weeks.

THE FOLLOWING DAYS AFTER SURGERY
* Sutures/Stitches: You may have sutures placed in your mouth to control the bleeding and hasten healing. If they are non-absorbably sutures, they have to be removed after a period of 1 week to 10 days. If they are absorbable ones, they will dissolve on their own over a period of 2 to 3 weeks.
* If you have been given an irrigation syringe, beginning on the 3rd day following surgery, fill it with salt water to flush the lower molar sockets. Use syringe 1-2 times daily for 3-4 weeks (until socket is closed).
* If swelling is still present on the 4th or 5th day following surgery, then begin using a warm moist compress for the next several days.

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