Post Operative Instructions
(After Dental Extractions)

If you had an intravenous sedative for your surgery, you may not remember much about the procedure. Although you may soon feel awake and alert, the sedative drugs are still in your system for a period of time.
For 24 hours after sedation or general anesthesia, DO NOT:
            – Drive a motor vehicle
            – Sign any documents of legal importance
            – Operate power tools
            – Do any high-risk activity
You must have someone with you at home at least 24 hours after a sedative.
You will likely feel some discomfort after the anesthetic, or “freezing” wears off. Take the recommended and prescribed pain medication as directed to relieve symptoms. The amount of pain you have will vary. You may notice an increase in the second or third day after the removal. Also keep in mind that the pain medication may not completely eliminate pain, but should at least make it manageable. The discomfort will probably last at least several days, possibly even 1-2 weeks depending on the surgical difficulty and your individual response. Rest quietly for 24 hours and avoid vigorous exercise and heavy lifting for at least 3-5 days to minimize discomfort and maximize healing. 
If you had stitches placed in your gums they will dissolve and fall out on their own in approximately one week. You may experience a few drops of blood in your saliva or minor discomfort when this occurs. If they come out earlier it is not a concern unless persistent bleeding occurs. They are harmless if swallowed.
Take as prescribed and as necessary.
            – Ibuprofen 600mg; Anti-inflammatory/ pain killer for mild to moderate pain.
            – Antibiotics; You MUST take as prescribed to prevent infection.
            – Narcotics; Pain killer that will relieve severe pain.
Swelling of your jaws and cheeks is normal after surgery and will generally increase for two or four days before it starts to slowly decrease. It is very helpful to apply cold compresses to the sides and your lower jaw for the first 48 hours after the surgery. A bag of ice or frozen vegetables wrapped in a towel can be used, 20 minutes on and then 20 minutes off. You may continue to use ice for several days if you feel it helps with the discomfort. In a few days you may notice bruising, which may appear blue or yellow, developing at the jawline and possibly into your neck. Both bruising and swelling are extremely variable and unpredictable.
Because of the freezing it may be difficult to judge temperature for the first few hours, so be careful with hot foods.  Experiencing some difficulty swallowing in the first few hours because of the freezing is normal. Eat very soft foods, including pudding, yogurt, soups, pasta, bread, eggs, and lots of liquids for the first 2-3 days and avoid straws. Then eat fairly soft foods (well cooked vegetables, soft breads) for up to a week after surgery. It may take several weeks for the socket to close over and until then you may notice food getting stuck in them. This may cause bad breath and a bad taste in your mouth. Lastly, avoid alcohol for at least 24 hours after surgery.
Do not rinse or actively spit at all for the first 24 hours as you may rinse the clots out of the sockets and cause bleeding. After the first day you may start to rinse gently with warm, mildly salty water after meals. Do not rinse with anything else for 3-4 days, then you may use mouth rinse. Please brush your teeth gently the evening of your surgery, avoiding the surgical area for 24 hrs.
Avoid smoking for 7 days to prevent dry sockets. Sockets could take multiple weeks to heal. If you cannot hold off until then, it is in your best interest to avoid smoking as long as possible after the surgery, and then to minimize it. Smoking may lead to many complications and cause prolonged healing. 
After you have teeth extracted, a clot of blood will form in the tooth socket or “holes”. It is very important that you avoid putting anything- your tongue, toothbrush, foods- near the surgical site. You should also avoid using a straw, smoking or actively spitting, as all these actions may cause bleeding. Minor oozing of blood and few spots of blood on your pillow in the morning is normal for 1-2 days. Follow these steps if you think you are bleeding excessively:
– Dampen 2 or 3 gauze pads and place directly on the surgical site (socket) that is bleeding.
            – Bite down firmly for 30 minutes to apply pressure.
            – Repeat two or more times if necessary.
If this does not stop the bleeding, call your surgeon’s office. If you feel the bleeding is extreme and the situation urgent, go to the closest emergency department or call 911.
After a dental extraction, you may experience “dry socket”. It is recognized after 7-10 days of heling if you experience:
            – Pain from surgery is better but then returns.
            – It becomes very painful.
            – Pain medication does not work.
            – Pain spreads to the front of the jaw and/or ear.
Dry socket occurs almost exclusively in the lower jaw, particularly at wisdom teeth sites. The condition will usually resolve itself, however you may wish to get the socket medicated to reduce the pain.
Occasionally an infection may occur after surgery. If you think you may have an infection, call the office.
Symptoms may include:
            – Increased swelling after the first 7-10 days.
            – Persistent or worsening pain after day 5.
            – You may feel unwell.
            – Foul tasting fluid draining from the infected site.