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REMEMBER THAT YOU
HAVE JUST HAD YOUR TOOTH/TEETH EXTRACTED
WHICH IS SURGERY!
BE KIND TO YOURSELF
The initial
healing period typically takes from
one to two weeks, gum tissue takes about 3-4 weeks to heal and complete
healing of the bone can take about 6-8 months depending on your care of
this area.
Some discomfort, bleeding and swelling should be expected in
the next 24 hours as your mouth heals. Following these simple
instructions will normally be all that is needed
As your mouth heals, you can promote faster
healing and avoid complications by simply following these instructions.
 | DO NOT DISTURB THE WOUND: In doing so you may invite
irritation, infection and/or bleeding. The healing process
begins immediately after surgery as your body sends
blood to nourish the tooth socket. Complete
healing will take one to two weeks and swelling may last
48 hours. Simple pressure from a piece of
gauze is usually all that is needed to control the bleeding and to
help a blood clot to form in the socket. Sutures may need to be
removed in 3-5 days. Keep your fingers and tongue away from this area. No
positive or negative pressure
like blowing up balloons.
Blowing your nose or sneezing violently can dislodge the
blood clot and impair healing, so if you have an upper
respiratory infection or allergies be sure to take the
appropriate medications to treat these conditions. |
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| DO NOT SMOKE OR USE
TOBACCO PRODUCTS
or ALCOHOL FOR
72 HOURS AFTER THE
TOOTH/TEETH Have BEEN EXTRACTED:
because smoke can interfere with
the healing process, promote bleeding and can cause a very painful
situation know as "dry socket". Continuing to smoke
during these first few days will slow healing and soft tissue will not
be able to begin to fill in the socket to form the blood clot needed
for healthy healing. Smoking can also interfere with the bone grow
that surrounds the socket resulting in slowing its process of filling
in the socket
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| BRUSHING:
For several days after the extraction, it is
important to keep the area as clean as possible to prevent infection
and promote healing. Do not directly brush the extraction site for the
first 3-4 days after surgery to prevent dislodging of the blood clot
from the socket. Don't use any toothpaste. Rinsing toothpaste from
your mouth could remove the blood clot. Instead this area can be gently and carefully wiped
with a clean, wet gauze pad or cloth. After this time you may
carefully brush your teeth around this area and floss gently.
|
| MOUTHWASH:
Avoid all rinsing for 24 hours after
extraction. This is to insure the formation of a blood clot.
Disturbance of this clot can lead to increased bleeding or the loss of
the blood clot. After the first 24 hours you should VERY GENTLY
RINSE this area 4 times a day using warm salt water (1
tablespoon salt in 8oz of warm water) or mild
antiseptic rinses like Breath RX. Rinse very gently after every meal
and snack, making sure that the water reaches the extraction site.
Rinsing removes food particles and debris from the socket to help
promote healing.
Chlorhexadine
mouth rinse BID for 10 days. |
| DO NOT SPIT OR SUCK THROUGH A STRAW: This will promote
bleeding and may dislodge the blood clot. |
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| BLEEDING: When you leave the office, you will be given verbal
instructions regarding the control of postoperative bleeding. A gauze pad will be placed on the extraction site that you are
asked to keep firm pressure on.
You will also be
asked to change this dressing every 30 to 40 minutes or so depending
on the amount of bleeding that is occurring.
The gauze
should be dampened before placing them over the surgical
site.
Change
gauze only 3-4 times so as not to remove the blood clot. Do not chew on the pack.
Don not such on the extraction site. It is normal for some
blood to ooze from the area of surgery for 12 hours. We
will also give you a package of gauze to take with you to use at home
if the bleeding should continue. Should you need to use the gauze at
home, remember fold the clean gauze into a pad, thick enough to bite
on. Than moisten it and place it directly on the extraction
site.
Hold it firmly in place, by biting down on the gauze pad or use finger pressure, for about 30-60
minutes. This pressure helps reduce bleeding and permits a clot to
form in the tooth socket. If bleeding still continues, moisten a
tea bag with water and wrap it in gauze and fold it in half and bite down on it for 30
minutes. Tea contains Tannic Acid which may help to
reduce the bleeding. Keep your head elevated with pillows to control
bleeding. Use
a towel on the pillow the first night, |
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| MEDICATIONS:
Some discomfort is normal after surgery.
Analgesic tablets i.e. Tylenol or Motrin or non-aspirin can be taken
(2) every four hours as needed or as directed by Dr. Peterson. Refer
to pain control article. Prescription medication, which may have been given to you, should also
be taken for 2-3 days after surgery or as directed. Don't drive while
taking any pain medication due to drowsiness. If antibiotics are
prescribed you should carefully follow the instructions and finish the
antibiotics until they are completely gone. Avoid aspirin as it may increase bleeding.
A side effect of
aspirin is it can increase bleeding by inhibiting blood clotting making it unsuitable
following extractions. To avoid nausea do not
take pain medications on an empty stomach. |
| SWELLING:
To prevent swelling, apply an ice pack or a cold
towel to the outside of your face in the area of the extraction during
the first 12 to 24 hours. Apply alternately, 10-20 minutes on then
10-20 minutes off, for an 6 hour or longer if necessary. Ice
is the best restriction to excessive swelling. The more
ice, the less swelling. After 24 hours, ice will not
stop swellingSalt water
rinses after 24 hours.
|
| SORE JAW JOINT:
Your jaw may be sore from holding your mouth open during
surgery. This may last 4-5 days. Massage the jaw muscles
gently/ Apply moist heat for 10 minutes on/10 minutes off.
Eat soft foods.
Do not over extend opening your mouth, it can
further aggravate this area. There may be some semi-permanent numbing
in the area of the extraction. It will decrease in size within
the first 6 to 8 weeks and may continue until 6 months after
surgery. |
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| DIET:
For the first 24-48 hours, you should maintain a diet of
soft foods, such as Jell-O, pudding, yogurt, cream of wheat, mashed potatoes,
clear soups,
etc. Food that crumbles such as potato chips, popcorn, crackers,
cookies, etc. should be avoided. Hot spicy foods should also be
avoided to prevent irritation and burns of the extraction site. Also
avoid carbonated and hot beverages for 3-4 days. Avoid sticky foods
like taffy. Eating immediately following
the procedure is not recommended. When the numbness has worn off you
may eat yet be sure to chew on the opposite side for the first 24
hours in order to keep food away from the extraction site. Also, keep
anything sharp from entering the wound (i.e. eating utensils, fingers
and other objects etc.) It is also important to drink 8 glasses of fluids
in between meals and with meals. Try vegetable and or fruit juices or
high-protein drinks. Cut food into small pieces to ease
chewing. Return to a normal diet as tolerated
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| ACTIVITY:
For the first 24 hours, your activity should be
limited because increased activity can lead to increased bleeding. No
bending over or heavy lifting for 2-3 days. Do not play any wind
instruments or blow up balloons for a period of 10-14 days. When lying
down elevate your head slightly.
Please be aware that you may
get quite
severe bleeds intra-orally following extractions and
endo, from flying and
recreational diving. This condition can be caused
barotrauma for up to a month after the surgery* |
| DO NOT DRINK ALCOHOL for 48 hours
after surgery.
|
| PAIN-that lasts
for up to a week or so but is gradually improving
should be considered typical. Pain that seems to be getting
worse after two days should be considered abnormal and
may require an evaluation by us.
After 24 hours, applications of heat over the
surgical area may help. |
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| For Women ONLY: It is
crucial that you follow these instructions and especially DO NOT
SMOKE. If you are taking birth control or are in the first
22 days of your menstrual cycle your are twice as
likely to develop a dry socket, which
is a very painful condition, after an extraction.
|
| ANESTHESIA WARNING:
When a local anesthetic is used your lip,
tongue and cheek will be numb for several hours after the procedure.
While it is numb, it will feel "funny". During this period
you must be careful not to bite, chew, pinch and/or scratch this
area which can lead to serious soft tissue trauma.
|
| LONG TERM PROBLEMS: You
may have a numb, tingling feeling in the area for 4-6 weeks or
longer. Having a missing tooth can lead to several
problems such as shifting teeth, difficulty chewing and malocclusion
which could lead to TMJ problems. This area will need to be restored
with a fixed bridge, implant, a removable partial or a denture to
insure good long-term dental health.
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| FOLLOW-UP APPOINTMENT: You are required
to make a post-op appointment in one week to check on the healing of this
area. If sutures were placed they will be removed at this time.
|
REPORT ANY UNUSUAL OCCURRENCES IMMEDIATELY !
If you have any questions regarding these directions or need any future
clarification or if you experience excessive bleeding or swelling,
persistent and severe pain, fever, or any reaction to medications you
should call Dr. Peterson 308 436-3491
Visit A.G.D. if you are a woman and are considering having a tooth
extractions: Check
menstrual calendar for tooth extraction
*British Journal of
Oral Health and
Maxillofacial Dentistry
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'Phantom' Tooth
Pain
— Phantom limb pain after an amputation
isn't the only type of mysterious pain that puzzles doctors
and worries patients. Dental patients who have a tooth
extracted can have pain at the site of the extraction for
months afterwards. It's the toothache that won't go away,
but there's no tooth there. It's not common, it affects
perhaps less than one percent of dental patients. But phantom
tooth pain can last for months, and can also spread
beyond the extraction site to other areas of the mouth.
Such phantom tooth pain may be related to changes in a
person's pain threshold. Phantom tooth pain is caused
by changes in surrounding nerves that can occur after some
extractions. No one knows what causes these changes.
Patients who suspect they may have phantom tooth pain should
consult a specialist in orofacial pain to obtain a
diagnosis. Often, when the pain spreads, dentists who don't
think about the possibility of phantom tooth pain will suggest
more procedures, such as extracting another tooth. "Don't
keep having procedures done," he advised, until a
diagnosis of phantom tooth pain is ruled out. Aug.
27, 2002 Post-extraction 'phantom' tooth can haunt patients By
Kathleen Doheny San Diego (Reuters Health) 2002 Reuters
Limited.
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February 06, 2008
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