Instructions Following Dental Extractions

Pain

A certain amount of pain following surgery is to be expected. For persistent pain use the medication prescribed. Always take pain medication with food.  Pain in general can last 1-2 weeks, with an average from 7-10 days.

We recommend alternating between Ibuprofen and Acetaminophen.  Rather than taking the two analgesic pain and anti-inflammatory medications together, by alternative taking each separate medication every 3-4 hours, this allows for a synergistic, longer lasting and more therapeutic effect  allowing for less discomfort.

If a narcotic is prescribed, use it only as necessary.  Do not drink or drive while on narcotics.  Narcotics can be addictive.  If you have any prior addictions, please let the Dr know prior to any prescribing.  We don’t recommend taking unless necessary. Narcotics can cause some stomach queasiness and constipation.  Use only if you need, for as little time as possible. If you are taking, you can take Ibuprofen and alternate similarly to the previous recommendation, but alternate with ibuprofen and the narcotic.

Some bleeding is to be expected. Bite into the gauze/apply firm pressure, which should be placed over the surgical area. Do not open and close your mouth. Leave the gauze in place for 30 minutes, and if you need to talk, talk through a clenched mouth, otherwise minimize all talking.

If slight bleeding continues, it usually can be controlled by simple biting pressure with a gauze for 30 minutes. Repeat if necessary.

If bleeding continues after the above measures, soak a tea bag in cold water then wrap it in a gauze. Place it firmly in the area of bleeding. Lying down with your head elevated can also be a benefit. Apply an ice bag to the cheek for 20 minutes on and 20 minutes off for today only. If there is swelling tomorrow, do not use ice. Begin applying warm, moist heat to the area. Avoid hot liquids. If you are unable to control bleeding or swelling please call us as soon as possible.

Sleep with your head elevated and try not sleeping on the side where the tooth was extracted. This will help with swelling and pain management.

Rinsing

Do not rinse, spit, smoke, or suck through a straw until the next morning. These activities may dislodge the blood clot, cause bleeding, and delay healing. These factors also increase your risk of dry socket.

Starting the day after surgery, gently rinse with salt water after meals to flush out food particles which may lodge in the extraction site. (1 teaspoon of salt to one cup of warm water) Continue this for at least three days after the extraction. If you are unable to rinse out of the food particles, you can purchase a curved syringe for irrigation and cleaning of the site. Do not pick at the extraction site. You may resume brushing as normal on your other teeth, just avoid the extraction site.

Diet

Do not chew on solid food while you are still numb. Eat light, soft foods, with as much fluid intake as possible. As soon as possible, change to solid foods, to help you heal faster. When you do eat, try to avoid the extraction site as much as possible. Avoid crunchy foods, like potato chips, pretzels, hard breads, etc.

Sutures/Stitches

Dissolvable stitches are used unless otherwise noted, and they normally fall out/dissolve over the next 1-7 days.

Possible Side Effects

• Slight Bleedings- control as instructed above.
• Swelling may be quite large for 4-5 days; control as instructed above.
• Pain sometimes may start around day 2 or 3, do not be alarmed as that can happen.
• There may be a slight elevation in your temperature for 24 – 48 hours. If a temperature continues, please call us. There might be a slight earache or jaw soreness due to having your mouth open for an extended period of time.
• If the corners of you mouth are stretched, they may get dry and crack temporarily. Keep you lips moist with Chapstick or Vaseline.
• Numbness may persist. This is usually a temporary condition and will gradually disappear in a few days to several weeks as the nerve tissue is repaired.  If you have this symptom please call so we can monitor and evaluate.
• Black and blue bruising may occur on the outside of the face. This is not unusual and make take a week or more to resolve.

And remember, Dr. Koppelman is happy to answer questions, do not hesitate to call if you are unsure!