Post-Operative Instructions For

Tooth Extractions, Including Wisdom Teeth

Please read these instructions carefully. Sometimes the after-effects of surgery are quite minimal, so not all of these instructions may apply to your specific case. Common sense will often dictate what you should do. However, when in doubt, follow these guidelines or call us for clarification.

Office: 660-269-7722 or Dr. O’Loughlin’s personal cell #: (given at appointment).

Your teeth were just extracted – Now what?

Bleeding

Right after surgery, you should be biting on gauze. Remember: “pressure stops bleeding.”

Bleeding should never be severe. If it is, it usually means the gauze was mistakenly being clenched between teeth instead of exerting pressure exactly onto the surgical site. So, be sure to adjust the gauze correctly.

 

  • Continue to bite together onto the gauze for 60 minutes right after surgery with gentle but firm pressure. If there is active bleeding during this hour, place new gauze and ensure it is positioned correctly. Remember, the first hour is most important!

During this hour, you may temporarily remove the gauze to eat, drink, or take mediation, but be sure to put new gauze right back in.

Do not sleep with gauze in your mouth, so do not sleep during this hour because the gauze can become a choking hazard.

  • If bleeding continues after the first hour, then place another gauze for 1 more hour.
  • If bleeding persists, then use a tea bag. Soak it in hot water, gently squeeze it damp dry, and bite together onto it firmly. Black Tea is best because it contains the most “tannins” which help blood coagulate & acts as an astringent to blood vessels.
  • If active bleeding still persists, then call us.

Pain

Right after surgery, you should be numb in the areas where surgery was performed. This numbness can last anywhere from 1-6 hours (or longer); You should begin taking pain medication (see below instructions) approximately 1-2 hours after surgery. Do this even if you don’t feel like you need it – ibuprofen particularly also helps control swelling.

The most severe discomfort usually starts right after the initial numbness wears off, and then for approximately 12 hours after that. *Note: Day 4 is generally the tipping point for most of your post surgery symptoms. On your 4th day after surgery, your level of pain and swelling should begin to slowly diminish.

When will my pain completely be gone? Everyone responds differently to surgery and pain, and everyone’s nerves behave differently. Your pain may be gone in 1-2 days or, less commonly, your pain may last weeks. Even if it lasts for weeks this does not mean there is a problem. The most important question to ask yourself after day 4 is: are my pain and other symptoms gradually decreasing or are they gradually increasing. If the pain is gradually decreasing, then generally there is no problem.  If it is increasing, or if you have any doubts or questions whatsoever, please give us a call.

Office #: 660-269-7722  7:30am–3:30pm, Mon-Fri

Dr. O’Loughlin’s Cell #: (given at appointment)

*If you have no kidney or liver issues, the following are generally recommended for pain control for adults. We recommend taking these with food (breakfast, lunch, dinner, and before bed with a small snack).

1st Recommendation for Pain Control

Ibuprofen (Advil) and Acetaminophen (Tylenol) together, simultaneously. Yes, you can safely take acetaminophen and ibuprofen together. Taking these two medications together works better to relieve pain than taking them separately.

  • Start by taking:

600mg Ibuprofen + 500mg Acetaminophen every 4-6 hours

  • If needed, you may increase these to:

800mg Ibuprofen + 1000mg Acetaminophen every 4-6 hours

*But do not exceed daily limits of 3,200mg Ibuprofen & 4,000mg Acetaminophen

2nd Recommendation for Pain Control

IF the 1st recommendation above does not provide enough pain relief, and IF the doctor wrote you a prescription medication, be sure to follow the dosing instructions written on the bottle. This type of medication will typically be a narcotic and make you groggy and slow down your reflexes, so Do Not drive an automobile or work around machinery. Also Do Not consume alcohol while taking narcotics – Alcohol can enhance side effects of narcotics in unpredictable and dangerous ways.

Diet

The #1 measure you can take to avoid infection is to prevent food from collecting into the empty socket holes left behind where your teeth were just pulled. “Where food goes, bacteria follows.” A great way to avoid this is to eat soft foods that you can just place into your mouth and safely swallow without having to chew, chew, chew. It’s while people are chewing that food tends to collect in the sockets.

It is advisable to confine the first day’s intake to liquids and soft or pureed foods (mashed potatoes, soup, puddings, ice cream, etc.) Avoid small foods like nuts, sunflower seeds, popcorn, etc that can easily collect in the empty sockets. 2 weeks is generally the minimum time frame needed to apply these dietary restrictions.

Do not drink/suck out of a straw, smoke a cigarette, suck on candy, etc. for 48 hours because this may dislodge blood clots out of the empty sockets and result in “dry socket.” In the case of extracted teeth, blood clots are good and necessary for proper healing and new bone formation.

Your Curved-tip Syringe

These are typically given to patients after wisdom teeth removal. Not until 24hrs after surgery may you begin to use the curved-tip syringe. Fill it with water and VERY GENTLY rinse food or debris out of your surgical sites after meals. *Be careful not to flush out the blood clots that need to stay in the sockets!

Prescription Mouth Rinse

Not until 24hrs after surgery may you begin to rinse VERY GENTLY with the mouth rinse you’ve been prescribed. Do this after every meal and also right before bed. Take approximately 1oz by mouth, swish very gently for 30 sec, then drool (not spit) it out. If you were Not prescribed a mouth rinse, then do exactly the same as described above but with salt water. It is a very effective substitute and produces similar results – ½ tsp salt stirred into 1 cup of warm water.

Sutures

In some cases you’ll come away from surgery with sutures that will dissolve on their own in about 2 weeks. If these come undone or become loose, do not be concerned. The sutures are not super important, and your tissue will still heal fine without them. But in the case of bone grafts and membranes, please call us if your stitches come undone etc.

Swelling

Swelling after dental surgery is common. It becomes most apparent the day after surgery and reaches it’s maximum by Day 4. You can minimize this by taking ibuprofen as soon as you get home (see above recommendations for pain control). You can also place ice packs or bags of frozen peas/corn firmly to your face or cheek adjacent to the surgical areas, alternating to each side every 20min during the first 12-24 hours after surgery. After 36 hours, ice has no beneficial effect and, instead, application of moist heat to the sides of the face is beneficial in reducing swelling. *If you ever experience swelling that begins to impede your airway/breathing, go to the emergency room or call 911.

Nausea & Vomiting

In the event of nausea and/or vomiting following surgery, if your health condition permits, do not take anything by mouth for about an hour including the prescribed medicine. Then start slowly with occasional small sips of water for a period of 15-30min. When the nausea subsides you can begin slowly increasing your fluid intake, eating solid foods, and taking the prescribed medications.

*For any questions call:

During business hours: 660-269-7722

After hours: Dr. O’Loughlin’s personal cell: (given at appointment)