Post-Op Instructions

Click on the link to view post-op instructions for that particular procedure. If you are our patient and have any questions regarding post-op treatment, please call us at (503) 397-0080.

•	Tooth Extraction
•	Wisdom Tooth Removal
•	Dental Implant Surgery

After a Tooth Extraction

Recovery after a tooth extraction should only last for a couple of days, but there are certain steps that you can take to speed up the healing process.

Bleeding

After your extraction, a blood clot should form in order to stop the bleeding and initiate the healing process. For this reason, you’ll be asked to bite onto a gauze pad for up to 45 minutes following the appointment. If the bleeding continues after this time period, use another gauze pad to bite firmly for an additional 30 minutes. You might need to do this several times before the bleeding stops.

The blood clot is essential in the healing process, so it is important that you don’t do anything to dislodge or disrupt it. Not only will healing be delayed, but you can also cause the wound to start bleeding again. To protect the clot:

•	Don't rinse out your mouth vigorously
•	Avoid using straws when drinking for at least 72 hours
•	Avoid drinking alcohol and smoking for several days following your procedure
•	Limit exercise for the first 24 hours, as this increase in blood pressure could cause bleeding at the extraction site and may damage the clot

Pain and Swelling

After you have gone through an extraction, you will likely experience some pain and discomfort along with swelling. Try using an ice pack or a bag of frozen vegetables in order to deal with the swelling, as you can place it along the side of your face. Swelling should usually go away within 48 hours of your procedure.

If you are prescribed any pain medication, it is important to take it as prescribed. If you notice that the medication isn't working as it was intended, feel free to call our office. You may also need to take antibiotics, and if they were prescribed, be sure to take them for the entire duration as instructed, even if your symptoms of infection go away before you’ve finished.

Other Tips for Caring for Your Mouth

Even if you are able to control the bleeding, pain, and swelling, there are a few other steps that you’ll need to take in order to promote healing:

•	Drink plenty of water and eat healthy, soft foods on the day of your procedure. Once you feel comfortable, you can return to your normal diet.
•	After 24 hours, get back into your normal dental routine. This will include daily brushing and flossing, as a clean and fresh mouth will be better prepared for quick healing.
•	Feel free to start resuming your normal activities in a day or two, depending on how you're feeling.

If you are experiencing severe pain, swelling, or heavy bleeding for 2–3 days after your procedure, or if you think you are reacting poorly to the medication you were prescribed, please call our office right away. Likewise, if your child goes through an extraction and experiences any of these symptoms, or vomiting, nausea and fever, be sure to contact us immediately.

After Wisdom Tooth Removal

Removing impacted wisdom teeth will be a major surgical procedure, so following the proper post-operative care will be vital to successful healing. If you don’t follow these instructions carefully, you may experience unnecessary pain and potential complications involving swelling and infection.

Immediately Following the Procedure

•	A gauze pad will be placed on the surgical area. Be sure to keep this in place for up to 45 minutes. After 30–45 minutes have elapsed, remove the gauze pad and discard it.
•	Avoid touching the wound or rinsing your mouth out vigorously. This could disturb the blood clot and may cause further bleeding.
•	Take your prescribed pain medications about four hours after your surgery, before the anesthetic wears off. We also recommend eating something soft, like applesauce or yogurt, 10–15 minutes before taking your medication.
•	Use ice packs against the side of your face to deal with the swelling.
•	Take the day of your surgery off to relax, and resume normal activities when you feel well enough to do so.

Bleeding

If you notice bleeding following your surgery, you shouldn't be alarmed. Slight bleeding, red-tinged saliva, or oozing are all common. Even excessive bleeding isn't an immediate cause for concern. First, rinse any old clots from your mouth, and then use a clean gauze pad to place over the area. Bite firmly and hold the gauze in place for another 30–45 minutes. Repeat this process if necessary.

If bleeding still continues, try switching out the gauze pad for a moist tea bag, and bite down on this for 30 minutes. It is believed that the tannic acid found in the tea can help to form a clot, as it will constrict the bleeding vessels. You can also help to control the bleeding by sitting upright and avoiding exercise.

If after all of this you are still experiencing excessive bleeding, call our office for additional instructions.

Swelling

With wisdom teeth extractions, swelling experienced around the mouth, eyes, sides of the face, and cheeks may be experienced. This is just your body’s normal response to surgery, but the swelling likely won't become noticeable until the day after your surgery and should reach its max 2–3 days post-op. However, the immediate use of cold packs can reduce or even prevent swelling.

To ice your face, fill up two small bags with ice and apply them to the sides of the face where the surgical procedure was performed. Place them on your face for 20 minutes each hour for the initial 24 hours following the surgery. After the first day, ice won’t do any good in preventing swelling.

If your swelling persists for several days, you shouldn't be concerned, as this is simply a normal reaction to an oral surgery. After 24 hours, you can use moist heat on the sides of your face, as this could be helpful in reducing swelling.

Pain

Pain can be moderate to severe following your surgery. For moderate pain, you can take:

•	Tylenol (regular or extra strength), 1–2 tablets every 3–4 hours
•	Ibuprofen, 2–3 tablets every 4–6 hours

You will also be prescribed prescription pain medication, and if you are experiencing severe pain, this is your best option for relief. Make sure that you are taking the medication as directed, and remember that it can make you sleepy. Never drive or work with machinery when taking prescription painkillers, and you should also avoid drinking alcohol.

Your pain should get better every day following your surgery. If this doesn't happen and your pain continues, you may need to contact our office.

Diet and Nutrition

If your procedure was performed with IV sedation or general anesthesia, you should initially only drink liquids following your procedure. Drink from a glass and avoid straws, as the sucking motion used to drink from a straw can dislodge the blood clot and cause more bleeding.

Feel free to start eating soft foods, but try to avoid chewing near the surgical sites. A high protein, high calorie diet is important, and you should be sure to get nourishment regularly. Drinking water consistently is also important in order to prevent dehydration, especially since you likely won’t be eating very much for the first few days.

Do the best that you can to not skip meals. If you continue to eat, you'll feel better, heal faster, and will have more strength.

Oral Hygiene

You'll need to take extra precautions to keep your mouth clean while you are recovering from wisdom teeth removal surgery. The day of your surgery, don't do any rinsing. While you can brush your teeth, rinse gently. The next day, you should start rinsing out your mouth with a saltwater solution 5–6 times per day. You should continue this technique until the healing process has been finished.

Discoloration

Some people notice bruising or skin discoloration that follows swelling. This discoloration could be yellow, blue, black, or even green in color, and it is simply due to the blood that is spreading under the tissues. It usually occurs 2–3 days after surgery, and it is a normal occurrence. The use of moist heat can help this discoloration to subside.

Antibiotics

If your surgeon has prescribed antibiotics, it is important to take them as directed, as they'll work to prevent infection. If you notice that you experience an unfavorable reaction or rash after taking the medications, discontinue use and call us right away.

Nausea and Vomiting

If you experience nausea or vomiting after surgery, don't eat or drink anything for an hour, and don't take any medications. After that hour, start sipping on ginger ale or another beverage that might help to soothe your stomach. Do this over a 15 minute period, and if the nausea goes away, you can start to take your medications and eat solid foods again.

Other Potential Complications

You should also be aware of other potential complications that might arise after your wisdom teeth removal surgery:

•	Numbness of the tongue, chin, and lips are common and generally only temporary. However, you should remember that if you are experiencing numbness you need to be careful to not bite one of these areas. If you have questions, give our office a call.
•	You might notice a slight temperature elevation after surgery, and this is fine, but if the fever persists you should notify our office. Tylenol can be used to reduce your fever.
•	If your tongue starts to feel hard bumps in your mouth, don't panic. These are parts of the bony walls that supported the tooth and not roots. They should smooth out on their own.
•	Keep your lips moist with Chap Stick or ointment, as the corners of your mouth will be especially prone to cracking and drying out after your surgery.
•	Pain or a sore throat when swallowing is common, as the muscles of your throat are prone to swelling. This sensation should subside in less than three days.
•	Jaw muscle stiffness can make it hard to open and close your mouth the first few days after our surgery. This issue is normal and should resolve on its own with time.
•	If the sutures that are placed in your mouth become dislodged, you shouldn't be concerned. They should dissolve on their own a week after surgery, so if one comes off, just take it out of your mouth and throw it away.
•	You should expect swelling and pain to get better each day following your procedure. If unusual symptoms begin or your pain and swelling suddenly worsens, call our office.
•	The space where the tooth was taken out will have a hole, but it will gradually fill in over the course of the next month. Try to keep this space clean until then by brushing and using salt water rinses.
•	A dry socket might occur if the blood clot is prematurely dislodged from your tooth socket. Symptoms can include severe pain, and you should contact our office if this happens.
•	Be aware that your typical nourishment has been disrupted. This is especially important if you intend to exercise, as you might feel weak and lightheaded.

You should also remember that no two mouths are exactly alike, and your case is unique. Never accept the well-intended suggestions or advice from friends. If you have a problem or concern, contact your family dentist or one of our surgeons.

After Dental Implant Surgery

After you've had dental implant surgery, it is important that you follow a series of instructions in order to promote the best possible healing. First and foremost, avoid disturbing the wound, and to do this, you shouldn't rinse, spit, or touch the wound for the first 24 hours after surgery.

Bleeding

It is perfectly normal to experience bleeding and pink or red-colored saliva for the first 24 hours following your surgery. If you are experiencing excessive bleeding where your mouth fills up quickly with blood, you can work to control it by biting down on a gauze pad that is placed directly onto the wound. Do this for 30 minutes, and if severe bleeding continues, please call our office for further guidance.

Swelling

Swelling is also common after your dental implant surgery. To minimize swelling, you can apply an ice pack onto the cheek outside the area where you had your surgery. Do this as much as possible within the first 24 hours. It can also be helpful to lay with your head elevated for the first three days in order to further reduce swelling.

Pain

About four hours after your surgery, you can begin to take your pain medications. Staying ahead of the pain is important, so you should take your first dose before the local anesthetic has worn off. If you are experiencing moderate pain, Tylenol can be used every 3–4 hours, or if you prefer, you can take ibuprofen every 4–6 hours.

If you are experiencing severe pain, use your prescribed medications as directed. Never take more than recommended, and always follow the instructions outlined by your surgeon.

Diet and Nutrition

Following your surgery, it is important to drink plenty of fluids, but avoid hot liquids. Soft foods should be consumed immediately following surgery, and after the first day, you can begin to return to your normal diet unless your surgeon instructs you otherwise.

Oral Hygiene

Proper oral hygiene is crucial for healing. After your surgery, be sure to use the oral rinse that has been prescribed to you, and start using this rinse twice daily the day following your procedure. Swish with the rinse for at least 30 seconds. You can also use warm salt water rinses several times a day, especially after eating. While you can brush your teeth around the abutments as they heal, be sure to be gentle.

Activity

Immediately following surgery, you should plan to rest and keep physical activity at a minimum. If you exercise, bleeding and throbbing may occur. You should also remember that you probably are not getting adequate nourishment throughout your recovery, so trying to exercise could even be dangerous.

Wearing Your Prosthesis

You should avoid wearing your dentures or flippers right after your surgery, and keep them out of your mouth for at least 10 days post-op. Your surgeon will specify exactly when it is safe to begin wearing these appliances again.