PETER H. PRUDEN, DDS*., P.C.
*Diplomat des American Board of Oral and Maxillofacial Surgery
*Mitglied der American Dental Society of Anesthesiology
*Member of the American College of Dentists
75 Prospect St. Rear Building, Huntington, New York 11743
Phone: 631-421-2471 Answering Machine: 631-476-3304 Fax: 631-547-6809
THE FOLLOWING INSTRUCTIONS FOR HOME CARE
ORAL SURGERY OR TOOTH EXTRACT
Pain and Discomfort:Some level of pain after extractions is not uncommon. It can radiate from the jaw to the ear, neck, or side of the head. For pain, follow these directions:
Take an over-the-counter non-narcotic pain reliever such as Advil (ibuprofen) 2-3 tablets every 4-6 hours or Tylenol (acetaminophen) 2 tablets every 4 hours, or prescription non-narcotic pain relievers as directed.
It's best to take one of these non-narcotic pain relievers before the local anesthetic wears off.
It's best to take pain relievers with food to prevent nausea and stomach upset.
When the local anesthetic wears off and you feel pain, take one of your prescription narcotic pain relievers (such as Tylenol #3 or Vicodin (hydrocodone)).
If pain does not improve after waiting 30 minutes, take another pill or half of the prescribed narcotic pain reliever. Do not take more than two prescription narcotic pain relievers within 3-4 hours. If the pain gets worse, call our practice.
coagulate:Do not disturb the clot. Its yellowish appearance and slight odor do not indicate an infectious state. Prevent the clot from breaking up by avoiding hard foods and not smoking.
bleeding:They just had oral surgery and gauze was placed over the extraction site to stop the bleeding.After 20 to 30 minutes, remove the gauze and replace with fresh gauze until the bleeding stops.
If the bleeding is persistent and heavy (use the tea bag method, see below):
Even after the simplest removal, bleeding is to be expected, which can last for about 24 hours. When the bleeding isextensive, follow these instructions:
Sit up straight and avoid physical exertion. Rinse your mouth gently with lukewarm water only once.
Use clean gauze or tissue to remove any blood clotsNOT ON THE TOOTH CAP.
Bite down on a large piece of moistened gauze, tissue, or paper towel placed directly over the cavity.The pressure should be applied for 20 minutes. Repeat if necessary.
A TEABAG(attached to your wisdom tooth guide) may be helpful. The tannic acid in the tea has an astringent effect..The tea bag shouldsoak by pouring a small amount of boiling water over it and letting it stand COLD in a cup. Strong tea can be applied to the wound with acontestor theA chilled, moistened tea bag can be placed on the wound..The pressure should be applied for 20 minutes. Repeat if necessary.
Call our practice if the bleeding continues.You may need additional stitching. If it is outside of business hours, call Physician Services at631-476-3304to come to the doctor.
Swelling:The swelling is usually greatest after two days and often lasts a week. It's not necessarily a sign of infection.An ice pack should be applied to the face at 20-minute intervals for the first 24 hours only..After 48 hours, a heating pad or hot water bottle can be placed on the face.just like you used the ice pack.
dry socket:Although the cause is unknown, a condition known as "dry socket" follows 2-3% of tooth extractions. Symptoms beginning two to four days after extractionThese include loss of the blood clot from the alveoli and moderate to severe pain. Treatment usually requires packing the dry socket with medical gauze. If you think you have a dry socket, please call our office to set up an appointment.
Seams (stitches): resolutionStitches were most likely placed to close the surgical wound. if they arebright, they dissolve and it will fall off after 2-3 days. If they are black, they are silk and must be removed by a doctor.In this case we would have arranged a follow-up appointment before you left our practice.
Diet:Do not try to chew solid food until the local anesthetic has worn off, you could accidentally bite your cheek, lip or tongue. start with aclear liquid nutritionsuch as tea, apple juice, clear broth, etc. If this is well tolerated, improve your diet by starting with soft foods that require little or no chewing, such as:Applesauce, yogurt, soup, gelatin, pastina, scrambled eggs, pancakes, etc.Avoid chewing in the surgical area. Proper nutrition is important for good healing. Drinking enough fluids, 2 liters a day, is important to avoid dehydration. Nevertheless,DO NOT DRINK THROUGH A STRAWas this can loosen clots at the donor site.
skin discoloration:Bruising of the skin near the surgical site and at the intravenous injection site may appear after about a day. This usually resolves on its own within a few days. Application of warm, wet baths to the arm at the IV site with elevation is recommended. If the infusion site becomes red or painful, please contact the office.
nausea:Nausea and vomiting may occur in certain people after general anesthesia. In this case, limit your intake to clear liquids such as tea, water, soft drinks, etc. until the symptoms disappear. Narcotic pain relievers are known to cause nausea in many people, so discontinue them and limit your pain relievers to non-narcotic pain relievers like Tylenol or Advil. If nausea and vomiting persists, please contact our practice and a prescription for an antiemetic suppository can be requested by phone.
Fever:Your temperature may be elevated for the first 24 to 48 hours after treatment. Take Tylenol every 3-4 hours; Drink plenty of fluids and get plenty of rest to bring your temperature down. If your temperature persists, please notify our office.
Mouthwash and dental care:You can gently rinse your mouth with warm water or warm saline (half a teaspoon of salt in 8 ounces of warm water) after meals and before bed starting on the second day. This removes food debris that may accumulate in the operated area. Do not use mouthwash or water. The other teeth should be brushed as usual, avoiding the surgical area. Good oral hygiene promotes healing.
Rest:Avoid fatigue. Go to bed early and rest during the day. Avoid exercising, jogging, climbing stairs, etc. Taking it easy will minimize bleeding and promote healing.
From smoking:Take the opportunity today to quit smoking. It increases bleeding, delays healing, and can cause a painful dry socket.
Bone Fragments:During the healing process, small, sharp bits of bone can break loose and poke through the gums. These non-root fragments usually function alone; However, if it bothers you, send it back to our office for removal.
Deafness:Paresthesia (numbness or abnormal sensation of the lips, tongue or gums) can occasionally occur after surgical removal of impacted teeth and other surgical procedures. This is the result of the proximity of the sensory nerves to the surgical site. This usually resolves over time but can occasionally be permanent. Often, soft tissue swelling at the surgical site can cause temporary numbness that subsides as the swelling goes down.
Immediate dentures:Patients with immediate dentures should not remove their dentures for 48 hours or until they return to their dentist for fitting. Typically, your dentist will prefer to see you approximately 24 to 48 hours after extraction and immediate placement of the dentures. If the dentures have to be removed prior to the visit, they may swell, which would prevent dentures from being placed at that time.
Infections:If you have been treated for an infection with a surgical incision and drainage procedure, it is not uncommon to have more swelling after the procedure due to the surgical swelling. Apply warm, moist heat to the swollen area of your face (to increase antibiotic circulation in that area). Warm to hot rinses should be used on the inside of the mouth as often as possible to encourage drainage from the infected area. The drain will likely be removed at your next appointment. If the infection gets worse and you experience double vision or difficulty swallowing or breathing, please call our office and/or go to the hospital straight away.
Birth control pill warning:Remember that birth control pills are not effective if antibiotics are being taken. Use an alternative method of birth control for the month. If you have any further questions, please contact our practice or your gynecologist.
PLEASE CALL OUR OFFICE:631-421-2471during the office hours belowif you have any questions about your surgery or care. If necessary, instructions and additional information will be given. If you call during these times, we can serve you more efficiently.
Our normal office hours are:
Monday 9 a.m. - 7 p.m. Thursday 9 a.m. - 7 p.m
Tuesday 9 a.m. - 7 p.m. Friday 9 a.m. - 7 p.m
Wednesday 9 a.m. – 7 p.m. Saturday 9 a.m. – 2 p.m
Outside of opening hours, please call our answering machineA 631-476-3304and ask the doctor to call you back.The doctor can be reached around the clock via our answering machine.If you don't hear from us within 20 minutes, please call voicemail (631-476-3304)AGAINand ask her to call the doctor.If a medical emergency occurs, contact the nearest HOSPITAL for the following conditions:
- If significant bleeding lasts more than four hours (more than oozing)
If your temperature remains elevated or exceeds 101 degrees F
If you have difficulty breathing or swallowing
If you are allergic to a medicine
If other unusual signs or symptoms are cause for concern
The greatest compliment our patients can give us isthe reference of your friends or loved ones. We appreciate your trust in our office team.