Dr. Joseph Krajekian DMD, MD, FAAOMS, DABOMS
Board Certified Oral and Maxillofacial Surgeon
Instructions after multiple extractions
DAY OF SURGERY
Bite down on the moist gauze packs that have been placed over the surgical areas, making sure they remain in place. Take out gauze after 60 minutes. If still bleeding, replace with new moist gauze for another 60 minutes. Do this until the bleeding is controlled. The gauze may be changed as necessary.
Do not disturb the surgical area for 24 hours. DO NOT rinse vigorously or probe the area with any objects or your fingers. You may brush your teeth gently. DO NOT SMOKE for at least 48 hours, since it is very detrimental to healing and can cause dry socket.
Intermittent bleeding or oozing is normal. It may be controlled by placing fresh moist gauze over the surgical areas and biting down firmly for 60 minutes.
Bleeding should never be severe. If bleeding persists or becomes heavy you may substitute a tea bag (soaked in hot water, squeezed damp-dry and wrapped in moist gauze) for 20 or 30 minutes. If bleeding remains uncontrolled, please call our office.
Swelling post operatively is normal. You can minimize this by using a cold pack or ice bag wrapped in a towel and applied firmly to face or check adjacent to the surgical area. This should be applied 20 minutes on and 20 minutes off during the first 24 to 48 hours after surgery. If you have been prescribed medicine for the control of swelling, be sure to take it as directed. After 48 hours, it is usually best to switch from ice to moist heat to the same areas.
Unfortunately most oral maxillofacial surgery is accomplished by some degree of discomfort. You will usually have a prescription for pain medication, and if you take the first pill before the anesthetic has worn off, you will be able to manage any discomfort better. Effects of pain medicines vary widely among individuals. If you do not achieve adequate relief, you may supplement each pill with an analgesic such as aspirin or acetaminophen. Some people may even require two of the pain pills at one time during early stages. Remember that the most of discomfort is usually within the first 2-3 days from surgery.
Nausea is not an uncommon event after surgery, and it is sometimes caused by pain medicines. Nausea may be reduced by preceding each pill with a small amount of soft food, then taking the pill with a large volume of water. Try to keep taking clear fluids and minimize the pain medication, call if you do not feel better or if repeated vomiting is a problem.
Eat any nourishing food that can be taken with comfort. Temperature of the food doesn’t matter, but avoid extremely hot foods. It is sometimes advisable, but not required, to confine the first day’s intake to bland liquids and pureed foods (creamed soups, puddings, yogurt, milk shakes, etc.). Avoid foods like nuts, sunflower seeds, popcorn, etc., that may get lodged in the socket areas. Over the next several days you can progress to solid foods at your own pace. It is important not to skip meals! If you take nourishment regularly, you will feel better, gain strength, have less discomfort and heal faster. If you are diabetic, maintain your normal eating habits as much as possible and follow instructions from us or your physician regarding your insulin schedule.
If you feel sharp edges in the surgical areas with your tongue it is probably the bony walls, which originally support the teeth. Occasionally small slivers of bone may work themselves out during the first week or two after surgery. They are not pieces of tooth and, if necessary, we will remove them. Please call the office if you are concerned
INSTRUCTIONS FOR THE SECOND AND THIRD DAYS
Keeping your mouth clean after surgery is essential. Use one quarter teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, but at least two or three times daily for the next five days.
Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing of all areas, but please make every effort to clean your teeth within the bounds of comfort.
Apply warm compresses to the skin overlying areas of swelling (hot water bottle, moist hot towels, heating pad) for 20 minutes on 20 minutes off to help soothe those tender areas. This will also help decrease swelling and stiffness.
Normal healing after tooth extraction should be as follows: the first day of surgery is usually the most uncomfortable and there is some degree of swelling and stiffness. The second day you will usually be far more comfortable and, although still swollen, you can usually begin a more substantial diet. From the third on GRADUAL, STEADY IMPROVEMENT should mark the remainder of your postoperative course. If a DRY SOCKET occurs (loss of blood clot from socket, usually on the 3rd to 5th day), there is a noticeable, distinct, persistent throbbing pain in the jaw, often radiating toward the ear and forward along the jaw to cause other teeth to ache. If you do not see steady improvement during the first few days after surgery, don’t suffer needlessly. Call the office and report symptoms so you can be seen as soon as possible.
It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, please call the office where you had surgery or Dr. Krajekian directly. A 24-hour answering service is available to contact Dr. Krajekian at 888-774-7773. Calling during office hours will afford a faster response to your question or concern.
PLEASE NOTE: Telephone calls for narcotic (pain killer) prescription renewal are NOT accepted WITHOUT office visit.