DAY OF SURGERY:
It is important that a blood clot forms on the extraction site to stop the bleeding, reduce pain and speed healing. Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. Change them every 20-30 minutes until bleeding has stopped, usually after one hour. If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30 minutes. The gauze may then be changed as necessary (typically every 30 to 45 minutes). It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning. The site may ooze for as long as 24 hours, this is normal.

Do NOT rinse vigorously or try to clean the area with any objects.

Do NOT brush the areas for 24 hours.

PLEASE DO NOT SMOKE for at least 72 hours, since this is very detrimental to healing and may cause a dry socket. This is a great time to quit smoking if you have been thinking about it!

Sneezing or coughing may dislodge the clot, so if you have seasonal allergies have medication on hand.

Limit yourself to calm activities for the day, no running or exercising for 24 hours.

BLEEDING:
Intermittent bleeding or oozing overnight is normal. Bleeding may be controlled by placing fresh gauze over the areas and biting on the gauze for 30-45 minutes at a time. Place an old towel over your pillowcase in case oozing occurs while you sleep at night. Bleeding should never be severe. If bleeding is severed it usually means that the packs are not exerting pressure on the surgical areas. Try re-positioning the packs. If bleeding persists or becomes heavy you may substitute a tea bag with tea leaves (not herbal tea) soaked in want) water, squeezed damp-dry and wrapped in a moist gauze for 20 or 30 minutes.

SWELLING:
Swelling can happen after oral surgery. It can be minimized by using a cold pack, ice bag, or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 24 hours after surgery. Swelling usually goes down 48 hours after surgery. If you have been prescribed medicine for the control of swelling, be sure to take it as directed.

PAIN:
Oral surgery can be accompanied by some degree of discomfort. You may be given a prescription for pain medication. Should you choose not to take prescription pain medicine, over the counter medications like ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) can be alternated to manage pain. If you take the first pill before the anesthetic has worn off, you should be able to manage any discomfort better. Some patients find that prescription pain medicine causes nausea, but if you precede each pain pill with food, chances for nausea will be reduced. The effects of pain medications vary widely among individuals. If you do not achieve adequate relief at first you may supplement each pain pill with an analgesic such as aspirin or ibuprofen. The most severe pain is usually within six hours after the local anesthetic wears off, after that your need for medicine should lessen.

How to alternate regular strength over-the-counter pain medication:
You will take a dose of pain medication every three hours
• Start by taking 650 mg of Tylenol (2 pills of 325 mg)
• 3 hours later take 600 mg of Motrin (3 pills of 200 mg)
• 3 hours after taking the Martin take 650 mg of Tylenol
• 3 hours after that take 600 mg of Motrin

We recommend that you follow this schedule around-the-clock for at least 3 days after surgery, or until you feel that it is no longer needed.

Important: Do not take more than 3000mg of Tylenol or 3200rtig of Motrin in a 24 hour period.

NAUSEA:
Nausea can occur after surgery, usually due to pain pills. It can be reduced by preceding each pain pill with soft food, and taking the pill with a large volume of water. Try to keep taking clear fluids and minimize dosing of pain medications, but call as if you do not feel better. Classic Coca Cola may help with nausea.

DIET:
Do not use a straw for the first few days after surgery. Avoid extremely hot or spicy foods. Avoid alcohol and carbonated drinks. It is best to eat soft foods the first day (soups, puddings, yogurt, milk shakes, etc.) It is hest to avoid foods that break into small pieces, like nuts, sunflower seeds, popcorn, etc., which may get lodged in the socket areas. It is important not to skip meals! If you eat regularly you will feel better and heal faster. If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.

CLEANING YOUR MOUTH:
Keeping your mouth clean after surgery is essential. Use 1/2 – 1 teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse and gently spit out portions of the solution, taking a few minutes to use the entire glassful. Repeat two to three times daily. Begin your normal oral hygiene routine as soon as possible after surgery. Please brush gently near the extraction sites so as not to dislodge the healing clot that forms over top of the socket. If you are given a plastic irrigating syringe, DO NOT use it for the first five days. Then use it daily according to the instructions until you are certain the tooth socket has closed completely and that there is no chance of any food particles lodging in the socket.

SHARP BONE:
If you feel something hard or sharp edges in the surgical areas, it is likely you are feeling the bony walls which once supported the extracted teeth. Occasionally small slivers of bone may work themselves out during the following week or so. This is normal and they will usually come out by themselves. If they cause discomfort, please call the office.

WHEN TO CALL US:
*If your bleeding increases rather than decreasing swelling increases beyond 2 or 3 days
*If you have a bead taste or odor in your mouth
*If you have a reaction to the medication

Call us at 219-874-7224. If you receive the voicemail, leave a message and your call will be returned shortly.