Extractions

Good oral hygiene should always be practiced at home, since the loss of a single tooth can have major impact upon your oral health and appearance. Although dentists will use every measure to prevent tooth loss, there still may be occasions that it becomes necessary for a tooth to be extracted. A tooth may need to be extracted if any of the following occurs:

• Severe decay
• Advanced periodontal disease
• Infection or abscess
• Orthodontic correction
• Malpositioned teeth
• Fractured teeth or roots
• Impacted teeth

It is critical to keep the extraction area clean to prevent infection. We will provide you with detailed instructions on how to care for the extraction site, as well as any necessary supplies to expedite your healing.

Note that, for 24 hours following an extraction, you shouldn’t smoke, rinse your mouth vigorously, or brush the teeth immediately adjacent to the extraction site.

Home Care After Extractions

The following information has been designed to help you properly care for your mouth after an extraction (tooth pulled):

FEELING: The anesthesia will begin to wear off in 30 minutes to 2 hours. Until that time, avoid all hot foods or liquids, and do not chew. This is to prevent accidentally burning or biting the lips, cheeks, or tongue until the feeling has returned.

GAUZE PACK: Fold or roll the gauze into a small pack and place over the extraction site. Maintain firm biting pressure on the gauze for one to two hours. Change the gauze pack every 15 to 30 minutes. It is normal for the surgical site to bleed slightly or ooze blood for 12 to 24 hours. If you lie down, keep your head elevated on at least two pillows. It is advisable to place a plastic bag over your pillow and under your pillowcase the night following surgery to prevent any oozing from staining your pillow.

ACTIVITY: Refrain from any unnecessary exertion. Avoid running, jogging, or any athletic activity for the first 24 hours after surgery. Excessive activity will increase blood pressure and may cause unusual bleeding.

COLD PACKS: For the first 2 to 8 hours after surgery, ice packs may be applied to the outside of the face over the extraction site. The ice pack should be held in place for 20 minutes, then removed for 10 to 20 minutes. These packs are helpful after difficult extractions to help reduce discomfort and swelling. A simple and inexpensive ice pack can be made by filling a zip-lock plastic bag with ice and water.

MEDICATIONS: For most extractions, a non-aspirin over-the-counter pain medication will provide excellent relief from any discomfort. DO NOT TAKE ASPIRIN PRODUCTS due to the possible increase in bleeding potential from such medications. If the need for a stronger pain medication or an antibiotic is anticipated, prescriptions for these medications will be provided.

DIET: It is important to maintain good nutrition during the healing phase. A liquid to soft diet should be adhered to for the first 12 to 24 hours. It is also very important to drink plenty of liquids during the first day or two after surgery. DO NOT DRINK THROUGH A STRAW; this may create a vacuum in your mouth and dislodge the blood clot and cause additional bleeding. ENSURE, SEGO, NUTRAMENT, and INSTANT BREAKFAST are excellent liquid meal substitutes. Soft foods such as mashed potatoes, oatmeal, cream of wheat, baby food, puddings, etc. , can be used until normal chewing is possible.

ORAL HYGIENE: Clean the rest of your mouth as usual, but avoid brushing or bumping the extraction site. DO NOT RINSE OR SWISH YOUR MOUTH WITH ANY LIQUID for the first 12 hours after surgery. Also, DO NOT SMOKE for the first 24 hours after surgery.

QUESTIONS/COMPLICATIONS: The following are complications commonly seen following extractions:

• Dry socket (alveolitis) is sometimes a problem after surgery. Its specific cause is unknown, but it is more common in smokers, and in women taking birth control pills or hormonal therapy. The symptoms associated with a dry socket are constant moderate to severe pain, bad taste, putrid odor, and poor clot formation at the surgical site. Treatment involves irrigation of the surgical area, an analgesic (pain relieving) packing, antibiotics, and/or anti-inflammatory medications.
• Excessive bleeding may occur, especially if aspirin or aspirin-containing compounds have been taken within 72 hours prior to the extraction. This problem is usually self-limiting, and requires only additional placement of gauze packs over the extraction site with good, firm biting pressure for an extended period of time. In severe cases, it may be necessary to re-evaluate the bleeding at the office. Treatment may require additional external pressure, or various medications to control the bleeding.
• Nausea or vomiting is common after oral surgical procedures due to the ingestion or swallowing of blood. This may be compounded by the nausea-producing qualities of some of the antibiotics or pain medications prescribed. If the vomiting is profound, the medications may be discontinued or additional oral medications or suppositories may be prescribed to control this problem.

There are a variety of complications that can arise after any oral surgical procedure. These problems are usually easily controlled, but may sometimes require additional therapy. If you experience any swelling, bleeding, pain, etc., that concerns or frightens you, please don’t hesitate to contact us.