How long should you have gauze in after tooth extraction

The Do’s and Don’ts after a Tooth Extraction

What is a tooth extraction?

The term refers to the painless removal of a tooth or tooth roots with minimum trauma to the surrounding tissues so that the extraction socket wound heals uneventfully and without any post-operative complications. Whenever any surgery takes place the first thing we want is to let it heal properly, quickly and smoothly. As a common practice, most of the dental surgeons have standard post-surgery instructions printed which are handed over to the patient. One must follow these instructions given by the dentist. Following all the post-operative instructions after tooth extraction reduces the incidence of infection and chances of dry socket. If aftercare instructions are not followed then it can cause complications, which can further lead to delayed healing. Here are some of the do’s and don’ts after a tooth extraction.

Do’s:

• Rest: Try to get some rest after Tooth Extraction. You may feel great but don’t exercise or do too much activity for at least 24 hours. When resting, keep your head in a slightly upright position on the pillow.
• Let it clot:Let the clot be formed on the tooth extraction site, which covers it and allows it to heal. After the procedure your dentist will give you a piece of gauze to bite on near the extraction site. Try to bite down and keep it in place for at least an hour afterwards. This will put pressure over the wound and help it to stop bleeding. However, make sure you don’t chew on gauze piece. If you can keep it in place longer that’s best, but make sure to change the gauze after roughly every half hour, depending on the amount of bleeding. If once the clot forms it becomes dislodge the nerve endings then become exposed. The nerves and capillaries spasm and constrict, limiting essential blood supply, which causes delay in healing. If the bleeding persists for a few hours after the procedure then try putting a wet tea bag on the site. The tannic acid present in black tea helps to aide in the clotting process.
• Ice Packs: Apply an ice pack on the side of your face where surgery was performed. This is done to reduce swelling. While on simple extractions swelling isn’t accompanied, in cases requiring severe cheek retractions swelling can occur after operation. The swelling after an extraction may not occur immediately, but can continue to swell for a few days, reaching a maximum at the 2nd or 3rd day. Application of the ice pack is most effective during the day of extraction as after 24 hours there is no significant beneficial effect. Ice packs should be applied 15 minutes on and 15 minutes off for 1-2 hour time periods.

Don’ts:

• Don’t smoke:For at least 48 hours after tooth extraction do not smoke. The chemicals in the smoke can affect the clot and hence the chances of developing dry socket 3-4 days after tooth extraction increases.
• Don’t eat solids immediately after: While you still have numbness it’s best not to eat solids. When you start feeling your jaws you can start taking solids. After tooth extraction, take soft and liquid foods like soups, mashed potatoes, yogurts, milkshakes, smoothies etc.
• Warm saline rinses: The main aim of rinsing is to clean the area of extraction as it is not possible to brush the socket. We mix salt to make the solution isotonic and similar to natural tissue fluid and thus it is less irritating than water. Rinsing is usually advised 12 hours after extraction. So, warm saline rinses help in cleaning and maintaining the hygiene of that area.
• Take your medicines as prescribed by your dentist: Don’t skip the medicines. If antibiotics are given they should be taken regularly. Pain killers and anti-inflammatory drugs are to be taken after tooth extraction. It help in reducing the pain and swelling. If the pain continues even after two days of tooth extraction and bleeding starts then you should call your dentist.
• Avoid Aspirin: Don’t ever take aspirin (Can take ibuprofen). Aspiring being a blood thinner will delay in clot formation thereby will prevent healing. Take the medications as prescribed by the physician and consult your dentist before taking any medicine.
• Avoid Sucking of any type: SMOKING, SIPPING, EATING HARD VEGETABLES are to be avoided after tooth extraction. Try taking soft and liquid food options such as soups, mashed potatoes, yogurts, milkshakes, smoothies etc. after tooth extraction. Avoid hot drinks, spicy foods, sodas, etc.
• Don’t poke into the gap created: Though for initial few days, it will feel a bit awkward to have a gap but don’t poke that area with any toothpick or tongue as it may delay healing, may provoke bleeding and can also lead to dry socket.

Most problems that patients face after surgery are related to pain and swelling, bleeding or oozing, dietary difficulties, or medication-related side effects. We have attempted to provide some helpful hints that you may use to minimize any post-surgical difficulties and make your experience as pleasant as possible. If you have any questions, please call our office.

Bleeding

Bleeding is common to some degree in the first 24 hours. Your bleeding should stop within 4 hours after surgery. Oozing and episodes of occasional bleeding may occur for up to 1–2 weeks, and you should not be alarmed. Usually, simple pressure with a wet, rolled gauze pad over the extraction site will stop the bleeding when applied for about 45 minutes to 1 hour. Remove the gauze after about 1 hour and replace it if the bleeding persists. A tea bag is often more effective in stopping the bleeding. If bleeding persists, the tea bag may be used like a gauze pad. Take the staple out of the tea bag, dampen it, roll it up, and place it over the extraction site. Bite on the bag for 45 minutes to 1 hour.

Swelling and Bruising

It is common to swell and bruise. Swelling is usually at its worst 48–72 hours after the surgery, and then it begins to improve. Bruising may occur over a few days and resolve within 2 weeks. Ice helps. Apply ice to your face over the surgical areas for about 20 minutes on and 20 minutes off over the first 24 hours.

Pain

Each person experiences pain in a different way, and what may seem like a minor procedure to one person may be very objectionable to another. Although pain may persist for a few days to some degree, it always seems to get better. If your pain does not improve, you may be developing a dry socket. A dry socket is a condition that may develop when the clot in an extraction site breaks down and leaves behind a painful socket that may need to be treated with medicated gauze in the office. Please call us if you are concerned that you may be experiencing unusual discomfort.

Warm saltwater rinses help muscle stiffness and pain. Mix a ½ teaspoon of salt in an 8-ounce glass of warm water (as warm as possible without burning yourself). Swish over the extraction site(s) and spit 3–4 times per day for 1 week starting the morning after your surgery. Avoid smoking! Do not use straws, and do not use a Waterpik®.

Take over-the-counter ibuprofen (200 mg) every 6 hours for 3–4 days or the prescribed anti-inflammatory medication. Call us if you develop any nausea, stomach cramps, upset stomach, or notice blood in your stool.

You have been prescribed narcotic pain medication. Take this medication as prescribed on that bottle if necessary.

Infection

Continue to take any antibiotics as prescribed. Unusual swelling or discharge may mean that you have an infection. Please note that your healing wound will appear whitish-grey. A slight elevation in temperature after surgery is common in the first 24 hours and does not necessarily signify an infection.

Brush your teeth. Your teeth need to be clean to help prevent an infection. Use a toothbrush, softened under warm water, and brush gently around the teeth next to your extraction sites. A little bleeding with brushing is common.

Diet

After your surgery, it will be difficult to eat. Hot, spicy foods and sharp particulate foods are especially difficult to chew and may irritate a wound or tooth socket. Softer, bland foods are the best to eat. Jell-O®, cottage cheese, ice cream, scrambled eggs, mashed potatoes, soft fish, apple sauce, macaroni and cheese, ground beef in small pieces, yogurt, and well-cooked vegetables are some examples.

You may try more substantial foods as the wounds begin to heal a few days after surgery. Be sure to use care when eating while your mouth is numb. You may expect to be numb from 2 to 12 hours depending on the anesthetic used.

Stitches

We may use dissolving or non-dissolving sutures. The sutures may untie, fall out, or dissolve in a few hours, a few days, or a week. Do not be alarmed by this. We usually remove them at your follow-up visit. They usually do not need to be present for more than a few hours.

Medications

Medications and general anesthetic agents may cause nausea and have undesirable effects. Take your medications with food if they upset your stomach, and please call us if you have any questions.

If you were provided an irrigation syringe because you had your lower wisdom teeth removed, please start using it 5–7 days after surgery.

Please review these tips for the safe use and proper disposal of prescription medications.

If you have any questions or concerns, please feel free to call our office at (360) 293-2808. Our after-hours emergency number is (360) 647-4027.