POST-OPERATIVE INSTRUCTIONS
POST-OP CHILDREN’S DENTISTRY
Please note the following instruction for common children’s treatments:
STAINLESS STEEL CROWNS
Your child has had stainless steel crowns placed to restore badly decayed baby teeth. The decay was removed and in some cases, if the decay was into the nerve of the tooth, the nerve was removed and a special medication was used. This procedure is called a pulpotomy.
The crowns are cemented in place. The gums around them may be tender for a day or two. The child may mention that his/her “bite” feels funny at first, but this will correct itself. Brush these crowns just like other teeth. They will get wiggly and fall out with the baby tooth at the normal time.
Your child must avoid sticky foods like toffee, sticky candy, suckers, bubble gum, etc. as these things may pull off a crown. If a crown does come off, they are easily re-cemented, but this must be done as soon as possible. Keep the crown and phone your dentist’s office for an appointment to have this done.
SPACERS
Your child has had a tooth removed and a spacer cemented. The spacer is meant to hold the space between two teeth for the adult tooth to erupt into in the future. When the adult tooth can be seen erupting through the gums, it is time for the spacer to be removed.
Brush the spacer to keep plaque and food from sticking to it. Your child must avoid sticky foods like toffee, sticky candy, suckers or bubble gum as these may damage or pull the spacer out of place. If this happens, the spacer can be easily re-cemented if done as soon as possible. Keep the spacer and phone your dentist’s office for an appointment.
BABY TOOTH EXTRACTION
Baby teeth are shorter than adult teeth but may be much wider. The socket will typically bleed for half an hour. Biting on gauze for 30 minutes, if possible, will help keep this under control. Any infection or abscess in the baby tooth should go away once the tooth is removed so no additional antibiotics will be necessary. Children’s Tylenol or Advil is all that may be required for the first few hours after treatment. Brushing can be started again the very next day. Choose foods for the first day that aren’t going to hurt the healing gums.
POST-OP EXTRACTIONS AND SURGERY
After you have one or multiple teeth extracted, it’s important that you follow all of your dentist’s post-operative instructions. This will optimize the healing process and minimize any potential risks associated with the procedure. Here are some things you should know if you have your wisdom teeth removed or another tooth extraction.
MEDICATIONS AND PRESCRIPTIONS
Any local anesthetic your dentist uses during the procedure should wear off anywhere from a half hour to 24 hours following your surgery. Once you no longer feel the effects of the local anesthetic, you will probably experience pain or discomfort. So, it’s important to begin taking your pain medication before this discomfort occurs. In addition, keep the following instructions in mind:
- All pain medication should only be taken as instructed on the label.
- Eat before taking your pain medication because not eating may cause nausea or vomiting.
- Gravol or Gravol suppositories can be purchased at your pharmacy and taken if you experience severe nausea or vomiting.
- Never operate a motor vehicle or hazardous equipment for at least 24 hours post-surgery.
- After 24 to 72 hours, you should be able to begin using over-the-counter pain relievers.
- Be sure to finish all antibiotic medications if prescribed.
- Female patients currently taking birth control pills will need to utilize another form of birth control while taking antibiotics.
CONTROLLING BLEEDING
It is not uncommon to experience bleeding after tooth extraction surgery. If this occurs, we recommend the following:
- Place gauze over the surgical site and apply pressure by biting down.
- Leave the gauze in place until the local anesthetic begins to wear off and oozing stops.
- Replace the gauze every hour or after eating and taking medications.
- If bleeding becomes excessive, place a cool, moist tea bag over your surgical site for about an hour while applying firm pressure.
- Your saliva may be pink or blood-tinged for up to 48 hours after the procedure. This side effect is normal. Also, you may experience a small amount of oozing.
- Be sure to rest with your head elevated by two or more pillows for the first day.
- You may need to cover your pillows with a towel to protect your bedding from blood staining.
BRUISING AND SWELLING
Bruising and swelling after surgical extraction is normal in varying degrees. Any bruising you experience should recede within five to 10 days. Swelling could take up to three days to reach a peak before it finally begins to subside.
Applying ice packs for two to three days after your procedure will help reduce swelling and numb the affected area. Simply fill a plastic bag with crushed ice and wrap this with a damp towel. Then apply the ice for 20 minutes, and leave it off for 10 minutes.
After you finish using an ice pack, you can switch to warm, moist heat by using a warm washcloth. The warm cloth can be applied to the cheek outside the surgical site for 15 minutes every hour you are awake for two days following your procedure.
If the swelling does not subside after four days or if it reappears after the initial healing process, you may have an underlying infection. Other signs that could indicate an infection are fever and generally feeling unwell. If this occurs, please contact our office as soon as possible.
You may find it difficult to use your jaw as normal for up to one month after tooth extraction. Begin to stretch and exercise your jaw the day after your procedure. You can use your finger or popsicle sticks to assist in stretching your jaw. For more information about jaw stretching exercises, contact our office.
SUTURES AND DRESSINGS
Your Gateway Dentistry Group dentist may use sutures and dressings as part of your treatment. Don’t be alarmed if you feel them with your tongue. Some are designed to dissolve on their own within a few days. Other types of sutures your dentist will remove during your post-operative appointment.
BRUSHING AND RINSING
Do not brush your teeth the day of your extraction procedure. You will also need to avoid brushing the surgical site for at least one week. This will allow the tissue to heal and will prevent the disruption of sutures or blood clots. You should be able to brush the remainder of your mouth as normal. Once you do resume brushing the surgical site, you may experience a small amount of discomfort or bleeding.
Do not rinse with or spit water for the first 24 hours following your procedure. You will also need to abstain from using a straw or any alcohol-based mouthwash as this could dissolve your surgical site’s blood clot prematurely.
To keep your surgical site clean, rinse gently with warm salt water after meals and before bed. Just add a half teaspoon of salt to a large drinking glass of warm water. Once 72 hours has passed, you are encouraged to rinse vigorously with this salt mixture for about two weeks.
HEALTH AND NUTRITION AFTER SURGERY
Proper nutrition is essential to the healing process after surgical extraction. For 24 hours after your procedure, eat only soft, cold foods like ice cream, yogurt, Jell-O, pudding, apple sauce and cottage cheese. After that, you should follow a soft diet for the next four days, including foods like mashed potatoes, eggs and pasta.
You will also want to increase your fluid intake for four days after your surgery. However, avoid carbonated beverages and alcohol. Do not drink from a straw for at least 24 hours as the sucking action could dislodge your blood clot and cause a painful dental condition called dry socket.
Here are a few extra health tips to keep in mind after tooth extraction surgery:
- Sleep: Sleep is important to the healing process. Be sure to obtain adequate sleep each day.
- Physical activity: You will want to avoid excessive physical exertion and activities that lead to fatigue for at least 14 days following your surgery.
- Smoking: Smoking after any type of surgery can lead to poor healing and increase your pain. It also increases your risk of infection. We recommend waiting at least 28 days after your surgery to begin smoking again. This will reduce your chance of having post-operative problems.
WHEN TO CALL YOUR DENTIST
Please contact Gateway Dentistry Group if you are experiencing any of the following symptoms after your tooth extraction:
- Difficult breathing or noisy breathing
- Excessive nasal congestion
- Wheezing
- Uncontrolled bleeding
- Persistent pain
- Itching or rash
- Swelling around your eyes unrelated to surgery
- Any other signs or symptoms that cause you concern
If for some reason you are unable to reach us, and you are experiencing difficulty breathing or severe bleeding, call 911 immediately or go to a hospital emergency room near you. If you have to be admitted to the hospital for any reason within 10 days of your surgery, contact us as soon as possible.
POST-OP INSTRUCTIONS FOR A SINUS GRAFT
A sinus graft may be needed for patients planning to get dental implants on their upper jaw. This surgical procedure is performed to increase the amount of bone located in the upper jaw, and to do this, the sinus must be moved up to make space for a bone graft. Attempting to place an implant without bone support can increase the risk of implant failure.
If you have a sinus graft, here are some important post-operative instructions to keep in mind.
COMMON POST-OPERATIVE ISSUES
After your sinus graft surgery, you may encounter the following issues:
- Swelling: Severe cheek swelling is a common side effect experienced by patients. Use ice packs to help reduce swelling. However, never place these directly on your exposed skin. Instead, wrap ice packs in a damp towel and put them gently on the sides of your face — 30 minutes on and 30 minutes off. If you do not have ice packs, a bag of frozen vegetables will do just fine. If your eyes swell shut, call our office as soon as possible.
- Nosebleeds: Nosebleeds are also normal for several days following your sinus graft surgery. You can treat these by leaning your head back. You can also apply direct pressure or an ice pack. If you produce bone granules, don’t be alarmed. Drainage is normal both from your nose and mouth. Simply wipe it away gently.
- Sneezing: It’s best to avoid sneezing as this could cause pressure build-up in the sinus and nasal regions. If you feel a sneeze coming on, sneeze through your mouth and do not pinch your nose.
- Blowing your nose: Try to avoid blowing your nose as this could cause the bone-graft material to move or loosen your stitches. If necessary, gently sniff or wipe the end of your nose.
MEDICATION
You may experience pain or discomfort after your sinus graft surgery. For that reason, start taking your prescribed pain medicine before the freezing wears off. Also, be sure to follow your dentist’s directions.
To reduce sneezing and nasal congestion, you can take Actifed or Sudafed. These can be purchased from your pharmacist. Take this medication as directed on the bottle for one week following your procedure.
SMOKING
Smoking puts you at risk of having post-operative problems and can also increase your pain level and lead to poor healing. Do not smoke at all for at least 72 hours following your surgery.
POST-OP INSTRUCTIONS FOR SINUS EXPOSURE
A frequent side effect encountered when upper molar teeth are extracted is a complication called sinus exposure. The teeth found near the back of your upper jaw are very close to your maxillary sinuses and oral cavity, which are air-filled regions beneath your eyes and behind your cheekbones.
If the sinus floor becomes exposed after molar extraction, these openings usually heal spontaneously. However, in some cases, one or more corrective surgeries may be necessary to fix sinus exposure. Be sure to follow these instructions in the case of sinus exposure after surgery to increase your chance that this issue will heal without further intervention.
POST-OP PRECAUTIONS
There are a number of different side effects which are normal following oral surgery. However, it’s important that you address them with care:
- Swelling: Utilize ice packs to reduce any swelling you may have. You will need to wrap ice packs with a damp towel to avoid placing them directly on your exposed skin. Apply the ice pack gently above the affected area for 30 minutes, then leave it off for 30 minutes.
- Nosebleeds: Nosebleeds and drainage from both your nose and mouth are normal and may occur for several days after your surgery. Drainage can be wiped gently away. To treat nosebleeds, lean your head back and apply direct pressure and an ice pack.
- Sneezing: Sneezing can cause pressure to build up in your sinus region. Although it’s best to attempt to avoid sneezing, if one comes on, sneeze through your mouth. Never pinch your nose.
- Blowing your nose: Blowing your nose can affect the healing process after oral surgery. Avoid blowing your nose, but if necessary, wipe your nose or sniff gently.
MEDICATION
As your anesthesia wears off after oral surgery, begin taking your prescribed pain medications immediately. However, be sure to take as directed by your dentist. Pain medication will help you stay comfortable which aids the healing process.
If you’re experiencing nasal congestion or sneezing, purchase Sudafed or Actifed from your pharmacist. Take these meds for about one week as directed on the bottle to reduce nasal symptoms.
SMOKING
Smoking should be avoided for the first 72 hours following your surgery as it can cause increased pain and lead to poor healing and other post-operative issues.
