After surgery instructions

Pain

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Some pain following extractions is not uncommon.  Any discomfort you may have may be controlled with different combinations of medication.  If one combination doesn’t work, please call our office so we may recommend a different combination.  For mild to moderate pain, if bleeding isn’t an issue, take two aspirin or aspirin substitute tablets.  (Bufferin, Anacin, Empirin, Tylenol, Advil, etc.) every 3 to 4 hours.  Children, especially young children, should receive similar doses of between ¼ and ½ the adult dose, and only if necessary.  (DO NOT GIVE CHILDREN ASPIRIN IF FLU SYMPTOMS EXIST).  A prescription has been given to you for additional pain relief.  Use the prescription as directed, together with aspirin or Advil intermittently. 
 

Bleeding

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A certain amount of bleeding is to be expected following tooth extractions or other surgeries.  If you feel the bleeding is unusual, call immediately to alert the office for more specific instructions.  This is important because it may be necessary to come back in, especially while office hours are still in progress so that you can be attended to.

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If a “normal” amount of bleeding occurs, place a small folded pad of gauze, slightly moistened, directly over the bleeding area.  Then place a larger wad of gauze over the first piece and bite or hold down firmly for 30 minutes to 1 hour.  Remove any large excess jellied blood clots before applying pressure.  Repeat the above process if necessary, but only for 30 minutes.  If bleeding persists, avoid hot liquids and stop all mouth rinses or sucking motions, (i.e. no straws).  Sit or sleep upright and avoid exercise.  Moist hot pads may be added intra-orally.  A good thing to do is place a hot tea bag directly onto the extraction site, which helps stop bleeding.  Note: regular caffeinated tea bags are stronger than decaf/herbal brand. Repeat as necessary.  (Tannic acid cauterizes and warmth coagulates the proteins in the blood and turns it into sludge to slow it.)  If bleeding continues, call the office.  It is normal for your saliva to be slightly colored for 1-2 days since few drops of blood in a lot of saliva looks like more than it really is.  It is also normal to wake up with blood on your pillow in the morning, so do not be alarmed.  Don’t sleep with gauze in mouth unless one end is exiting oral cavity or you could be in danger of inhaling it in your sleep.

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Swelling

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You may expect some swelling after dental surgery; rebound swelling is to be expected as the Medrol dose pak starts to taper off.  Swelling is a part of the natural healing process and may last several days to weeks. This is dependent upon the nature and extent of your surgery.  Individuals with fair skin or who bruise easily may experience some discoloration of the skin in the area surrounding the surgical procedure(s). Such discoloration (from seepage of blood from soft tissue planes) surrounding the surgical area and at the site of the intravenous infection may occur after a day or so, or even up to a week later.  This, again, is a normal body reaction and will resolve on its own in a few days up to a few weeks.  Water-tight closure can make blood back up (i.e. two black eyes) and gravity can also make blood seep in a dependent fashion- i.e. top jaw to bottom jaw, neck, etc.

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To reduce ordinary, immediate, post-operative swelling, apply an ice pack or washcloth saturated with ice water to the face over the operated site immediately for 6-8 hours.  The ice pack should be applied for 5 minutes on, then 5 minutes off, etc. for the first 24-48 hours for best results.  Swelling, discoloration, and restricted jaw movements are expected, (can be greatest on the second post-operative day).  Keeping your head elevated (while awake and asleep) will limit the tendency to swell.

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On the 3rd day, ice may be continued, or moist heat (not a heating pad) may be applied to increase comfort. To treat discoloration, application of witch hazel and warm moist soaks to the arm at the IV site with elevation of the arm, plus anti-inflammatories, are advised.  Continue your antibiotics.  Should the IV site become red or painful, please contact the office immediately at (361) 992-3873.
 

Sore Throat

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A sore throat for 24-48 hours is common after a general anesthesia case where you have been intubated with a breathing tube; slight bloody discharge from the nose is also common initially.  Please contact the office should either symptom persist.
 

Nausea

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As with all general anesthetics, some nausea and vomiting may occur in certain individuals.  Limit intake to clear liquids only, such as tea, water, soda, etc. until symptoms subside.  If nausea continues, contact this office for assistance.  A prescription can be called in for your convenience in either oral or suppository form (Compazine or Tigan suppositories).

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Leaving the gauze in place until all bleeding stops will help prevent blood from seeping into the stomach which can also cause nausea.  In addition, narcotic prescriptions are known for causing nausea in most individuals, therefore discontinue these and limit your pain medicine to the non-steroidal anti-inflammatories such as Advil and Dolobid with food.  Coating your stomach with Mylanta or Peptobismol when taking meds may also help.  Over-the-counter meds, such as Pepsid, Zantac, Axid, etc. may also help.