Please begin taking pain medication before the freezing wears off. If your pain is well controlled, you will be able to eat and gain the necessary nutrition to heal. For this reason, pain control is very important. Try to record your pain level at least three times a day on a scale from 1 to 10. If your pain level is at a 7 or 8 consistently, call us.

This sheet is designed as a guide to assist you in your pain management.

1  Use Advil/ Ibuprofen for inflammation and pain. Advil/ Ibuprofen is often the best medication for pain control. ​ AVOID​​ it if you have an allergy to NSAIDS or ibuprofen, or if you have a history of stomach problems/ulcers/bleeding/sensitivity, kidney problems or are already taking NSAIDS ( naproxen, Toradol or Celebrex).

2 If you were prescribed a narcotic such as Tylenol 3, take as prescribed only. If the narcotic is upsetting your stomach, try to take it after eating. If it is still upsetting your stomach, ​ STOP​​ taking it and take Tylenol extra strength instead. If you have any liver problems, ​AVOID​​ taking Tylenol.

Typical Regimen for the first 24 hours after surgery:

After extraction of a tooth it is important for a blood clot to form to begin the healing process. Any time there is a disruption of the clot, there can be an increase in risk of bleeding or delay in healing.

When you leave our office, you will have gauze to bite down on. Continue to bite on the gauze for 1 hour or until the bleeding stops. Try not to check or remove the gauze too often as you may disrupt the clot that is forming.

If the bleeding or oozing persists, place another gauze pad and bite firmly for another 30 minutes. You may have to do this several times.

After the blood clot forms, it is important not to disturb or dislodge the clot as it aids healing. Do not rinse vigorously, suck on straws, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours. These activities will dislodge or dissolve the clot and slow down the healing process. Limit vigorous exercise for the next 24 hours as this will increase blood pressure and may cause more bleeding from the extraction site.

After the tooth is extracted you may feel some pain and experience some swelling. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum. Take pain medications as prescribed. The swelling usually subsides after 48 hours.

Use the pain medication as directed. Call the office if the medication doesn’t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of infection are gone. Drink lots of fluid and eat nutritious soft food on the day of the extraction. You can eat normally as soon as you are comfortable.

It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean.

After a few days you will feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling for 2-3 days, or a reaction to the medication, call our office immediately.

A small amount of bleeding is to be expected following the operation. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 minutes. If bleeding continues, a moist tea bag can be used for 30 minutes. If bleeding occurs, avoid hot liquids, exercise, and elevate the head. If bleeding persists, call our office immediately. Do not remove immediate denture unless the bleeding is severe. Expect some oozing around the side of the denture.

Use ice packs (externally) on the same side of the face as the operated area. Apply ice for the first 36 hours only. Apply ice continuously while you are awake.

For mild discomfort use aspirin, Tylenol or any similar medication; two tablets every 3-4 hours. Ibuprofen (Advil, Motrin) 200mg can be taken 2-3 tablets every 3-4 hours.

For severe pain use the prescription given to you. If the pain does not begin to subside in 2 days, or increases after 2 days, please call our office. If an antibiotic has been prescribed, finish your prescription regardless of your symptoms.

Drink plenty of fluids. If many teeth have been extracted, the blood lost at this time needs to be replaced. Drink at least six glasses of liquid the first day.

Do not rinse your mouth for the first post-operative day, or while there is bleeding. After the first day, use a warm salt water rinse every 4 hours and following meals to flush out particles of food and debris that may lodge in the operated area. (One half teaspoon of salt in a glass of lukewarm water.). After you have seen your dentist for denture adjustment, take out denture and rinse 3 to 4 times a day.

Restrict your diet to liquids and soft foods, which are comfortable for you to eat. As the wounds heal, you will be able to advance your diet.

The removal of many teeth at one time is quite different than the extraction of one or two teeth. Because the bone must be shaped and smoothed prior to the insertion of a denture, the following conditions may occur, all of which are considered normal:

The area operated on will swell reaching a maximum in two days. Swelling and discoloration around the eye may occur. The application of a moist warm towel will help eliminate the discoloration quicker. The towel should be applied continuously for as long as tolerable beginning 36 hours after surgery (remember ice packs are used for the first 36 hours only).

A sore throat may develop. The muscles of the throat are near the extraction sites. Swelling into the throat muscles can cause pain. This is normal and should subside in 2-3 days.

If the corners of the mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment like Vaseline. There may be a slight elevation of temperature for 24-48 hours. If temperature continues, notify our office.

If immediate dentures have been inserted, sore spots may develop. In most cases, your dentist will see you within 24-48 hours after surgery and make the necessary adjustments to relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.

Post-Operative Instructions – Implant Placement and Bone/Tissue Grafting

• BLEEDING: Small amounts of blood in the saliva can make your saliva appear quite red. This is normal and may be noticed the rest of the day after the procedure.
• PLEASE DO NOT DISTURB THE WOUND AND SUTURES. It will be a natural tendency for your tongue to touch and play with the sutures. This will cause early wound breakdown and exposure of the implant or graft, resulting in a higher failure rate. As the swelling subsides, it might feel like the stitches are loosening up. Please do NOT cut them.
• SMOKING: Smoking should be stopped following surgery. Healing and success of the implant will be substantially reduced by the cigarette smoke and chemicals in your body.
• PAIN: Some discomfort is normal after surgery. To minimize pain, take two Tylenol, Advil or similar non-aspirin pain reliever every 3 to 4 hours until bedtime to maintain comfort. Take it before the anesthesia wears off. If prescription pain medication is prescribed, take it as instructed on the label. Don’t exceed the dose on the label. Taking with food or milk will help reduce upset stomach. Avoid driving or operating heavy machinery when taking pain prescriptions. Do not drink alcohol while taking prescription pain medications.
• NAUSEA: This is most often caused by taking pain medications on an empty stomach. Reduce nausea by preceding each pain pill with soft food and taking the pill with a large glass of water.
• SWELLING: Applying an ice bag to the face over the operated area will minimize swelling. Apply for 15 minutes and then remove for 15 minutes. Continue this for the first day.
• NUMBNESS: The local anesthetic will cause you to be numb for several hours after you leave the office. Be very careful not to bite, chew, pinch or scratch the numb area. Sometimes the implant procedure causes residual numbness or tingling for six weeks or longer.
• BRUSHING: Do not brush your teeth for the first 8 hours after surgery. After this, you may brush your teeth gently, but avoid the area of surgery until the area has healed.
• RINSING: Avoid all rinsing or swishing for 24 hours after your procedure. After 24 hours you may begin gentle rinsing with a saltwater solution (1/2 teaspoon salt + 1/2 teaspoon soda + 8oz warm water). Avoid commercial mouth rinses. You may be instructed to use a prescription antimicrobial mouth rinse.
• DIET: Keep all chewing limited to the opposite side (the side not operated on) of the mouth. Eat soft foods for the first two days. Maintain a good, balanced diet. Return to normal regular meals as soon as you are able after the first two days. Drink plenty of water. Avoid alcohol for 48 hours.

Do not disturb the wound. If surgical packing was placed, leave it alone. The pack helps to keep the tooth exposed. If it gets dislodged or falls out do not get alarmed.

BLEEDING

Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding which results in your mouth filling rapidly with blood can frequently be controlled by biting with pressure on a gauze pad placed directly on the bleeding wound for 30 minutes. If bleeding continues please call for further instructions.

SWELLING

Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag, a plastic bag, or towel filled with ice cubes on the cheek. Apply the ice continuously as much as possible for the first 36 hours.

DIET

Drink plenty of fluids but avoid hot liquids or food. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed.

PAIN

You should begin taking pain medication as soon as you feel the local anesthetic wearing off. For moderate pain, take 1 or 2 Tylenol or Extra Strength every 3-4 hours. Ibuprofen (Advil, Motrin) may be taken instead of Tylenol. Ibuprofen which is bought over the counter, comes in 200 mg tablets: 2-3 tablets may be taken every 3-4 hours as needed for pain. For severe pain, the prescribed medication should be taken as directed.

ORAL HYGIENE

Mouth cleanliness is essential to good healing. Clean your mouth thoroughly after each meal beginning the day after surgery. Brush your teeth as best you can and rinse with warm salt water (1/2 teaspoon of salt in a cup of warm water) six times a day. Continue this procedure until healing is complete.

REMEMBER: A clean wound heals better and faster.

ACTIVITY

Keep physical activities to a minimum immediately following surgery. If you are considering exercise, throbbing or bleeding may occur and it this does happen, you should discontinue exercising. Be aware that your normal nourishment intake is reduced so exercise may weaken you. If you get light headed, stop exercising.  Call us at 905-592-2599 with questions or concerns

• Once the anesthetic (freezing) wears off, feeling some pain is normal. Most of your pain will be present for the first 24 to 48 hours after your surgery. Some soreness or discomfort at the site of the surgery may last for 3 to 5 days.
• Brush and floss your teeth as usual, but stay away from the wound. If you are still bleeding a lot and it has been 4 hours or longer since your surgery, call us at 905-592-2599.
• A full day after surgery, rinse your mouth gently with warm water. Add 1/2 teaspoon of salt to a cup of warm water each time you rinse. Rinse 4 or 5 times a day, for 3 or 4 days.
• Sutures will dissolve on their own, in 3 -5 days, but they can start dissolving as soon as tomorrow.
• After surgery, your jaw muscles may be sore, and it may be hard to open your mouth for up to 7 to 10 days. This is expected.
• Resume normal diet as much as possible. Avoid any hot foods or drinks as this may cause bleeding.
• Normal activities can be resumed as tolerated.

Upper teeth near the back of the upper jaw are usually very close to the maxillary sinuses, which are air-filled cavities beneath your eyes and behind your cheekbones. A frequent complication of removing upper molar (back) teeth is exposure of the sinus floor. Most exposures will heal spontaneously or with minimal intervention as long as the following instructions are strictly adhered to after the surgery:

• Some intermittent nose bleeding from the side of the surgery site is a normal occurrence. Please do not be alarmed.
• Do NOT blow your nose vigorously for two weeks. There is a natural communication between your nose and sinus. Any positive pressure in your nose will be directly transferred to the sinus and subsequently to the fresh extraction site. If you feel “stuffed up”, decongestants such as Drixoral, Dimetapp or Sudafed will help reduce pressure in the sinuses.
• Please keep your tongues away from the fresh surgical site. As the swelling subsides, the stitches might feel like they are loosening up, please do not cut them prematurely.
• Do NOT smoke for two to three weeks. Smoking has a much more profound effect on oral wounds than it does on any other part of the body, since the effect of the smoke is in direct contact with the healing wound. Wound breakdown and poor healing are ten times more prevalent in smokers than in non-smokers.
• When sneezing, please do so with your mouth open, and do not sneeze holding your nose. The generated pressure must be released without transmitting to your sinuses.
• Anything that causes pressure in your nasal cavity must be avoided. Avoid “bearing down” – as when lifting heavy objects, blowing up balloons, playing musical instruments that require a blowing action or any other activity that increases nasal or oral pressure. Scuba diving and flying in pressurized aircraft may also increase sinus pressure and should be avoided.
• Failure to adhere to these instructions could result in a permanent communication (fistula) between your mouth and your sinus. This would require an additional highly invasive surgery that would incur further cost and recovery time. Prevention is always the most prudent option.

• Jello


• Creamed Soups & Broths


• Yogurt


• Puddings


• Oatmeal


• Smoothies


• Mashed Potatoes


• Macaroni & Cheese


• Omelets


• Scrambled Eggs


• Applesauce