These are the post-extraction instructions given to patients at the practice. This is very simple and effective, I deal with relatively fewer postoperative complications. I do it both verbally and in writing.
Extraction is quite a traumatic experience for anybody, and although I usually give instructions verbally in surgery, I feel people may not remember it all or take on all the information especially after a surgical procedure, so I would like you to read through this leaflet carefully and if you have any further doubts, please contact the surgery.
One of the most important things to do after an extraction is to bite on the cotton wool pad given without moving it (so try not to talk or move it with your tongue). Keep biting on it at the same position for about half an hour. If you are prone to bleeding (i.e. on a blood thinner) for up to an hour. It is important not to move the cotton wool roll as it pulls on the blood clot that is formed and can either disrupt the clot or create more bleeding which will prevent the clot to be flushed out or a poor blood clot formation.
Another important thing to remember is to just keep swallowing. Don’t collect the saliva in the mouth. There will be a taste of blood seeping through into the saliva – just try to not let it collect in the mouth. Please do not spit out. The more you spit out the more it will bleed. Every time you spit out you create a vacuum in your mouth because of which will produce more bleeding from the bottom of the clot and can sometimes dislodge the clot or prevent a good clot from forming. It is therefore very important that you Do not spit out for the rest of the day.
No smoking for at least 24 hours, ideally it would be best to stop smoking for 24 hours before. The best would be to refrain from smoking for 1 week before AND 1 week after any surgical procedure.
Avoid alcohol for the rest of the day.
No rinsing the mouth out. Try not to rinse or gargle or get any even if there is some taste please leave and keep swallowing and do not rinse the mouth out as this can again dislodge the clot.
Try not to look into the extraction site by pulling on your lip or cheek as can cause disruption to the clot and can induce more bleeding.
Leave the site alone and do not touch as this can transfer bacteria from your fingers or tongue to the extraction healing site and can cause an infection.
An ice pack is very helpful in controlling the healing and avoiding much edema formation. An icepack on the outside of the mouth around the area as soon as possible on the day of extraction and every 2-3 hours is very helpful.
Have only soft and cool food for the rest of the day. You can have some pasta, cooled down soup, rice, a sandwich etc. This will help with adequate wound healing, as any hot food can disrupt or affect the formation of a good clot.
For pain relief, the anaesthetic usually takes up to 2-4 hours to wear so I advise that within this time frame of having the extraction, have a small meal and take a painkiller. If you can have only paracetamol then of course this is fine, however, the best pain relief can be found with alternating ibuprofen(200/400mg depending on pain/procedure) and co-codamol (8/500 of codeine -paracetamol combination. Both of these are available over the counter. One of the best modalities is Ibuprofen immediately after the extraction, 4 hours later a dose of co-codamol, 4 hours later ibuprofen and keep topped up like that.
You may need painkillers for the first couple of days and can then taper down slowly. Keep on top of it to maintain the painkiller effect as it takes longer to work once the pain has kicked in.
Try to avoid brushing on the day and brush very carefully around the area for a couple of days. If at all you catch the area after with either toothbrush or when eating and it starts bleeding again, please use the clean cotton wool rolls provided with this extraction leaflet, and bite down on this for an hour to help with completely controlling the bleeding.
If you cannot control the bleeding and it is during working hours, please contact the practice as soon as possible. If it is outside of practice opening hours and if the bleeding is not stopping, as long as you are not rinsing your mouth out or spitting out and the bleeding is not stopping after biting down on the cotton wool roll for 1 hour, kindly contact the local hospital.
If there were any stitches placed then these will need to be removed after about 2 weeks, so please kindly make an appointment for this on departure today.
The day after the extraction, it would be a good idea to use a teaspoon of salt dissolved into lukewarm water, and to hold this in the mouth over the region of extraction. You do not want to gargle or apply further forces but just to keep in the area, by tilting your head to allow oedema and/or infection to seep out into the saltwater to get better wound healing and relief.
It is quite natural to have some pain, discomfort, and/or swelling in the area after extraction for up to 2-3 days.
If the pain is not getting better or if it is getting worse, then there is sometimes a chance of a dry socket where the blood clot has come out and the bone is exposed in the mouth. This condition is usually pre-empted if the patient is a smoker/if the tooth was previously infected/difficult extractions/usually on the lower arch and it does not have effective treatment options. You can call the surgery and we will need to book you in to clean out the socket and dress it with medication (for some temporary relief). If you follow all the instructions as above for the proper clot care, we can do our best to avoid this very painful condition.
If you have any further queries or problems, please contact the surgery on the phone
number or our patient care coordinator via email.
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