Oral Surgery

The following steps are necessary for achieving proper healing with minimal complications. The first 24 hours of self-care instructions must be followed closely or delayed healing can be expected.

  1. Moist gauze packs are to be left in place for___hour(s). Bite on the gauze with slight pressure. Remove it briefly only to eat or drink, then replace it for the remaining period of time.
  2. Rest the remainder of the day, refraining from any smoking and physical activity. This will allow for good clot formation.
  3. Ice should be used for___hours to minimize swelling and should cover a large area. The ice bag should be placed within a towel making sure that the part next to your face is slightly moist. An additional towel should be used to secure the ice bag to your face.
  4. Aspirin, Tylenol, or Advil should be a sufficient pain remedy for most extractions. However, do not take any of these if an allergy exists. Local anesthesia usually lasts two hours, therefore take tese one hour before the anesthetic ears off. If you have been given a prescription, please do not drink alcoholic beverages, operate motor vehicles, or perform duties that require mental concentration for 8 hours after taking the medication. Be aware that pain medication does not totally eliminate discomfort but rather allows you to tolerate the discomfort.
  5. Do not rinse vigorously for 24 hours.
  6. You must eat to feel healthy. Suggestions are milkshakes, liquids, lukewarm soup, baby food, cold drinks, ice cream, food that you can chew lightly or regular meals if you are sufficienly comfortable to eat.
  7. After 24 hours, brush your teeth and rinse your mouth well, especially after meals. Keep your mouth clean. Even if sutures are present, brush in that area. You will not dislodge the sutures or injure the surgery area while brushing.
  8. Slight oozing of blood is to be expected for the first 24 hours.
  9. Swelling and trismus (difficulty and stiffness when opening the mouth) are to be expected. The more difficult the extraction, the greater the selling and stiffness.
  10. Paresthesia (numbness of the lower lip) is always a possibility with the removal of lower molar teeth, but please call if this occurs.
  11. Maxillary (upper) sinus exposure seldom occurs but it is always possible with the removal of upper molar teeth. Again, please call the office if the problem arises.
  12. A dry socket may develop 2 to 5 days after lower extractions, please contact the office if you feel that this is occurring.

After the first 48 hours

The following will reduce swelling and promote healing:

  1. Continue to keep the mouth clean with a toothbrush and mouthwash.
  2. Use hot water mouthrinses. Use 2 tablespoons of salt with one quart of water, then heat it to the same temperature as yo would coffee. Place 1/2 cup of the solution into your mouth and place it over the area until the solution cools. Repeat until the quart is gone, repeating this process 4-6 times a day. It takes about 5-14 days for the swollen area to return to normalcy.

Your Medications

Three types of medications that you may need to use before and after treatment:

  1. Analgesics for pain
  2. Antibiotic for infection
  3. Anti-inflammatory to decrease inflammation

If you are allergic to any of the medications such that you break out in a rash or have difficulty breathing, do not take them. Call our office: 717-367-1336.

  1. Analgesics: Ibuprofen (Advil, Motrin) and aspirin relieve pain and are moderately effective as anti-inflammatories.
    • Ibuprofen – Take 600 to 800 mg immediately after treatment. Four hours later take another 600 mg. Then take 400 mg every 4 to 6 hours, as needed. Call the office if ibuprofen is needed for longer than four days.
    • Aspirin – 600 to 900 mg can be used every 4 to 6 hours for 36 hours. Prolonged use of aspirin can effect clotting.
    • Tylenol – Not as effective as the above unless combined with a narcotic.

    Should you experience severe discomfort, the following regimen has been proven to be extremely effective:

    • Take 2 Ibuprofen tablets, two hours later take 1 Vicoprofen tablet followed by 2 Ibuprofen tablets two hours later, then 1 Vicoprofen two hours later. Continue this sequence for a period no longer than 24 hours. If your discomfort still persists, contact the office.
  2. Antibiotics: Medications are to be taken as written on the prescription bottle unless otherwise indicated.

    Antibiotics impair oral contraceptives. Women using oral contraceptives should use an alternate method of birth control while antibiotics are being taken.

    Adjustment to prescription in order to increase antibiotic effectiveness:

    • Amoxicillin, 500mg: Take 2 tablets every 8 hours for 48 hours, then complete the prescription taking 1 tablet every 8 hours.
    • Cleocin (Clindamycin), 150 mg: Take 2 tablets every 6 hours for 48 hours then complete the prescription taking 1 tablet every 6 hours.
    • Keflex (Cephalosporin), 500 mg: Take 2 tablets every 6 hours for 48 hours, then complete the prescription taking 1 tablet every 6 hours. If you are allergic to penicillin, there is a chance you may be allergic to Keflex. Please notifiy the doctor if you experience an allergic reaction.
  3. Anti-inflammatories:
    • Medrol Dose Pack: take as listed on the pack
    • Prednisone 5 mg
      • Mild (12 tablets) – Start with 2 tablets, then take 1 tablet every 12 hours
      • Moderate (18 tablets) – Start with 2 tablets, then take 1 tablet every 8 hours