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After Surgery

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This section is a compilation of after dental procedure instruction sheets. All of these sheets were written and customized by Dr Landers. Via patient suggestions and advancements in dental care, these sheets have been through many updates over the past 16 years. Since these sheets are updated at our office, these documents will continually be updated to help you and your friends to manage your after visit concerns.

#1 Bleeding Swelling or Fever

It is natural to expect some swelling after surgery. Swelling will become progressively worse after three days, and may not subside completely for ten days. To keep swelling to a minimum, apply an ice pack to the outside of your face for 15 minute on, then 15 minutes off for the first 24 hours. Do not go to sleep with ice pack in place, and be sure to wrap the ice accordingly. Do not be alarmed if you wake up more swollen then when you went to bed. Sleep with your head elevated above your heart the evening after surgical procedure. Keeping the head slightly elevated helps to minimize the swelling.

You may experience a slight feeling of weakness or chills during the first 24 hours. It is also possible to run a low-grade fever. If this persists for more than 24 hours, please call the office. Get plenty of rest this week and do not over exert yourself.

It is natural to have some blood mixed with your saliva for the first two or three days after a surgical procedure. It is not harmful if you swallow it, as it is mostly saliva. However, a bleeding problem would be considered if your mouth were to fill rapidly with blood in just a few minutes. Should this occur, do not rinse to stop the bleeding.


  1. Limit Physical Activity
  2. Keep your head and neck elevated
  3. Take a wet tea bag or a folded & moistened gauze and place it over the bleeding area. Press firmly* for 15- 20 minutes. If bleeding stops, no further treatment will be needed. If the bleeding will not stop, call our office.

*Please be careful in surgical areas with sutures.

You Should Avoid

  • Excessive Spitting and/Or Mouth Rinsing
  • Smoking Cigarettes
  • Avoid mouth Pressure i.e.; Sucking On A Straw Creates Negative Mouth Pressure.

Anti-Coagulant Medications
If you are or were taking any of the following medications before the surgical procedure it’s likely the effects are causing your bleeding.

  • Heparin
  • Comidin
  • Warfarin
  • Aspirin use daily

If you are taking any of the above medications and are unable to control bleeding, you should call our office. You will likely need additional therapy to stop your bleeding. Please bring the name and phone number of the physician who prescribed this medication.

#2 General After Visit Instructions For Extractions


  1. Do not disturb the area of surgery. The first stages of healing are aided if the surgical area is not disturbed. Avoid vigorous chewing, spitting, rinsing, or using a straw. Please follow these suggestions, or initial healing may be delayed, active bleeding restarted, or infection introduced.
  2. Expect minor bleeding or “oozing” from the operative site. For the first hour, keep firm pressure on the area of surgery by biting on the gauze sponge placed in your mouth by your doctor. Note that the gauze sponge can be replaced with new folded gauze when needed. If bleeding persists, continue pressure on fresh sponge for an additional 30 minutes to one hour. Biting on a moist tea bag wrapped in the gauze provided may help control bleeding from the tooth socket.
    If active bleeding should occur at any time, carefully rinse mouth to remove any blood clots and apply a fresh gauze sponge to the bleeding site. Firm pressure for 15-30 minutes usually controls the problem.
    Should active bleeding persist, contact our office at (312) 263-7823.
  3. Limit physical activity during the first 24-48 hours after surgery. Overexertion may lead to post-operative bleeding and discomfort. When you lie down, keep your head elevated on a pillow.
  4. Some degree of discomfort and pain may arise as numbness subsides. At first sign of pain or discomfort, take one Ibuprofen or Tylenol tablet and repeat as directed on the bottle as necessary, or take pain medication prescribed according to the instructions on the container.
  5. Pain following removal of an impacted tooth will be most severe within the first 6-8 hours after the operation. To limit the amount of pain, you must take the medication prescribed in exact accord with the instructions given. Do not wait for the pain to become unbearable before using the pain tablets, since it will then be more difficult to control. Moderate to severe post-operative pain usually does not last longer than 24-48 hours, and there should be no more than slight pain or discomfort after the third day. If pain persists beyond this time, or seems to be increasing, you should notify the office as soon as possible.
  6. Swelling related to surgical procedure usually develops during the first 12-24 hours following surgery. Swelling can be minimized by applying an ice pack over the area for 30-45 minutes of every hour during the first 24 hours following the procedure, unless you receive special instructions.
  7. Fluid intake is important. Drink all the fluids you desire: milk, milk shakes, decaffeinated tea, soda, broth, soup, and so on.
    Avoid using straws.
  8. Diet and food is largely a matter of your choice during the first 24 hours. Try to take some soft foods that require little or no chewing. (Soup, Jell-O, mashed potatoes, applesauce etc.)
  9. Take any regularly scheduled medication (for diabetes, high blood pressure, etc.) on your regular schedule, unless advised to do otherwise by doctor or your family physician.
  10. Limit or avoid smoking completely, as it tends to slow healing processes.

The Day Following Surgery and Thereafter

  1. On the morning of the day following surgery, rinse your mouth carefully with a solution made by adding a 1/2-teaspoon salt to a large glass of warm water. Repeat six to eight times a day until remaining soreness subsides. Resume brushing any remaining teeth and your regular oral hygiene as soon as possible.
  2. If you received sutures, they were placed to control bleeding and aid healing. Sutures will be removed easily and painlessly in 7-10 days.
  3. Any swelling, soreness, or “stiffness of the jaw muscles” can be relieved by applying a warm, moist towel to the affected side of the face several times a day. Take any prescribed pain medication as directed. Use the warm rinses described above.
    If swelling, tenderness, or pain should increase after the first few days, return for an examination.
  4. Sometimes, a special soft diet may be necessary for the first few days following surgery. Most patients are able to resume regular food intake within a short time.
  5. Black and blue marks may appear on the skin of the face during the first few days after surgery. Moist heat application will help relieve this condition.

Your doctor and staff have done everything possible to provide you with the best in anesthetic and surgical care. However, the ultimate success of your operation now depends on correct post-operative management. You have been given specific verbal and written instructions for proper home care. Be sure to follow these instructions carefully. Only in this way will you avoid most complications, which lead to unnecessary discomfort and delayed recovery. Should any undue reactions or complications arise, notify the office at (312) 263-7823.

#3 Jaw Muscle Soreness

Muscle Soreness
Difficulty in opening the jaws and muscle stiffness are common after some extractions, particularly wisdom teeth. This is normal and will improve in 5-10 days.

This condition is almost always self-limiting and will improve in 5-10 days. For this reason, no definitive therapy is indicated. We recommend that you take Advil or Motrin as needed and begin this routine after 48 hours:

  1. First use chewing gum at short intervals
  2. Then use your thumb on the upper teeth and middle finger on lowers to complete gentle stretching exercises. These exercises are completed by relaxing your jaw muscles and holding you mouth open for short intervals. These jaw muscle exercises are very similar to the exercises used to stretch other muscles in your body i.e. legs or back stretching exercises.
  3. Applied moist heat to affected area

#4 Lost or Loose Suture

This section is a compilation of after dental procedure instruction sheets. All of these sheets were written and customized by Dr Landers. Via patient suggestions and advancements in dental care, these sheets have been through many updates over the past 16 years. Since these sheets are updated at our office, these documents will continually be updated to help you and your friends to manage your after visit concerns.

#5 Pain After Extraction Dry Socket

A dry socket is when part of the blood clot either dissolves or falls out of the surgical extraction site. This is not a serious complication, but is often a painful one. A common symptom which is a sign of dry socket is: pain that is increasing several days after the extraction. If this is the case please contact our office as some medication may need to be placed to improve comfort and aid in the healing process.

Patient History & Symptoms

  • Extreme pain, foul odor and taste but no draining infection
  • Patient reports extraction 3-4 days prior (especially lower 3rd molars)
  • Gingival inflammation
  • Extraction Socket looks dry (bone my be exposed due to loss of clot)
  • Patient who did not read or follow the post visit Extraction instructions

Dry Socket Patient Instructions:
Call our office for an appointment. A member of our team will gently rinse the area and place a medicament. This medicament will usually ease your pain in less than an hour. You will need to return in 24 hours for removal of initial packing and additional placement of a fresh medicament. Usually patients will need 1, 2 or 3 visits to eliminate dry socket.

Rx: For this situation we will usually recommend a Pain Medication. (Antibiotics are not usually indicated)

Dry Socket At Home Care
There is no absolute way to steer clear of dry socket. When dry socket occurs, healing will slow down and the “hole” in your mouth will require extra care.

  • Avoid all sodas, juices, alcohols, & carbonated beverages for 1 week.
  • Limit strenuous activity & avoid stressful situations (limit caffeine). This will keep your blood pressure at a normal level, reduce bleeding, and help the clot to form.
  • Avoid hot liquids, since they may dissolve and dislodge the clot and/or newly placed medicine.
  • Avoid cigarette smoking & tobacco products
  • Do not attempt to clean the healing tooth socket or adjacent teeth.
  • Beginning the morning after Medicament is placed, gently rinse your mouth with 1-cup of warm water + ½ teaspoon of salt. Introduce the rinse near the surgical area and gently shake your head. Please do not swish. This is done twice daily (AM & PM) for one week.
  • Please do not use any other mouth rinses or mouthwash during this early healing period. Most popular mouth washes have alcohol and can disrupt clot formation!
  • Stay well nourished. Drink lots of liquids and eat soft, nutritious foods. Do not chew on anything hard or crunchy. No chewing gum! Do not eat on or near the extraction site as to avoid getting food caught in the opening!

If you experience swelling and pain, you can help reduce them by periodically applying cold compresses to the face for 15 minutes at a time. Use an ice bag or cold, moist cloth.

When there is no swelling you can begin to use a warm compress to aid in the healing process.

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