In order to control bleeding, maintain steady firm pressure by closing on the gauze that has been placed over the extraction site(s). Don’t chew on it and avoid talking.
After 45-60 minutes, the first set of gauze can be removed; this is generally the best time to take your first post-operative dosage of pain medication as prescribed. While you may take a little water to help swallow the pills, avoid rinsing or swishing it around in your mouth. After swallowing the medication, place a fresh set of gauze over the extraction site(s) and apply pressure.
After applying pressure for another 45-60 minutes, this second set of gauze can be removed, and it is unlikely that more gauze will be necessary. It is normal for the surgery site(s) to ooze blood for the next 24 hours; however this is generally a relatively small amount (it seems like more when mixed with your saliva) and should not be a problem to swallow.
Avoid rinsing, spitting or drinking through a straw during this initial 24 hours as this may disturb clot formation and cause bleeding or healing problems such as “dry socket”. If excessive bleeding should persist (i.e. blood is filling up in your mouth), use remaining gauze in the manner described above.
Should you run out of gauze, applying pressure by closing on a moistened tea bag placed over the site(s) for 30-45 minutes can also help if available (tea contains tannin which helps constrict blood vessels) or call your dentist at the clinic or at the after-hours number provided below.
In order to minimize swelling, place an ice pack (packaged frozen vegetables also work well) against your cheek/ mouth adjacent to area of the extraction site(s) for about 10 minutes and then remove it for about 10 minutes. Keep alternating the application and removal every 10 minutes for the remainder of the day of the surgery until you go to sleep this evening.
Avoid eating foods that require chewing for the remainder of today, especially while you are still numb (keep in mind you may have been given long-acting local anesthetic that can last 6-8 hours). Soup (not too hot), ice cream, yogurt, porridge, jello, etc. are some examples of acceptable foods. Over the next 3-4 days avoid hard, tough, or crunchy foods and keep to a softer diet such as pasta, scrambled eggs, mashed potatoes, milk shakes, smoothies, citrus fruits, Boost, blenderized food, and the like. As your healing progresses you may gradually return to a more normal diet.
24 hours after the surgery, begin rinsing the extraction sites with warm water (a teaspoon of salt can be added to an 8 oz glass of water if you wish). Preferably rinse after meals, before bedtime and upon awakening each morning (i.e. 4-6 times/ day).
You can brush your remaining teeth as best you can, but keep the toothbrush away from the surgery site(s) for at least 10-14 days after which most people can begin to gently resume normal oral hygiene procedures again. If your dentist provides rinsing aids (e.g. curved plastic syringe) or antibacterial mouth rinses, use them as directed.
Rest and relax as much as possible when you get home on the day of the surgery. When you are lying down, even when sleeping tonight, keep your head elevated with a couple of pillows. Although this will help lessen the blood pressure in your head and minimize oozing, it is normal for you to drool some blood overnight; therefore use an old towel or pillowcase over your pillow(s). Keep your activities to a low level over the next 5-7 days; avoid physically strenuous things that will elevate your heart rate and blood pressure such as physical training, heavy lifting, etc..
If you have been sedated for the surgical procedure, its effects can last throughout the remainder of the day. Therefore, it’s best to have a responsible adult present to help look after you. Be particularly careful when using the washroom, as there are many hard objects on which to hit your head should you lose your balance. Take your other medications as prescribed, they are intended to control pain and swelling.
Keep in mind that if your pain medication contains a narcotic such as codeine (e.g. Tylenol #3), it will tend to make you drowsy and therefore you should not drink alcohol and you should avoid activities such as driving that you could injure yourself or someone else if not fully alert. Also remember that the longer you take narcotics such as codeine, the more likely you are to suffer from constipation. Therefore, after a day or two of using a narcotic like Tylenol #3 together with an NSAID (pain relieving anti-inflammatories like Ibuprofen commonly known as Motrin or Advil), try taking the NSAID by itself and see if it is effective enough. NSAIDs can be a little irritating to the stomach and therefore are often recommended to be taken with food or milk if possible.
If you are a smoker, you should abstain from smoking for at least 72 hours (3 days) and longer if possible. Smoking greatly contributes to the possibility of developing bleeding and/ or healing complications (such as dry socket) due to the negative effects of the smoke and nicotine.
Ref: Dr. Richard Burns, DDS