When can I eat?

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            You can eat when there is no longer any bleeding at the extraction site and the numbness from the local anesthesia has worn off. Avoid food that is hot: heat draws blood flow and can restart the bleeding. After the procedure, food should be soft and cool.

 

Why can’t I swallow after the procedure?

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            You can.  Because of the local anesthesia, you are swallowing, but are  unable to feel it. This is a specially true if you have been numbed in several places.

 

Why am I still bleeding many hours after the procedure?

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            This is usually from the ineffective use of the gauze pads placed in the mouth after surgery. It is most common in patients will have received intravenous sedation and who fall asleep when they go home. While sleeping, the patient is not aware if the gauze moves away from the extraction site, nor are they biting down to apply pressure. Patients who are awake but very numb may also be  unaware if the gauze is in the wrong place. The gauze pads must be in the right place and thick enough to apply pressure when biting or they are not doing anything! If there are teeth on either side of the extraction site, the gauze pad must be wedged between adjacent teeth to make direct contact with the gum where the extracted tooth used to be. Never lie flat down after a procedure.  Elevation of the head 45° or more decreases blood flow to the head and neck and reduces bleeding tendency.  In addition, the greater the number of teeth removed, the longer it usually takes the bleeding to stop since there are more places to get under control. Don't spit blood.  If the gauze pads soak through and there is blood in the mouth, change the pads to thick new ones placed in the proper position. This keeps the mouth clean, stops the bleeding, and eliminates the need to spit. Overtime with hourly gauze pad changes, the pads become mostly white with just some red color picked up from the complete clot.  Active bleeding has now stopped, and the use of gauze can be discontinued. By bedtime, the clotting is usually complete and biting on gauze is not recommended. In the following days, do not place the gauze back in again after clotting has taken place, or the gauze will irritate the tissues and cause the bleeding to restart.

 

Why is the extraction site uncomfortable sometimes up to several weeks after surgery?

 

            Removal of a tooth, especially a difficult or impacted one, is a surgical procedure on bone. Unlike most dental procedures where you return to normal the same day, there is a recuperative period with oral surgery.  This is similar to surgery elsewhere in the body, especially the bones and joints, the recovery can take weeks to months.  Maximum discomfort and swelling occurs 2 to 3 days after the procedure. This is the normal inflammatory process and is not infection. From there, discomfort can persist for up to several weeks. Factors of predisposed to this inflammation and discomfort include: older patients, extraction of teeth that had the root canals, lower teeth more than uppers (especially impacted teeth), smoking, and females on birth control pills.  The information is more pronounced when the patient is in a reclined position (i.e. in bed at night). The gum tissue at the extraction site will take 6 to 8 weeks to close over and food that accumulates should be gently rinsed free with plain water.

 

Why is an ice pack applied to reduce swelling used only on the first day?

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            Ice is used to prevent swelling; it does nothing for existing swelling. Ice is therefore applied on the first day (the day of surgery) to reduce the amount of swelling that develops 2 to 3 days later when the swelling maximizes. Whatever swelling develops on the second or third day after surgery will not be affected by use of ice at that point, and will be larger if ice was not use the first day. Remember, ice is not used for infectious swelling.

 

Why can I be nauseous or light-headed post-operatively?

 

            The most common cause of this are swallowing blood from improper use of gauze, taking the narcotic pain medicines on an empty stomach, or being dehydrated from not drinking or eating anything. Allow the stomach to empty itself, then take the appropriate measures to correct the cause.