How long should you leave gauze in after tooth extraction

The Do’s and Don’ts after a Tooth Extraction

What is a tooth extraction?

The term refers to the painless removal of a tooth or tooth roots with minimum trauma to the surrounding tissues so that the extraction socket wound heals uneventfully and without any post-operative complications. Whenever any surgery takes place the first thing we want is to let it heal properly, quickly and smoothly. As a common practice, most of the dental surgeons have standard post-surgery instructions printed which are handed over to the patient. One must follow these instructions given by the dentist. Following all the post-operative instructions after tooth extraction reduces the incidence of infection and chances of dry socket. If aftercare instructions are not followed then it can cause complications, which can further lead to delayed healing. Here are some of the do’s and don’ts after a tooth extraction.

Do’s:

• Rest: Try to get some rest after Tooth Extraction. You may feel great but don’t exercise or do too much activity for at least 24 hours. When resting, keep your head in a slightly upright position on the pillow.
• Let it clot:Let the clot be formed on the tooth extraction site, which covers it and allows it to heal. After the procedure your dentist will give you a piece of gauze to bite on near the extraction site. Try to bite down and keep it in place for at least an hour afterwards. This will put pressure over the wound and help it to stop bleeding. However, make sure you don’t chew on gauze piece. If you can keep it in place longer that’s best, but make sure to change the gauze after roughly every half hour, depending on the amount of bleeding. If once the clot forms it becomes dislodge the nerve endings then become exposed. The nerves and capillaries spasm and constrict, limiting essential blood supply, which causes delay in healing. If the bleeding persists for a few hours after the procedure then try putting a wet tea bag on the site. The tannic acid present in black tea helps to aide in the clotting process.
• Ice Packs: Apply an ice pack on the side of your face where surgery was performed. This is done to reduce swelling. While on simple extractions swelling isn’t accompanied, in cases requiring severe cheek retractions swelling can occur after operation. The swelling after an extraction may not occur immediately, but can continue to swell for a few days, reaching a maximum at the 2nd or 3rd day. Application of the ice pack is most effective during the day of extraction as after 24 hours there is no significant beneficial effect. Ice packs should be applied 15 minutes on and 15 minutes off for 1-2 hour time periods.

Don’ts:

• Don’t smoke:For at least 48 hours after tooth extraction do not smoke. The chemicals in the smoke can affect the clot and hence the chances of developing dry socket 3-4 days after tooth extraction increases.
• Don’t eat solids immediately after: While you still have numbness it’s best not to eat solids. When you start feeling your jaws you can start taking solids. After tooth extraction, take soft and liquid foods like soups, mashed potatoes, yogurts, milkshakes, smoothies etc.
• Warm saline rinses: The main aim of rinsing is to clean the area of extraction as it is not possible to brush the socket. We mix salt to make the solution isotonic and similar to natural tissue fluid and thus it is less irritating than water. Rinsing is usually advised 12 hours after extraction. So, warm saline rinses help in cleaning and maintaining the hygiene of that area.
• Take your medicines as prescribed by your dentist: Don’t skip the medicines. If antibiotics are given they should be taken regularly. Pain killers and anti-inflammatory drugs are to be taken after tooth extraction. It help in reducing the pain and swelling. If the pain continues even after two days of tooth extraction and bleeding starts then you should call your dentist.
• Avoid Aspirin: Don’t ever take aspirin (Can take ibuprofen). Aspiring being a blood thinner will delay in clot formation thereby will prevent healing. Take the medications as prescribed by the physician and consult your dentist before taking any medicine.
• Avoid Sucking of any type: SMOKING, SIPPING, EATING HARD VEGETABLES are to be avoided after tooth extraction. Try taking soft and liquid food options such as soups, mashed potatoes, yogurts, milkshakes, smoothies etc. after tooth extraction. Avoid hot drinks, spicy foods, sodas, etc.
• Don’t poke into the gap created: Though for initial few days, it will feel a bit awkward to have a gap but don’t poke that area with any toothpick or tongue as it may delay healing, may provoke bleeding and can also lead to dry socket.

Activity

• Keep relatively quiet the day of the extraction. Keep the head elevated, higher than the heart.
• The sedated patient may resume normal activities in 24 hours.

Safety

• Someone should stay with the sedated patient for 3 to 4 hours after surgery.
• Do not use power tools or other dangerous machinery for at least 24 hours after surgery. Pain pills may affect the ability for 3 to 4 hours after each dose.
• Legally, you may not drive for 24 hours after sedation and should not sign any important papers.

Gauze packs

• Change gauze packs every 30 minutes as needed. Discontinue gauzes when bleeding stops, usually after 3 to 4 hours. Do not leave the gauze in overnight.
• A sleeping patient should be aroused to check the gauze every 20 minutes. Never let a patient sleep unattended or for long periods with gauze packs in the mouth.
• If oozing starts, bite on gauze pack until the bleeding stops. You can also use a wet teabag like gauze and bite down on it (for example, a Salada or Lipton teabag; do not use herbal or decaffeinated teabags.).

Diet

• The patient can drink at any time. Remove all gauze to drink, then replace gauze packs as needed. Do not drink hot drinks; drink only cold drinks for the first 24 hours.
• To avoid biting the tongue, the patient can eat as soon as feeling returns and bleeding stops.
• The patient can eat cold, soft foods (ice cream, jello, yogurt, pudding, sherbet, cottage cheese) for the first 24 hours. After the first 24 hours, you can add warm, soft foods (soups, soft cooked pasta dishes, mashed potatoes, scrambled eggs, cream of wheat). Avoid hard, crunchy foods (bagels, pizza, hamburgers, popcorn, chips). Gradually advance your diet as tolerated.

Pain management

• Take prescribed pain medication before feeling returns to the involved area. Take medication with milk, ice cream, or anything that doesn't require chewing.
• Take pain medication as directed. We recommend you take Ibuprofen 800 mg every 8 hours, added Percocet (Vicodin) every 4 to 6 hours as needed. Do not take additional Tylenol.
• Ice packs to the jaw can reduce pain, swelling and/or bleeding the first 24 hours then heat at intervals only.
• Do not drink alcoholic beverages while using pain pills or antibiotics.

Care of the mouth after tooth extraction

• To help prevent a "dry socket," do not smoke, rinse, spit, or brush for 24 hours.
• 24 hours after surgery, begin brushing teeth and start rinsing with warm salt water.

Miscellaneous instructions

• If we gave you an IV medication for swelling, it will wear off between the second and third day. You may feel more discomfort than previously experienced. This is normal; however, if pain increases or is not alleviated with pain medicine, call the office.