Oral Surgery
Pre-Surgery Instructions
Pre-Surgery Instructions

Before any oral surgical procedure you should:

- Eat a light and easily digestible meal the night before your appointment

- If you are going to be sedated, DO NOT eat or drink anything on the day of your appointment

- Wear short sleeves and loose-fitting clothing

- Arrange for a relative or friend to stay in the office with you and be ready to drive you home

- You may NOT drive a car on the day of the surgery if you are to be sedated!

Tooth Extraction

When the extraction of a tooth is required:
1) An incision in the gums is made
2) The tooth is removed
3) The area is stitched up and is allowed to heal


During this time, it is important to think about a tooth replacement option. An extracted tooth leaves an open area in the jaw which, in time, allows the neighboring teeth to drift into the area where the tooth was extracted. This in turn, causes a chain reaction to all the surrounding teeth. Also, if you are considering placing an implant in the future, you should consider asking your dentist to place a bone graft at the time of surgery to preserve the bone width and height.

After Extraction Care

NUMBNESS
Your lips, teeth, cheek and/or tongue may be numb for several hours after the procedure. To avoid injury, you should avoid any chewing and hot beverages until numbness has completely worn off. It is very easy to bite or burn your tongue, cheek or lip while you are numb.

BLEEDING
Biting on moistened gauze until the bleeding subsides is the best way to control the bleeding. Change the gauze has it becomes saturated with new moistened gauze. If bleeding persists after 2-3 hours, keep your head elevated and sit upright. You may try ?home remedies? such as moistened tea bag placed on the side for 30 minutes to help control bleeding. Overnight, it is normal for some blood to ?ooze? from the area of the surgery. If you notice excessive bleeding call the office immediately or go to the nearest emergency room.

BRUSING AND SWEELING
You may experience some busing in the area of the surgery. In some people, this is a normal response and should resolve within 7-14 days after surgery. Swelling is the best controlled by the immediate application of ice packs for the first 24 hours following surgery. Ice packs should be applied to the outside of the face in the intervals of 20 minutes on and 20 minutes off.

LIMITED OPENING
Jaw muscled stiffness with some limited opening of your mouth may occur after removal of teeth. This is a normal response and may take several weeks to improve. Using warm moistened towels on your face 24 hours after surgery may improve the stiffness.

FEVER
There may be a slight elevation of temperature for the first 24-48 hours after surgery. If a fever is present, it is extremely important to drink plenty of fluids. Please call the office if there is a concern.

EATING AND DRINKING
Drinking plenty of fluids is essential. Do not suck through a straw as this will promote bleeding. Eating soft nutritious foods is encouraged as soon as the bleeding has stopped and for the first few days after surgery.

BRUSHING AND RINSING
For the first 24 hours, do not brush or rinse your teeth as this may disrupt healing. After 24 hours, gentle brushing with a soft toothbrush is encouraged, but avoid the extraction site. Avoid brushing sutures, if placed. You may use a warm saltwater rinse (1/2 tsp mixed with 8 oz. of warm water) 3-4 tomes per day after the first 24 hours to help soothe the discomfort. Do not spit for the first 48 hours after surgery.

SMOKING
Do not Smoke for at least 48 hours after surgery. Smoking adversely affects oral hygine and contributes to dry socket. Spitting and rinsing too early after surgery may also contribute to this painful condition.

EXERCISE
Please refrain from strenuous activities until 48 hours after surgery, as this will promote bleeding and interface with the healing process.

MEDICATIONS
You may be prescribed medications. Take them as directed to help control the discomfort. To avoid nausea, do not take pain medications on an empty stomach. Please note: Some antibiotics may interfere with the effectiveness of birth control pills. Please check with your pharmacist.

Wisdom Tooth Development
Wisdom Tooth Development

Wisdom teeth generally begin to form in your pre-teen years. By late teen years, the crown of the wisdom teeth will begin to erupt through the gums if there is adequate room. By mid twenties, your wisdom teeth will either be able to fully erupt or will have become impacted. Early removal of wisdom teeth makes the procedure easier for the patient to tolerate and promotes faster healing after wards. By your early forties, the wisdom teeth roots have become fully anchored to the jawbone and if required to be extracted, will be much harder and will need more time to heal.

Wisdom Tooth Positions

Wisdom teeth under ideal circumstances should grow in straight like any other tooth. However, it is common for wisdom teeth to become impacted inside the jaw or just under the gums. If this occurs, your wisdom teeth should be removed.

Common Impactions:
1) Horizontal Impaction
2) Angular Impaction
3) Vertical Impaction
4) Soft Tissue Impaction

Wisdom Tooth Problems

The problems involving your wisdom teeth may be caused by the size of your jaw and/or by how crowded your teeth are. Common warning symptoms that there is an un-natural problem in the development of your wisdom teeth could be pain and swelling.

Symptoms can be caused by:
1) Infection to the gums
2) A crowded tooth displacing neighboring teeth
3) A decayed wisdom tooth
4) Poorly positioned wisdom tooth
5) A cyst that destroys bone

Wisdom Tooth Removal

Removal of wisdom teeth could be done while you are sedated and being carefully monitored.

1) An incision is made in the gums.
2) The overlaying bone is removed to
expose the crown of the tooth.
3) The tooth is then extracted as a whole or under certain circumstances, it may be necessary to be removed in pieces. This is generally done for severely impacted wisdom teeth.
4) The area is stitched closed and allowed to heal.

After Wisdom Tooth Removal

Post-operative care of the removal of impacted teeth is very important. Carefully follow instructions to minimize unnecessary pain and complications of infection and/or swelling.

BLEEDING. A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or slight blood traces in the saliva is not uncommon. To help minimize bleeding, avoid any sort of exercise or excitement. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. This action should create a blood clot and bleeding will stop; however, if bleeding does not stop repeat as necessary. As an alternative to the gauze gently bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. If bleeding does not subside, call the office at 305.531.0063 for additional instructions.

Standard After Surgery Instructions:
- The gauze pad placed over the surgical area should be kept in place for a half hour prior to removal.
- Vigorous mouth rinsing the surgical area following surgery should be avoided. Vigorous sucking through a straw should be avoided. Touching the surgical area should be avoided. These actions may cause the blood clot to become dislodged and cause excess bleeding.
- Begin taking the prescribed pain medications as soon as you begin to feel discomfort.
- Place ice packs to the sides of your face where surgery was performed.
- Restrict your activities the day of surgery and resume normal activity when you feel comfortable.

SWELLING. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon as it is the body's normal process in repairing itself. Swelling does not always appear immediately. It may take 12 to 24 hours before swelling becomes apparent. Swelling may not reach its maximum until 2-3 days post-surgery. Swelling may be minimized by the immediate use of ice packs post-surgery. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 36 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.

PAIN MEDICATION. For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every three to four hours or Ibuprofen, (Motrin or Advil) two-four 200 mg tablets may be taken every 3-4 hours. For severe pain, take the tablets prescribed as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive or operate machinery and avoid alcoholic beverages. Pain or discomfort should subside more every day. If pain persists, it may require attention and you should call the office for assistance.

DIET. After general anesthetic or I.V. sedation, liquids should be initially taken. Do not use straws. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. Nourishment and regular fluid intake is important to your recovery. At least 5-6 glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.

HOME HYGIENE CARE. There will be a cavity where the tooth was removed. The cavity will gradually over the next month fill in with the new tissue. In the mean time, the area should be kept clean especially after meals with salt water rinses or a toothbrush. No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the night of surgery but rinse gently. The day after surgery you should begin rinsing at least 5-6 times a day especially after eating with a cup of warm water mixed with a teaspoon of salt.

ANTIBIOTICS. If Sunset Family & Cosmetic Dentistry, PLLC has prescribed antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection. Call the office in the event of a rash or other unfavorable reaction at 305.531.0063.

NAUSEA. Occasionally, a prescribed pain medicine may induce nausea and/or vomiting following surgery. Do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on coke, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.

Other Complications
- NUMBNESS. As discussed in your pre-surgery consultation numbness of the lip, chin, or tongue can occur, but there is no cause for alarm. This is usually a temporary condition. If you do experience numbness be careful not to bite your lip of tongue as you will not feel the action. Call Sunset Family & Cosmetic Dentistry, PLLC if you have any questions.

- TEMPERATURE. Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.

- DIZZINESS. Taking pain medications can make you dizzy. You can get light headed when you stand up suddenly. Before standing up, you should sit for one minute then get up.

- SUTURES. Sutures may be placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, this is no cause for alarm. Just remove the suture from your mouth and discard it. In about a week post surgery the sutures will be removed by Dr. Eduardo Ubieta. It is a simple procedure that does not require any anesthesia or needles and only takes a few minutes.

- SORE THROAT PAIN. Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.

- JAW STIFFNESS. Stiffness of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.

Surgery FAQs

Pre-surgical
Q: Is there a food and drink restriction prior to surgery?
A: If treatment calls for the patient to be sedated then yes there are food and/or drink restriction. The patient must not consume anything, including water for 6-8 hours prior to surgery.

Q: Will antibiotics be prescribed prior to surgery?
A: We commonly use antibiotics to kill bacteria found in the mouth, which will also prevent infection after treatment, particularly with the placement of dental implants immediately after extracted teeth. The specific drug used depends on the medical profile and well being of the patient and the type of treatment.

Q: Do I need to avoid certain medications?
A: It is important to discuss all medication with Sunset Family & Cosmetic Dentistry, PLLC during your pre-surgical consultation. In most cases medication should be continued unless specifically instructed to withhold them. Typically Plavix, Aspirin, Coumadin and other types of blood thinners can also be continued. When necessary Sunset Family & Cosmetic Dentistry, PLLC will consult with your physician to safely manage your medications.

Q: Are the rules different for ORTHOGNATIC SURGERY different from tooth extractions of dental implant placement?
A: Yes, very different. Patients who are undergoing surgical procedures on only one jaw usually go home the same day. Patients who are having surgery on both jaws will generally stay overnight. Generally it is necessary to wire the jaws together after orthognatic surgery. In general, the jaws are immobilized securely with rubber bands for the first 1-2 weeks and then loosely for an additional 3-5 weeks. It is very important to discontinue any medication which are ?blood thinners? or which may increase your tendency to bleed. Please stop taking the following medications at least 2 weeks before surgery. Sunset Family & Cosmetic Dentistry, PLLC will provide specific instructions prior to your surgery date.

Surgery
Q: Will anesthesia be used?
A: Sunset Family & Cosmetic Dentistry, PLLC will discuss your anesthesia options. Our goal is to provide minimal discomfort as possible.

Q: How is the anesthesia administered?
A: Depending upon your treatment we may administer a local anesthesia such as lidocaine or nitrous oxide. For a more involved treatment we may recommend an oral sedation or intravenous sedation.

Q: What do I need to be aware of before intravenous sedation?
A: You may not have anything to eat or drink (including water) for eight (8) hours prior to the appointment. No smoking at least 12 hours before surgery. Ideally, cut down or stop smoking as soon as possible prior to the day of surgery. A responsible adult must accompany the patient to the office, remain in the office during the procedure, and drive the patient home. The patient should not drive a vehicle or operate any machinery for 24 hours following the anesthesia experience. Please wear loose fitting clothing with sleeves which can be rolled up past the elbow, and low-heeled shoes. Contact lenses, jewelry, and dentures must be removed at the time of surgery. Do not wear lipstick, excessive makeup, or nail polish on the day of surgery. If you have an illness such as a cold, sore throat, stomach or bowel upset, please notify the office. If you take routine oral medications, please check with Sunset Family & Cosmetic Dentistry, PLLC prior to your surgical date for instructions.

Q: Will my vital signs be monitored during and after treatment?
A: Sunset Family & Cosmetic Dentistry, PLLC and/or one of their highly trained surgical assistants will continuously monitor your vital signs.

Q: How long will the surgery take?
A: The length of surgery depends on your treatment. Some surgery's are less than 30 minutes, while other procedures may take considerably longer. Sunset Family & Cosmetic Dentistry, PLLC will provide you with the estimated time of surgery at your pre-surgical consultation.

Q: Will there be a lot of bleeding with a tooth extraction?
A: It's important for a blood clot to form to stop the bleeding after a tooth extraction. You will be asked to bite on a gauze pad for 30-45 minutes immediately after the extraction. If the bleeding or oozing still persists, place another gauze pad and bite firmly for another 30 minutes. You may have to do this several times. After the blood clot forms, it is important not to disturb or dislodge the clot as it aids healing. Do not rinse vigorously, suck on straws, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours. These activities will dislodge or dissolve the clot and retard the healing process. Limit vigorous exercise for the next 24 hours as this will increase blood pressure and may cause more bleeding from the extraction site.

Post Surgery
Q: How long is the on-site recovery before I can leave the office?
A: Plan to stay in our recovery room for at least 20 minutes if sedation was involved, or until Sunset Family & Cosmetic Dentistry, PLLC is satisfied that you are recovered sufficiently to go home. If your procedure required sedation you must be completely alert before leaving the office for home. You must have a ride home. You may not drive yourself. It is recommend that you do not drive for a minimum 24 hours after surgery.

Q: Will you prescribe antibiotics and pain medication?
A: Procedure and patient health are determining factors of what antibiotic and/or medication will be prescribed. Call the office if the medication does not seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time, even if signs and symptoms of infection are gone. Drink lots of fluid and eat nutritious soft food on the day of the extraction. You can eat normally as soon as you are comfortable. Dr. Ubieta will discuss what, when, how long and dosage with you in both the pre-surgery and post surgery interviews.

Recovery
Q: How long will I be off of work/out of school?
A: Depending on the extent of the procedure and type of sedation you may resume work and a normal life style anywhere from a few hours to a few days. It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean. After a few days you will feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling for 2-3 days, or a reaction to the medication, call our office immediately.

Q: Will there be swelling or facial bruising?
A: After the tooth is extracted, you may feel some pain and experience some swelling. An ice pack or an unopened bag of frozen peas or corn applied to the area will keep swelling to a minimum. Take pain medications as prescribed. The swelling usually subsides after 48 hours. In some treatments there may be some minor bruising; however, in procedures such as dental implant placement ordinarily there is no bruising seen. For teeth removal or jaw procedures, women and/or very light skinned patients may experience slight bruising. Taking blood thinner will help reduce bruising. It is, however, not uncommon to have a black eye or discolored cheek or neck following extensive procedures. Sunset Family & Cosmetic Dentistry, PLLC will discuss what bruising if any would be related to your procedure treatment.

Jaw Surgery

Very infrequently, a problem may be caused more by the jaws not being in the correct position than in just the teeth being crooked. In these cases it may be necessary to surgically reposition the jaws. Usually, braces will be placed first and the teeth aligned on each jaw. Then the jaws are moved surgically so that the teeth fit together. We work closely with an oral surgeon to plan and coordinate this combined approach to treatment.

Impacted Canine
Impacted Canine

Impacted canines may be retrieved with braces, using a surgical approach via a gold chain or straight wire. Tissue covering the tooth is uncovered. A chain or wire is attached to the tooth crown. Tissue is placed back over the tooth leaving the chain or wire coming out of the gum. For the purpose of this illustration a gold chain is used to retrieve the canines. The chain is attached to the tooth crown and the link is attached to a flexible archwire so that the wire is active (bent). Once a month, the wire is reactivated by using the next link up on the chain until the impacted canine erupts enough to attach a regular bracket on the canine. With the regular bracket in place, a more flexible wire is added directly to the bracketed canine. This process will bring the canine into position within the arch by forcing the canine to conform to the straight archwire form. This is a long process taking anywhere from 8-12 months.

Bone Grafting

Bone grafting is commonly performed by an oral and maxillofacial surgeon to replace or augment bone in areas of tooth loss. Bone grafting to the jaws and facial structures may be necessary in a wide variety of scenarios. The most common bone grafts are facial skeleton and jaw procedures. Other common procedures include tooth extraction site graft, bone graft reconstruction and for a sinus lift. Shrinkage of bone often occurs when a tooth is lost due to trauma, severe caries, or periodontal disease. Additionally, bone loss may have already occurred due to infection or pathology around a tooth. There are many artificial biocompatible bone substitutes available; however, the best material for a bone graft is your own bone, which most likely will come from your chin, the back part of your lower jaw or your hip bone. The hip is considered to be a better source because the hip bone has a lot of marrow, which contains bone-forming cells. There are also synthetic materials that can be used for bone grafting. Most bone grafts use a person's own bone, possibly in combination with other materials.

To place the removed bone in the recipient site, little holes are drilled in the existing bone to cause bleeding. This is done because blood provides cells that help the bone heal. The block of bone that was removed will be anchored in place with titanium screws. A mixture of the patient's bone marrow and some other bone-graft material will then be placed around the edges of bone block. Finally, a membrane is placed over the area and the incision closed.

The bone graft will take about 6 to 12 months to heal before dental implants can be placed. At that time, the titanium screws used to anchor the bone block in place will be removed before the implant is placed.

Facial Trauma
Facial Injuries

Oral and maxillofacial surgeons are trained, skilled and uniquely qualified to manage and treat facial trauma. Injuries to the face, by their very nature, impart a high degree of emotional, as well as physical trauma to patients. Typically, facial injuries are classified as either soft tissue injuries (skin and gums), bone injuries and fractures, or injuries to special regions such as the eyes, facial nerves or the salivary glands. Oral and maxillofacial surgeons are well versed in emergency care, acute treatment and long-term reconstruction and rehabilitation both physical and emotional.

Oral Pathology

The inside of the mouth is normally lined with a special type of skin (mucosa) that is smooth and coral pink in color. Any alteration in this appearance could be a warning sign for a pathological process. The most serious of these is oral cancer. The following can be signs at the beginning of a pathologic process or cancerous growth:

- Reddish patches (erythroplasia) or whitish patches (leukoplakia) in the mouth
- A sore that fails to heal and bleeds easily
- A lump or thickening on the skin lining the inside of the mouth
- Chronic sore throat or hoarseness
- Difficulty in chewing or swallowing

These changes can be detected on the lips, cheeks, palate and gum tissue around the teeth, tongue, face and/or neck. Pain does not always occur with pathology, and curiously, is not often associated with oral cancer. However, any patient with facial and/or oral pain without an obvious cause or reason may also be at risk for oral cancer.

Ankylosis
Ankylosis

This refers to a tooth or teeth (primary or permanent) that have become "fused" to the bone, preventing it or them from moving "down" with the bone as the jaws grow. This process can affect any teeth in the mouth, but it is more common on primary first molars and teeth that have suffered trauma (typically the incisors). Treatment can vary depending on the degree of severity of the ankylosis (how "sunken into the gums" a tooth may appear). The degree of severity usually will vary depending on how early the process started, and as a general rule, the earlier it starts, the more severe the ankylosis becomes with age. Several considerations must be taken before any treatment is provided, and your dentist will discuss all the risks and benefits of each treatment option.

Crown Lengthening

Crown lengthening is a surgical procedure that re-contours the gum tissue and often the underlying bone of a tooth. Crown lengthening is often for a tooth to be fitted with a crown. It provides necessary space between the supporting bone and crown, which prevents the new crown from damaging bone and gum tissue.

Distraction Osteogenesis

Distraction Osteogenesis (DO) is a treatment for some deformities and defects of the oral and facial skeleton. Distraction Osteogenesis, first used in 1903 became popular in western medicine in the 1960's, has provided Sunset Family & Cosmetic Dentistry, PLLC with a safe and predictable method to treat selected deformities of the oral and facial skeleton. Distraction Osteogenesis means the slow movement apart (distraction) of two bony segments in a manner such that new bone is allowed to fill in the gap created by the separating bony segments. Distraction Osteogenesis Surgery is usually done on an outpatient basis with most of the patients going home the same day of surgery. The surgical procedure itself is less invasive so there is usually less pain and swelling.

Distraction Osteogenesis works well on patients of all ages. In general, the younger the patient the shorter the distraction time and the faster the consolidation phase. Adults require slightly longer period of distraction and consolidation because the bone regenerative capabilities are slightly slower than those of adolescence or infants.

Frequently Asked Questions

Q: Will my insurance company cover the cost of Osteogenesis surgical procedure?
A: Most insurance companies will cover the cost of the Osteogenesis surgical procedure provided that there is adequate and accurate documentation of the patient's condition. Of course, individual benefits within the insurance company policy vary. After you are seen for your consultation at our office, we will assist you in determining whether or not your insurance company will cover a particular surgical procedure.

Q: Is Distraction Osteogenesis a painful procedure?
A: Since all Distraction Osteogenesis surgical procedures are done while the patient is under general anesthesia, pain during the surgical procedure is not an issue. Post-operatively, you will be supplied with appropriate analgesics (pain killers) to keep you comfortable, and antibiotics to fight off infection. After surgery there is no more discomfort that having braces tightened.

Q: What are the advantages of Distraction Osteogenesis versus traditional surgery for a similar condition?
A: Distraction Osteogenesis surgical procedures typically produce less pain and swelling than the traditional surgical procedure for a similar condition. Distraction Osteogenesis eliminates the need for bone grafts and provides greater stability in cases where significant movement of bony segments are involved.

Q: What are the disadvantages of Distraction Osteogenesis?
A: Distraction Osteogenesis requires the patient to return to the surgeon's office frequently during the initial two weeks after surgery. This is necessary because in this time frame the surgeon will need to closely monitor the patient for any infection and teach the patient how to activate the appliance. In some cases, a second minor office surgical procedure is necessary to remove the distraction appliance.

Q: Can Distraction Osteogenesis be used instead of bone grafts to add bone to my jaws?
A: Yes. It has become an easy process to place and use a distraction device to slowly grow bone in selected areas of bone loss in the upper and lower jaws. The newly formed bone can then serve as an excellent foundation for dental implants.

Q: Does Distraction Osteogenesis leave scars on the face?
A: No. The entire surgery is done within the mouth and the distraction devices used by Sunset Family & Cosmetic Dentistry, PLLC remain inside the mouth. There are no facial surgical incisions are made so no unsightly facial scars result.

Post-Surgery Instructions
Post-Surgery Instructions

Fold a piece of clean gauze into a pad thick enough to bite on and place directly on the extraction site. Apply moderate pressure by closing the teeth firmly over the pad. Maintain this pressure for about 30 minutes. If the pad becomes soaked, replace it with a clean one as necessary. Do not suck on the extraction site (as with a straw). A slight amount of blood may leak at the extraction site until a clot forms. However, if heavy bleeding continues, call your dentist. (Remember, though, that a lot of saliva and a little blood can look like a lot of bleeding).

The Blood Clot
After an extraction, a blood clot forms in the tooth socket. This clot is an important part of the normal healing process. You should therefore avoid activities that might disturb the clot.

Here's how to protect it:
- Do not smoke, rinse your mouth vigorously or drink through a straw for 24 hours.
- Do not clean the teeth next to the healing tooth socket for the rest of the day. You should, however, brush and floss your other teeth thoroughly, gently rinse your mouth afterwards.
- Limit strenuous activity for 24 hours after the extraction. This will reduce bleeding and help the blood clot to form. Get plenty of rest.
- If you have sutures, your dentist will instruct you when to return to have them removed.

Medication
Your dentist may prescribe medication to control pain and prevent infection. Use it only as directed. If the medication prescribed does not seem to work for you, do not increase the dosage. Please call your dentist immediately if you have prolonged or severe pain, swelling, bleeding, or fever.

Swelling & Pain
After a tooth is removed, you may have some discomfort and notice some swelling. You can help reduce swelling and pain by applying cold compresses to the face. An ice bag or cold, moist cloth can be used periodically. Ice should be used only for the first day. Apply heat tomorrow if needed. Be sure to follow your doctor's instructions.

Diet
After the extraction, drink lots of liquids and eat soft, nutritious foods. Avoid alcoholic beverages and hot liquids. Begin eating solid foods the next day or as soon as you can chew comfortably. For about two days, try to chew food on the side opposite the extraction site. If you are troubled by nausea and vomiting call your dentist for advice.

Rinsing
The day after the extraction, gently rinse your mouth with warm salt water (teaspoon of salt in an 8 oz. glass of warm water). Rinsing after meals is important to keep food particles away from the extraction site. Do not rinse vigorously!

Post-Surgery Instructions for Children
Post-Surgery Instructions for Children

Anesthesia - The feeling of numbness will begin to wear off in 30 minutes to 4 hours. Until that time, avoid all hot foods or liquids, and do not chew. This is to prevent accidentally burning or biting the lips, cheeks, inside of your mouth or tongue until the feeling has returned

Gauze Pack - Fold the gauze into a small pack and place over the extraction site and apply firm pressure for one to two hours. Change the gauze pack every 15-30 minutes.

Bleeding - It is normal for the extraction site to bleed slightly or ooze blood for 12 to 24 hours following surgery.

Ice Pack - For the first 2 to 8 hours after surgery, ice packs should be applied to the outside of the face over the area of the extraction site. The ice pack should be held in place for 15 minutes on, and then removed for 15 minutes. Doing this throughout the day will help reduce discomfort and swelling.

Medications - DO NOT TAKE ASPIRIN PRODUCTS due to the possible increase in bleeding potential. If prescription medications were prescribed please follow label instructions carefully. For most extractions, a non-aspirin over the counter pain medication will provide good pain relief. Do not take more than the recommended dosage!

Diet - A liquid or soft diet should be adhered to for the first 12 to 24 hours after surgery. It is important to drink plenty of liquids for the first day or two. Avoid the use of a straw as it may dislodge the blood clot that is forming in the extraction site.

Oral Hygiene - Clean the rest of your mouth as usual, however avoid bumping or brushing the extraction site. DO NOT RINSE OR SWISH YOUR MOUTH for the first 24 hours following surgery.

Possible Complications:

Dry Socket - This is sometimes a problem after surgery. The symptoms associated with dry socket are constant moderate to severe pain, bad taste, putrid odor, and poor clot formation at the surgical site. If you think you have ANY of these symptoms call our office as soon as possible.

Fever - Monitor your temperature for the first 24 to 48 hours. Any elevated temperature should be reported to our office.

Swelling - Some swelling during the first 24 to 48 hours can be expected.

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