The tooth is out! What now?
· Numbness: The mouth will be numb approximately two to four hours. Watch to see that your child does not bite, scratch, or injure the cheek, lips, or tongue during this time.
· Bleeding: Bleeding was controlled before we discharged your child, but some occasional oozing (pink or blood-tinged saliva) may occur. Hold gauze with firm pressure against the extraction site until oozing has stopped. Holding firm pressure for 4 minutes should stop the bleeding. You may need to change the gauze or repeat this step. If bleeding continues for more than two hours, contact us.
· Surgical Site Care: Today, do not disturb the surgical site. Do not stretch the lips or cheeks to look at the area. Do not rinse vigorously, use mouthwash or probe the area with fingers or other objects. Beginning tomorrow, you may rinse with warm salt water (1/2 teaspoon of salt with one cup of water) after eating. If the child is unable to rinse, you can clean the area with salt water on a 2×2 gauze.
· Daily Activities: Today, avoid physical exercise and exertion as this can increase bleeding. Return to normal activities as tolerated tomorrow.
· Diet: After all bleeding has stopped, the patient may drink cool non-carbonated liquids but should NOT use a straw. Encourage fluids to help avoid dehydration. Cold soft foods (e.g., ice cream, jello, pudding, yogurt) are ideal for the first day. By the second day, consistency of foods can progress as tolerated. Until healing is more established (approx. 5 days), avoid foods such as nuts, seeds, popcorn, and tortilla chips that may get lodged in the surgical area.
· Oral Hygiene: Keeping the mouth clean is essential. Today, teeth may be brushed and flossed gently, but avoid stimulating the surgical site. Soreness and swelling may not permit vigorous brushing of all areas, but please make every effort to clean the teeth within the limits of comfort.
· Pain Management: Because some discomfort is expected, you may give your child acetaminophen (Tylenol), or ibuprofen (Advil, Motrin) before the numbness wears off. Do NOT give aspirin to your child. Follow the instructions on the bottle for dosing based upon your child’s age/weight. We recommend using Tylenol on the day of the procedure and then ibuprofen the day after the procedure. Tylenol can be given every 4-6 hours and ibuprofen can be given every 6-8 hours.
· Watch for:
o Swelling: slight swelling and inflammation may occur for the next two days. If swelling occurs, ice packs may be used for the first 24 hours (10 minutes on then 10 minutes off) to decrease swelling and/or bruising. If swelling persists after 24 hours, warm/moist compresses (10 minutes on then 10 minutes off) may help. If swelling occurs after 48 hours, call our office
o Fever: A slight fever (temperature to 100.5 degrees Fahrenheit) is not uncommon the first 48 hours after dental surgery. If a higher fever develops or the fever persists, call our office
o Dry Socket: Premature dissolving or loss of a blood clot following removal of a permanent tooth may result in a “dry socket.” This typically occurs on the third to fifth day after the extraction, with a persistent throbbing pain in the jaw. Call our office if this occurs