FAQ ( Frequently Asked Questions )

FREQUENTLY ASKED QUESTIONS

BRUISING / DISCOLORATION:

The correct term is ecchymosis. It is not a true bruise since no contusion of tissue has occurred. it can be somewhat ugly but it is not serious. We have had patients get quite upset about it, but it is not preventable and has no relationship with the quality of the surgery.

It occurs when blood collects be/ow the surface of the tissue and then is broken down by the cells. Blood has iron in it. This iron forms pigments of green, orange and blue that diffuse to the surface, much like water in a paper towel does. Once it blots to the skin it then slowly drains down the face, into the neck and ultimately the chest wall. This is done by gravity through lymphatic channels and can be very slow in resolving. Again, it is not serious and is self limiting. We are sympathetic for your appearance and ask for your patience.
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BLEEDING:

Bleeding is usually modest regardless of age. “Normal” bleeding is 2-6 hours of gradual improvement. Slight oozing can be normal for the first 2-3 days. Immediately after surgery, gauze should be placed over the sockets and firm biting pressure used to hold it in place. This gauze should be changed every 1/2 hour for the first several hours then left out if possible. If bleeding starts up again, usually biting on gauze for 1/2-1 hour will stop any bleeding that restarts. Be careful what and how you eat. Keep foods soft and cold for the first day or two. “Hot makes you bleed and cold makes you clot”. No hot coffee, soups or tea for the first 24 hours. Do not spit, rinse, smoke, use straws or drink from a bottle. They all increase bleeding. If excessive bleeding does occur, please notify our office.
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PAIN:

Most patients have very little pain! Pain after surgery is not uncommon however, and some patients will unfortunately have a fair amount. This is not always related to how hard the tooth was to remove. Normal pain is usually experienced immediately after the “numbing” medicine wears off. Then it generally gets better unless there is swelling of the gums or stiffness of the jaw muscles. These are both fairly common with more difficult extractions. Pain is usually worse at night. Pain that was getting better then increases can be normal, but it can also be related to a partial/complete clot loss (dry socket) or possibly an infection. Both conditions can be treated with medicine or limited surgery if necessary. Sometimes the jaw begins to ache simply because the patient is beginning to use it more. ‘If it hurts, don’t do it”!
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SWELLING:

Not every patient swells the same. In general, the harder the tooth the more swelling occurs. Normal swelling is “23 days getting worse followed by 2-3 days getting better”. Ice placed on the jaws for the first 6-8 hours after surgery can help tremendously. Medicine is also given with an intravenous procedure to help reduce swelling. Older patients can expect more swelling over a longer period of time. Swelling can also be greater if an artificial clot is placed.

To minimize swelling it is recommended that ice cubes (cubes in a washcloth or plastic bag will do) be placed on the cheek over the area of surgery for twenty minutes with ten minute rest intervals. This can be done for up to twelve hours.
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UPSET STOMACH:

“Nausea” is fairly common after surgery. 90% of cases are related to taking medication after the surgery such as pain medication or antibiotics. Any medications taken on an empty stomach (even vitamins!) can be upsetting. Pain medication is the most common pill to cause stomach upset. Nausea is actually a “side effect” of most narcotic pain medications and most patients would be just as comfortable taking ibuprofen.

After the first 12 hours nausea is usually not related to the general anesthetic. The anesthetic drugs are designed to be removed from the body very quickly. If you do have stomach upset, stopping the pain medication is usually the first step. It can take 24 hours for the side effects to finally go away. If your case was not “infected” to begin with, stopping the antibiotics can also help and it is usually not harmful to do so. Dehydration or “drying out” is our main concern. Try drinking a “sip” per minute of your favorite drink and try to finish a glass within an hour.

There are medications that can relieve stomach upset but most have side effects of their own.

Trading one problem for another is not always the best choice. Most medications are suppositories since patients have trouble “holding down” pills of any type.
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DIET:

Patients are encouraged to eat as soon as possible after surgery. Clear liquids and broths are an excellent start. Ice cream, and yogurt are good initial solids. As the patient is able to tolerate more food, cooked cereal, mashed potatoes scrambled eggs, and similar foods may be added.

For patients having had local anesthetics, or after the initial period of stomach upset passes, it is suggested that a regular diet be eaten. All patients should avoid food with small particles such as chips, nuts, seeds, etc. which can be trapped in open sockets.
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FEVER:

Fever or an elevated temperature is common. It is normal for the mouth to have a higher temperature than normal (1-2 degrees at most) after any surgery done in the mouth.

An elevated temperature can be related to dehydration from the fasting period prior to the general anesthetic, and not drinking enough the first few days after. The general anesthetic itself can be responsible for a small elevation of body temperature.
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ACTIVITY:

Patients are to rest immediately after any general anesthetic. Supervision is advisable since quick changes in body position (standing up too fast) can lead to dizziness and possible fainting. Sit down in a shower and use the bathroom in a sitting position as well. Pain medications and dehydration can also prolong the period of dizziness.
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ORAL HYGIENE:

Patients who have had oral surgery should not rinse their mouths for the first
twenty- four hours. After that it is advisable to rinse the surgical area with warm
salt water (one half teaspoon in eight ounces of water). This is to be done after
all meals and before going to sleep at night. The remaining teeth can be brushed
carefully but may lead to a small amount of normal bleeding.
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POST-OPERATIVE VISITS:

In many cases, patients are given appointments for post-operative visits. The purpose of these visits is to check the progress of healing, look for signs of infection, pack wounds when needed, etc. It is important that these appointments be kept in order to provide good care to our patients.
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NUMBNESS:

“Numbness” usually lasts only 2-3 hours but in some cases can last a full day.
Numbness that lists longer than this is still seldom serious and is best reevaluated
at the one week post-op visit. Please be careful not to burn or bite yourself
during this period!
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SUTURES:

Two types of sutures are mainly used and both are “dissolvable”. The short acting ones may only last a day to one week. The second types does last up to three weeks and sometimes will require removal. Patients receiving the “long lasting” suture will usually be advised of this possible need for future removal.

We hope that your visit to our office was a pleasant one. If there are any questions about your surgery, do not hesitate to call us
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