patient information
Simply fill out the form below, and you will be presented with directions that include a map, the travel time, and distance. If you need any additional information, please contact our Gilbert office at 480-279-3113.
Before Anesthesia | After Wisdom Tooth Removal | After Exposure of an Impacted Tooth |
After Tooth Extraction | After the Removal of Multiple Teeth |
After the Placement of Dental Implants
The removal of impacted teeth can be a serious surgical procedure. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.
Immediately Following Surgery
Bleeding
A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. 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 30 minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag (not herbal tea) for 30 minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.
Swelling
The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery. The swelling will not become apparent until the day following surgery and will not reach its maximum until two to three days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two plastic bags filled with ice, ice packs, or even bags of frozen vegetables should be applied to the sides of the face where surgery was performed. The ice packs should be left in place for 20 minutes and then removed for 10 minutes. This can be repeated for the first 24 hours. After 24 hours, ice has no beneficial effect on the amount of swelling. 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
For mild-to-moderate pain, non-steroidal anti-inflammatory medication (NSAIDs) such as Ibuprofen (Motrin or Advil) or Naproxen (Naprosyn or Aleve) may be taken. Ibuprofen comes in 200 mg tablets; 3 to 4 tablets may be taken every 6 to 8 hours, depending on dosage. Naproxen comes in 500mg or 1000mg tablets; 1-2 tablets may be taken twice daily.
Do not take any of the above medications if you have a known allergy, condition which contraindicates their use, or for any reason have been instructed by your doctor not to take them.
For severe pain, take the medication prescribed by Dr. Spanganberg, as directed. The prescribed medication may be taken along with Ibuprofen or Naproxen. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should begin to subside more and more every day, after day 3. If significant pain persists, or worsens, it may require attention and you should call the office.
CAUTION: If you suddenly sit up or stand from a lying position, you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.
Diet
Start by drinking clear liquids, (apple juice, Sprite, Ginger Ale, etc.), after general anesthesia or IV sedation. Do not use straws when drinking from a glass. The sucking motion may cause more bleeding by dislodging the blood clot. It is essential to prevent dehydration by taking fluids regularly. Your food intake may be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5 to 6 glasses of liquid should be taken daily. You may eat anything soft by chewing away from the surgical site(s). High calorie, high protein intake is very important. Try to maintain a normal caloric intake. Try not to miss a single meal. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat.
Smoking
Do not smoke for at least 2 days after surgery. Nicotine may break down the blood clot and cause a "Dry-Socket".
Keep the Mouth Clean
No rinsing of any kind should be performed until the day following surgery. It is alright to brush your teeth the night of surgery, but rinse gently. The day after surgery you should begin rinsing at least 3 to 4 times a day with a cup of warm water mixed with a teaspoon of salt, especially after eating.
Discoloration
In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal postoperative occurrence, which may occur two to three days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.
Antibiotics
If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions.
Nausea & Vomiting
In the event of 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 15-minute period. When the nausea subsides, you may resume taking solid foods and the prescribed medicine.
Other Complications
Finally
Sutures are 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 most cases, dissolvable sutures are used that will disappear on their own in 7 to 10 days. In the case that non-dissolvable sutures were used, Dr. Spanganberg will let you know this at the time of the procedure. The sutures will then need to be removed at a later date, depending on the type of procedure. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure.
The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur, call the office for instructions.
There will be a cavity where the tooth was removed. This cavity will gradually fill in with new tissue over the next month. During this healing period, the area should be kept clean especially after meals with salt-water rinses or a toothbrush. A plastic syringe, designed specifically to keep these areas clean, will be provided to you at your follow-up appointment.
Your case is individual. No two mouths are alike. Do not accept well-intended advice from friends. Discuss your problem with the persons best able to effectively help you: Dr. Spanganberg or your family dentist.
Brushing your teeth is okay – just be gentle at the surgical sites.
A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of increased pain at the surgical site and even pain radiating to thee ear may occur two to three days following surgery. This is not an infection, but it can be treated. Call the office at 480.279.3113 if this occurs.
If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.
Do not disturb the wound. If surgical packing was placed, leave it alone. The pack helps to keep the tooth exposed. If it gets dislodged or falls out, do not get alarmed.
Bleeding
Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding which results in your mouth filling rapidly with blood can usually be controlled by biting with pressure on a gauze pad placed directly on the bleeding wound continuously for 30 minutes. Do not vigorously rinse your mouth or spit, as this will worsen the situation. If bleeding continues, please call for further instructions.
Swelling
Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag, a plastic bag or towel filled with ice cubes or even a bag of frozen vegetables on the cheek in the area of surgery. The ice packs should be held in place for 20 minutes and then removed for 10 minutes. This can be repeated for the first 24 hours. After 24 hours, ice has no beneficial effect on the amount of swelling.
Diet
Drink plenty of fluids. Avoid hot or spicy liquids or food. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as tolerated, unless otherwise directed.
Pain
For mild-to-moderate pain, non-steroidal anti-inflammatory medication (NSAIDs) such as Ibuprofen (Motrin or Advil) or Naproxen (Naprosyn or Aleve) may be taken. Ibuprofen comes in 200 mg tablets; 3 to 4 tablets may be taken every 6 to 8 hours, depending on dosage. Naproxen comes in 500mg or 1000mg tablets; 1-2 tablets may be taken twice daily.
Do not take any of the above medications if you have a known allergy, condition which contraindicates their use, or for any reason have been instructed by your doctor not to take them.
For severe pain, take the medication prescribed by Dr. Spanganberg, as directed. The prescribed medication may be taken along with Ibuprofen or Naproxen. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should begin to diminish more and more every day, starting after day 3. If significant pain persists, or worsens, it may require attention and you should call the office.
Oral Hygiene
Mouth cleanliness is essential to good healing. Clean your mouth thoroughly after each meal beginning the day after surgery. Brush your teeth as best you can. Rinse with warm salt water (one teaspoon of salt in a cup of warm water) or a mouth rinse 3-4 times a day. Continue this procedure until healing is complete.
REMEMBER: A clean wound heals better and faster.
Activity
Keep physical activities to a minimum immediately following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Be aware that your normal nourishment intake will likely be reduced. Exercise may weaken you. If you get light headed, stop exercising.
After tooth extraction, it’s vital for a blood clot to form to stop the bleeding and begin the healing process. That’s why we instruct you to bite on a gauze pad for 30-45 minutes after the appointment. If the bleeding or oozing still persists, insert 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 delay 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.
After the tooth is extracted you may experience some pain and 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 begins to subside after 72 hours.
Use the pain medication as directed. Call the office if the medication doesn’t seem to be working. If antibiotics are prescribed, continue to take them until all the tablets are gone, 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.
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 that does not begin to resolve after two to three days, or a reaction to the medication, call the office immediately at 480.279.3113.
A small amount of bleeding can be expected for up to twenty-four hours following the operation. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 minutes. If bleeding persists, continue replacing the gauze pad every 30 minutes. If the bleeding does not seem to be decreasing, a moist tea bag (not herbal tea!) can be used in lieu of the gauze. Black tea contains tannic acid which acts a potent hemostatic agent.
If you wear a denture, partial denture or single tooth “flipper”, Do not remove the prosthesis unless the bleeding is severe. Expect some oozing around the side of the prosthesis.
Use ice packs (externally) on the same side of the face as the operated area. The ice packs should be held in place for 20 minutes and then removed for 10 minutes. This can be repeated for the first 24 hours. After 24 hours, ice has no beneficial effect on the amount of swelling.
For mild-to-moderate pain, non-steroidal anti-inflammatory medication (NSAIDs) such as Ibuprofen (Motrin or Advil) or Naproxen (Naprosyn or Aleve) may be taken. Ibuprofen comes in 200 mg tablets; 3 to 4 tablets may be taken every 6 to 8 hours, depending on dosage. Naproxen comes in 500mg or 1000mg tablets; 1-2 tablets may be taken twice daily.
For severe pain, take the medication prescribed by Dr. Spanganberg, as directed. The prescribed medication may be taken along with Ibuprofen or Naproxen. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should begin to diminish more and more every day, starting after day 3. If significant pain persists, or worsens, it may require attention and you should call the office. If an antibiotic has been prescribed, finish your prescription regardless of your symptoms.
Drink plenty of fluids. If many teeth have been extracted, the blood lost at this time needs to be replaced. Drink at least six glasses of liquid the first day.
Do not vigorously rinse your mouth for the first post-operative day. After the first day, use a warm salt-water (One teaspoon of salt in a glass of lukewarm water.) rinse every four hours and following meals to flush out particles of food and debris that may lodge in the operated area. After you have seen your dentist for denture adjustment, take out denture and rinse three to four times a day.
Restrict your diet to liquids and soft foods that are comfortable for you to eat. As the wounds heal, you will be able to advance your diet.
The removal of many teeth at one time is quite different than the extraction of one or two teeth. Because the bone must be shaped and smoothed prior to the insertion of a denture, the following conditions may occur (all of which are considered normal):
If immediate dentures have been inserted, sore spots may develop. In most cases, your dentist will see you within 24-48 hours after surgery and make the necessary adjustments to relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.
Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There may be a metal healing abutment (cap) protruding through the gingival (gum) tissue; this is normal.
Bleeding
A small amount of bleeding or reddening of the saliva can be expected for up to twenty-four hours following the operation. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 minutes. If bleeding persists, continue replacing the gauze pad every 30 minutes. If the bleeding does not seem to be decreasing, a moist tea bag (not herbal tea!) can be used in lieu of the gauze. Black tea contains tannic acid which acts a potent hemostatic agent and should stop the bleeding. Despite these measures, if the bleeding continues, call the office at 480.279.3113.
Swelling
Use ice packs (externally) on the same side of the face as the operated area. The ice packs should be held in place for 20 minutes and then removed for 10 minutes. This can be repeated for the first 24 hours. After 24 hours, ice has no beneficial effect on the amount of swelling.
Diet
Drink plenty of fluids. Avoid hot liquids or food. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed.
Pain
For mild-to-moderate pain, non-steroidal anti-inflammatory medication (NSAIDs) such as Ibuprofen (Motrin or Advil) or Naproxen (Naprosyn or Aleve) may be taken. Ibuprofen comes in 200 mg tablets; 3 to 4 tablets may be taken every 6 to 8 hours, depending on dosage. Naproxen comes in 500mg or 1000mg tablets; 1-2 tablets may be taken twice daily.
For severe pain, take the medication prescribed by Dr. Spanganberg, as directed. The prescribed medication may be taken along with Ibuprofen or Naproxen. The prescribed pain medicine will likely make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should begin to diminish more and more every day, starting after day 3. If significant pain persists, or worsens, it may require attention and you should call the office.
Do not take any of the above medications if you have a known allergy, condition which contraindicates their use, or for any reason have been instructed by your doctor not to take them.
Antibiotics
Be sure to take the prescribed antibiotics as directed to help prevent infection.
Oral Hygiene
Good oral hygiene is essential to good healing. The night of surgery, use the prescribed Peridex Oral Rinse before bed. The day after surgery, the Peridex should be used twice daily, after breakfast and before bed. Be sure to rinse for at least 30 seconds then spit it out. Warm salt-water rinses (one teaspoon of salt in a cup of warm water) should be used at least four to five times a day, as well, especially after meals. Brushing your teeth with the healing abutments is not a problem. Be gentle initially when brushing the surgical areas.
Activity
Keep physical activities to a minimum immediately following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise.
Wearing Your Prosthesis Partial dentures, flippers, or full dentures should not be used immediately after surgery and for at least ten days, unless otherwise indicated by Dr. Spanganberg. If you have any questions regarding the instructions given in the preoperative consultation, contact the office at 480.279.3113.