Post-Op Instructions

1.  After your procedure please do not disturb the area.  Avoid forcefully rinsing or spitting.  Some bleeding is normal for the first 24 hours. Biting on a gauze pad placed directly on the wound for 30 minutes will help reduce bleeding.  After a blood clot has formed, you should place ice chips in your mouth, not necessarily on the wound site, for the next three to four hours.  The ice chips will help bring down the temperature in your mouth and thereby help reduce the swelling.  Avoid spitting, and it is recommended that you swallow instead.  If bleeding continues, please call our office at 212-382-2999.

2.  Please take all medications, including mouth rinses, as prescribed.

3.  Swelling and bruising may occur.  The use of ice packs following your surgery will help diminish the swelling you may experience in the next 48-72 hours.  Applying ice for 15-20 minutes followed by resting the same amount of time works very well.

4.  After 24 hours, brushing and oral hygiene procedures should be done as usual in all untreated areas.  In the treated areas, please limit your oral hygiene to brushing using a soft manual toothbrush.  Avoid dental flossing in treated areas during the first week following surgery.  No undiluted mouthwash, salt water or peroxide rinses should be used during the first week following surgery.

5.  Drink plenty of fluids.  Stay away from spicy and acidic foods.  Also avoid sharp and crunchy foods like tacos, chips and nuts.  Tobacco and alcohol should not be used.  Alcohol should not be used in combination with pain medications or antibiotics.

6.  Keep physical activities to a minimum immediately following surgery.  Avoid strenuous activity for two to three days.

7.  If you have any questions or concerns, or in the event in an emergency, please call our office at 212-382-2999.  If you are experiencing a serious or life threatening emergency, please call 911 or visit the nearest emergency room.

1.  After your first appointment for crown treatment, a temporary crown is usually placed on the tooth or teeth involved after they are prepared and an impression is taken.  The temporary crown protects the site while the custom crown is being produced.  Temporary cement is used so that the crown can be easily removed at your next appointment.

2.  If your temporary crown comes off before your next appointment, place the temporary back on your tooth and call our office.

3.  With both your temporary crown and permanent crown, you may experience some discomfort due to irritation of the area during the treatment procedures.  You may also experience sensitivity to cold or pressures.

4.  Your new permanent crown will be shaped and shaded especially to your teeth in color and fit.  The temporary crown is made to serve you temporarily, so its color and fit are not custom-matched to your teeth.

5.  After your new permanent crown is in place, you may need a few days to adjust to it.  If you feel the bite is not correctly balanced, please call for an appointment and we can adjust it.

6.  Care for your new crown with proper brushing and flossing.  It is especially important to keep the edge of the crown clean at the gum line.

7.  If you have any questions or concerns, please call our office at 212-382-2999.

1.   After an extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process.  Bite on a gauze pad for 30 minutes after the extraction.  If bleeding or oozing continues after you remove the gauze pad, place another gauze pad and bite firmly for another 30 minutes.  After a blood clot forms, you should place ice chips in your mouth, not necessarily on the wound site, for the next three to four hours.  The ice chips will help bring down the temperature in your mouth and thereby help reduce the swelling.  Avoid spitting, and it is recommended that you swallow instead.

2.  After the blood clot forms, it is important to protect it, especially for the next 24 hours.  Do not: smoke, suck through a straw, rinse your mouth vigorously, or clean the teeth next to the extraction site.  These activities will dislodge the clot and slow down healing.  Limit yourself to calm activities for the first 24 hours: this keeps your blood pressure lower, reduces bleeding and helps the healing process.

3.  After the tooth is extracted, you may feel some pain and have some swelling.  You can use an ice bag to keep this to a minimum.  The swelling usually starts to go down after 48 hours.

4.  Use pain medication only as directed and call the office if it does not seem to be working.  If antibiotics are prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone.

5.  Drink lots of fluids and eat only soft, nutritious foods on the day of the extraction.  Don’t drink alcoholic beverages and avoid hot and spicy foods.  You can begin eating normally the next day or as soon as it is comfortable.

6.  Gently rinse your mouth with a salt water solution three times a day beginning the day after the extraction (a teaspoon of salt dissolved in eight ounces of warm water).  Also, rinse gently after meals since it helps keep food out of the extraction site.

7.  It is very important to resume your normal dental routine after 24 hours.  This should include brushing your teeth and tongue, and flossing at least once a day.  This speeds healing and helps keep your breath and mouth fresh.

8.  Call our office right away at 212-382-2999 if you have heavy bleeding, severe pain, continued swelling after two or three days, or a reaction to the medication.

1.  Blood clotting:  After an extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process.  Bite on a gauze pad for 30 minutes after the extraction.  If bleeding or oozing continues after you remove the gauze pad, place another gauze pad and bite firmly for another 30 minutes.  After a blood clot forms you should place ice chips in your mouth (not necessarily on the wound site) for the next three to four hours.  The ice chips will help bring down the temperature in your mouth and thereby help reduce the swelling.  Avoid spitting, and it is recommended that you swallow instead.

2.  Protecting the blood clot:  After the blood clot forms, it is important to protect it, especially for the next 24 hours.  Do not: smoke, suck through a straw, rinse your mouth vigorously, or clean the teeth next to the extraction site.  These activities will dislodge the clot and slow down healing.  Limit yourself to calm activities for the first 24 hours: this keeps your blood pressure lower, reduces bleeding and helps the healing process.

3.  Antibiotics:  If an antibiotic has been prescribed, start taking it the first day (unless directed otherwise) and use to completion.  You can reduce stomach upset by taking it with food and/or plenty of liquid.

4.  Ibuprofen:  If we prescribed ibuprofen, start taking it the day of the bone graft surgery and continue for two days.  After that you can still take it as needed for pain.  Do not use ibuprofen for more than one week.

5.  Pain medication:  Take one pain pill as soon as you can after surgery.  It will usually work better if taken before the numbness wears off.  After that, take only as needed.  Take any narcotic pain pills with food and/or plenty of liquid.  Do not drive after taking any narcotic pain pill and do not take them with sleeping pills or alcohol.

6.  Ice:  Use a cold pack (a plastic bag of frozen peas works well) to the face over the area where the procedure was done for 10 minutes at a time, twice an hour, for the first six hours.  You can periodically use an ice bag the rest of the day of surgery and the next day.  If you use the ice bag as directed, you should have less swelling than you would have otherwise. Less swelling = less pain.  Do not use hot packs or a hot water bottle.

7.  Sleep somewhat inclined:  For the first two nights after the procedure, sleep in a recliner chair or with your head propped up with some pillows.  A recliner is better.  If you keep your head above your heart level for the first two days, it will significantly cut down on post-op swelling.  Less swelling = less pain.

8.  Swelling:  Most people get some swelling and, if they do, it usually happens about 48-72 hours after the surgery.  Using the ice bag and sleeping inclined as directed above will help a great deal with keeping it to a minimum.

9.  Liquid in the brown jar:  (if necessary) is chlorhexidine (Peridex), a topical antiseptic available by prescription.  Use a Q-tip cotton swab to apply it.  The ear cleaning Q-tips work best, as they are very absorbent and hold a good size drop of liquid.  Apply about three times/day for four weeks to the surgical site by dabbing the chlorhexidine soaked Q-tip to the surgical area.  Do not scrub it in.  During the first four weeks, whenever you do start any tooth brushing at the surgical site, dip the toothbrush in the chlorhexidine, as well.  Once this liquid is applied, do not eat, drink or rinse out for 30 minutes.

10.  Oral hygiene:  Do not use a Waterpik or an electric toothbrush around the surgical area for six weeks after the procedure.  Do not floss around the tooth/teeth worked on for one week, to avoid accidentally taking out any of the stitches.  After four weeks, there should be no oral hygiene restrictions, except for Waterpiks and electric toothbrushes as noted above.

11.  Stitches and “Barrier membrane”:  The stitches and barrier membrane over the extraction site are usually non-dissolvable and will need to be removed about three to four weeks later.

12.  Salt water rinses:  Rinse your mouth out (don’t swish) with a warm salt water solution (one teaspoon of salt dissolved in eight ounces of warm water).  Hold this in the mouth for 30 seconds and spit out.  Repeat.  Do this four to five times per day for seven days.  Start the day after the procedure.

13.  Exercise:  Avoid strenuous exercise for the first seven days.  Strenuous physical activity may increase post-operative pain or cause post-operative bleeding and swelling.  Less activity = less pain.

14.  Touching the surgical site:  It is important that the surgical site remains untouched during the initial stages of healing.  We recommend that you avoid stretching your mouth to look at the site and avoid playing with your tongue on the surgical site.

15.  Bleeding:  “Pink” saliva is normal for a few days.  If you have bleeding, wipe the area clean of any “blood clots” first. It has to be thoroughly cleaned.  Then apply gentle pressure to the extraction site for 10 straight minutes with a soaking wet tea bag (black tea works the best), or a soaking wet gauze pad, or a clean washcloth.  Be sure it is soaking wet.  If it is not, the clot will stick to it and start bleeding again when you pull it away.  If it won’t stop, call our office immediately.

16.  Food:  Stay on a soft diet, chew away from the extracted tooth/teeth and avoid any foods that would be more likely to get stuck in the extraction site, such as corn, popcorn, nuts, and seeds (fruit like strawberries have seeds).  Do this for at least five weeks (if we used a non-resorbable barrier we removed, then for one week after the barrier is removed).  Citric juices, carbonated beverages or acidic foods, like tomatoes, may make it hurt, but won’t damage the graft healing.  For the first seven days, avoid really hot foods or drinks.  Consider a nutritional food supplement (Carnation Instant Breakfast drink, Ensure, Slim-Fast, Glucerna for diabetics.)  After five weeks, there should be no eating restrictions.  Don’t use straws for the first week.  No milkshakes with a straw for four weeks.

17.  Smoking:  Avoid smoking during the healing process.  Smokers have a much higher incidence of dry sockets.  If you do smoke, keep it to five cigarettes or fewer per day and only smoke half the cigarette.  No cigars or pipes.  Do this for at least six weeks.

18.  Aspirin:  Unless you have a special medical reason for taking aspirin (tell us at least a week ahead of time if this is the case), do not take aspirin products for seven days prior to through two days after the extraction procedure.  Aspirin can cause bleeding.

19.  Contact us:  If you have any questions or concerns, or in the event in an emergency, please call our office at 212-382-2999.  If you are experiencing a serious or life threatening emergency, please call 911 or visit the nearest emergency room.

1.  Your anesthesia will wear off in approximately one to three hours after the procedure.  It is very important not to chew on the numb side (to prevent biting tongue, lip, etc.) until the anesthesia wears off.

2.  Your tooth (or teeth) may be sensitive to hot, cold or pressure from the procedure.  This is COMPLETELY normal.  The more invasive the procedure, the more sensitivity you may experience.  The possible symptoms of hot, cold or pressure will cease within a few days to a couple of weeks.  In very few instances, this sensitivity could last even longer.  As long as your teeth or gums are continuing to feel better, (not staying the same, or getting worse,) everything is fine.  There is no need for concern.

3.  We may have prescribed Ibuprofen (Motrin).  This IS NOT for pain.  Ibuprofen is to reduce the inflammation in the area worked on, and will further eliminate hot, cold and pressure sensitivity, if taken as directed.  If you are allergic to or cannot tolerate ibuprofen (Motrin, Advil, etc.,) please advise us.  If discomfort continues for more than a couple of weeks, please call our office at 212-382-2999.

4.  Once the anesthesia has worn off and you feel as though any of the teeth we have worked on are hitting first, please give the office a call immediately.  This imbalance with your bite may cause further discomfort and should be adjusted.

1. While we try to insure that the dentures fit as perfectly as possible the first time, additional appointments may be necessary for some adjustments.  They are usually done in order to allow the tissues and your bite to get accustomed to the new denture.

2. Ongoing care for your restoration includes brushing your teeth and surrounding tissues after every meal and snack, and flossing at least once a day before bedtime.  Brushing both partial and complete dentures is very important.  Rinsing your mouth with water or mouthwash will also help to remove any additional particles that may have been missed during brushing and flossing.

3. You should visit our office at least once a year to have your partial or full dentures adjusted and checked by the doctor.  Wearing ill-fitting dentures or partials without proper care and adjustment can cause severe bone loss and very serious oral disease.  Please call our office at 212-382-2999 at the first signs of any symptoms or if you are experiencing ongoing pain or discomfort.

1.  FOR THE REMAINDER OF THE DAY:

a.  Do not spit.  Use a tissue to wipe your mouth as needed, or swallow your saliva.
b.  Do not use a drinking straw.  Drink straight from the cup.
c.  Do not smoke.
d.  Keep fingers and tongue away from the surgical area.  Spitting, the use of a straw, smoking, and poking can dislodge the blood clot that is forming, and will cause bleeding from the area.  Also, smoking can increase the chances of an infection.

2.  FOR BLEEDING:  Some minor bleeding is expected after implant surgery.  It will usually subside quickly, and stop within an hour or two after surgery.  A little oozing is normal and may persist for several hours.  Upper implants may occasionally trigger some bleeding from the nose.  This is normal and will stop quickly.

a.  Keep gauze on the surgical area with some pressure for 30 to 45 minutes.
b.  Remove the gauze after 30 to 45 minutes, and replace it with a new piece of gauze if you are still bleeding.  It is important to make sure the gauze is directly on the surgical site.  Firm pressure for another hour should stop the bleeding.
c.  If you find that this is not working after your third attempt, use a moistened tea bag instead of the gauze.  The tannic acid in tea will help to form a clot, and stop the bleeding.
d.  If all else fails, please call our office at 212-382-2999.

3.  FOR SWELLING:  Most patients will experience some swelling after surgery.  It may be mild or severe, and is different for every patient.  The swelling will get bigger for the first 24 to 48 hours before it starts to go away.  It may last for several days to one week.  Some bruising may also develop on the face.

a. Use an ice pack on the cheek or face next to the surgical site.  Keep it on for 15 to 20 minutes, then off for 10 minutes, and repeat until you go to sleep.  Start again the next day.
b. Sleep with your head elevated slightly above the heart.  This will keep swelling down.
c. On the third day, change to moist heat instead of ice packs.  This will bring the swelling down faster.

4.  EATING:  You may eat soft foods as soon as the anesthetic wears off.  Try not to chew directly on the surgical site.  You may resume a regular diet as soon as you feel up to it.  Please stay well nourished and well hydrated.  You will heal faster.

5.  BRUSHING:  You may brush your teeth, avoiding the surgical area, either tonight, or tomorrow morning.  Be gentle, and do not spit or rinse forcefully.  Start brushing the surgical area on the second day, and be very gentle on the stitches.

6.  RINSING:  You may start rinsing today, gently, with some warm salty water every few hours.  Do not use mouth rinses containing alcohol for a few days.

7.  MEDICATIONS:  You were probably given one or more prescriptions for medications.  Take all medications with a full glass of water, and as directed.  Call us if you experience severe nausea or diarrhea, or cannot swallow your pills.

a. Antibiotics: Continue until the bottle is empty.  Do not quit halfway.
b. Pain Medicine: Continue as necessary.  Since narcotics can make you drowsy, no driving, operating machinery, or alcoholic beverages while you are taking them.
c. Mouth rinse: Peridex (chlorhexidine) or Periogard.  Swish with one-half ounce for 30 seconds, and spit it out, two times per day.

8.  If you have any questions or concerns, please call our office at 212-382-2999.

1.  After your first appointment for inlay/onlay treatment, a temporary filling is usually placed on the tooth or teeth involved after they are prepared and an impression is taken.  The temporary filling protects the site while the custom inlay/onlay is being produced.  It is usually soft and gummy in texture so that it can be easily removed at your next appointment.

2.  If your temporary filling comes off before your next appointment, place the temporary back on your tooth and call our office.

3.  With your temporary filling and with your permanent inlay/onlay, you may experience some discomfort due to irritation of the area during the treatment.  You may also experience sensitivity to cold or pressure.

4.  Your new permanent inlay/onlay will be shaped and shaded especially to your teeth in color and fit.  The temporary filling is made to serve you temporarily, so its color and fit are not custom-matched to your teeth.

5.  After your new permanent inlay/onlay is in place you may need a few days to adjust to it.  If you feel the bite is not correctly balanced, please call for an appointment and we can adjust it.

6.   Care for your new inlay/onlay with proper brushing and flossing.  It is especially important to keep the edge of the crown clean at the gum line.

7.  If you have any questions or concerns, please call our office at 212-382-2999.

1.  After your procedure, please do not disturb the area.  Avoid forcefully rinsing or spitting.  Do not drink through a straw.

2.  Some bleeding is normal for the first 24 hours.  Biting on a gauze pad placed directly on the wound for 30 minutes will help reduce bleeding.  If bleeding continues, please call our office at 212-382-2999.

3.  Please take all medications, including mouth rinses, as prescribed.

4.  After 24 hours, warm salt water rinses (one teaspoon of salt dissolved in eight ounces of warm water) can be used four to five times a day after meals.

5.  After 24 hours, brush your teeth with a soft manual toothbrush.  Be gentle with brushing the surgical areas.

6.  Sutures may be placed after the surgery and most sutures dissolve on their own.

7.  Swelling and bruising may occur.  The use of ice packs following your surgery will help diminish the swelling in the next 48-72 hours.  Applying ice for 15-20 minutes followed by resting the same amount of time works very well.  After 24 hours, if swelling is still present, apply a warm pack to aid in comfort and reduce swelling and bruising.  Alternate the warm pack on and off in 15 minute intervals, as needed.

8.  Drink plenty of fluids.  Stay away from spicy foods, and sharp and crunchy foods like tacos, chips and nuts.  Tobacco and alcohol should not be used 24 hours following surgery.  Alcohol should not be used in combination with pain medications nor antibiotics.

9.  Keep physical activities to a minimum immediately following surgery.

10.  If you have any questions or concerns, or in the event in an emergency, please call our office at 212-382-2999.  If you are experiencing a serious or life threatening emergency, please call 911 or visit the nearest emergency room.

1.  Root canal therapy often takes two or more appointments to complete.  A temporary filling or crown is placed to protect the tooth between appointments.  After each appointment when anesthetic has been used, your lips, teeth and tongue may be numb for several hours after the appointment.  Avoid any chewing until the numbness has completely worn off.

2.  Between appointments it is common (and not a problem) for a small portion of your temporary filling to wear away or break off.  If the entire filling falls out, or if a temporary crown comes off, call us so that it can be replaced.

3.  It is normal to experience some discomfort for several days, especially when chewing.  To control discomfort, take pain medication as recommended.  To further reduce pain and swelling, rinse three times a day with a warm salt water rinse (one teaspoon of salt dissolved in eight ounces of warm water, rinse-swish-spit).

4.  If antibiotics are prescribed, continue to take them as prescribed, even if all symptoms and signs of infection are gone.

5.  To protect the tooth and help keep your temporary in place, avoid eating sticky foods (especially gum), hard foods, and if possible, chew only on the opposite side of your mouth.  It is important to continue to brush and floss normally.

6.  Usually, the last step after root canal treatment is the placement of a crown on the tooth.  A crown covers and protects the tooth from breaking in the future.  If your bite feels uneven, if you have persistent swelling or pain, or if you have any other questions or concerns, please call our office at 212-382-2999.

1.  Following scaling and root planing, you can expect to notice less redness, less bleeding, and less swelling of your gum tissues.  Your teeth may feel smoother, and your mouth will taste and feel better.  Your gum health must be maintained with proper home care, as instructed, and regular professional care.

2.  When anesthesia has been used, your lips, teeth, and tongue may be numb for several hours after the appointment.  Avoid any chewing until the numbness has completely worn off.  It is easy to bite or burn your tongue or lip while numb.

3.  It is recommended that you take some ibuprofen (Motrin or Advil, one to two tablets, every four to six hours as needed) before the anesthetic completely wears off.  This will help with any swelling or pain at the injection sites where the anesthetic was administered.

4.  It is not unusual for the teeth to be more sensitive to hot or cold temperatures, and/or sweets.  This occurs as the gum tissue heals and shrinks in size.  Brushing two to three times daily with sensitivity toothpaste or using fluoride rinses may help alleviate this over time.  If sensitivity continues or is severe, professional application of a desensitizing agent may be required.

5.  For a few days, a soft diet is recommended, chewing on the opposite side.

6.  Consistent and thorough daily oral hygiene is essential to the proper healing of your gum tissues.  Brushing, flossing and rinsing with recommended products are critical.  Use Listerine, or if prescribed, Peridex (chlorhexidine).

7.  If a localized antibiotic (Arestin) was placed, please follow all additional instructions given to you at your appointment.

8.  In most cases, only one-half of the mouth is treated at a visit.  Please remember to keep all appointments to complete the treatment on the opposite side, and all follow-up appointments thereafter.

9.  If you have any questions or concerns, please call our office at 212-382-2999.

1.  Please refrain from blowing your nose for up to four weeks following your surgery.  Do not hold your nose when sneezing.

2.  Please take all medications as prescribed, included decongestants as necessary.

3.  Avoid flying in pressured aircraft, scuba diving, bearing down when lifting heavy objects, blowing up balloons, playing musical instruments that require a blowing action or any other activity that increases nasal or oral pressure for at least four weeks after surgery.

4.  It is important to keep your mouth clean after surgery to reduce the risk of infection and promote rapid healing.  Start salt water rinses (one teaspoon of salt dissolved in eight ounces of warm water) the evening of surgery or the day following your procedure after each meal or four to five times daily.

5.  Brush your teeth gently with a soft manual toothbrush on the evening of your surgery or the first post-operative day and continue at least twice a day.

6.  Drink plenty of liquids.  Eat soft foods for the first several days after surgery.  Advance to a regular diet as you become more comfortable.  Please avoid chewing or creating pressure on the bone graft site.  Please avoid drinking alcoholic beverages or smoking during the first one to two weeks following your surgery.

7.  All removable appliances including partial dentures, flippers and full dentures must be checked for proper fit before they can be worn.

8.  Swelling and bruising may occur.  The use of ice packs following your surgery will help diminish the swelling you may experience in the next 48-72 hours.  Applying ice for 15-20 minutes followed by resting the same amount of time works very well.

9.  If you experience severe or persistent sinus or nasal congestion, please give the office a call at 212-382-2999.

10.  If you have any additional questions or concerns, or in the event in an emergency, please call our office at 212-382-2999.  If you are experiencing a serious or life threatening emergency, please call 911 or visit the nearest emergency room.

1.  After your procedure please do not disturb the area.  Avoid forcefully rinsing or spitting.  Some bleeding is normal for the first 24 hours.  Biting on a gauze pad placed directly on the wound for 30 minutes will help reduce bleeding.  If bleeding continues please call our office at 212-382-2999.

2.  Please take all medications, including antibiotics and mouth rinses, as prescribed.  Follow any other instructions provided by the office during your visit.

3.  Warm salt water rinses (one teaspoon of salt dissolved in eight ounces of warm water) can be used four to five times a day after meals.

4.  Brush your teeth with a soft manual toothbrush.  Be gentle with brushing the surgical areas.  Sutures may be placed after the surgery and most sutures dissolve on their own.

5.  Swelling and bruising may occur.  The use of ice packs following your surgery will help diminish the swelling you may experience in the next 48-72 hours.  Applying ice for 15-20 minutes followed by resting the same amount of time works very well.

6.  Drink plenty of fluids.  Stay away from spicy foods.  Also avoid sharp and crunchy foods like tacos, chips and nuts.  Tobacco and alcohol should not be used.  Alcohol should not be used in combination with pain medications or antibiotics.

7.  Keep physical activities to a minimum immediately following surgery.

8.  If a surgical bandage was used, it is desirable for it to remain in place for 24 hours.  Do not remove it; it will come off when ready.  Once removed, you can begin cleaning the wound gently with a cotton swab dipped in a mouth rinse.

9.  If you have any additional questions or concerns, or in the event in an emergency, please call our office at 212-382-2999.  If you are experiencing a serious or life threatening emergency, please call 911 or visit the nearest emergency room.

1.  Immediately following surgery, keep the gauze pad placed over the surgical area with pressure applied by biting down until the bleeding stops.  A certain amount of bleeding is to be expected following a surgical procedure.  Placing the gauze pad over the area and biting firmly may control excessive bleeding.  Slight bleeding, oozing, or redness in the saliva is not uncommon.  Repeat as necessary within a one-hour period following surgery.  To help minimize bleeding, refrain from physical exercise, sitting up, and excitement.

2.  You may become dizzy when getting up following surgery and for a few days after the surgery.  Sit up slowly and give yourself a minute to adjust before getting up and walking.

3.  Swelling and stiffness are to be expected the first 24 hours after surgery.  Swelling around the face, eyes and surgical site is not uncommon.  This swelling may not appear until the day following the surgery and may become more noticeable two to three days later.  You can help to minimize the swelling by applying a cold compress on the face near the extraction site alternating on for 20 minutes then off for 20 minutes.  After 36 hours the ice will have no further impact on swelling.  After this period, the application of moist heat to the sides of the face can help reduce swelling.

4.  If you have been prescribed pain medication besides aspirin, Tylenol or ibuprofen (Advil or Motrin), do not drive, operate heavy equipment, work around machinery or tools or engage in any other activity that may be unsafe when groggy, as your reflexes and judgment will be affected by the medication.  Medication should not be taken on an empty stomach.  If you have been placed on antibiotics, take the medicine as directed.  Antibiotics may be prescribed to help prevent infection.

5.  For 24-48 hours following your surgery, do not suck on a straw, drink from a bottle, rinse, spit, or smoke.  Doing so may result in dislodging the clot and encouraging bleeding.  Avoid hot and spicy foods, carbonated and alcoholic beverages.  During the first few days after surgery restrict your diet to liquids and soft foods such as soups, yogurt, juice, and smoothies.

6.  Avoid vigorous activities for three to four days after surgery.  No heavy lifting.  You may go back to your normal routine as tolerated.

7.  Rinsing, spitting and brushing should be avoided the day of surgery.  Resume brushing the day after surgery, avoiding surgical sites with the toothbrush.  After brushing, rinse gently with warm salt water (one teaspoon of salt dissolved in eight ounces of warm water).  Start the day after surgery three times a day for 7-10 days.  Rinsing with warm salt water will help keep the surgical areas clean and help dissolve the sutures.

8.  Please do not use the irrigating syringe for the first five days.  After five days, fill the syringe with warm salt water and flush out the socket.  This will flush out any food or debris.

9.  If numbness of the lip, chin, or tongue occurs there is no cause for alarm.  This is usually temporary in nature.  You should be aware that if your lip or tongue are numb, you could bite it and not feel the sensation.

10.  A dry socket may occur when a blood clot gets dislodged prematurely from the walls of the tooth socket.  Symptoms such as severe and/or throbbing pain at the surgical site, the ear, chin, adjacent teeth, and jaw three to four days following surgery that do not respond to pain medication can indicate a dry socket.

11.  Please call our office at 212-382-2999 if you experience severe pain, excessive bleeding or swelling, or if you have any questions or concerns.  If you are experiencing a serious or life threatening emergency, please call 911 or visit the nearest emergency room.