Post Op instructions Flashcards
What should patients expect after an extraction
Pain
Bleeding
Swelling
Bruising
Infection
Jaw stiffness
What pain is normal following extraction
Varying degrees - will likely peak 48h post op
Should gradually improve over the next few days but occasionally still painful after 1-2 weeks
How can pain be managed
Advise patient to take analgesia before anaesthetic wears off (1-2h)
Take analgesia regularly for first couple of days
If you can get on top of the pain before it starts you have a much better chance of keeping it under control
After first few days, use analgesia as required
Who should be cautious of taking Ibuprofen
Previous or active peptic ulceration/ gastro-oesophageal reflux disease (GORD)/
The Elderly
Pregnancy & lactation
Renal, cardiac or hepatic impairment
History of hypersensitivity to Aspirin & other NSAIDs
Asthma (do not give Ibuprofen to patients with asthma unless they have taken it before with no problems)
Patient taking other NSAIDs
Patients on long term systemic steroids
Is bleeding normal following extraction
A little bleeding postoperatively is to be expected
Ensure bleeding has stopped before allowing the patient to leave the surgery
Blood-stained saliva for up to 72h post op is normal
Can bleed in response to LA wearing off, agitating socket, changes in BP, eating/drinking
How should bleeding be managed at home
Roll up some damp gauze and bite on it for 20-30minutes - repeat once if this isn’t effective
If bleeding persists, patient should contact practice / Out of Hours
Make sure the patient has contact details before they leave the surgery
If they cannot get the bleeding to stop and cannot get you or a dental emergency team - they should go to their nearest A&E
Why should written instructions also be given
It is good practice to follow verbal instructions up with written instructions
Should reinforce verbal instructions
Should not replace verbal instructions
Include emergency contact details
Available in different languages
When is swelling concerning
Normal reaction to trauma can persist for up to 2 weeks
If the swelling continues to increase in size after 2 days or the patient is worried that there may be an infection, they should get in touch with you
What are the signs and management for infections
Uncommon
Increase in pain or swelling after 2 days, or discharge/bad taste from socket may indicate infection
Antibiotics not required unless signs/symptoms of infection
What instructions can be given on jaw stiffness
Pain and stiffness associated with the TMJs/ muscles of mastication is to be expected
Can result in a limitation in mouth opening
Can take up to 2 weeks to settle
Soft diet can be helpful
Aside from expectations what instructions should be given in general following an operations
Avoid smoking
Avoid alcohol
Avoid increasing blood pressure
Toothbrushing
Mouth rinsing with HSMW
Discomfort in adjacent teeth is to be expected
What are extra considerations to make patients aware of following a surgical extractions
Pain, swelling and bruising likely to be increased
Patient likely to have stitches placed- advise patient if these are resorbable or not and when they are likely to fall out
Sutures can become uncomfortable as the area heals - if this occurs, consider removing suture
May recommend Chlorhexidine mouthwash
