Post-Operative Patient Management

Question 1

When doing surgical consent form, what should you mention? (8)

Answer 1

Bleeding 
bruising
swelling
pain
dry socket 
Trismus
diet 
OHI

Question 2

Post-op Bleeding
What do you need to tell them about gauze?
-how long?

Answer 2

Moistened and directly on the sockets for the first HOUR

[new ones should be moist as well]

Question 3

Cautions related to bleeding (4)

Answer 3

• No smoking 12 hrs
• No straws
• Rinse/spitting
• No exercise for 12 hrs

Question 4

Tell the patient to call IF (3)

Answer 4

1. LONG term bleeding
2. Bright red bleeding
3. Large Liver clots

Question 5

Secondary to gauze placement (what else can be used besides gauze to help with bleeding?)

Answer 5

Tannic acid from teabags (also moisten)

Question 6

Bruising information to tell patient

Answer 6

Simply mention it to decrease anxiety if it happens.

Question 7

Swelling is worst during (time period)

Answer 7

2-3 days (up to week for old people)

Question 8

Continued or exacerbated swelling past day three may indicate

Answer 8

infection

Question 9

What can be used to reduce swelling?

Answer 9

ice packs (on 20 off 20 for first 24hrs)
Heat AFTER 3rd day!

Question 10

What extractions cause more trismus?

Answer 10

Mandibular molars (3rds)

Question 11

Diet concerns

Answer 11

-Eat soft foods for first day

Question 12

Oral hygiene instructions (3)

Answer 12

DONT use tpaste for the first day.
After 1st day:
-salt water rinse
OR
-Chlorhexidine rinse

Question 13

Peak Pain occurs when?

Answer 13

12 hours after surgery

Question 14

Pain lasts about how long?

Answer 14

2days

Question 15

What NSAID should be prescribed?

Answer 15

Ibuprofen (600 mg/dose)

Question 16

What procedures are more likely to need a central acting medication?

Answer 16

(central acting means narcotics)

Surgery’s with bone removal tend to need more than just ibuprofen/acetaminophen

Question 17

Dry Socket

-Definition

Answer 17

Delayed healing and not a suppurative infection.

Question 18

Dry Socket Symptoms (4)

Answer 18

• Pain on 3-4 day
• Bad breath/taste
• Lymphadenopathy
• Appears barren OR filled with yellow nasty YUCK!

Question 19

Dry Socket PAIN

• describe sensation
• radiates to
• Why we get the pain

Answer 19

• Sensation: dull throbbing
• Felt in: EAR and Incisors
• PAIN due to: exposed nerve endings from BONE

Question 20

What “might” cause Dry sockets?

Answer 20

Fibrinolytic activity

Question 21

Dry Socket happens where most oft?

Answer 21

IMPACTED mandibular 3rds

-rare in maxillary of any kind

Question 22

Dry Socket Prevention (4)

Answer 22

Low trauma
irrigation
PRE and Post op chlorhexidine
Gel sponge with tetracycline (for alcoholics)

Question 23

Dry Socket treatment (2)

Answer 23

• Irrigate

- get them out of pain

Question 24

What do we place into the Dry Socket to reduce pain and act as a antibiotic?
-This placed material is soaked in (2)

Answer 24

Iodoform Gauze SOAKED IN

• Eugenol
• Benzocain