dental disorders
How To Do an Emergency Tooth Extraction
Aftercare
Have patient bite on a tightly folded, slightly dampened gauze for 3 to 4 hours after the extraction (initially changing pads every 30 to 60 minutes), to facilitate clot formation in the socket. To prevent Postextraction alveolitis (dry socket) (ie, to retain the clot within the socket) instruct patient not to swish, spit, suck on anything, or drink from a straw for 24 hours. If possible, encourage no smoking for a week. After 24 hours, the patient may begin gentle warm salt water rinses several times per day. However, vigorous swishing is prohibited for 1 week. To help reduce swelling (which peaks on day 3 or 4), have the patient apply ice packs—30 minutes on, then 30 minutes off—for the first 24 hours and sleep with the head elevated for several days. During the first 3 days, the diet may progress from liquids, to dairy, to soft foods. The patient should not chew on the affected side, and should avoid excessively hot or cold foods for 7 days. Antibiotics are not indicated unless infection was present or a sinus was inadvertently penetrated. Ice chips and NSAIDs (nonsteroidal anti-inflammatory drugs) are given for pain; narcotic analgesics (eg,acetaminophenwithcodeine,hydrocodone, oroxycodone) may be used if needed, depending on severity of extraction. Arrange follow-up with an appropriate dentist in 1 to 2 days. Advise the patient that intermittent light bleeding or oozing is common for several days and can be treated by biting on a gauze pad as described above. 