Dry Socket/ Post-operative dental issues
Dealing with Post-Operative Dental Issues (Post-Extraction)
• Bleeding or Pain Directly After an Extraction:
o Can be helped with taking a wet tea bag and biting on it. The pressure helps the bleeding and the tannins in the tea bag help to heal the wound and stop bleeding. (We never specify a certain type of tea…some data points to not using herbal teas, but any tea bag usually helps)
• Pain Relief After an Extraction:
o For most dental pain relief following an extraction, we often do not find the need to prescribe a narcotic.
o We recommend, when appropriate – 400-600 mg of OTC ibuprofen every 6 hours and if needed, can also add and stagger doses of OTC (see end of this document for references related to dosages) acetaminophen (either regular or extra strength) every 6 hours as well.
o Only in very difficult surgical cases do we typically recommend and prescribe narcotics, so you shouldn’t see too many folks requesting them.
Note: The dental department has our own narcotics protocol and formulary as well.
You can find it here on SharePoint: (B)/Prescribing%20Narcotics%20for%20Dental%20Patients.doc?web=1
• Dry Socket aka Alveolar Osteitis:
o Presents usually 3-4 days post-op after an extraction.
o Most typically seen in smokers.
o Usually report a very bad taste in the mouth, often metallic, along with severe pain that pain meds don’t touch.
o Usually no associated swelling.
o Often report pain with cold air on site.
• Treatment of Dry Socket:
o Often the only relief is with a special paste (key ingredient is Eugenol or clove oil) to be placed into the socket by a dentist to help the exposed bone heal.
o A temporary home remedy is to soak a tea bag with clove oil and put on the extraction site.
o Pain meds can diminish the problem a tiny bit, but being seen by a dentist ASAP (ie next day if it’s in the middle of the night) for post-op treatment is best.
Sources for OTC Ibuprofen and Acetaminophen Dosing Protocol
Hersch, Elliot et al. (April 2011) Prescribing Recommendations for the Treatment of Acute Pain in Dentistry Compendium: Volume 32, Number 3
Denisco, Richard C. et al (July 2011) Prevention of prescription opioid abuse: The role of the dentist Journal of American Dental Association (JADA) 142(7) pgs 800-810.
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