Category Archives: Postoperative Patient Management


OPERATIVE NOTE FOR THE RECORDS The surgeon must enter into the records a note of that transpired during each visit. Some critical f.u tors must-be entered into the chart. The first is the date of the operation and a brief identlfication of the patient; then the surgeon states the diagnosis and .reason for the extraction  e.g., non restorable caries or severe periodontal disease). Comments regarding the patient


POSTOPERATIVE FOLLOW UP VISIT All patients should be given a return appointment so that the surgeon can check the patient’s progress after the. surgery. In routine, uncomplicated procedures, a follow-up visit at 1 week is usually adequate. If sutures are to be removed, that can be done at the I-week postoperative  appointment. ‘ ‘Moreover, patients should be informed that shouldany question or


Ecchymosis In some patients blood oozes submucosally (SM) and subcutaneously (SC), which appears as a bruise in the oral tissues on the face (Fig, 10-3), Blood in the subcutaneous tissues is known as ‘ecchvmosis. This is usually seen in older patients because of their decreased tissue tone and weaker intercellular attachment. Ecchymosis is not dangerous and does not increase pain or infection. Patients,


Trismus Lxtraction of teeth may result in trismus. or limitation in opening  the mouth. This is the result of inflammationinvolving the muscles of mastication. The trismus may be a result of multiple injections of local anesthetic, especially if the injections have’ penetrated muscles. The muscle most likely to be involved is ‘the medial pterygoid muscle,which may be  nadvertently penetrated by {he

Control of Infection

Control of Infection To control infection the surgeon must carefully adhere . to the principles of surgery. No other special measures must be taken with the average patient. However, some patients, especially those with depressed host defense responses, may require antibiotics to prevent , infection. Antibiotics in these. patients should bead ministered before the surgical procedure is begun (see Chapter 15). A


Edema Most surgical procedures result in a’ certain amount of edema or swelling after surgery. Simple extraction of a single tooth will probably not result. in swelling that the  patient can see, whereas the extraction of multiple impactedteeth with reflection of soft tissue and removal of bone·may result in large amounts of swelling (Fig. 10-2). Swelling usually reaches its maximum 24 to 88 hours after

Oral Hygiene

Oral Hygiene Patients “should be advised that keeping the teeth and mouth reasonably clean results in a more rapid healing oftheir surgical wounds. On the day of surgery patients (an gently brush the teeth that are away from the area of surgeryin the usual fashion. They should avoid brushing the teeth immediately adjacent to the extraction site to prevent a new bleeding episode and to avoid pain. The next


Diet Patients who have had extractions may avoid eating because of local pain or fear of pain when eating. Therefore they should be given very specific instructions regarding their postoperative. diet. A high-calorie, highvolume liquid diet is best for the first 12 to 24 hours.  The patient must have an adequate intake of fluids,usually at least 2 quarts, during the first 24 hours. The flu ids can be juices, m


CONTROL OF POSTOPERATIVE PAIN AND DISCOMFORT  All patients expect a certain amount-of pain after a surgical  procedure, so iris important for the dentist to discuss this -issue carefully with each patient before discharge from the office. The surgeon must help the patient” have a realistic expectation of what type of pain may occur, The surgeon must therefore pay attention to the patient’s concerns


CONTROL OF POSTOERATIVE BLEEDING Once an extraction has been completed, the initial maneuver to control postoperative bleeding is the placement of a  small, damp gauze pack directly over the empty socket.Large packs that cover the occlusal surfaces of the teeth <10- not apply pressure to the bleeding socket and should not be used (Fig. 10-1). The gauze should be moistened .the oozing blood does not coagulate