How should I manage pain after oral surgery?
One of the biggest concerns most people have about dental surgery revolves around pain management. We obviously don't want to feel pain during a procedure, which is why good anesthetic is important. That said, we assume that after any sort of surgical procedure there will be some discomfort.
Helping To Minimize Pain
1. Anti-inflammatory medications - As a rule, the majority of post-surgical pain doesn't come from the procedure itself, but rather from swelling and inflammation stretching the tissue in the area afterwards. An over-the-counter anti-inflammatory medication taken before the procedure and continued for several days after the procedure can greatly reduce the amount of swelling and therefore the amount of pain after surgery. Making the assumption that we have a healthy adult patient (speak with your dentist/doctor about how your health and other medications you take may be affected), we typically recommend taking 2 Aleve (or generic naproxen) an hour or two before the procedure and then continuing one Aleve each evening and morning for the next 4-5 days. By keeping the swelling to a minimum, we greatly reduce pain and the need for narcotic pain medications. It's important to note that while Advil/Motrin/Ibuprofen are the same type of drug as Aleve, they do not work as well because they don't stay in the body as long, making it much more difficult to stay ahead of inflammation)
2. Cold compresses also help minimize swelling in the first 48 hours. Using a cold compress for 15 minutes on and 15 minutes off helps reduce swelling and thus the need for narcotics.
3. Use multiple types of pain medication. Anti-inflammatory drugs as mentioned in #1 work at the site of the surgery to reduce inflammation. Drugs such as Tylenol (acetaminophen) and most prescription pain relievers (such as codeine) act directly on the brain to block pain signals. By attacking the pathways by which our body feels pain along different points, we can more effectively reduce the amount of discomfort you feel.
4. Stay ahead of it! It's much easier to prevent pain, swelling, and inflammation than it is to get rid of it once it occurs. This is especially true for the swelling and inflammation, which is why we recommend taking anti-inflammatory medications before the surgery as well as for several days afterwards, regardless of how good you may feel. Remember that medications take time to be absorbed into the body after you swallow the pill (generally allow an hour for a pill to have its full effect).
5. Be nice to yourself and don't abuse your surgical site. While this sounds obvious, it's actually easier to abuse a surgical site than you might initially think. Chewing food, grinding your teeth while you sleep, even stretching your lip or cheek back to take a look at the surgical site can cause irritation or damage to the site if not done carefully. We have seen several instances where patients have ripped their stitches out simply by pulling at their cheek to get a good look at a difficult-to-see place in their mouth. Different surgeries require different types of post-operative care, so be sure to ask your dentist about what type of post-surgical care your surgery requires.
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