How to Minimize Pain after Oral Surgery

“How bad is it going to hurt?” At only sixty pounds, and with big blue eyes, my little patient looked at me asking me a fundamental question that I have been asked many times before. Jack was only seven years old but he knew what he was most frightened of about his upcoming surgery and had the courage to ask me about it.

Patient’s fears about pain following oral surgery are well founded. Removal of teeth, with the often necessary cutting of jaw bone, is one of the most painful surgical procedures that can be done to a human being. I think that almost everyone has heard a horror story regarding wisdom tooth removal. And we have all heard the expression “It was harder than pulling teeth.” No wonder everyone is so scared.

Oral surgery doesn’t have to be a horrible experience. It can, in fact, be a very good experience with the right set of circumstances. The first circumstance is that you need a highly skilled surgeon. The second circumstance is that you need to know a few things about how to take care of yourself after the procedure.

Surgeon selection is probably one of the most critical aspects of care that will determine if you have a good experience or a bad one. The “rougher” the surgeon, the more tissue damage at the surgical site created by that surgeon. Tissue damage leads to inflammation (swelling). Inflammation and pain share many of the same chemical pathways in the body. Thus, the more inflammation, the more pain following the surgery. Numerous studies have demonstrated that a more skilled surgeon’s patients will have better outcomes and will return to normal function more quickly. A gentle surgeon creates less tissue damage so her patients have less inflammation and thus less pain. So lesson number one is to pick a good surgeon.

Pain perception is dependent on a series of chemicals signaling within the body as well as reflexes. Minimizing post operative surgical pain requires minimizing inflammatory signaling within the body. At Geisler OMS, we utilize several techniques to achieve this. Non steroidal anti-inflammatory medications for patients who can tolerate them are prescribed. We also include acetaminophen in our protocol for pain management (again for patients who can tolerate the medication). We also recommend the use of topical anti-inflammatories such as Arnica. Cannabidiol (CBD) is a promising anti-inflammatory agent which can be used topically as well as systemically for the management of pain and swelling.  So lesson number two is to use the medications that your surgeon prescribes as recommended. Listen to what they have to say and follow their advice. They want you to have a great outcome.

Other simple tips for minimizing pain following oral surgery include the application of ice for the first twenty-four hours to minimize swelling. We recommend following icing with heat for twenty-four hours. Oral hygiene is also very important and will help in minimizing infection. Infection increases inflammation.

Finally, one of the simplest tips that I can share with you is to use moistened gauze when changing your oral pads following extraction(s). Using dry gauze can cause you to pull out a blood clot which will lead to dry socket, a very painful condition that is best avoided.

 

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