This appointment involves examining the extraction site and determining how well the healing process is proceeding. You’ll also want to know if the patient is in any discomfort or has any concerns. Typically, this is a very short appointment. All that really needs to be done is to rinse the extraction site with saline and a monojet syringe, and make a treatment note. Patient instructions include:
continued rinses with saline and to notify the Oral Surgery Department if any discomfort arises.
Most patients are then discharged to prn (as needed) status. If a dressing needs to be changed, have them come back in 2-3 days. There are, however, a couple of things to keep in mind:
Suture Removal: Most surgical procedures requiring sutures will use the resorbable gut type. Some patient however will have silk sutures, which must be removed. How can you tell if the sutures are silk or gut? The easiest way to tell is to look at the operative notes in axiUm. If sutures were placed, there will be a note as to the type. The gut sutures typically resorb within 4-5 days. If it is necessary to remove sutures (silk sutures were placed or gut sutures have not completely resorbed and the extraction site is healing well), be sure to thoroughly rinse the sutures with saline. It is important that the sutures are free from any debris before removing them. Ask for a suture removal kit from the supply window. Then, carefully cut the suture between the knot and the tissue. The goal is to pull the suture out without pulling any portion of the suture that was exposed to the oral cavity through the tissue. The video on suturing has a good demo on suture removal and can be accessed on the Canvas site.
Dry Socket: Some patients will develop a dry socket which can present as extreme, constant pain. This condition seems to be more common in, although not limited to, lower posterior extraction sites. Treatment is palliative and can include placing of iodoform gauze or alveogel in the extraction site. Again, thoroughly rinse the site with saline. Advise patients to avoid chewing on that side and to gently rinse after meals. The patient should return in 1-2 days to remove gauze and re-evaluate. An alternative treatment could be copious rinses with saline. Discuss the best treatment for the patient with the faculty.