Care after tooth extraction
February 10, 2018 8:21 AM   Subscribe

My poor husband has been diagnosed with severe periodontal disease and is going to have to get a few teeth pulled next week. I'm sure he's going to feel miserable after. What can I do to help him feel more comfortable after the extraction, both physically and mentally?
posted by anonymous to Health & Fitness (19 answers total) 1 user marked this as a favorite
I got a lot of teeth pulled when I was a kid before braces. A few things that were helpful besides the obvious

- if he's got a mouth full of icky bloody taste after the extractions, chewing on wet minty teabags can tamp down the angry feeling of his gums and make his mouth taste better
- dentists orders that seem weird should still be totally followed. No straws!
- you may be able to get prescriptions ahead of time (i.e. you run out to get them while he is in the chair) this can make the drive home not include some long agonizing "waiting in the parking lot at the drug store" part of it. Likewise if he is really nervous sometimes an ativan or something beforehand is something the dentist can prescribe.
- caffeine can help novocaine wear off, in my experience
- make some delicious and MUSHY foods, think on whether he has a favorite
- similarly binge tv or otherwise, splurge on something you'd both love to hole up and watch.

The good news is that dentistry is pretty good at putting mouths back together again, it just takes time and money. I hate the dentist usually but getting rid of problem stuff to build up new stuff is usually a step in the right direction (and often really hard for people!) so good on him for getting it managed.
posted by jessamyn at 8:36 AM on February 10, 2018 [6 favorites]

Rice bags in the freezer.
posted by onecircleaday at 9:09 AM on February 10, 2018

I wouldn't assume he's going to feel all that miserable; he should receive appropriate anesthesia and pain/swelling management. That said, the anxiety ahead of the procedure can leave you exhausted afterwards, and the *caine can give you something of a amphetamine hangover, so the big emphasis immediately afterwards should be rest. Don't go back to work, don't stay home and feel obligated to do housework. Get in bed/on the couch/in his favorite chair, Netflix and nap the day away.

Do call and ask if they can call in all his post-op meds a day or two before, and pick up some sports drinks at the drugstore while you're there so there's cold electrolytes ready in the fridge at home. (Tip: not red ones; if he throws up it'll scare the hell out of both of you.) If you don't have face-friendly ice packs (we like these), pick some up.

I've always struggled with soupy food after dental work, as I always end up with at least one numb lip and spilling. I like soft but cohesive stuff that travels firmly, like twice-baked potato, broccoli rice casserole, oatmeal, scrambled eggs/quiche/omelette.
posted by Lyn Never at 9:15 AM on February 10, 2018 [1 favorite]

Here's a thing about periodontal disease: the most common reason that teeth are extracted is that there is no longer bone supporting them. What this means is that the extractions themselves require less force and are generally "easier". This means less post-op discomfort in many cases.

Each patient heals differently, but best practices are to follow the post-op instructions closely; eat a soft, but substantial diet; take pain meds as directed; don't smoke or rinse violently; call the office if anything unexpected happens.

The mental part may be challenging, but as others have said, we can do amazing things at rehabilitating the bite and smile these days, and sometimes getting rid of diseased tissue or teeth is the best start.
posted by OHenryPacey at 9:18 AM on February 10, 2018 [5 favorites]

YES, get pain relievers early--and if you're supposed to ice anything, bring ice into the dentist's office so that you can ice right away, not leave it 'til you get home. I don't get that at all with doctors who advise icing things and taking painkillers immediately. Hey, give me a pill and a bag of ice right then and there, why not? Otherwise I'm hanging out in the drugstore with my mouth stuffed full of bloody cotton waiting around with the novocaine wearing off and the lower half of my face inexorably swelling to the size of a basketball.
posted by Don Pepino at 9:20 AM on February 10, 2018 [2 favorites]

And, Absolutely, NO sucking on hard candy, straws, or (if he smokes) no cigarettes or any sucking of any kind. This could dislodge the coagulating blood and result in a 'dry socket' which is 10x more painful!
posted by donaken at 9:25 AM on February 10, 2018 [3 favorites]

I meant to include this recipe: basic congee.
posted by Lyn Never at 9:28 AM on February 10, 2018

I’d suggest having a variety of soft foods on hand. He might want soup. He might want ice cream. But it might not be a good idea to have his favorite, since if it ends up tasting a bit like blood, that might spoil it for him for years.

Would also suggest, if you have Netflix or other streaming services, making plans for what movies or tv shows he’d like to watch. It can be super annoying to try to find something interesting when you’re feeling crappy, so having a list in advance could make that easier. Or see if you can get DVDs from your library. If he’s into podcasts, a list of episodes to listen to would be good.
posted by FencingGal at 9:58 AM on February 10, 2018 [4 favorites]

When I had my tonsils out a couple of years ago, I ate a lot of yogurt and drank a lot of milkshakes and Ensure protein drinks. Anything else made my mouth feel terrible. Anything hot or even warm was painful for the first week or so.

So stock up on his favorite ice cream, rice pudding, or chocolate mousse.

Does he usually drink coffee or tea? If so, be careful about letting him go into caffeine withdrawal -- maybe he'll want to sip cold or lukewarm drinks just to get some of it into his system. (I didn't know about caffeine counteracting novocaine, as Jessamyn says above.)

If he's taking pain meds round the clock, it can help to set an alarm to make sure you get the correct dose. Otherwise he may wake up a few hours later and be in pain because the previous dose has worn off.

It sounds like he has a loving partner to take care of him, so I'm sure that will ease his recovery as well!
posted by vickyverky at 10:13 AM on February 10, 2018 [1 favorite]

Have a variety of soft foods available. Bread pudding, rice & gravy, jello, ices and ice cream, ginger ale. A lot of the foods in the comfort foods thread. A good travel mug is nice for managing drinks while the mouth is numbed up, gums are sore, while using drugs and not using a straw. Some good videos cued up, maybe an audio book; the library is a good resource. When I'm sick, I love it when someone just brings me the ginger ale and jello because deciding what I want is nope. This works best if the sick person actually likes ginger ale or jello.
posted by theora55 at 11:26 AM on February 10, 2018 [1 favorite]

Mashed potatoes are like my favorite food in the world so I made a giant vat of em when I had wisdom teeth out.
posted by noloveforned at 11:34 AM on February 10, 2018

I just had two extractions last month, the last molar on the upper left and the last molar on the lower right. Ibuprofen was enough to kill most of the pain, but a few Norco in the day or two after were appreciated.

I didn't eat much after and my mouth was still tender a few weeks later. I ate a lot of ice cream and fresh mozzarella cheese and cottage cheese and poached eggs and pureed soups and Odwalla juices and protein shakes. Basically I didn't want to chew anything (not even soft foods) for weeks - BUT I also had a couple of root canals at the same time and that may have made the aversion to chewing worse.

Oh and I drank a TON of fresh pineapple juice (available at Trader Joe's), because the bromelain in the pineapple juice is a good anti-inflammatory. Green tea too. The swelling went down a lot faster this time than when I had my wisdom teeth out about 10 years ago.

Also I had a clean house waiting for me, my comfiest lazy clothes, my favorite blanket, and a bunch of TV to binge. And a big fat grey cat to pet.
posted by elsietheeel at 11:54 AM on February 10, 2018 [5 favorites]

I have no dental or prescription insurance, so I had all my wisdom teeth extracted with pliers and novocaine and had no pain meds. The saltwater rinse was the Most Amazing Thing Ever. I did it 4x a day (as I was instructed at the time) and ate soft, cool (not ice cold) foods. I also drank my coffee and water lukewarm. No straws, smoking, or vaping.
posted by xyzzy at 1:09 PM on February 10, 2018

I also didn't know about the novocaine-caffeine thing either and I have a dentist appointment on Tuesday so I'm going to test the heck out of that. I'm resistant to novocaine so they have to use a ton of it and then it takes FOREVER to wear off.

And yeah definitely have him do the saltwater rinses. I didn't do them often enough and I bet if I had done I probably would have healed a lot faster. (The taste of salt water makes me gag.)

Finally, ditto what jessamyn said about being proud of taking steps to fix his mouth. I have a severe dental phobia and no insurance and I finally went back to the dentist in December. I'm spending about $20k and bankrupting myself to fix things (two extractions, six root canals, an additional crown, and 20+ fillings), but even though it's going to cause a lot of stress financially, I don't have to worry about my teeth anymore. And periodontal disease can put you at a greater risk for heart disease and stroke, so there's another good reason to keep your teeth and gums as healthy as possible.
posted by elsietheeel at 2:19 PM on February 10, 2018 [2 favorites]

Scope out things that your husband generally uses to feel comfortable. Funny movies? Soft music? Good books? A heating pad for his back? Dark room? Bright and sunny? Puzzles? Company? Solitude?

I’d suggest everything mentioned by folks above, plus also fresh sheets on the bed. Maybe a new pillow for his side of the bed (with a waterproof cover under the pillow case for the drooly time). Good lotion, maybe with soothing lavender in it. Maybe a milkshake with a spoon or just ice cream.

I’d probably want folks to drop by, maybe for a mushy foods potluck? Or just have friends drop off mushy foods. But that might be the very last thing in the world he would want.
posted by bilabial at 6:14 PM on February 10, 2018 [1 favorite]

[This is an answer from an anonymous MeFite.]
I'm 47 years old and down to eight natural teeth thanks to periodontal fun. I spent years fighting a losing battle to keep my teeth and am happier now, free from constant infections etc despite the obvious anxiety about, well everything. But it's not that bad.

I also smoke regularly, and am alcohol-dependent. So have some wisdom and hacks to offer that may "help" someone else if not you.

I may be conflating experiences here but went through three rounds of extractions -- wisdoms, then posterior (and went a month with only half a mouthful of teeth), then anterior.

Good advice has been given regarding post-op care so won't dwell on that too much but definitely stock up on soft foods. For me it was largely Zoodles, mac and cheese, soup, applesauce, yogurt, pudding, mashed potatoes and gravy. And "meals in a bottle" -- those are very good for nutrition; vanilla with vodka was my favorite. A year later I STILL have an abundance of some of this stuff but it doesn't matter -- be prepared to get whatever calories in that feel appetizing at any given moment.

Now as I recall, typical instructions were four days no smoking, 7 days no alcohol. I was honest with my dentist and said that's just not going to happen, at least as far as the drinking goes. I had bloodwork done and gave him the results, he consulted with an oral surgeon and basically was told I was ok. After one procedure the first thing I did after getting home was pour myself a large glass of straight vodka on the rocks (beer is my go-to but I was leery of carbonation, and wanted high-octane). Obviously the main concern here is blood thinning so definitely wise to avoid but I managed to mitigate it.

For smoking, it was "hope for the best, prepare for the worst" I stocked up on patches and also got myself an e-cig in advance, thinking at least less suction and relatively "pure" compared to the toxins in cigarettes.

Posterior teeth (wisdoms, molars) are the highest risk for the dreaded "dry socket" which I managed to avoid. After wisdom teeth (first procedure) I was at the drugstore filling scrips and got myself a 2-litre plastic bottle of cheap pop. Inspired by a misspent youth I did nicotine "bottle tokes" by the end of the day -- dumped the pop out, cut a hole in the bottom of the bottle. Insert lit cigarette and very gently inhale (not suck!) from mouth of bottle.

I am not recommending any of these things to others, but it did work for me.

Another time I made it three days, e-cig aided and thought I had actually quit until e-cig flaked out and I was back smoking.

Anyway, coming from someone who has been through worse, it's not that bad. You (he) will be happier when it's over.

Hopefully this is the end of the road but in my case, as soon as extractions were mentioned I jumped into self-advocacy mode. Had a meeting with my dentist and said ok, what does look like in a year? Five years? Ten years? Because if we're going to do this, we need to do it right. He consulted with my periodontist and the plan they came up with blew my mind on presentation but in hindsight was absolutely the wisest course of action but would not have happened had I not spoken up. The other road would have been continued misery with other teeth, and continued procedures when situations became untenable. So I got proactive and am very happy I did.

That was the short story!
posted by cortex (staff) at 10:40 AM on February 11, 2018 [1 favorite]

Anon above seems like a very clever person ;-) but neglected to stress the importance of rinsing. I was prescribed Peridex but plain old lukewarm water and salt works just fine. Be beyond religious with that.
posted by raider at 2:05 PM on February 11, 2018

When I got my wisdom teeth out, my mom put ice packs in the toes of a pair of socks and knotted the open ends together so I could drape it over my head and the icepacks were held on either side of my jaw without me having to hold them in place with my hands. She also got me a milkshake to eat with a spoon on the way home, and I ate soft foods like applesauce, yogurt, and ice cream for a couple days. And binge-watched movies and napped.
posted by abeja bicicleta at 2:09 PM on February 11, 2018

Okay can confirm the caffeine/Novocain connection myself. I got out of the chair an hour ago, immediately drank a grande iced coffee with a shot of espresso, and I am now almost completely un-numb. Thanks jessamyn!
posted by elsietheeel at 12:48 PM on February 13, 2018 [2 favorites]

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