Postoperative Hemorrhage

267.62 Figure 2-19.—Aphthous stomatitis. lesion is usually found on the lip as shown in figure 2-20. NOTE: Some oral lesions are caused by an infectious disease; therefore, wear rubber gloves when examining the patient. SYMPTOMS—The patient may complain of a painful swelling; a fever blister, cold sore, or canker sore; a great amount Of pain when eating or drinking; and a fever, a headache, or a rundown feeling (herpetic gingivostomatitis). 267.63 Figure 2-20.—Recurrent labial herpes. SIGNS—Your examination may show red, swollen areas with blisters or small craters formed in the centers, or these lesions covered with grayish-white or yellowish membrane. TREATMENT—Since these conditions will normally disappear spontaneously within 7 to 10 days, measures to eliminate the patient’s discomfort are all that is necessary. Have the patient rinse with a warm solution of sodium bicarbonate several times daily. Treat stubborn recurrent cases by encouraging the patient to hold 1 teaspoon of tetracycline oral suspension in the mouth for 2 minutes 4 times daily for 5 days. Symptomatic relief may be obtained from anesthetic troches, ointments, or solutions such as an anesthetic mouth rinse. Also, tell the patient not to smoke; eat hot, spicy, or acidic foods; or drink alcoholic beverages. Postoperative Hemorrhage This condition may occur any time from a few hours to several days after the tooth extraction. The bleeding from the extraction site may be light or heavy. Treat all abnormal postextraction bleeding as serious. SYMPTOMS—The patient may say that bleeding started or failed to stop after an extrac- tion and that he or she is swallowing or spitting out large amounts of blood and feels weak from blood loss. A patient may also complain of a large amount of blood on bed clothing after sleeping; however, a small amount of blood in the saliva is normal after extraction. SIGNS—These include blood oozing or flowing from a recent extraction site after normal clotting should have occurred and a large amount of blood or large blood clots in the patient’s mouth or on the clothing. TREATMENT—Initial attempts at con-trolling the hemorrhage should be directed at removing any clot in the mouth extraneous to the alveolus. Place a tightly folded 4 x 4 gauze pad or tea bag over the wound site, and have the patient bite firmly for 15 to 20 minutes. Keep the mouth as dry as possible, and encourage the patient to breathe through the mouth because this will help to keep it dry. 2-51