The removal of impacted teeth is a surgical procedure; therefore post-operative care is very important. Unnecessary post-operative sequelae, such as pain, swelling, bleeding, etc. can be minimized if the instructions are followed carefully.

Immediately Following Surgery:

  • The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded. It can be replaced with fresh gauze if bleeding continues.
  • Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
  • Take the prescribed pain medications with food or carbonated beverages before you begin to feel discomfort.
  • Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
  • Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for explanation.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing or redness in the saliva is not uncommon. Excessive bleeding may be controlled by placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite firmly on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright and avoid exercise. If bleeding does not subside, call for further instructions.

Pain

For soreness, Ibuprofen (Aleve or Advil) may be taken. Avoid aspirin or aspirin-based products, as these will interfere with blood clotting following surgery.

For pain, take the tablets prescribed as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.

Swelling

The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling may not become apparent until the day following surgery and may not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 36 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.

Diet

After General Anesthesia or I.V. Sedation, liquids should be initially taken. Return to your regular diet as soon as possible. Do not use straws. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. Care should be taken to avoid chewing on your tongue or lip while your mouth is still numb. A high calorie, high protein, high carbohydrate intake is very important. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake may be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, have less discomfort and heal faster if you continue to eat.

Keep the mouth clean

No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the night of surgery. The day after surgery you should begin rinsing at least 8-10 times a day with 8 ounces of warm water mixed with a 1/4 teaspoon of salt.

Other Complications

  • If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful. Call Drs. Curry or Butler if you have any questions.
  • Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
  • You should be careful going from the lying down position to standing. You could get light headed when you stand up suddenly. Before standing up, you should sit for one minute then get up.
  • Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Drs. Curry or Butler.
  • If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as chapstick.
  • Sore throats and pain when swallowing are not uncommon. The muscles become swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.
  • Stiffness (Trimus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time. A quick return to a regular diet helps to diminish stiffness.

Discoloration

Infrequently, discoloration of the skin follows swelling. The development of black, blue, green or yellow discoloration is due to blood spreading beneath the tissues and may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.

Antibiotics

If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reactions. Call the office if you have any questions.

It is now appreciated that antibiotics will inactivate most birth control pills. Sexually active women who take birth control pills should use an alternate form of birth control until they start a new package of birth control pills after the antibiotic course has been completed.

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on coke, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.

Finally

  • Sutures may be placed in the area of surgery to minimize post-operative bleeding and to aid healing. Sometimes they become dislodged but this is no cause for alarm. Just remove the suture from your mouth and discard it. Depending on the type of sutures used, they will dissolve in one to two weeks. So it’s really nothing to worry about.
  • The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur call our office for instructions.
  • There will be a cavity where the tooth was removed. The cavity will gradually over the next month fill in with the new tissue. In the mean time, the area should be kept clean especially after meals with an irrigation syringe. You will be given one at the time of your post operative appointment.
  • Your case is individual because no two mouths are alike. Do not accept well intended advice from friends. Discuss your problem with the persons best able to effectively help you: Drs. Curry, Butler or their staff.
  • Brushing your teeth is okay - just be gentle at the surgical sites.
  • A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur 3-5 days following surgery. Call the office if this occurs.
  • If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.

As oral and maxillofacial surgeons, Drs. William Curry and Monte Butler manage a wide variety of problems relating to the mouth, teeth and facial regions.


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