The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.
A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon for the first twenty-four (24) hours. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for sixty (60) minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty (30) to sixty (60) 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 or sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.
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 will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on for half an hour and then off for half an hour and repeated 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 and help with stiffness felt in the jaw area.
For moderate pain, one or two (1-2) tablets of Tylenol or Extra Strength Tylenol may be taken every three to four hours or you may take two to three (2-3) 200 mg tablets of Ibuprofen, (Motrin or Advil) every 3-4 hours.
For more significant 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.
After general anesthetic or I.V. sedation, liquids should be taken initially. Most people can begin drinking fluids once home. Do not wait for the freezing to be gone. Start with clear fluids initially and progress to soup (such as chicken or beef broth), fruit or vegetable juice. The evening of surgery is fine to start milk products such as milkshakes, yogurt and pudding. Drink as much as you are able. Small amounts should be taken frequently. A vitamin supplement is a good idea.
Advance your diet over the next few days to include softer foods such as pasta, scrambled eggs, well-cooked vegetables, fish, etc. Avoid straws for the first few days as the suction can cause bleeding.
No rinsing of any kind should be performed until the day following surgery. The day after surgery you should begin rinsing at least 5-6 times a day especially after eating with a cup of warm water mixed with half a teaspoon of salt (sea salt is ideal). You can brush your teeth gently beginning the morning after surgery.
In some cases, bruising of the skin follows swelling. The development of black, blue, green, or yellow bruising is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up recovery.
If you have been placed on antibiotics, take the tablets or liquid as directed. Discontinue antibiotic use in the event of a rash or other adverse reaction. Call the office if you have any questions. Women need to be aware that certain antibiotics can decrease the effectiveness of oral contraceptive medications.
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 a carbonated beverage. REMEMBER NOT TO USE A STRAW. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine. Gravol may be purchased without a prescription and may be helpful if nausea persists.
Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, this is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures are the “dissolving” type and will fall out in 3-10 days on their own.
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 fill gradually over the next month with new tissue. In the mean time, the area should be kept clean, especially after meals, with salt-water rinses and an irrigating syringe beginning on the 5th day after your extractions. The irrigating syringe should be used twice a day to the lower sockets.
Your case is individual, 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: your surgeon or your family dentist.
Brushing your teeth is okay the day after surgery - 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 4-7 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. Usually, regular exercise can begin 3-5 days following surgery. Check with your nurse or surgeon for further directions.