The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain, infection, and swelling can be minimized if the instructions are followed carefully.
A certain amount of bleeding is to be expected following surgery. This amount is typically light and intermittent. Slight bleeding, oozing, or redness in the saliva is common for approximately 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 thirty minutes. Repeat if necessary. If bleeding continues, bite 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, keep your head in an elevated position and avoid significant physical activity. Call our office for further instructions if the bleeding does not subside.
After tooth extraction, it is important for a blood clot to form to stop the bleeding and begin the healing process. After the blood clot forms, it is important not to disturb or dislodge the clot as it aids healing. Do not rinse vigorously, suck on straws, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours. These activities will dislodge or dissolve the clot and slow the healing process. Limit physical activity for at least the first 24 hours as this may cause more bleeding from the extraction site.
The degree of swelling 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. Usually the swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days. However, the swelling may be minimized by the immediate use of ice packs. Ice packs can consist of baggies filled with ice or frozen vegetables, and should be applied to the sides of the face where surgery was performed. The ice packs should be left on for a minimum of 20 minutes for every hour the patient is awake. After 48 hours (2 days), ice has no further benefit. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Starting 2-3 days after surgery, the application of moist heat to the sides of the face may be of benefit in reducing the size of the swelling.
For mild to moderate pain, one or two tablets of acetaminophen (Tylenol or Extra Strength Tylenol) may be taken every four hours for pain. Alternatively, one to two tablets of 200 mg ibuprofen (Motrin or Advil) may be taken every 3-4 hours.
For severe pain, take the prescribed medications as directed. The prescribed pain medicine may sedate you so do not drive an automobile or work around machinery. Avoid alcoholic beverages and only mix medications if advised by your doctor. Pain or discomfort following surgery should subside more and more every day. Prolonged, intense pain may require attention and you should call our office.
After general anesthetic or IV sedation, your diet should begin with liquids. Drink from a glass and avoid using straws. The sucking motion of using a straw can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away form the surgical sites. High calorie, high protein intake is very important to promote healing so avoid skipping meals. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. The equivalent of at least 5-6 glasses of liquid should be taken daily. You will feel better, have more strength, less discomfort and heal faster if you are hydrated and continue to eat.
Avoid rinsing of any kind until the day following surgery. You can brush your teeth the night of surgery but do not rinse or spit forcefully. The day after surgery you may begin gentle rinses, especially after eating. You can rinse with tap water, salt water, or a prescribed mouth rinse. Direct irrigation of the site should be delayed for approximately 1 week. You will be given instructions to do this after the surgery if it is necessary.
In some cases discoloration (or bruising) of the skin follow the swelling process. The development of black, blue, green, or yellow discoloration 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 the removal of the discoloration.
Antibiotic usage is not necessary in all surgical cases. Antibiotics may be given to help prevent infection, or to treat an active infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Otherwise, take the tablets or liquid as directed until the course is completed. Call the office if you have any questions or adverse reactions.
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 bland liquid, such as a cola, 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. If the problem persists, please call our office.
Sutures are often placed in the area of surgery to minimize post-operative bleeding and to help healing. Resorbable sutures last for approximately 2 days to 2 weeks. Sometimes they become dislodged and is not a cause for alarm. Just remove the suture from your mouth and discard it. Swallowing sutures will cause you no harm. Non-resorbable sutures should be removed approximately one week after surgery. The removal of sutures is quick and requires no anesthesia or needles.
The pain and swelling should subside more and more each day following surgery. Please call our office if your post-operative pain or swelling worsens or you experience unusual symptoms
There will be a cavity where the tooth was removed. The cavity will gradually fill in with new tissue over the next several months. In the mean time, the area should be kept clean especially after meals with rinses or a toothbrush.
Your case is individual and no two mouths are alike. Be careful accepting well intended advice from friends. Discuss your problem with the persons best able to effectively help you: our doctors, our staff, or your dentist.
Brushing your teeth is okay starting the day of the surgery, but 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 worsen approximately 4-7 days following surgery. This is not a dangerous problem and will not cause any long-term healing problems. We may be able to help the discomfort so please call the office if this occurs.
Avoid strenuous exercise for at least 1 week. Be aware that if you are involved in regular exercise, your normal nourishment intake is reduced. Exercise may weaken you. Stop exercising if you get light headed.