The removal of impacted teeth is a 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.
IMMEDIATLEY 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.
Vigorous mouth rinsing or touching the 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 medication before you begin to feel discomfort.
Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
Place an ice pack to the side 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 normal for 24 hours. Excessive bleeding (your mouth fills up with blood) can be controlled by biting on a gauze pad placed directly on the bleeding area for 30 minutes. Repeat if necessary. If you continue to bleed 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, do not become excited, sit upright and avoid exercise, if bleeding does not subside call us at (203) 744-1240 for further instructions.
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 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 baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. 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 pain from swelling. At times, Dr. Gedeon will prescribe a medication that will help reduce the amount of swelling after surgery.
PAIN:For moderate pain, two tablets of Extra Strength Tylenol may be taken every 3-4 hours or Ibuprofen (Motrin or Advil) two to four 200 mg. tablets may be taken every 4-6 hours.
For severe 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 at (203) 744-1240.
DIET: After general anesthesia or IV sedation, liquids should be initially taken. Do not use a straw, drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. High calorie, high protein intake is very important. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will 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, less discomfort and heal faster if you continue to eat. Caution: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.
KEEP THE MOUTH CLEAN: No rinsing of any kind should be performed until the day following surgery. You can brush your teeth carefully the night of surgery. The day after surgery you should begin rinsing at least 5-6 times a day with a glass of warm water mixed with a teaspoon of salt especially after eating.
DISCOLORATION: In some cases, discoloration of the skin follows surgery. 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 after surgery. 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 unfavorable reaction. Call the office at (203) 744-1240 if you have any questions.
ORAL HYGIENE: Mouth cleanliness is essential to good healing. Clean your mouth thoroughly after each meal beginning the day after surgery. Brush your teeth as best you can. Rinse with warm salt water (1 teaspoon of salt in a glass of warm water) six times a day. Continue this procedure until healing is complete. REMEMBER; a clean wound heals better and faster.
NAUSE 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.
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 our office at (203) 744-1240 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 were not able to eat or drink prior to surgery. It was also difficult to take fluids. Taking pain medication can make you dizzy. 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 protrusion in the surgical area with their tongue. They are not roots; they are the bony walls which supported the tooth. These protrusions usually smooth out in time. If not, they can be removed by Dr. Gedeon.
If the corners of your mouth are retracted they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline.
Sore throat and pain when swallowing is not uncommon. 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.
Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, this is not cause for alarm. Just remove the suture from your mouth and discard it. Dr. Gedeon often uses dissolvable sutures; they will usually take 7-10 days to dissolve. If he uses the conventional sutures they will be removed 7-10 days after your surgery. The removal of sutures requires no anesthesia or injections. It takes only minutes and there is no discomfort associated with this procedure.
The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens call our office at (203) 744-1240 for instructions.
There will be a cavity where the tooth was removed. The cavity will gradually over the next month fill in with new bone and gum tissue. In the meantime, the area should be kept clean especially after meals with salt water rinses.
Brushing your teeth is okay just be gentle at the surgical sites.
Dry socket is when the blood clot gets dislodged prematurely from the surgical site. Symptoms of pain at the surgical site will persist. This requires treatment so please contact the office for a follow up visit with Dr. Gedeon.