After Exposure of an Impacted Tooth

Do not disturb the wound and avoid chewing food in the area of the exposure for one (1) week.

Bleeding

A certain amount of bleeding is to be expected for a day or two (2) following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing with cold water and wiping any old clots from your mouth, then placing a gauze pad over the area and applying firm pressure for thirty (30) to 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, sit upright, and avoid exercise. If bleeding does not subside, call 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 may not become apparent until the day following surgery and will not reach its maximum until three (3) to four (4) days after surgery. However, swelling may be minimized by following the guidelines listed below. 

• Apply a cold compress to the side(s) of the face where surgery was performed. The cold compress should be utilized for the first 24 – 36 hours by leaving it on the face in the area for twenty (20) minutes, then removing it for twenty (20) minutes. A cold compress has no beneficial effect in reducing swelling thirty-six (36) hours after surgery. 
• Take two (2) to three (3) tablets of ibuprofen every four (4) hours. 
• While in a resting position, it is important to keep your head elevated above your heart. 

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 (36) hours following surgery, the application of a warm compress to the face over the area(s) where surgery was performed is beneficial in reducing the size of swelling. Apply the warm compress for twenty (20) minutes, then remove it for twenty (20) minutes until swelling and jaw stiffness subside.

Diet

Drink plenty of fluids. Avoid hot liquids or food. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible, unless otherwise directed.

Pain

Unfortunately, most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication, but it may take up to several hours for the pharmacy to prepare your prescribed pain medication. Taking over-the-counter pain medication (two [2] tablets Extra Strength Tylenol and three [3] tablets Ibuprofen 200mg) before the numbness wears off will help you be able to manage any discomfort better. Effects of pain medicines very widely among individuals. For ongoing moderate discomfort, one (1) or two (2) tablets of Extra Strength Tylenol may be taken every four (4) hours. Ibuprofen (Motrin or Advil) may be taken instead of Tylenol, unless you are on Coumadin/warfarin. Ibuprofen bought over the couner comes in 200mg tablets. Two (2) to three (3) 200mg tablets (400 – 600mg total) of Ibuprofen may be taken every four (4) hours as needed for discomfort.

For severe pain, take the tablets prescribed as directed. The prescribed pain medicine will make you groggy and slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. If you do not achieve adequate relief from your prescription, you may supplement your prescription with two (2) to three (3) 200 mg tablets of Ibuprofen every four (4) hours, if you are NOT also on Coumadin/warfarin. Some people may even require two (2) of the prescription tablets at a time during the early stages, but that may add to the risk of upset stomach. The more severe discomfort is usually experienced within the first three (3) days after the surgery. Pain or discomfort following surgery usually subsides more and more each day after that, and your need for medicine should lessen as well. Sometimes, the pain increases as the swelling increases over the next two (2) to three (3) days. If significant pain persists for more than three days, it may require attention and you should call the office. Do not take any of the above medication if you are allergic, or have been instructed by your doctor not to take it.

Oral Hygiene

Mouth cleanliness is essential to good healing. No vigorous rinsing should be performed the day of surgery. You may brush your teeth the night of surgery, but rinse gently. Avoid brushing the gums in the area of surgery for one (1) week. The day after surgery, you should begin gently rinsing after meals and additionally, for a total of four (4) to six (6) times a day, with an 8oz. glass of warm water mixed with one-half teaspoon of salt. Continue this procedure for one week following your surgery.

Discoloration

In some cases, discoloration of the skin follows swelling. 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 two (2) to three (3) days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.

Nausea & Vomiting

Nausea may occur after surgery, and is sometimes caused by stronger pain medications. Nausea may be reduced by preceding each tablet with a small amount of food, then taking the tablet with a large volume of water. In the event of nausea and/or vomiting following surgery, do not take anything by mouth for a least an hour, including the prescribed medicine. You should then sip on tea or ginger ale (after stirring out carbonation). You should sip slowly over a 15-minute period. If you are not on Coumadin/warfarin, you may also try Alka-Seltzer or Pepto Bismol. When the nausea subsides, you can begin taking solid foods and the prescribed medicine. If nausea persists for more than four hours, call the office.

Sutures

Sutures may be 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. In most cases, sutures will dissolve unnoticed within a week. Occasionally, sutures require removal after one week. The removal of sutures is a quick procedure that requires no anesthesia or needles and is usually associated with minimal to no discomfort.

Activity

Keep physical activities to a minimum immediately following surgery. If you exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light-headed, stop exercising.