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.
Do not use mouthwash for at least twelve hours after leaving the office. You can brush your teeth the night of surgery but rinse gently. 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 ½ teaspoon of salt. Brushing the top of your tongue should help eliminate any bad taste. After the first 24 hours, use the curved tip plastic syringe you were given with warm salt water. Gently flush the extraction socket clean.
A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Place gauze over the wound and bite down firmly for at least thirty minutes. Repeat if necessary. 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, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.
For mild to moderate pain, one or two tablets of Advil or Ibuprofen may be taken every four hours. For severe pain, take two tablets of Advil or Ibuprofen every 4 – 6 hours AND your prescribed pain medicine as labeled. Please start taking your medication before the local anesthesia and numbness wears off. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. If you suddenly sit up or stand up from a lying position, you may become dizzy and a few people black out for a few seconds. 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.
If you have been placed on any antibiotic (you will be told this), take the tablets or liquid as directed. The drugs you may be given will minimize swelling, reduce discomfort, prevent infection and promote healing. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions.
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. The ice packs should be left on thirty minutes out of each hour. After 24 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. The swelling should be greatest the second or third day after surgery, and thereafter slowly recede. Some temperature rise is to be expected after surgery.
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 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.
For the first few hours, liquids only may be consumed. DO NOT USE STRAWS as sucking motion causes more bleeding – drink from a glass. Dehydration must be guarded against when having oral surgery. Since a patient’s solid food intake may be limited the first day, it is necessary to compensate for this by increasing the fluid intake (at least five or six glasses of liquid a day should be taken). Drink fluids such as water, orange juice, tomato juice, ginger ale or milk and follow with a soft diet for about 2 days.
After fluids for the first few hours, you may eat anything soft by chewing away form the surgical sites. High calorie, high protein intake is very important. Refer to the section on suggested diet instructions at the end of the brochure. Soft nutritious foods such as soft boiled eggs; chopped meats, custards, jello, thick soups, milk, milk shakes or a liquid dietary supplement should be substituted. Nourishment should be taken regularly. Try not to miss a single meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.
Nausea can be caused by the anesthetic medicine, pain medicine or by swallowing blood. It is good to have a milk shake, soup (warm not hot) or some other products in your stomach before beginning on pain medicine. If this does not help, suppositories for nausea may be used. 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.