The removal of impacted teeth is a serious surgical procedure. The recovery period for this procedure is 3-5 days. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.
Things to Avoid the First 24 hrs. Following Surgery
Vigorous mouth rinsing and spitting following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to dislodge.
Picking and probing at the surgical site
Sipping through a straw
Blowing your nose
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 24 hrs. After the first hour, if persistent bleeding occurs, moisten a tea bag, wrap it in gauze and bite down on it for 30 minutes. The tannic acid in the tea bag helps to form a clot by contracting the bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid excessive exercise. If bleeding still does not subside, please call our office 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 two to three days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two plastic bags filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be applied for 20 minutes per hour for the first 48 hours following surgery. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Forty-eight hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.
After surgery you may be prescribed pain medication. Please take as directed. Remember to take your medication with food.
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.
Drink liquids after general anesthesia or IV sedation. Do not use straws when drinking 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 site(s). High calorie, high protein intake is very important. Try to maintain a normal diet. 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 five to six 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 or spitting of any kind should be done until the day following surgery. You can gently brush your teeth the night of surgery. The day after surgery you should begin rinsing at least five to six times a day with a cup of warm water mixed with a teaspoon of salt especially after eating.
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 postoperative occurrence, which may occur two to three days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.
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 rash or other unfavorable reaction. Call the office if you have any questions.
Nausea & 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 15-minute period. When the nausea subsides, you can begin taking solid foods and the prescribed medicine. If the nausea persists it may indicate that you are having an adverse reaction to the medication. Please call our office at (603) 225-3482.
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.
A slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office.
Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls, which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by the surgeon.
If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with chapstick or an ointment such as Vaseline.
Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in two to three days.
Stiffness (trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event that will resolve in time.
A dry socket is when the blood clot get dislodged prematurely from the tooth socket. Symptoms are EXTREME pain at the surgical site and even pain to the ear may occur two to three days following surgery. If you are a smoker and are smoking following your procedure, you are a candidate for developing a dry socket. If this occurs, you will need to be seen in the office for treatment.
Dissolvable 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. Please call our office if you have questions regarding your stitches.
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 the office for instructions.
There will be a cavity where the tooth was removed. The cavity will gradually fill in with new tissue over the next month. In the meantime, the area should be kept clean especially after meals with salt-water rinses or a toothbrush.
Refrain from exercise or playing sports during your 3-5 day recovery period. Also, if you play a woodwind instrument (trumpet, clarinet, flue, horn, tuba) please refrain from playing at least one week post-operatively.