After Exposure of an Impacted Tooth
Do not disturb the wound. If surgical packing was placed, leave it alone. The pack helps to keep the tooth exposed. If it gets dislodged or falls out do not be alarmed.
Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding which results in your mouth filling rapidly with blood can frequently be controlled by biting with pressure on a gauze pad placed directly on the bleeding wound for two hours. If bleeding continues please call 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 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 on for 20 minutes then off for 20 minutes while you are awake. After 36 hours, ice has a minimal effect. Swelling or jaw stiffness is a normal response to surgery, there is no cause for alarm unless you feel that it is increasing with time. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.
After general anesthetic or I.V. sedation, clear liquids should be initially taken. Do not use straws. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. After three hours, you may drink full liquids (milkshakes, protein shakes, etc.) or have anything that you do not have to chew (yogurt, ice cream, scrambled eggs, etc.). Smoothies are not a good choice because they may contain small seeds and particles. High calorie and 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.
Unless there is a contraindication (bleeding disorder, kidney disease, stomach problems), you should begin to take Ibuprofen as soon as your are able – well before the local anesthesia begins to wear off. Tylenol (Acetaminophen) may be taken instead of Ibuprofen, but this should not be combined with the stronger, prescribed pain medicine as this medicine already contains Acetaminophen. Ibuprofen however, may be combined with the stronger prescribed pain medicine as these two medicines act on you body in different ways. Ibuprofen bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken every 4-6 hours as needed for pain. For severe pain, the prescribed medication may be taken as directed. Do not take any of the above medication if you are allergic to it, or have been instructed by a doctor not to take it.
For severe pain, take the tablets prescribed as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. While taking: do not drive an automobile or operate any potentially dangerous machinery for 24 hours. Do not drink alcoholic beverages in combination with pain medicine. 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.
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 (1/2 teaspoon of salt in a cup of warm water) six times a day. Continue this procedure until healing is complete.
REMEMBER: A clean wound heals better and faster.
Keep physical activities to a minimum immediately following surgery. If you are considering exercise, a throbbing sensation 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.