Surgery Instructions

After Tooth Removal

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.

Immediately 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 wound 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 medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.
Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
Place ice packs to the sides of your face where surgery was performed. Refer to the section on Swelling for an explanation.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. 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 30 minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for 30 minutes. Additionally, one can minimize further bleeding by remaining calm, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.

Swelling

Swelling is normally expected after oral 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 applied to the sides of the face where surgery was performed. The ice packs should be applied for 20 minutes on and 20 minutes off for the first 12-24 hours. After 24 hours, ice has no beneficial effect, and it is best to switch to moist heat to the sides of the face, reducing the degree of the swelling.

Pain

Pain after oral surgery is variable. But, it is best to utilize the prescription pain medicine before the anesthetic has worn off. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery while utilizing narcotic pain medicine. 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.

Diet

Eat nourishing food that can be taken with comfort. For the first day, you should be on a soft diet (creamed soups, eggs, puddings, yogurt, milkshakes, etc). Avoid foods like nuts or foods with seeds which may become lodged in the socket areas. Over the next days, you can progress to solid foods at your own pace. Minimally maintain your hydration with plenty of fluids, but don’t skip meals. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat.

Keep The Mouth Clean

No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the night of surgery but rinse gently. The day after surgery you should begin rinsing at least two to three times a day with a cup of warm water mixed with a teaspoon of salt especially after eating.

Bruising

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.

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 rash or other unfavorable reaction. Call the office if you have any questions.

Nausea & Vomiting

Nausea is not an uncommon event after surgery, and it is sometimes caused by stronger pain medicines. Nausea may be reduced by preceding each pill with a small amount of soft food, then taking the pill with a larger volume of water. Try to keep taking clear fluids and minimize the pain medicine, but call the office if you do not feel better or if repeated vomiting is a problem

Sharp Edges

If you feel sharp edges in the surgical areas with you tongue, it is probably the bony walls which supported the tooth. In addition, small slivers of bone, not teeth, might work themselves out after surgery. If necessary we will remove them.

Dry Socket

Dry socket occurs when the blood clot in the extraction site is lost resulting in persistent throbbing pain. If the pain is not managed with the prescribed medications please call our office.

Dentures

If immediate dentures have been inserted, do not remove them for the first 48 hours unless our doctors state it is permissible. This will assist in your dentist’s post-operative denture adjustment visit, relieving those sore spots.

Open Sinus Instructions

If you were informed of a sinus perforation, then follow these instructions for 21 days. Take all prescribed medications as directed. Refrain from vigorous mouth rinsing. Do not smoke. Do not blow your nose. Do not sneeze with your mouth closed. Avoid strenuous exercise. Do not engage in scuba diving, snorkeling, flying, or any activity that would cause a pressure change between the nose and the mouth. Strict adherence to these instructions may prevent the necessity of a surgical closure at a later time

Other Complications:

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. 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 medications can make you dizzy. You could get light headed when you suddenly stand up. Before standing up, you should sit for one minute and then get up.
If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with 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.
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. Just remove the suture from your mouth and discard it.