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 carefully followed.

Immediately Following Surgery

Keep the gauze pad placed over the surgical area in place for 45 minutes. After this time, the gauze pad should be removed and discarded.
Avoid vigorous mouth rinsing or touching the wound area on the day of surgery. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
Take the prescribed pain medications as directed. This may include a dose of pain medication before surgery or while you still feel the effect of the local anesthetic.
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. Alternate the placing of the ice pack: 15 minutes on; 15 minutes off for the first 6-8 hours. Refer to the section on swelling for an explanation.
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 for the first 24 hours.
Do not drive or operate any kind of machinery or a motor vehicle for 24 hours after surgery.

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 directly over the surgical area and biting firmly on the gauze 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 (937) 778-1623 or after 5:00 pm and before 8:00 am call (937) 778 1271.

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 will not become apparent until the day following surgery and will not reach its maximum until 2 to 3 days after surgery. However, the swelling may be minimized by the immediate use of ice packs. Ice packs or two baggies filled with ice should be applied to the sides of the face where surgery was performed. Apply the ice packs for 15 minutes, then remove them for 15 minutes while you are awake. Continue this alternate treatment of 15 minutes “on” and 15 minutes “off” with the ice packs for the next 8-12 hours. 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. However, if the swelling gets worse after 3-4 days please call Dr. Tinkler at (937) 778-1623. After 36 hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the amount of the swelling.

Pain

For moderate pain one to two tablets of Tylenol or Extra Strength Tylenol may be taken every 3-4 hours or Ibuprofen, (Motrin or Advil) two to three 200-mg tablets may be taken every 4-6 hours. Please do not exceed the recommended maximum daily dose that is printed on the label in a given 24 hour period.

For severe pain, take the pain medication that may have been prescribed as directed. The prescribed pain medicine may 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 after the first 48 hours. If pain persists, it may require attention and you should call the office. (937) 778-1623

Diet

After a general anesthetic or I.V. sedation, liquids should initially be taken. Do not use straws. Drink 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 sites. High calorie, 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, experience 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 3-4 times a day, especially after eating, with a cup of warm water mixed with 1/8 to 1/4 teaspoon of salt. You may also use a commercial mouthwash twice daily. Do not use a “Water Pic” for at least one week.

Discoloration

In some cases, discoloration of the cheeks and neck follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the skin. This is a normal post-operative occurrence, which may occur 2-5 days post-operatively and may persist for as long as two weeks following surgery. Moist heat applied to the area may speed the disappearance 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 or control infection. Discontinue antibiotic use in the event of an itching rash, nausea, vomiting, diarrhea, or other unfavorable reactions. Call the office if you have any questions. (937) 778-1623.

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth including the prescribed medicine for at least an hour. You should then sip on ice water. After an hour if the nausea subsides, you may try things like 7-Up, ginger ale, or tea with sugar. When you feel sure the nausea is under control, you can begin taking solid foods and the prescribed medicines.

Other Complications

Numbness of the lip, chin, or tongue 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. Call Dr. Tinkler if you have any questions.

A slight elevation of temperature immediately following surgery is not uncommon. (100 degrees Fahrenheit or less) If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
Be careful going from the lying down position to standing. Taking pain medications can make you dizzy. You could get light headed when you stand up suddenly. Before standing up, you should sit for one minute then get up.
Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls that supported the tooth. These projections usually smooth out spontaneously. If not, Dr. Tinkler can remove them.
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.
A sore throat and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-4 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.

Finally

Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. If the sutures become dislodged, this is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures will come out approximately one week after surgery. If removal of the sutures is necessary it requires no anesthesia or injections. It takes only a minute or so, and there is generally little discomfort associated with this procedure. It is really nothing to worry about.

The pain and swelling should begin to subside 2-3 days after surgery. If your post-operative pain or swelling worsens after four days 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 2 months. In the mean time after the first week the area should be kept clean, especially after meals, with vigorous brushing of the adjacent teeth and gums.

Your case is individual, no two mouths are alike. Do not accept well-intended advice from friends. Discuss your problem with the persons best able to help you effectively: Dr. Tinkler, his staff, or your family dentist.

Brushing your teeth is good. — Just be gentle at the surgical sites during the first week after surgery.

A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur 3-5 days following surgery. Call the office if this occurs. A dry socket requires the placement of medication in the socket to relieve the pain.

If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising. It is wise to reduce the amount of exercising you do for 3-5 days after having your teeth removed.