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.

GENERAL INSTRUCTIONS:

  • Do not spit or drink out of a straw. The sucking motion can cause more bleeding by dislodging the blood clot.
  • The gauze pad placed over the surgical area should be kept in place for a half an hour. Every half hour, the gauze pad should be removed and replaced with fresh gauze until the bleeding subsides.
  • Take the pain medications recommended or prescribed as soon as you go home. Do not wait until the pain starts.
  • 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.
  • 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.
  • Do not drive or operate hazardous machinery for 24 hours after surgery or if you are taking narcotic pain medications
  • Do not drink alcoholic beverages (including cough syrups) or smoke during the recovery period
  • Take your temperature twice a day for the next 7 days

CONTACT THE OFFICE IF YOU HAVE:

  • Nausea and vomiting
  • Inadequate pain control with current pain regimen
  • Diarrhea/Constipation
  • Bleeding
  • Worsening swelling after the fourth post-operative day
  • Excessive swelling/redness around the wound area
  • Foul discharge from the surgical sites
  • Unable to urinate within 8 hours of being discharged
  • Develop a fever (=100.4°F or =38°C)

CALL 911 OR GO TO THE NEAREST EMERGENCY ROOM IF YOU SUDDENLY DEVELOP:

  • Weakness or numbness on one side of the body
  • Drooping of the face on one side
  • Not able to speak or understand others’ speech
  • Sudden loss of vision
  • Bad headache for no reason
  • Chest pain
  • Shortness of breath

ANTIBIOTICS: If you were prescribed an antibiotic, take as directed until you finish the entire antibiotic course. If you develop a rash, itching, diarrhea or any other adverse reaction from the medication, stop taking the medication and contact our office.

PAIN MEDICATION: It is recommended that you take pain medication on a full stomach or with a snack. Do not take both Ibuprofen capsules and suspension, take one or the other. Same goes for the Tylenol and any other medication that contains Tylenol. For best pain control, alternate Ibuprofen and Tylenol analgesics every 3-4 hours or as directed by your physician. Only take narcotic medication if the previous pain regimen does not adequately control your pain.

*If prescribed narcotic pain medications: do not consume alcoholic beverages or operate heavy machinery while taking narcotic medication. Narcotic pain medications can cause some constipation and may require a stool softener or laxative. You can get some over-the-counter Colace to help with the constipation. Other side effects of narcotics include nausea, vomiting, sedation. If you encounter nausea or vomiting, stop the narcotic medication and call the office. Medication to control nausea can be prescribed and a different narcotic can also be prescribed. Using less of the narcotic medication can moderate all of these side effects. If your pain control is inadequate with the medication you have been prescribed, call the office for assistance.

MEDICATIONS: Restart all home medications upon returning home.

SWELLING: It is normal to experience some significant swelling following surgery. Swelling is usually worst on day 3 following surgery and will slowly begin to improve thereafter. Ice placed on the sides of the face during the first 48 hours is helpful in moderating the swelling. The ice packs should be used 20 minutes on, 20 minutes off, while you are awake. After 48 hours, you may apply warm compresses or warm towels to the sides of your face as often as tolerated. Test on a different area of your skin before applying to your face. Warm saltwater rinses will keep the mouth clean and help reduce the intraoral swelling. Call the office if swelling continues to increase after the fourth post-operative day.

BLEEDING: A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is common. Excessive bleeding may be controlled by first gently 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 thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, sit upright and avoid strenuous activities. If bleeding does not subside, call for further instructions.

ORAL HYGIENE: Good oral hygiene is essential in order to ensure proper healing and to reduce the possibility of infections. Avoid rinsing of any kind until the day following surgery. You can brush your teeth the night of surgery but rinse gently. Starting the next day after surgery, start rinsing your mouth with the provided mouthwash each morning and night. You should also rinse your mouth with salt water following each meal. A toothbrush should be used carefully in areas of the mouth not involved in the surgical procedure.

DIET: After having oral surgery it is recommended the patient maintain a semi-liquid diet for 24 hours. A regular diet should be resumed as soon as possible, avoiding peanuts, pretzels, and foods with seeds.

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. Call Dr. Mirdamadi if you have any questions.
  • 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. 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 which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. Mirdamadi.
  • 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 2-3 days.
  • Stiffness (Trimus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.

Finally

  • Sutures are placed 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 form your mouth and discard it. The sutures will be removed approximately one week after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure. So it’s really nothing to worry about.
  • 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 over the next month fill in with the new tissue. In the mean time, the area should be kept clean especially after meals with salt water rinses or a toothbrush.
  • 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 effectively help you: Dr. Mirdamadi or your family dentist.
  • Brushing your teeth is okay – just be gentle at the surgical sites.
  • 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 2-3 days following surgery. Call the office if this occurs.
  • 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.