After Exposure of an Impacted Tooth

Bleeding

It is normal to experience some bleeding or redness in your saliva 24 hours after the procedure. If you experience excessive bleeding, place a moistened gauze pad directly on the wound and bite down for at least 30-45 minutes. Call for further instructions if bleeding persists.

Swelling

Swelling is our body’s natural reaction to surgery and eventual repair. Swelling can be minimized by applying ice packs immediately following surgery. Apply ice packs continuously during the first 36 hours, 20 minutes on, and 20 minutes off.

Diet

Avoid hot liquids and food. Eat soft foods that don’t need to be chewed, such as yogurt, pudding, mashed potatoes, etc. Eat a high-calorie, high-protein diet. Eating regularly and not missing a single meal will help you to feel better, have more strength, and heal faster. 

Drink plenty of fluids throughout the day to ensure you remain well-hydrated. Since your food intake will be limited for the first 1-2 days, you should compensate by drinking at least 5-6 glasses of fluid per day. 

Caution: You may feel dizzy or faint when standing up from a lying or sitting position. If you are lying down after surgery, sit up slowly and place your feet on the ground.  Stay seated with your head elevated for one minute before standing. On occasion, a patient may faint following sedation/anesthesia due to a lack of blood flow to the brain. If the escort witnesses the patient fainting, please elevate the patient’s legs above their head for 30 seconds. This will allow oxygenated blood to return to the patient’s brain and restore consciousness. Staying well hydrated following surgery will help prevent fainting.  

Pain

As with any surgery, some degree of discomfort is to be expected. You will usually be given a prescription for pain medication. We recommend taking pain medication before the numbing medication has worn off for the best pain management. You will experience the most severe pain within 6 hours of the anesthesia wearing off. After that, your need for pain medication should decrease.

For moderate pain, take a dose of Ibuprofen (Children’s Advil or Motrin) every 4-6 hours as needed for pain. Do not exceed the maximum daily dosage suggested on the bottle. For severe pain, the prescribed medication should be taken as directed. To avoid stomach upset, take the pain medication after a meal or with a small snack. If you have allergies to any medications above, do not take them. If your doctor has advised you not to take the medications mentioned above, do not take them.

Do not take Ibuprofen if you:

•  Have an intolerance to it
•  Have a history of stomach ulcers 
•  Have a history of kidney disease 

While taking pain medication, do not:

• Operate a motor vehicle
• Operate machinery (lawn mower, etc.) 
• Drink alcohol 

If you still experience significant pain that is not improving 3-5 days after surgery, notify the clinic. Prescription pain medication has the potential to be addictive, so it’s very important that you only take it if you are experiencing significant post-operative pain. If you do not finish all your prescription medication, take the unused medication to the police station or a pharmacy, and they will dispose of it responsibly. Never leave unused medication in your medicine cabinet at home. 

We recommend the following protocol for optimum pain management:

Take each medication with a small snack and a full glass of liquid.

Immediately Following Surgery: 1 Prescription pain pill

3 Hours Later: Ibuprofen dosage

3 Hours Later: 1 prescription pain pill

3 Hours Later: Ibuprofen dosage 

NOTE: The dosage of the prescription pain medication can be increased to 1 1/2 to 2 pills if needed for pain management.

Nausea and Vomiting

Nausea and vomiting are common side effects of anesthesia and pain medication. To reduce nausea, eat a small snack before taking the medication and drink a large amount of fluids when you take the medication. If you are nauseous and/or vomiting after surgery, avoid eating, drinking, or taking pain medication for at least one hour. After the hour has passed, sip ginger ale, tea, or coke. Sip slowly over a period of fifteen minutes. Do not use a straw. You may begin taking solid foods and the prescribed medication when you no longer feel nauseous. To help with nausea and vomiting, do not take medication on an empty stomach.

Oral Hygiene

Keeping your mouth clean following surgery is essential to good healing and is one of the best ways to avoid infection. You should carefully brush and floss your teeth the night of surgery, avoiding the surgery site. Be gentle initially when cleaning the surgical areas. The brush should only make contact with the teeth in the area of surgery. Do not brush the sutures. Brush teeth after each meal.  A child’s soft toothbrush can be utilized for this purpose, paying particular attention to keeping the brush in direct contact with the teeth. ​​You may be prescribed a bottle of Chlorhexidine mouth rinse, begin using it the night of surgery after brushing and flossing. This mouth rinse should be used twice daily, after breakfast and before bed, until gone. Rinse for at least 30 seconds before spitting it out. Do not drink or eat food for 15 minutes after using the mouth rinse.

The day after surgery, rinse with warm salt water at least 5-6 times a day, especially after eating. To make the salt water rinse, mix one teaspoon of salt with a cup of warm water. In addition to a saltwater rinse, mix 50% hydrogen peroxide/50% water. Dip a Q-tip in the solution and gently wipe over the surgery site. This will ensure plaque doesn’t accumulate on the sutures or teeth surrounding the area. Try to avoid over-the-counter mouthwashes that contain alcohol. Do not use a water pik for 2 weeks after surgery. 

Remember: Keeping the wound clean will ensure it heals better and faster. 

Activity

Keep physical activity to a minimum for the first few days following surgery. Exercise can cause an increase in blood pressure and result in throbbing and bleeding. After oral surgery, your food intake is often reduced, which can lead to feeling weak and limit your ability to exercise.

Smoking

DO NOT SMOKE for a minimum of 4 weeks following surgery. The toxic chemicals and heat in cigarette or marijuana smoke is harmful to the healing of wounds. Ideally, you should quit smoking as this will give the surgical site the best chance of healing.