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 get 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 30 minutes. Spitting, rinsing the mouth, using drinking straws or excessive changes (too frequent or too many changes) of gauze pads are often the cause of excessive bleeding. If bleeding continues please call for further instructions.
Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag or a plastic bag or towel filled with ice cubes on the cheek in the area of surgery. If the exposure was a palatal positioned tooth without cheek side incisions on the alveolar (jaw) ridge, then ice applied to the external face is not useful. In the case of a cheek side exposure of a tooth or incisions made in this area, intermittent application of the ice compresses 20 minutes on and 20 minutes off done continuously as much as possible for the first 12 to 24 hours may be helpful to reduce the amount of swelling that occurs from surgery.
Drink plenty of clear fluids without a straw for the first 24 hours after surgery. Avoid hot liquids or food. Full liquid foods such as milkshakes, soup, mashed potatoes, yogurt, pudding, ice cream, protein drinks, oatmeal, cream of wheat, apple sauce can be eaten eight to twelve hours after surgery if taken with drinks of water. Thereafter a return to a soft diet of pancakes, noodles, muffins, macaroni and cheese, and other foods in this consistency for the next few days then a return to a normal diet a tolerated as soon as possible unless otherwise directed by the doctor.
You should begin taking pain medication as soon as you feel the local anesthetic wearing off. For mild to moderate pain, 1 or 2 Tylenol or Extra Strength Tylenol may be taken every 6 hours for patients over the age of 12 years. Ibuprofen (Advil, Motrin) may be taken instead of Tylenol and often works better. Ibuprofen bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken every six to eight hours for patients over age of 12 years as needed for pain. For severe pain, the prescribed narcotic medication should be taken as directed.
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 avoiding the exposure site for the first few days. After 4 days a gentle whisk brush stroke with your soft tooth brush directly over the site will help clean the area. Rinse your mouth with warm salt water (one half to one teaspoon of salt dissolved in a cup of warm water) four to six times a day. Continue this hygiene procedure until your follow-up exam.
REMEMBER: A clean wound heals better and faster.
You will need to keep physical activities to a minimum immediately following surgery for the first day. If you are considering exercise, you should realize that throbbing or bleeding may occur which may make you discontinue your exercising. Be aware that your normal nourishment intake is reduced and exercise may further weaken you. If you get light headed, stop exercising.