After Exposure of an Impacted Tooth
Immediately Following Surgery
- If you received intravenous sedation or general anesthesia, you may feel drowsy for several hours. Remember do not drive a vehicle, operate any machinery, or undertake important matters for 24 hours following your anesthesia experience and plan to rest for the remainder of the day.
- Keep the gauze pad in place over the surgical site with firm biting pressure for one (1) hour. After this time, the gauze pad should be removed and discarded. A new gauze pad does not need to be placed unless bleeding continues or recurs.
- Avoid vigorous mouth rinsing, sucking on straws, smoking, and/or touching the wound area following surgery. This may initiate bleeding by dislodging the blood clot.
- Take the prescribed pain medications before you begin to feel discomfort. This will usually coincide with the start of the local anesthetic wearing off which typically occurs 4 to 6 hours after surgery.
- Restrict your activities the day of surgery and avoid exercise. Lie down upon returning home with your head elevated on two or three pillows or sit up in a recliner and take it easy.
- You may place an ice pack to the side of your face where surgery was performed to help minimize swelling.
A certain amount of bleeding is to be expected following an expose and bond surgery. Slight oozing or blood-tinged saliva is not uncommon for the first 12-24 hours. Keep the gauze pad in place over the surgical site with firm biting pressure for one (1) hour. After this time, the gauze pad should be removed and discarded. A new gauze pad does not need to be placed unless bleeding continues or recurs. If bleeding does not subside, please call our office for further instructions.
Swelling is normally expected after most surgical procedures and is usually proportional to the extent of the surgery performed. Swelling around the mouth, cheeks, eyes, and sides of the face is not uncommon. This is the body’s normal reaction to surgery. Most swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, swelling and discomfort may be minimized by the immediate use of an ice pack. An ice pack (a bag of frozen peas work great) should be applied to the side of the face where implant surgery was performed. This ice pack should be applied for 30 minutes on and 30 minutes off for the first 24 to 48 hours while awake. After 48 hours ice has no beneficial effect. Instead, the application of moist heat to the sides of the face may be helpful in reducing the size of the swelling more quickly. On occasion, some residual swelling may last a week or longer.
Take the prescribed pain medications before you begin to feel discomfort. This will usually coincide with the start of the local anesthetic wearing off which typically occurs 4 to 6 hours after surgery. Taking pain medication on an empty stomach may cause nausea, so it is recommended to take the pills with food or drink. Pain medication may make you groggy and slow your reflexes. Do not drive a vehicle, operate any machinery, or undertake important matters while medicated. It is also best to avoid alcoholic beverages. If you do not achieve adequate pain relief you may supplement each pill with an over-the-counter pain medication such as ibuprofen. When appropriate you may transition from the prescribed pain medication to an over-the-counter pain medication such as acetaminophen (Tylenol) or ibuprofen (Advil/Motrin).
It is best to wait until your local anesthetic has completely worn off before beginning to eat. Drink from a glass and do not use a straw as this may encourage more bleeding by displacing the blood clot. Avoid hot foods and liquids the first day after surgery. You may eat anything that is soft and cool the first day by chewing away from the surgical site. Avoid hard, crunchy foods that may disturb the area. It is best to progress to more solid foods and return to your normal diet as soon as possible.
Begin gentle, warm salt water rinses (1 teaspoon of salt in 1 cup of warm water) the morning after surgery. Rinsing with salt water at least 3-4 times a day, especially after eating, will help to reduce inflammation and will gently flush food particles away. Dr. Conquest may prescribe an antibiotic mouth rinse to use in place of salt water. Continue to brush your teeth as best you can – remembering to be careful around the surgery site.
Antibiotics may be prescribed for certain patients after surgery to help prevent infection. If you have been placed on antibiotics, take the tablets or liquid as directed until gone. Discontinue antibiotic use in the event of a rash or any other unfavorable reaction and contact our office immediately. If you were prescribed an antibiotic and are currently taking oral contraceptives, you should use an alternate method of birth control for the remainder of this cycle.
The Surgical Site
You may have sutures in your mouth to minimize bleeding and to help with healing. If one or two of these sutures fall out early, there is no cause for alarm. Just remove the suture from your mouth and discard it. Unless Dr. Conquests informs you otherwise, the sutures we place will dissolve and fall out on their own in 1 to 2 weeks.
If a surgical packing material was placed at the surgical exposure site please try to leave it alone. The packing helps to keep the tooth exposed. If it gets dislodged or falls, out please contact our office for further instructions.
Plan on scheduling an appointment with your orthodontist one to two weeks following your procedure. There may be a small gold chain protruding from your surgical site and tied to the wire of your braces with a black suture or silver wire. Your orthodontist will remove this suture or wire before beginning the process of moving your impacted tooth into the proper position.
What Else Should I Know?
Keep your lips moist with chap stick or an ointment such as Vaseline. Due to stretching of the mouth during surgery, your lips may dry out and crack – especially at the corners.
Stiffness (Trismus) of the jaw muscles may occur and cause difficulty when opening your mouth and during chewing for several days following surgery. This is a normal post-operative event which will resolve on its own after several days. Taking an anti-inflammatory medication such as ibuprofen (Advil/Motrin) may help.
You should avoid strenuous exercise for 2 to 3 days following your surgery as this can cause the surgical site to start bleeding again. After a few days you should be fine to return to your normal routine.