After Exposure of an Impacted Tooth

surgical instructions

Please do not disturb the wound. In select cases packing may be used to help keep the tooth exposed. If surgical packing was placed, try to leave it alone. If pieces of the packing become dislodged or the packing falls out do not get alarmed, it will not require replacement.

Bleeding

Excessive bleeding which results in your mouth filling rapidly with blood can usually be controlled by biting on a moistened gauze pad.  Apply firm direct pressure on the bleeding wound for 30 to 60 minutes. If bleeding persists apply firm direct pressure with a moistened tea bag. Tea has tannic acid which is an astringent. The direct pressure and the tannic acid help to form a clot by constricting blood vessels. Slight blood tinged saliva or blotting blood on gauze may persist off and on for a day or two after surgery. In general, this does not require management with gauze pressure. If active bleeding continues please call the office for further instructions.

Swelling

Swelling is a normal occurrence after surgery. To help minimize swelling, immediately apply an ice bag or a sealed plastic bag filled with ice cubes on the face in the area of surgery. Ice should be used continuously or as much as possible while awake. Ice is most helpful during the first 24 hours after surgery. After 72 hours ice has no beneficial effect.

Diet

Drink plenty of fluids. Cool or warm liquid and soft food and should be consumed on the day of surgery. Gradually return to a normal diet over several days as swelling and pain diminish. Please see our General Postoperative Care Instructions for more detailed dietary information.

Pain

You should begin taking pain medication as soon as you feel the local anesthetic wearing off. For slight to moderate pain, 1 or 2 Tylenol may be taken every 4 hours. Ibuprofen (Advil, Motrin) may be taken instead of Tylenol. Take two 200mg tablets of ibuprofen every 4 hours or three 200mg tablets every 6 hours as needed for pain. For severe pain, the prescribed medication should be taken as directed.

Many post-operative pain medication such as Tylenol #3, Percocet and Vicodin contain narcotics. These medications can make you dizzy, sleepy, impair coordination and judgment. If you are taking narcotic pain medication you should remain at home. Do not operate complex equipment (such as a lawn mower), drive a car or make important decisions while taking narcotic pain medication.

Oral Hygiene

Start brushing your teeth with tooth brush and tooth paste as best you can the evening of surgery or the day after surgery. Avoid brushing directly on the surgical site. Rinse with warm salt water (1/2 teaspoon of salt in a cup of warm water) five to six times a day. Continue this procedure until healing is complete. If Peridex (chlorhexidine) was prescribed, begin rinsing with it on the evening of surgery or the day after surgery. Rinse one capful in the mouth for one minute and spit out twice a day after brushing for 10 to 14 days.

REMEMBER: A clean wound heals better and faster.

Activity

Keep strenuous physical exertion to a minimum the first few days following surgery. In general, it is best to avoid strenuous exertion until pain and swelling resolves. If you experience pain, throbbing or bleeding during exercise you should discontinue exercising, wait a day or two, then try again.

Be aware that you may be weakened due to reduced nutritional intake. If you become light headed or experience throbbing at the surgical site, stop exercising, wait a day or two, then try again.

It is best to walk, move about and/or sit in a chair. Short naps in bed are acceptable. Lying in bed for a prolonged period of time during the day is not healthy; it will only enhance fatigue and slow recovery. You will feel stronger and better faster if you get your body moving.

Please review our General Post-Operative Care Instructions for additional helpful information.