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POSTOPERATIVE
INSTRUCTIONS:
It is
essential that you follow these special instructions given to you to aid in your
recovery. All Oral Surgery
procedures require extensive postoperative care, and recovery will be smoother
if you do observe the following instructions.
The policy of this office is to cooperate with your dentist and physician
in treatment of your case. A report
is always made to the referring doctor.
You
should reduce your activity as much as possible for several hours after Oral
Surgery. This helps to reduce bleeding and permits the formation of a
blood clot which is necessary for healing.
BLEEDING:
Some
bleeding following surgery is to be expected.
Some oozing of blood may continue for a short time and may even persist
until the next day. It is normal
for the saliva to be lightly streaked with blood for about one day.
Do not mistake this for extensive bleeding. However, if there is more than just oozing the following
procedure will help control it:
1. Rinse the mouth once with mouth wash.
2. Wipe the extraction site and remove any excessive clot present.
3. Take a clean gauze pad, place it directly over the extraction site on the
gum, wedging it tightly between any teeth which may be present.
4. Bite firmly so there is pressure against the bleeding spot for about 45
minutes and repeat if necessary.
5. If bleeding continues in spite of the above measures, replace the gauze
with a tea bag moistened in warm water and repeat the above procedure.
6. If the bleeding is still not controlled, please call our office.
Bleeding sometimes occurs 4 to 5 days following surgery.
Use the above methods listed for controlling the bleeding and contact our
office for a postoperative appointment.
RINSING:
Do not
rinse until the next morning.
Rinsing
may disturb the clot and should NOT be done in the presence of bleeding. The day
after surgery, rinse with a solution of a half teaspoon salt in a glass of warm
water. Rinsing should be done after
meals and before bedtime until the surgery site is no longer tender.
SWELLING:
Swelling
following oral surgery should be expected.
It usually reaches its greatest peak on the second or third postoperative
day. On awakening the morning after
surgery, a large amount of swelling should not be cause for alarm.
The
swelling may take five to six days to disappear and may vary from very little to
a great amount depending on the individual reaction and procedure performed.
ICE:
Upon
reaching home put an ice bag wrapped in a towel on your face, 20 minutes on and
10 minutes off. Continue doing this
during waking hours for the first 6-8 hours following surgery.
Do not use any ice pack after the first 48 hours.
HEAT:
48 hours
after surgery change to heat. A
heating pad or hot towel applied to the swollen area for 30 minutes three to
four times daily will help reduce the swelling more rapidly.
NAUSEA:
A small
percentage of patients will experience nausea following surgery due to the
swallowing of blood, the medication prescribed, or the anesthetic itself. Taking the medication on an empty stomach should be avoided
to reduce nausea. Please call the
office if nausea persists for more that 12 to 18 hours.
BAD
TASTE OR MOUTH ODORS:
May be
due to sutures or dissolvement of the blood clot.
Also a fine white deposit may appear on the gum, which is simply food
deposit and should not be mistaken for infection.
Frequent mouth rinses can alleviate the situation.
DISCOMFORT:
For
discomfort take the medication that was prescribed as often as it says on the
label. If the discomfort is not controlled by the medication, please
call the office.
DIET:
Eat a
soft or liquid diet following surgery. Do
not skip any meals. As your
discomfort lessens resume your regular diet.
You will feel better, have more strength, and heal faster if you eat.
FLUIDS:
Drink
plenty of fluids such as ginger ale, tea, coffee, or water.
Drink at least 8 glasses a day until you are eating properly.
OPENING
OF MOUTH:
An
inability to open your mouth after surgery can be expected.
The use of hot compresses on the outside of your faced in addition to
rinsing with hot salt water will be of help.
Try to force your mouth open a few times daily to help reduce muscle
stiffness.
LIPS:
If the
corners of your mouth are cracked or sore following surgery keep them lubricated
with a little Vaseline.
DISCOLORATION:
Do not be
alarmed if a yellowish blue-black discoloration appears on your face after
surgery. It may take a week or so
to fade away. This sometimes
extends down into the neck or up under the eye.
POSTOPERATIVE
VISITS:
It is
important that you return for postoperative examination and treatment following
any surgery in the mouth.
When the
sutures are placed they must be removed. If
they fall out they should not be of any undue concern; however, the surgical
site still should be observed by the doctor.
POSSIBLE
COMPLICATIONS:
Following
any oral surgical procedure (particularly the removal of impacted lower wisdom
teeth) several side effects may occur.
1. You may have a sore throat or earache for a few days.
If the medication you are taking does not make you comfortable, call the
office.
If you
have pain which becomes worse after few days this could indicate inflammation
of the tooth socket. It is
important for you to call the office immediately and arrange for treatment. Do not wait for your next scheduled appointment.
2. Other teeth in the same area as the surgery is performed may ache due to
sympathetic pain.
3. In the case where an impacted tooth or a cystic area lies in close
proximity to another tooth the possibility does exist that damage may have been
caused by the impacted tooth or cystic area to the adjacent tooth.
Since this problem may not be noticeable until after the tooth or cyst is
removed, postoperative observation will be carried out to determine if this has
occurred.
4. You may develop a fever. If
the temperature reaches 101 degrees, call the office.
5. A numbness of the lower lip or tongue may occur on the same side as the
surgery. This should cause you no
alarm. It normally will disappear;
however, the period of numbness will vary in different patients. Please mention this at your postoperative visit.
6.
There may be an opening in your gum after surgery.
This will fill in with time. Rinse
your mouth after meals to keep it clean.
7. After teeth are extracted the patient may feel hard projections in the
mouth and think they are roots. This
is usually a hard, bony partition that surrounds the roots of the teeth. These generally work themselves out, or usually disappear
within 2 weeks. However, please
contact this office so you may be observed.
8. Tightness of the muscles may cause difficulty in opening the mouth
following surgery.
9. On occasion gum shrinkage or gum overgrowth may occur depending on the
type of surgery performed. Please
mention this at your postoperative visit so this may be observed.
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PRIOR
TO YOUR WISDOM TEETH SURGERY
Examination
Before
the surgeon can determine if your wisdom teeth should be removed, he or she will
conduct an examination of your mouth and discuss the results with you.
This examination will include x-rays, which show the presence of
the impacted teeth and reveal such important things as curved roots, proximity
of the tooth roots to nerves, and other vital surgical information that cannot
be determined by visually inspecting the mouth.
Your surgeon will
discuss the results of your examination with you and will recommend an
appropriate treatment plan.
A
complete health/medical history will be taken, with particular attention
to allergies, medications or health problems that might affect surgery and/or
administration of anesthesia. The
surgeon will examine your mouth for any signs of swelling or infection,
and will check your blood pressure and certain other vital signs
in order to determine the type of anesthesia to use during surgery.
It is important that you provide complete information, particularly about
medications you may be taking, so the surgeon has an accurate assessment of your
health prior to recommending surgery.
Preparing
for Your Surgery Visit
The
following are tips to help prepare for your surgical appointment:
1. Clothing – Wear loose, comfortable clothing with sleeves that can be easily rolled up.
If you are to be given an intravenous anesthetic, tight sleeves can make
this difficult.
2. Transportation –
Arrange to have someone accompany you to your surgery appointment and drive you
home afterward. You may be drowsy for a while after anesthesia, and driving
yourself is unsafe.
3. Diet –
If intravenous anesthesia will be administered, do not eat or drink for at least
6 hours prior to your surgery appointment.
4. Medications –
Adhere to any medication schedule that is prescribed by the surgeon prior to
surgery. For example, antibiotics
may be prescribed in certain cases to eliminate any infection that may otherwise
complicate surgery and healing. Your
surgeon will explain any medication schedule that is needed for your individual
case.
WHAT
TO EXPECT DURING WISDOM TEETH SURGERY
 1.Anesthesia
Modern
anesthesia technology now makes it possible to perform even complex surgery in
the dental office with little or no discomfort.
During surgery, one or more of the following is used to control pain and
anxiety: local anesthesia that numbs the surgical area; nitrous
oxide-oxygen (sometimes called “laughing gas”) to relax you; intravenous
sedation for relaxation; and general anesthesia that puts you to
sleep. Your surgeon will fully
explain the type of anesthesia that is most appropriate for your needs.
Anesthesia will
permit the removal of your wisdom teeth with little or no discomfort.
 2.The
Surgical Procedure
The
method used to remove your wisdom teeth will depend on various factors, for
example, the position of the teeth; the length of curvature of the tooth roots;
the thickness of the bone surrounding the teeth; and so on.
If the teeth have fully erupted, it is possible to simply remove each
tooth intact from its socket in the bone, using forceps or other instruments
designed for this purpose. If gum
tissue is covering the tooth, an incision will be required to turn back the gum
and expose the tooth. Likewise, if
bone covers the tooth, the surgeon will remove sufficient bone to expose the
tooth and allow its removal.
The surgical
procedure used to remove your wisdom teeth will take up to one hour, although
this varies according to each case.
3.Immediately
Following Surgery
If
your surgery was performed in the dental office or hospital outpatient facility,
you will probably rest for some time before you are driven home by your
companion. During this
“recovery” time the surgeon or an assistant will monitor your condition and
make sure you are ready to leave.
AFTER
YOUR WISDOM TEETH SURGERY
What
to Expect
Your
Surgeon and/or the office staff will give you specific instructions to follow
after surgery is completed. You can
expect some bleeding for a while, and you will probably be asked to bite gently
on gauze for a few hours after surgery to allow a blood clot to form in the
extraction site(s). Even a little
blood can seem like a lot to you, so don’t be alarmed by gentle oozing of
blood for a few hours after surgery. However,
if bleeding is excessive after you return home, contact your surgeon
immediately for instructions.
 Ice
packs applied to the face following surgery will help to reduce swelling, but
expect some swelling to occur during the normal healing process.
This swelling may increase for the first 48 to 72 hours and then begin to
subside. There may be some
discoloration of the skin during healing, first black-blue in color, then
turning yellow and disappearing in a few days.
There may also be pain for several days following surgery.
Your surgeon will prescribe the appropriate pain medication for your
needs.
Diet
As
your mouth heals following surgery, your jaw may be sore and may not open as
wide as usual. After a few days,
moist heat applied to the face may be helpful, and gentle opening and closing of
the mouth can help exercise the jaws and restore normal movement.
In the extraction sites, the formation of a blood clot following surgery
is important for the healing process, so be careful not to disturb this clot
when eating. For the first two days
following surgery, eat soft foods and drink fluids, but avoid using a straw.
The suction could disturb clotting.
Do not rinse your mouth vigorously until clotting is complete, although
gentle rinsing with salt water may be recommended by your surgeon to aid
healing. Avoid eating hard or
sticky foods that might damage your jawbone, particularly if bone was removed
during surgery. And remember that smoking can disturb blood clots and the
healing process. Clean your mouth
gently with a toothbrush after the first day following surgery, but avoid
disturbing blood clots with the toothbrush.
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DURING
HEALING
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| YES |
NO |
| Soft foods |
Tobacco use |
|
Fluids without straw |
Sucking fluids with straw |
|
Gentle cleaning of mouth |
Vigorous rinsing or cleaning that will disturb blood clots |
| |
Hard/sticky foods |
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Vigorous exercise during the first 3-5 days |
EMERGENCY
ASSISTANCE:
Contact
our Huntington office at (631)
427-7373 during regular business hours.
Contact
our Centereach office at (631)
737-2626 during regular business hours.
PLEASE
feel free to contact our office at (516) 795-0715 after office hours if you need
any additional advice with regard to your progress or recovery.
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