Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.
Bleeding
A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened, squeeze dried tea bag for sixty minutes, repeat as necessary. The tannic acid in the dry tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.
Swelling
The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 24 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.
Pain
Dr. Langwinska may prescribe pain killers after for post surgery recovery. Please note that in many cases pain killers are not necessary. If pain killers are not prescribed, you may use over-the-counter medication such as Tylenol or ibuprofen (avoid aspirin unless otherwise instructed). If prescribed, take the narcotic as directed. The narcotic pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If still in severe pain after 3-4 days, contact the office.
Diet
After oral conscious sedation you will feel numbness in your mouth. Once the numbness wears off do not use straws. Instead, drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites (avoid hot liquids and meals as this can cause extra bleeding). High calorie, high protein intake is very important. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat. Caution: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.
Keep the Mouth Clean
No rinsing or spitting of any kind should be performed until 2 days following surgery. You can brush your teeth the night of surgery but do so gently. The day after surgery you should begin rinsing at least 5-6 times a day especially after eating with a cup of warm water mixed with a teaspoon of salt.
Discolouration
In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discolouration is due to bruising beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discolouration.
Antibiotics
If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent or cure infection. It is important that you continue to take antibiotics for the full prescription amount. Do not stop taking when you stop feeling pain, as the infection is subsiding but not yet healed when pain is no longer felt.
Discontinue use of antibiotics if you experience any non-normal side effects (i.e. difficulty breathing, rash, severe stomach issues), and call the office immediately.
Nausea and Vomiting
In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then take sips of water. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine, but stop the narcotic pain medication.
Other Issues
Avoid heavy coughing, sneezing, or nose-blowing following surgery, as the forceful movements may cause dislodgement of the clot and further surgical complications.
If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. If you experience numbness for more than 3 days, contact the office.
Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery. It was also difficult to take fluids. Taking pain medications can make you dizzy. You could get light headed when you stand up suddenly. Before standing up, you should sit for one minute then get up.
If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as vaseline.
Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.
Stiffness (Trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.
Finally
Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, which is no cause for alarm. Gently remove the suture from your mouth and discard it (however, do not remove the suture if it is not dislodged itself. Forcing to a remove a suture will cause bleeding and may cause an infection in the area, causing a return visit). The sutures will dissolve in your mouth between 3 and 7 days.
The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur, call the office for instructions.
There will be a cavity where the tooth was removed. The cavity will gradually fill over the next month with new tissue. In the mean time, the area should be kept clean especially after meals with salt water rinses or a toothbrush. You may also use a WaterPik®, but do so very gently.
Your case is individual, as no two mouths are alike. Do not accept well-intended advice from friends. Discuss your problem with the persons best able to effectively help you: your dentist.
Brushing your teeth is okay — just be gentle at the surgical sites.
A dry socket is when the blood clot dissolves prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur 2-3 days following surgery. Pain should not increase with time. Call the office if this occurs.
If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.