After Exposure of an Impacted Tooth
Do not disturb the wound. If surgical packing was placed, leave it alone. The packing helps to keep the tooth exposed. If it gets dislodged or falls out, do not get alarmed but please contact our office for instructions.
Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding that rapidly fills your mouth with blood can frequently be controlled by biting with pressure on a gauze pad placed directly on the bleeding wound for 30 minutes. 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 filled with ice cubes on your cheek near the area of surgery. Apply the ice as much as possible for the first 36 hours.
Drink plenty of fluids. Avoid hot liquids or hard foods. Only consume soft food and liquids on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed.
Pain MANAGEMENT SUGGESTIONS
NSAIDs (IBUPROFEN, NAPROXEN, ASPIRIN):
- NSAIDs are by far the most effective medications for pain after oral surgery, however some patients cannot take them (due to ulcers/reflux, blood thinners, asthma, etc.).
1) Take 3 ibuprofen (Advil, Motrin) tablets (200mg each) every 6 hours as needed. Try to get the first dose taken before the local anesthetic/numbness wears off. If needed, a maximum of 4 tablets can be taken every 6 hours – up to 3,200mg per day.
2) Take 1-2 naproxen sodium (Aleve; 220mg) every 12 hours as needed. Do not exceed 4 tablets (880mg) per day.
- If you need better pain control after taking the NSAIDs (or if you cannot take NSAIDs), you should take Tylenol (acetaminophen):
3) Take acetaminophen (Tylenol) 325-1000mg every 4-6 hours as needed. DO NOT take more than 4,000mg of acetaminophen per day.
PRESCRIPTION OPIOID PAIN MEDICATIONS:
If you’ve taken adequate doses of an NSAID and/or Tylenol and feel that your pain is not tolerable, then it is appropriate to add the prescription opioid:
4) If you received a prescription for codeine (Tylenol #3) or hydrocodone (Vicodin, Norco, Lortab, etc.) – you can take that if you need better pain control.
*Be aware that these have Tylenol/acetaminophen in them, so you must be careful to be mindful of the maximum daily dose of Tylenol, which is 4,000mg.
5) If you received a prescription for oxycodone or hydromorphone/Dilaudid: these do not contain Tylenol/acetaminophen. You should be sure to try an NSAID and Tylenol before adding these medications.
- Pain from a tooth extraction usually resolves within 1-2 days, although infections can prolong pain for another day or two. If you are not seeing progress in your pain after 2 days, you should call our office.
Oral Surgery Nurse’s Line – (319) 337-8384
After Hours /Weekends – Mercy Hospital of Iowa City – (319) 339-0300, ask for the oral surgeon on call.
Oral cleanliness is essential to good healing. Clean your mouth thoroughly after each meal, beginning the day after surgery. Brush your teeth normally if possible. Rinse with warm salt water (1 teaspoon of salt in a cup of warm water) six times a day. Continue this procedure until healing is complete.
REMEMBER: A clean wound heals better and faster.
Keep physical activities to a minimum immediately following surgery. If you exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.