SWELLING/BRUISING. Swelling and/or bruising is to be expected following surgery. To help control this, apply an ice bag to the operated side of the face for 20 minutes; remove for 20 minutes. Repeat this alternating procedure during the first to third day. To be most effective, the application of ice packs should begin as soon as possible. It is usual after removal of wisdom teeth to have a decrease in mouth opening, and this resolves over 1-3 weeks. If bruising occurs this slowly resolves over a period of a few days to a week. Should your swelling increase after 1-2 weeks, contact your oral surgeon. Remember that swelling is worst about 2-3 days after surgery. 

RINSES. Do not use a straw or rinse the mouth the day of surgery as the blood is in the process of clotting. Beginning the next day, rinse the mouth gently using up to a full glass of very warm water, in which a half reaspoon of salt and a half teaspoon of baking soda have been dissolved. This is important both for healing and hygienic purposes. For extensive surgical procedures these rinses should be repeated every hour the first three days. After that, six times daily will suffice. If the extractions were routine, rinsing the mouth after meals will suffice. Commercial mouth rinses (Cepacol, Lavoris, hydrogen peroxide, etc.) may also be used three times a day to keep your breath fresh and sweet. Resume regular oral hygiene (tooth brushing and flossing) as soon as possible.

PAIN. The amount and duration of pain one should expect are very unpredictable. Most pain after surgery can be managed with ibuprofen 600mg (Nuprin, Advil, Motrin IB) taken three times a day continuously for the first three days after surgery. If you are having more pain than can be controlled with ibuprofen (or similar medications) or with the prescription you may have received, it would be best to call the office during regular office hours if possible. There can be muscle discomfort after surgery, which limits your mouth opening for 1-3 weeks. Hot packs and ibuprofen 600mg three times a day can help with the tightness. Remember that the third day after surgery is generally the most painful.

BLEEDING. After your teeth were removed, a gauze compress was placed on the wound, and you were asked to keep your jaws closed tightly for 30 minutes. This was to help stop bleeding and keep saliva away from the open tooth socket. This compress may be discarded after 30 minutes. Some oozing will continue and is to be expected. This is normal and is no cause for alarm. If excessive bleeding occurs, take a 4 by 4 piece of gauze, fold to make a firm compress, place directly on the area which is bleeding, and apply firm, steady biting pressure for 40 minutes. Sit upright, keep quiet, and avoid spitting or talking while biting on the pack. This may have to be repeated. A tea bag, dipped in cool water and used instead of gauze, may also be quite effective. If these measures do not succeed, call this office. After office hours, an answering service will take your call and reach the doctor on call.

DIET. You will feel better, have more strength, less pain and heal faster if you continue to eat, but it is best to eat liquids or non-chewy foods for a few days. Because of surgery, it may be necessary to eat soft foods such as soup, milk, Jello, cooked cereal, or milk shakes for several days. Some of the liquid diet preparations are helpful.

FLUIDS. It is very important that fluid intake be adequate. Even though it may be awkward, an adult should consume two to three quarts of fluids each day. Children should have a proportional amount. Avoid alcoholic beverages.

ACTIVITY. Patients are instructed to return home immediately on discharge from our office with their driver or adult escort.

REST. It is always important to get plenty of rest with any surgery or illness.

FEVER. A low grade fever is usual after even a simple procedure. Fever may be caused by inadequate fluid intake as well. If excessive or at all questionable, do not hesitate to phone the office.

STITCHES. In some cases stitches have been placed in the gums. Usually dissolving stitches are used. An appointment for stitch removal may be made if stitches have not dissolved after 7 days.