Postsurgical Instructions Exposure of Impacted Tooth With General Anesthesia

Care of your mouth after surgery has an important effect on healing. Swelling, discomfort, restricted jaw function, and skin discoloration is to be expected. However, following these instructions closely will help to insure a rapid and uneventful recovery.

Sedation Slows Reflexes For 24 Hours

The effect of the general anesthetic can make you lightheaded, dizzy, or faint if you get up too quickly. Sit for 1 minute before standing up. Move slowly and be aware that you may need to sit down immediately. Do not drive or operate machinery for 24 hours after sedation.

Pain Management Overview

Baseline Pain Control Regimen

650 mg Tylenol (Acetaminophen) 2 x 325 mg tablets 4 times per day. Breakfast, lunch, dinner, and right before bed. (Avoid Tylenol if you have been told not to take this medication or have liver failure)
200-600 mg Advil (Ibuprofen) 1-3 x 200mg tablets 4 times per day. Breakfast lunch, dinner, and right before bed. (Avoid ibuprofen if you have been told not to take this medication or if you have a history of stomach ulcers, kidney disease, or take a blood thinning medication)

If Additional Pain Control is Needed

2.5 – 5 mg Oxycodone ½ – 1 x tablet up to 4 times per day if needed for additional pain control.
Do not stop taking the baseline pain control regimen if you need the oxycodone

Postoperative pain control is of paramount importance to us and our patients after surgery. We want you to be as comfortable as possible as you recover from your surgery. When you return home and the local anesthesia (numbing medicine) wears off, you will transition to oral pain medications to assist in pain control. The goal of postoperative pain management is to use oral pain medications to reduce pain to a tolerable level while the body heals and reduces pain naturally overtime. This may result in a maximal oral medication regimen which can be progressively decreased over the recovery process.
Modern medicine uses three common classes of medications to achieve this goal, Acetaminophen (e.g. Tylenol), Non-Steroidal Anti-Inflammatory Drugs (NSAID e.g. Ibuprofen/Advil), and opiates (e.g. Oxycodone). Each act on different pain pathways within the body which allows them to all work synergistically at the same time. Using different classes of pain medications allows us to maximize the potential benefits of any one class while minimizing their respective side effects. During the postoperative period we want to maximize your pain control while minimizing any potential side effects.
All pain medicine should be used in an “as needed” fashion. If you are not in pain, you do not need to take pain medicine. However, the baseline pain control regimen outlined above can be more effective if taken on a “scheduled” basis, regularly spaced time intervals, during the postoperative period where significant pain is anticipated. The baseline pain control regimen is more effective if taken on a “scheduled” basis rather than waiting for significant pain before taking the pain medicine. This “scheduled” strategy allows you to maintain a constant level of pain control in your blood which ultimately results in more effective pain control. If you would like to take the baseline pain control regimen on a “scheduled” basis to maximize its effectiveness we recommend taking these medications ~ 4 times per day, convenient times for most patients are breakfast, lunch, dinner, and right before you go to bed. The baseline pain control regimen can be taken together as instructed above for up to 1 week without concern for significant side effects in a healthy patient. However, if you find yourself continuing to need a “scheduled” baseline pain control regimen after 1 week, please let us know so we can make sure that you are healing appropriately.
Opiate derived pain medications, like oxycodone, have rightfully received a lot of attention in the media recently due to their addictive potential. While this class of medication can be addictive it is important to note that addiction occurs when these medications are used for prolonged durations for chronic pain, not for acute postoperative pain. As such, these medications are safe to use as prescribed for a short duration after your surgery. However, they have other side-effects as well such as nausea, constipation, and drowsiness which are undesirable. As a result, we still reserve this class of medication for as needed additional pain control if the baseline pain control regimen above is insufficient.
We hope all our patients recover as painlessly as possible. However, recovering from surgery is typically uncomfortable. The strategies and philosophies outlined above will not make the recovery from surgery painless, but they should serve to reduce the pain to a tolerable level while the body heals and subsequently reduces pain naturally. If you ever feel that the pain is unbearable despite these medications, please let us know so we can make sure that you are healing appropriately.

Diet With While You Are Numb

For the first few hours after returning home your lips will still be numb from the local anesthesia given during surgery. While your lips and tongue are numb it is safe to eat and drink, but best to not chew to avoid inadvertent injury when accidently biting or burning your lip or tongue. Examples of foods you can eat without chewing include any liquid, smoothies, milkshakes, ice cream, yogurt, creamy soups etc.

Diet With After The Numbness Wears Off

Numbness of the lips and tongue may persist through the first evening. Once the numbness begins to wear off you can advance your diet to more substantial foods, but it is still important to chew away from the grafted site to protect it. We would recommend you stick to softer foods and chewing away from the surgical site until it is more comfortable which can take up to 2 weeks.

Swelling

Fortunately, swelling after this procedure is typically minimal. Ice can be applied to the area for the first 48 to 72 hours to help limit the accumulation of swelling. However, swelling is often mild and icing is not imperative.

School

Most kids will be able to return to school the day following the procedure although some will prefer to take a day or two off. It is not dangerous to return to sedentary activities like school, but it may be sore.

Sports

It is best to refrain from athletic activity for 5 days following your procedure to make sure you are fully recovered and ready to return to more strenuous activity. When you do return for the first time you should only do half of what you would typically do and rest to make sure that you are not over stressing your body. Again, this is not typically dangerous but can result in significant discomfort if you push your body too hard too soon.

Dental Routine

It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth twice a day. However, be gentle around the implant site until the soft tissue in that area has healed, typically 2 weeks. The surgical site heals best next to clean teeth.

Sutures

The sutures in your mouth will dissolve on their own. This typically takes 7-14 days, however, if a suture comes out early it is not a problem. Leave the sutures alone if possible and they will take care of themselves. Often, they will come out when you are eating food and you will swallow them, that is not a problem.

Allergic Reaction

If you develop hives or a rash, discontinue all medications and immediately contact our office.

Telephone Support 24/7: (650) 342-0213

Post-surgical follow-up is an important part of your care. We want you to have a successful and comfortable recovery. Please call the office if you have any questions or concerns about your procedure or postoperative healing.

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Exposure of Impacted Tooth