After Exposure of an Impacted Tooth

BLEEDING

A certain amount of oozing is normal following an exposure/bonding procedure. This will continue for several hours after the surgery and in some situations longer. Avoid spitting or vigorous rinsing as this may stimulate bleeding. To control bleeding:

  1. Moisten gauze pack with water, squeeze excess water from gauze pack, place directly over the bleeding surgical site and bite down with firm pressure. Ensure that the packing is directly in contact with the bleeding site and that the pack is not just located between the teeth, which will not control the bleeding.
  2. Maintain constant pressure for at least 30-45 minutes. The amount of blood and the intensity of redness should lessen with repeated packings. Repeat the gauze packing as necessary. Multiple packings may be needed to control the bleeding.
  3. You may substitute a moistened tea bag for the gauze.
  4. We do not recommend sleeping with gauze in the mouth unless the surgical site is actively bleeding. After active bleeding has subsided, a towel may be placed on the pillow before the patient goes to sleep, if desired. If the patient is still bleeding upon awakening, repack the surgical sites with gauze to control the bleeding.
  5. Contact the office with any concerns of excess bleeding.

PAIN

It is common to have pain after surgery. The pain may radiate to adjacent areas such as the forehead, temple, ear, eye, adjacent teeth, and the neck. This will go away naturally as the surgical area heals. The pain is usually the most severe as the local anesthetic wears off. Local anesthetics wear off at varying lengths of time, possibly within 1-3 hours following surgery, depending on the nature of the procedure. We recommend that the patient eat something at least 30 minutes prior to taking pain medication, prior to the anesthetic wearing off. Take all pain prescription medication as directed.

We recommend taking Ibuprofen (200-600 mg) and/or Tylenol (500 mg-1,000 mg) prior to the anesthetic wearing off, assuming that there are no allergies to these medications. These medications can be taken simultaneously, as needed, for additional pain control, or they can be taken alternately. For example, if taken alternately, the Ibuprofen (200-600 mg) can be taken, and then 3 hours later the Tylenol (500 mg-1,000 mg) can be taken, and so on, repeating this pattern as needed.

NAUSEA

Nausea may sometimes be felt after surgery. Nausea can be caused by swallowing blood from an inadequately packed surgical site, pain medication, or medicines used for general anesthesia. If nausea occurs, limit your diet to clear liquids (water, Gatorade, Seven-up, Ginger Ale, iced tea, etc.) for 12-24 hours or until the nausea subsides. If the nausea is from swallowing blood, repack the area for better control of the bleeding. Contact the office if repeated vomiting is a problem.

SWELLING

The surgical area will oftentimes swell and may become quite large. The peak swelling usually occurs on the third day after surgery and may take another 3-5 days to resolve. This swelling may cause difficulty opening the mouth, which will subside as the swelling resolves. An ice pack may be applied to the face overlying the surgical areas for 15 minutes, then off for 15 minutes for the first 24 hours. Warm compresses are recommended after 24 hours.

DIET

It is important to maintain oral intake of fluids following surgery. It is advisable to confine the first day’s diet to bland liquids, pureed, or soft foods. This includes soups, puddings, milk shakes, yogurts, etc. Over the following couple of days, progress to a regular diet as comfort dictates (as soon as it is comfortable to eat regular foods). Maintaining nutrition after surgery will allow you to feel better after surgery.

ORAL HYGIENE

It is important to maintain adequate oral hygiene of the surgical site and to resume brushing and flossing as early as possible.

RINSING

Do not rinse for the first 24 hours. Do not rinse if surgical sites are still oozing. This will cause the bleeding to continue and potentially worsen. After the first day, if the bleeding has stopped, you may rinse using a salt water rinse composed of ½ teaspoon of salt in a glass of warm water as needed.

BRUSHING

Tooth brushing should continue as normal, but avoiding the surgical site until the tissue is comfortable to resume brushing.

HOW TO CONTACT US

Please contact our office if you have any questions or concerns at (310) 372-7575.

For after-hour emergencies you may contact Dr. Ying at (424) 634-0254. Thank you.