Swelling & Post-Operative FAQ - Part 2
If you read this and feel there is an area of information on swelling or post-operative care that we have left out, please contact us and we can address the information you would have liked to find.
Q. When will I become swollen?
From the time your surgery begins, the tissues in the surgical area will react to the surgical trauma by swelling. Usually swelling is extremely slow but continues for up to 3 to 3.5 days. By then your face may look very swollen, but this is a normal reaction of the body. Usually, on day 4 after surgery, the swelling begins to subside.
Q. How can I limit the swelling?
The degree to which you swell will depend on the type of surgery and how well you follow the post-operative instructions you were given. For example, if you take the anti-inflammatory drugs (Naproxen) there will be less severe swelling.
You should also use ice packs on the outside of the face to cool the tissues. This limits swelling and reduces discomfort. We usually advise you use a small bag of frozen peas wrapped in a damp face washer or kitchen chux. Change the bag of frozen peas regularly. Use of an ice pack for 20 minutes every 1-2 hours is usually effective.
Q. What about post-operative infection?
Avoiding an infection is important and this is why you should use Savacol mouthwash as a gentle mouth bath for 2 minutes every morning and night after brushing your teeth for 3 days before surgery (if possible) and for 10 days after surgery. This will help to control the vast numbers of bacteria that exist in your mouth and thereby help to reduce the chance of infection. Brush the top surface of your tongue gently with your toothbrush as the rough surface is home to many millions of bacteria.
Use hot water as a mouth bath many times a day. This helps heat the tissues, increasing blood flow through the tissues improving healing.
It is best to bathe the mouth gently. You MUST NOT “swish” the Savacol mouthwash or the hot water around the mouth vigorously. If you “swish” around you may open up the stitches or disturb the surgical site and the blood clot that has formed. If the blood clot is lost from the extraction socket, then the tooth socket can become a food trap. Consequently, bacteria and food accumulate and an infection may occur leading to a “dry socket”.
Q. What is a dry socket and how does it occur?
In the upper jaw the blood supply to the jawbone is very good and usually, the body’s immune system can deal with any minor infection, therefore healing takes place without complication.
In the lower jaw, the blood supply to the bone is far less efficient because the bone is more dense. As a result, infection occurs more commonly and may lead to a condition known as a dry socket where the blood clot that formed after the tooth was removed is lost from the tooth socket. This leaves a hole where food debris can gather. Bacterial accumulation in the presence of this food debris quickly leads to infection. A dry socket is characterised by increasing severe pain, usually arising 3-7 days after surgery. Usually, the gum surrounding the extraction site is very tender.
Q. What do I do if I get a dry socket?
Dry sockets are easy to cure but you will need to call the practice (normal working hours from Mon to Thu 0800-1730 call 4725 1656) or call Dr. Priestland’s mobile number outside these hours (his number is to be found on the post-operative instruction leaflet you were given at your consultation appointment and on the practice business and appointment cards).
You will need to make an appointment to return as soon as we can see you to gently flush out any accumulated food particles and then Dr. Priestland will place a dry socket dressing called Alvogyl, into the infected tooth socket. Within 30 minutes much of the pain will have been eliminated and over the next 24-48 hours the dressing will treat the infection.
Q. Can infection be prevented?
In an attempt to prevent infection, Dr. Priestland will normally ask you to use a mouthwash known as Savacol (containing 0.2% Chlorhexidine) for 2-3 days before your surgery. Chlorhexidine is an antiseptic that kills many of the bacteria that live in the mouth. By reducing the number of bacteria present, you reduce the chance of infection after surgery.
Dr. Priestland may also prescribe some antibiotics (usually Keflex) for you to take every 8 hours. If you had surgery as a day case under general anaesthetic and you have an infection, then you will receive the same antibiotic intravenously while you are asleep just prior to the operation starting. However, you must continue the antibiotic in tablet form for the following week. You will, therefore, need to start your medications 8 hours after surgery.
If you had your surgery at the practice you should have started your antibiotics and anti-inflammatory drugs (both Keflex and Naproxen) the night before surgery and continue them every 8 hours.
In part three of “Frequently asked questions concerning tooth extraction and dental surgery” we will answer questions about post-operative bleeding, whether or not you can take your Warfarin or other anticoagulant drugs (blood thinners).
If you would like more information, contact NQ Surgical Dentistry today.