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Oral Surgery


Wisdom Teeth Oral Surgery


.Between the ages of 17 and 24, wisdom teeth usually emerge from the gum. When these teeth are healthy and properly aligned, they do not have to be removed. Unfortunately, many times this is not the case.

When wisdom teeth (also called 'third molars') erupt, they may have to be extracted for several reasons:
•  Your jaw is too small; they become impacted and are unable to break through the gum tissue.
•  Food and germs can get trapped under the flap of wisdom teeth that are only partially erupted and cause an infection.
•  A wisdom tooth that comes in at an awkward angle, with the top of the tooth facing forward, backward, or to either side.
•  A cyst can form around an impacted wisdom tooth, causing an infection, or damage to other teeth or the jaw bone.

These problems are usually resolved by removal of the impacted third molars. And early removal is recommended to avoid more serious issues. With an oral examination and panoramic x-ray, Dr. Rogers can evaluate the position of the wisdom teeth and assess the likelihood of present or future problems.

Removal of wisdom teeth is normally performed with local anesthesia and nitrous oxide; IV sedation is also available upon request. After removal, gauze is placed in the extracted areas to control bleeding. The gum tissue may be sutured (stitched) if necessary. After surgery, a post-operative kit is provided, which includes care instruction, prescriptions for pain and antibiotic medications. We will also schedule a follow-up appointment approximately 7 to 10 days following surgery.

Dental Surgery Post-Operative Instructions


NOTE: The following generalized post-operative care instructions apply to many oral surgery procedures. However, always follow specific post-operative and other care instructions given to you by your health care providers. If you have any problems or questions, please be sure to promptly discuss them with Dr. Rogers or his staff.

Bleeding


Biting on the gauze pads will probably be necessary for the first few hours to control bleeding. Be sure to change them every 15 minutes or so. Keep the head elevated and rest. Do not spit or rinse excessively, or engage in physical activity since this stimulates bleeding. Some oozing could last up to 24 hours.

NOTE: If heavy bleeding persists, replace the gauze with a clean folded gauze pad placed over the surgery site and maintain pressure until the bleeding stops. In rare cases, a tea bag (tannic acid) may need to be used to encourage clotting (regular, not herbal tea). Call our office if your bleeding does not stop or remains heavy.

Swelling


Swelling is normal following any surgical procedure in the mouth. It should reach its maximum within 48 to 72 hours and then diminish by the fifth to eighth day after the procedure. The anti-swelling medications we often prescribe can substantially reduce swelling and speed up recovery.

Place ice or cold compresses on the face in the area of the surgery for ten minutes every half-hour for the first eight to twelve hours. Ice is only effective on the day of surgery.

Discomfort


The greatest discomfort will occur as the anesthetic wears off, usually within 1 to 2 hours after the procedure. If a long-acting anesthetic was used, you may be numb for much longer. Pain medications can require 30 to 45 minutes to take effect, so do not wait for pain to become severe before taking your prescribed medication dosage. The pain should gradually diminish over the next few days.

Smoking


Avoid smoking during the first week after surgery.

Diet


A nutritious liquid diet is necessary for the first day. Hard foods eaten while the mouth is numb can dislodge sutures (stitches) and cause other problems. As the numbness wears off, you can gradually progress to harder foods.

Physical Activity


You should rest and relax for at least 24 to 48 hours after any dental surgical procedure.

The Day After Surgery


•  Brush your teeth, but avoid the surgery area. As your mouth heals, gradually brush the teeth near the surgery area. Placing your toothbrush under hot water for a few moments can soften the bristles.
•  Rinse your mouth twice a day with the oral antibiotic rinse that was given to you, for five to seven days after surgery.
If antibiotics are prescribed be sure to take them all as directed.

WARNING: Antibiotics can cause birth control pills to become temporarily ineffective. Be sure to consult with Dr. Rogers if this is a concern.

•  We generally use self-absorbing sutures (stitches) that do not need to be removed. However, it is still a good idea to schedule a follow-up office visit five to seven days after surgery. This also allows us to address any problems, prevent unnecessary pain, and ensure rapid healing.
•  “Dry socket” is a delayed healing response that can occur during the fifth to seventh post-operative day. It involves a tooth socket on the lower jaw and can cause throbbing pain on the side of the face that may radiate up toward the ear. In mild cases, simply increasing the pain medication for a few days can control the symptoms. If this is unsuccessful, please call our office to arrange for medication to be placed in the socket. The condition generally resolves itself even if untreated. Dry sockets can be caused or aggravated by rinsing or spitting too much on the first day after surgery, engaging in too much physical activity, using a straw, smoking, taking birth control pills, a difficult surgical procedure, or by a pre-existing infection. The condition is more common in patients over 30 years of age. Post-menopausal women and those taking hormone replacements are also at a slightly higher risk.
•  Do not chew hard (even on a hard crust of bread or piece of ice) for four to six weeks after having your lower wisdom teeth removed, and do not participate in sports where you could be struck in the jaw. The lower jaw is temporarily weakened after this procedure and an impact could cause a fracture requiring the jaws to be wired together for healing (that is not fun).
•  Residual anesthesia or other medication in your body can make some people light-headed for a few days, particularly during or after a hot shower. Be very careful after any surgical procedure and while taking medication. You may need to avoid driving, operating dangerous equipment, or other activities that could be adversely affected.

Contact The W. Todd Rogers Dental Office Immediately if You Experience:


•  Excessive bleeding that cannot be controlled.
•  Excessive discomfort or pain.
•  Excessive swelling, or swelling that spreads or enlarges after 48 hours from surgery.
•  Allergies or other reactions to medications.

Suggested Diet After Oral Surgery


Selections should be included from the four basic food groups:

Dairy


Soft cheeses such as cottage cheese, cream cheese, milk, ice cream, and pudding or custard

Meat & Protein


Tender pieces of ground meats, chicken, fish without bones, and cooked legumes

Fruit and Vegetables


Cooked or canned fruits, ripe bananas, vegetables without skins or seeds, mashed potatoes, and squash

Bread and Cereal Group


Soft bread, macaroni, noodles, rice, spaghetti, cooked breakfast cereals with milk, ready-to-eat flaked and puffed wheat or rice

Beverages


Milk, carbonated drinks, juices, tea or coffee

Extras (for in between meals)


Milk drinks, fruit or vegetable juices, eggnog, ice cream or broth
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2465 Research Parkway
Colorado Springs, CO 80920

Fax: (719) 528.5834
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