Exposure of Impacted Tooth

After Exposure of Impacted Tooth

After Exposure and Luxation or Ligation of an impacted tooth or other surgical procedures of the mouth, certain steps must be followed to minimize postoperative discomfort and improve surgical outcomes.

Please read and follow the instructions carefully.

The Surgical Site

Do not disturb the wound. If surgical packing was placed, leave it alone. The pack helps to keep the tooth exposed. If the packing becomes dislodged or falls out, do not get alarmed.  If a bracket and chain were placed, do not disturb them.

Remember to contact your orthodontist to ensure a timely appointment to begin monitoring the eruption and movement of the impacted tooth.


A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Persistent bleeding may be controlled by gentle rinsing or wiping any old clots from your mouth, followed by placing a folded gauze pad over the area and biting firmly for 45 minutes. Remember, it is the pressure over the surgical site, not the absorbency of the gauze that results in clot formation! Change the gauze packs every 45 minutes 4 or 5 times over 4 to 5 hours. If bleeding continues, make sure that the gauze packs are positioned directly over the extraction sites, and the patient is biting on the gauze with good firm pressure.

Elevating the head with 2-3 pillows or sitting up in a recliner will also help stop the bleeding by decreasing the blood pressure in the mouth.

If bleeding persists, bite on a moistened tea bag over the extraction site for thirty minutes. The tannic acid in the tea bag helps to form a clot.  To minimize further bleeding, do not become excited, sit upright or lay with your head elevated, avoid exercise and strenuous activities. If bleeding does not subside, call for further instructions.


You should begin taking pain medication as soon as you have eaten, before the local anesthetic wears off. If you are experiencing nausea from the anesthesia, avoid eating or taking prescribed pain medication until it subsides. Once the nausea has subsided, try taking Ibuprofen or Tylenol for pain before resorting to the prescribed narcotics. For moderate pain, take Ibuprofen's (Advil or Motrin).  For severe pain, the prescribed medication should be taken as directed.  If pain persists, or increases after 36 hours, it may require attention.

Remember, all pain medications have the possibility of causing an upset stomach.   To decrease the possibility of an upset stomach, always take your pain medications with some food when possible.

Nausea and Vomiting

Nausea can be caused by the anesthesia, the blood in your mouth and stomach from the surgery, or the prescribed pain medication. In the event of nausea and/or vomiting following surgery, stop taking anything by mouth for at least an hour including the prescribed medicine. You should then sip on coke, tea or ginger ale. You should sip slowly over a 15 minute period. When the nausea subsides, you can begin eating solid foods. Before trying the prescribed medicine, try taking Ibuprofen or Tylenol for pain. There is less chance of nausea with these medications. You may find that they are completely effective at managing your discomfort.

If nausea and vomiting persist, please call the office for instructions.


Swelling is a normal occurrence after surgery. To minimize swelling, apply a plastic bag or towel filled with ice on the cheek in the area of surgery. Apply the ice as much as possible for the first 36 hours.

Bruising and Discoloration

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal postoperative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.


Drink plenty of fluids, and avoid hot liquids or food until the numbness has subsided to keep from scalding yourself. Soft food and liquids should be eaten on the day of surgery. Unless otherwise directed, return to a normal diet as soon as possible. Do not use straws for at least 5-7 days. High calorie, high protein intake is very important. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly.

Keep the Mouth Clean

Until the day following surgery, no vigorous rinsing should be performed. You can gently brush your teeth the night of surgery, but remember to rinse gently. The day after surgery, begin gentle rinsing at least 5-6 times a day, especially after eating, using a cup of warm water mixed with a teaspoon of salt.  If your doctor has prescribed any special mouth rinses, perform these rinses as directed.  Remember, a clean wound heals faster and better.


Infection following multiple extractions is very rare, but can occur. Typically, this will occur 2-5 days following surgery. Signs and symptoms include increased swelling after 3 days or failure of the swelling to begin subsiding after 4 days along with increased pain, or development of a fever. Infection is typically managed by antibiotics, but can sometimes require drainage or other procedures. Should you experience these, please call the office for instructions

Physical Activity

Keep physical activities to a minimum for 2-3 days following surgery.   If, when exercising, throbbing or bleeding occurs you should discontinue exercising. Be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get lightheaded, stop exercising.