Events that may occur following Oral Surgery

1. Patients respond differently to oral surgery procedures. A variable amount of swelling can be expected, especially when difficult third molar teeth are removed. Meticulous care at home after your surgery will be the best help in preventing this problem.
2. Because the nerve in the lower jaw, which supplies feeling to the teeth and lower lip, is very close to the roots of the impacted third molar, a possibility of minor nerve damage exists upon their removal. This shows up as numbness of the lip, chin and/or tongue or increased sensitivity of the teeth, gums and skin of the lower lip and chin. Should this rare complication occur, it is normally not a permanent situation, but complete return of feeling can take place in a few weeks to several months.
3. A variable amount of discomfort always accompanies oral surgery procedures. Guidelines for management of this discomfort will be given to you. Please follow these instructions carefully.
4. It is impossible to predict with any degree of accuracy just how long your regular activities must be limited. Most patients are able to resume relatively normal activities within 2 to 3 days following surgery. This period, in a small percentage of patients, may increase to as much as a week.
5. A low-grade fever is to be expected. It is important to drink plenty of liquids after oral surgery. If, however, the temperature gets over 101 degrees, contact the office and Dr. Shroyer will prescribe medication for you.
6. Following an extraction, there can be a delay in the healing of the socket. This problem occurs in about 10% of patients and, unfortunately, cannot be predicted or prevented. The blood clot which forms in the opened extraction site disintegrates and dissolves resulting in pain in the jaw, ear and neck. This is an uncomfortable situation which usually occurs about 3rd to 5th day following surgery. Recovery takes 1-2 weeks, during which time a medicated dressing is placed in the socket to control the discomfort.
7. Sinus involvement is not unusual following removal of upper teeth. The roots of upper premolar and molar teeth are very close to and often protrude into the sinus. Tooth removal can result in exposure of the sinus. This normally presents no problem, but, if it does, it is usually either a sinus infection or an opening between the mouth and sinus. This opening will usually close on its own within 6 weeks. Surgical closure may be necessary if complete repair does not occur within 3 months.
8. If a patient is fair-skinned (light complexion), there are often areas of bruising on the skin near the surgical area. This can also occur in the mature adult patient.
9. Oral wounds can become infected due to the high bacterial population of the mouth. Antibiotics are sometimes given for the infection and/or for prevention of infections.
10. There will be a bad taste and unpleasant odor in your mouth due to the blood clots that form in the extraction site. Following extraction, the extraction site may form a depression or hollow area which may trap food particles. The odor and food particles may be removed with warm salt water rinses.
11. Bone spicules sometimes work their way through the gum tissue and feel sharp to the tongue. In most instances they wok out on their own, but it may becomes necessary to remove them.
12. An extremely rare complication of surgery is the separation (or fracture) of the jaw. If the teeth are very deep and the bone is thin, this may occur. In this case, treatment is necessary.
13. The venipuncture (needle in the vein) or the medications injected for sedation or anesthesia can sometimes produce an inflammation of the vein called phlebitis. This firmness and tenderness of the vein usually clears up without treatment. If this condition persists without improvement, an examination is necessary for diagnosis and treatment by Dr. Shroyer.
14. After your surgery, if any problem develops which you are unable to manage, please do not hesitate to call 468-5400 and ask the advice of our office staff or Dr. Shroyer.

Recommendation for Post-operative Management of Discomfort

1. Take three (3) Ibuprofen 200mg tablets every 4 hours for the first 24 hours with the first dose starting 1 1/2 hours prior to surgery. This will be a total of 6 doses. Brands of Ibuprofen 200mg are available at your grocery or drug store (Advil, Nuprin, Motrin IB).
   
   After the first 24 hours following your surgery, you may begin to take three (3) ibuprofen 200mg tablets every 4 hours only if needed for discomfort. If you feel that you do not require the Ibuprofen, do not take it.
   
   
2. Should the Ibuprofen NOT sufficiently relieve your discomfort, you may take the prescription medication (usually Lortab or Mepergan Fortis) as follows:
   
   
   1. Try at least 2 or 3 doses of Ibuprofen 200mg (3 tablets) every four hours prior to using the heavier medication. DO NOT take the heavier medication immediately after your surgery. The main side effect from the heavier medication can cause nausea and vomiting.
   2. If you feel that you require the stronger medication, you should eat something substantial prior to taking the medication (i.e. soup, oatmeal etc.). DO NOT take the heavier medication on an empty stomach.
   3. If you are allergic to aspirin or ibuprofen DO NOT take the ibuprofen.
   4. If you have asthma and are sensitive to ibuprofen it is recommended that you not use ibuprofen.
   5. It is most important that you not take the Lortab on an empty stomach or immediately after surgery.

   The heavier medication should only be used as a last resort as it is a very strong drug and can have most unpleasant side effects.