Complications

STITCHES

Dissolvable stitches are usually used to close surgical sites in the mouth. They may take between one and three weeks to dissolve.If they become loose, excessively irritated or cause unusual discomfort, they can be removed by our staff.

SWELLING

Swelling following surgery is to be expected and should reach a maximum between 48 and 72 hours after surgery before subsiding. If swelling increases beyond 72 hours after surgery, call our office. The amount of swelling varies from patient to patient. Cooperation and compliance with these written instructions will minimize your total amount of swelling, pain and reduce your recovery time. As the swelling resolves, a hard knot may be noticed over the side of the jaw at the surgical site. This knot probably represents bleeding into the tissues around the surgical site which has formed a clot and poses no threat. If no increase in size or increasing pain is noted, apply heat to the area after 72 hours.

PAIN

Pain should begin to subside within 48 hours after surgery. If you experience persistent pain {beyond three days after surgery} that requires any medication other than aspirin, Ibuprofen, or Tylenol, call our office. “Dry sockets”, {delays in healing caused by the absence of a blood clot in the socket} occasionally occur following the removal of lower wisdom or back teeth. They usually feel like a jaw or earache, cause a foul taste or smell in the mouth and appear 3 to 5 days following the removal of teeth. If your pain is increasing 3 days after surgery, call our office. You will not heal properly or relieve the pain until the socket is rinsed and packed with a soothing gauze by our office staff. Notify our office as soon as possible if this condition exists.

BLEEDING FROM THE NOSE

Following the removal of any back upper tooth, bleeding may occur into the sinus cavity

above the roots of the teeth.This could result in a nose bleed following surgery.This is usually a self-limiting event and requires no additional immediate treatment other than avoiding blowing the nose and taking decongestant medications such as over-the-counter Sudafed to maintain proper sinus drainage.Should a nose bleed persist or you experience pressure in the face below the eye, call our office as soon as possible.

NAUSEA AND VOMITING

You may experience nausea and vomiting from swallowing bloody drainage during or after surgery. Nausea associated with sitting or standing up may be caused by pain or lack of proper fluid intake resulting in low blood pressure. Occasionally, nausea may be associated with low blood sugar as well. The best treatment for this type of nausea is to drink more clear liquids such as room temperature carbonated beverages and avoid rapid changes in position. Certain pain medications may also cause nausea. Taking these medications with pudding or soup may help. Call our office if you experience nausea or vomiting past the first few hours at home. Pay particular attention to smaller children who can rapidly dehydrate from vomiting and may require earlier intervention.

FAINTING

Low blood pressure {from anesthesia, lack of proper fluid intake or pain medications} may cause fainting. Make certain a responsible adult is available to accompany you to the restroom while under the influence of anesthesia or pain medications. Avoid locking any doors or entering small rooms alone while recovering. The best treatment for fainting is to recline the patient with the feet slightly elevated until consciousness returns. It is not uncommon for patients after fainting to exhibit a brief seizure-like jerking just before consciousness returns. Encourage drinking liquids to restore body hydration. If the patient is prone to hypoglycemia or takes medications for diabetes, loss of consciousness may be due to low blood sugar. Giving the patient sugar in the form of sweet tea or carbonated drinks containing sugar may help. If the patient continues to have fainting spells or does not regain consciousness, notify our office immediately and/or call 911.

URINARY RETENTION

Occasionally, patients are unable to void {empty their bladder} following surgery. This could be the result of underlying urinary tract problems, spasm from medications, over-distention, or the lack of adequate fluid intake. If you are unable to void for 6 to 8 hours after drinking an adequate amount of fluid, notify our office immediately.

DISCOLORATION

Discoloration of the skin, bruising of the surgical site or of the I.V. site sometimes occurs with extensive procedures such as the removal of impacted wisdom teeth. Sometimes these discolored areas may be tender to touch and associated with a hard knot. Discoloration alone without pain and swelling is usually not a major concern. Discoloration is best treated with hot compresses after 72 hours, sunlight and time.

SORENESS OF THE I.V. SITE

Anesthesia medications are sometimes irritating to the vein and may form a knot that extends up the arm from the site of injection. This condition usually responds well to treatment with hot soaks and medication. Should this problem occur, notify our office immediately.

FEVER

It is not uncommon to run a low-grade fever the night following surgery. Drinking more liquids is important to maintain proper hydration during a fever. Should fever exceed 100 degrees Fahrenheit on an oral thermometer for longer than 24 hours, if you develop chills or should you develop a fever after the first 24 hours, notify our office.

AIR LEAKAGE

When the upper back teeth are removed{especially impacted upper wisdom teeth}, an opening to the sinus cavity may be present. Be careful not to blow your nose, try to clear your ears by applying pressure with your nose clamped, or sneeze with your nose clamped. This could cause the blood clot to blow out into the mouth, cause more bleeding or create an opening from the sinus cavity into the mouth through the socket of the tooth. If you notice leakage, fluid draining through the nose when you drink or swallow, a squeaking noise when you swallow, or pain below your eye worse when you bend over or shake your head, notify our office as soon as possible.

OTHER CONSIDERATIONS

If you have any questions not covered, other concerns, or are uncertain about our instructions, please do not hesitate to contact our office or answering service. It is often easier to correct problems early before they become serious complications later. It is our desire to provide the best possible quality care for our patients. Patient’s proper understanding and performance of instructions before surgery and during recovery is critical to a favorable surgical experience. If we can assist you further in any way please notify us. There is never a charge for most routine care following surgery.