Post-Operative Instructions
Bleeding, Discomfort, & Swelling
Bleeding--controlling bleeding after an extraction or surgery is a matter of applying undisturbed pressure over the bleeding area for an extended period of time (usually about an hour). This is best accomplished by following the following steps: carefully place 1-2 pads of 2"x2" gauze over the bleeding area (it is helpful if you have someone assist you in this process). Use a flashlight to see the area better. Use a spoon to help pull back the cheek. Visualize the area that is the source of the bleeding. Wipe away the saliva and blood to get a good look at the surgical site. Place the gauze pads over this area. Bite down firmly and consistently for at least one hour. After this time has elapsed gently remove the gauze from the surgical site. If there is still bleeding, repeat this process until bleeding has stopped.
Problems: If you notice that there is still bleeding while the gauze is over the area, you may not have the gauze positioned correctly in order to apply adequate pressure. Re-position the gauze and apply pressure again. If this does not help, take 1-2 additional gauze pads and add them to the gauze you are currently using to make a thicker pad. Position this over the area and apply pressure again. Carefully position so that the gauze is directly over the source of the bleeding. If you are not able to get the bleeding to stop despite all attempts you should contact Dr. Fortner.
Discomfort & Swelling--discomfort and swelling are normal parts of post-operative healing. The incidence and intensity of each are difficult to predict. It is, however, normal for both of these symptoms to increase in size or intensity during the second and third post-operative day. While beginning on the fourth day, they should both begin to resolve. You can help decrease both of the symptoms by being very gentle to the surgical area.
For mild discomfort, Ibuprofen or Advil is recommended--200-800 mg. every four (4) hours. Be cautious with the amount, as the more you take, the more likely it is to cause stomach upset.
The prescription pain medication is to be used only for higher levels of discomfort. Take 1-2 every four hours, as directed on the bottle. It is alright to combine your pain medication with the Ibuprofen in small amounts. However, the risk of nausea is increased.
Ice Packs--It is helpful to apply ice packs to the area of the surgery only during the first 8-12 hours. Never leave the ice packs in place for more than 10-15 minutes at a time.
In rare cases, during the first few hours following the surgery, intense pain may be experienced which isn't relieved by pain medication. This is usually a very short-term side effect, present when the local anesthetic is wearing off. It is best for the patient to be aware of the short-term nature (30 min. to 1.5 hrs.) of this condition. Pain medication may be increased at this time if the maximum dose has not been taken in the last four (4) hours.
It is normal for swelling to appear and become worse during the first three (3) days following surgery. However, if you experience an increase in swelling or discomfort after the fourth day, you should contact Dr. Fortner.