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After Apicoectomy

Immediately following surgery:

Remove the gauze pad, that was placed directly over incision/surgical site, 20 minutes after leaving our office. Immediately began to push the cold fluids. This will help the bleeding to subside. Placing gauze over the incision repeatedly will begin to irritate the gum tissue. Remember a tooth wasn’t extracted, only incisions were made in the gum tissue.

Avoid vigorous mouth rinsing or touching the wound area following the surgery. This may initiate bleeding by causing the blood clot that has formed to become dislodged.

To minimize any swelling, place an ice pack to the side of your face where surgery was performed.

Take the prescribed pain medication as soon as you can so it is digested before the local anesthetic has worn off. (This instruction will be given to you, by the nurse, after the procedure. The local anesthetic is different for everyone and lasts only so long.) Having something of substance in the stomach to coat the stomach will help minimize nausea from the pain medication.

Restrict your activities the day of surgery and resume normal activity when you feel comfortable. If you are active, your heart will be beating harder and you can expect excessive bleeding and throbbing from the wound.

NO SMOKING UNDER ANY CIRCUMSTANCES.

Bleeding:

A certain amount of bleeding is to be expected following surgery. Since the wound is sutured closed, the bleeding is usually clotted a short time after surgery. Sight bleeding or oozing causing redness in the saliva is very common. For this reason, the gauze will always appear red when it is removed. Saliva washes over the blood clots and dyes the gauze red even after bleeding from the wound has actually stopped.

Excessive bleeding may be controlled by first GENTLY rinsing or wiping an old clots from your mouth, then placing a gauze pad over the area and biting down firmly for 20 minutes.

If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting blood vessels. This can be repeated if necessary.

To minimize further bleeding, sit upright, do not become excited, maintain constant pressure on the gauze (no talking or chewing) and avoid exercise. Call the office for further instructions.

Swelling:

The swelling that is normally expected is usually proportional to surgery involved.

If there is a fair amount of cheek retraction involved with your apico, then it would be appropriate to apply ice on the outside of your face on the affected side.

The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. The swelling may be minimized by the immediate use of ice packs. The ice packs should be applied 20 minutes on/ 20 minutes off until bedtime that night. After 24 hours, ice has no beneficial effect.

The day following surgery the application of moist heat to the side of the face may help some in reducing the size of any swelling that has formed. Use 3-4 times a day for 30 minutes each.

Bright red, rock hard, hot swelling that does not indent with finger pressure which is getting bigger by the hour would suggest infection. This usually would develop around day 3-4 after surgery when you would expect swelling to be going down, not up. If this should occur, call our office immediately.

 
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