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If you have questions or concerns regarding your recent oral surgery, please call the office during the day . The office phone number is listed above. It is difficult for us to to diagnose your problem over the telephone, so it is likely that the doctor will ask you to come into the office for evaluation.

Some questions, however, can be answered over the phone; if you leave a message for the doctor, he will return your call as soon as possible.

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Please call the office, (419) 473-2707, first to determine how to reach the doctor on call. If the office is closed an answering machine will pick up the phone. The message will give you instructions for contacting the doctor on call. If a pager number is given, please call this number and carefully punch in your telephone number after the tone so the doctor can call you back. Please be carefull when punching in your telephone number and please include your area code. After you have entered your telephone number, please hang up and stay off the telephone until the doctor has returned your call. Your call should be returned within 15 minutes. If your call has not been returned within 15 mintues, please repeat this sequence, taking care that you enter a working and available telephone line. Please note that, occasionally, a cell or home telephone number will be given by the answering machine; please call this number as instructed. If the answering machine fails to pick up your call, you may page Doctor Lawrence at 419-534-9549 or call him at 419-304-1954.

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Be calm and realize that even a small amount of blood in the mouth increases the flow of saliva and makes it looks as though there is more bleeding than there actually is. If you are concerned that the surgical area is bleeding more than one might expect, do the following: Gently rinse out your mouth. Then wipe the inside of your mouth and teeth with a dry piece of gauze. Look in a mirror or have someone look in your mouth to determine the exact point of bleeding. If there are large loosely hanging blood clots present these should be removed by grasping them with clean gauze.

Roll a moist piece of gauze or clean cloth into a shape that will fit into the bleeding area. Place this moist dressing over the surgical site and push down on the pack with your finger so that you feel firm pressure over the surgical area. You can “bite” into the gauze if you are careful about placing the gauze in the correct position. It is important to limit activity during this time. Try to maintain a comfortable sitting position. Avoid excitement or activity. Do not spit. This may increase or prolong bleeding. To remove blood or saliva from your mouth, lean forward and let the fluid run out of your mouth into a towel or receptacle. Then wipe your lips as necessary.

If after following these steps you feel that the bleeding is excessive have the doctor on call paged by calling 419-473-2707. Prolonged excessive bleeding can be life threatening; if your call is not returned within 30 minutes, it may be prudent to present to the emergency department at the nearest hospital. If you go to an emergency center for evaluation or treatment please inform our office at your earliest convenience.

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Significant pain is common after oral surgery. It is very important to take appropriate pain medication on a regular basis to keep discomfort under control. It is best to start taking pain medication before the numbness wears off from surgery. For mild pain, medications such as tylenol or aspirin work very well; The nonsteroidal pain medications such as ibuprofen (motrin) are also excellent pain relievers. Most pain medications do not stay in your system very long; it is important, therefore, to take them on a regular basis.

For more severe pain you will need to take the pain medication that has been prescribed for you; if you have not been given a prescription and are not having relief with the over the counter medications such as aspirin, tylenol and motrin, then you should call the office. Prescription medications such as tylenol with codeine, hydrocodone or oxycodone and darvocet are all narcotic pain relievers and are very strong. These pain medications will work very well when taken in an appropriate manner, but they can also cause problems. It is common for these medications to cause nausea especially if your stomach is empty. You will likely tolerate these medications much better if you have food in your stomach before you take the medication. Even so, some patients do not tolerate one particular medication well; in this case, you should call the office as you may tolerate a different prescription much better. Often, narcotic pain medications make patients tired and dizzy; you should not drive, operate machinery or attempt any potentially dangerous task while taking these medications. Feelings of dizziness can be minimized by lying down after taking these medications. Narcotic pain medications may also cause constipation; if this occurs it is best to minimize the use of the medication. If this problem persists, please call the office.

Each patient tolerates medication differently. Allergy to these medications is possible; should you have a reaction to any medication that you have taken it is very important that you stop taking that medication and call the office for further information. It is important to remember that some patients just do not do well with some medications; if you find that the medication you are taking is just not working, then please call the office for help.

Usually, the intense surgical pain experienced on the first 2-3 days decreases to a moderate soreness over the next few days. Pain that increases on the 3rd or 4rth postoperative day may indicate the presence of a dry socket. Often this pain is very intense and will spread to the ear, chin and neck. Dry sockets are seen following up to 15% of extractions; they are not dangerous and do not represent infections, but they are very painful. If you experience late postoperative pain that is increasing rather than decreasing it is appropriate to call our office. Medicated dressings can be placed in affected sockets to radically decrease the discomfort you may be experiencing. Untreated, dry sockets will usually dissipate over 3 to 5 days and pose no threat to your health.

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Swelling is expected after oral surgery; the amount of swelling seen is often proportional to the difficulty and extent of the surgery. Swelling increases quickly over the first 3 post operative days and then decreases over the next 3 to 5 days. Swelling after the extraction of impacted teeth is often significant. Should you become concerned about swelling that occurs after surgery it is important that you come into the office so that your surgeon may evaluate your post operative course.

Postoperative swelling can be minimized by the use of ice packs within the first 24 hours of surgery. An ice pack (a bag of frozen peas works well) should be placed on the outside of the face for 20 minute periods at a time. The use of NSAID's (nonsteroidal medication such as ibuprofen and anaprox) before and after surgery may also reduce the extent of postoperative swelling. Often patients are given prescriptions for such medications and they should be taken as directed. Some of these medications are available over the counter in grocery stores and pharmacies; please direct any questions regarding the use of these medications to your surgeon.

Many patients report a temperature after surgery, especially if they have been sedated for the procedure. A low grade temperature the day after the procedure should not be alarming. If, however, you develop significant fever with swelling it is imperative that you return to the office for evaluation.

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Bruising in the soft tissues of the neck and face is often seen following oral surgery. This may manifest as discoloration of the skin; usually the area will appear black and blue, but as time goes on the bruise may appear greenish yellow. The bruising seen after surgery is due to the oozing of blood into the tissue planes of the face, and although unsightly, is of little consequence. Usually, all signs of bruising disappear within 10 days. Should you become concerned about this bruising a visit to our office would be in order.

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Nausea following surgery can be caused by the medications used during anesthesia, by medications taken after surgery, or by blood getting into the stomach. As the medications pass through your system and as the bleeding stops the nausea will go away. Nausea seen in the first few days after surgery is usually related to the use of narcotic pain medications. Identifying the medication that is upsetting your stomach and stopping this medication is key to feeling better. All patients respond differently to these medications; although one may make you sick, another may not. Please call the office if you are having trouble tolerating the medications you have been given.

Not eating or drinking enough after surgery can make nausea worse. It is very important to keep trying to take food and fluid despite not feeling well. Prescriptions for nausea medications are available; please call your doctor for further information. Keep in mind that all medications have side effects, and it is often better to follow the above recommendations and be patient for the nausea to clear.

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Limited jaw opening is not uncommon after the removal of lower wisdom teeth. This is caused by local swelling and spasms of the jaw muscles. Usually your jaw will loosen up on it's own within a week after surgery. Physical therapy in the form of jaw exercises several times a day will help a great deal. If, by the 5th day after surgery, jaw mobility does not improve you will need to present to the office for evaluation.

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Numbness of the lower lip, teeth and tongue may be seen following the removal of an impacted lower wisdom tooth. This is almost always a temporary condition; full feeling usually returns within several weeks to several months. If you should experience numbness that persists beyond one week after surgery you will need to present to the office for evaluation.

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Occasionally patients will place their tongue near an extraction site and feel something sharp and hard protruding through the gums. This is not part of a tooth but rather the bone that held the tooth in the jaw. Try to leave this area alone and be patient. If the bone is still visible after two weeks, you will need to present to the office for evaluation.