Most surgical procedures result in a’ certain amount of edema or swelling after surgery. Simple extraction of a single tooth will probably not result. in swelling that the patient can see, whereas the extraction of multiple impactedteeth with reflection of soft tissue and removal of bone·may result in large amounts of swelling (Fig. 10-2). Swelling usually reaches its maximum 24 to 88 hours after the surgical procedure. It begins to subside on the third or fourth day and is usually resolved by the end of the first
week: Increase swelling after the third day may be anindication of infection rather than postsurgical edema. Once the surgery is completed and the patient is ready to be discharged, application of ice packs to the area may
help minimize the swelling and make the patient feelmore comfortable; it also allows patients to playa role in their postsurgical care. Ice should not be placed directly on the skin, but rather a layer of dry cloth should be
placed between the ice container and the tissue to preventsuperficial tissue damage. The ice bag should be kept on the local area for 20minutes and then left ‘off for 20 minutes. Ice pack application should be maintained for no more than 24 hours, because longer application does not help. Ice packs are only minimally effective in controlling edema. Some surgeons prefer the intraoral application of ice. This can beaccomplished by having the patient hold ice chips in the mouth or by sucking on a flavored Popsicle,
On the second postoperative day, neither ice nor heat should be applied to the face. On the third and subsequent postoperative days, application of heat may help to resolve the swelling more quickly. Het sources such as
hot water bottles and heating pads are recommended. Patients should be warned to avoid high-level heat for long periods jo keep from burning 01 injuring the skin.