After Wisdom Tooth Removal

The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.

Immediately Following Surgery

The gauze pad placed over the surgical area should be kept in place for approximately 1 hour. After this time, the gauze pad should be removed, discarded and replaced as necessary.
Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
Take the prescribed pain medications as instructed.
Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
Place ice packs to the sides of your face where surgery was performed. Refer to the section on Swelling for an explanation.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for 45 minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for 45 minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, try to relax, sit upright, and avoid exercise.

Swelling

The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until two to three days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Ice packs, or two plastic bags filled with crushed ice, should be applied to the sides of the face where surgery was performed. The ice packs should be alternated from side to side every 20 minutes, continuously while you are awake. After 24 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a common response to surgery. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.

Pain

For moderate pain, the ibuprofen (Motrin or Advil) may be taken four times daily, as prescribed by your doctor.

For severe pain, take the prescribed narcotic tablets as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery while taking these medications. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, you may call the office to schedule a visit with your doctor.

Diet

Drink plenty of liquids after general anesthesia or IV sedation to avoid dehydration. Begin drinking fluids slowly but consistently. Avoid using straws when drinking from a glass for five days. The sucking motion can cause more bleeding by dislodging the blood clot. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least five to six glasses of fluids should be taken daily.

You may eat anything soft by chewing away from the surgical site(s). High calorie, high protein intake is most beneficial. Try to maintain a normal, but soft, diet. Chewing regular foods may cause impaction of food debris into the sockets which could lead to a dry socket. Try not to miss a single meal. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat.

CAUTION: If you suddenly sit up or stand from a lying position, you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.

Keep The Mouth Clean

No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the night of surgery but avoid brushing the surgical sites and rinse gently. The day after surgery you should begin gentle rinsing at least five to six times a day with salt water (a cup of warm water mixed with a teaspoon of salt), especially after eating.

Discoloration

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal postoperative occurrence, which may occur two to three days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.

Antibiotics

If you have been placed on antibiotics, take the tablets or liquid as directed. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions.

Nausea & Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on Coke, tea, or ginger ale slowly over a 15-minute period. When the nausea subsides, you can begin taking soft foods and the prescribed medicine. Do not take the prescribed medications on an empty stomach, as this is one of the most common causes of nausea and/or vomiting after oral surgery.

Other Complications

If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is typically temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. Take care to avoid trauma to a numb lip or tongue by chewing slowly.

A slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen may be taken to reduce the fever. Please call before taking any of these medications for fever, as you may have already been prescribed medications containing Tylenol or ibuprofen.

You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery. It was also difficult to take fluids. Taking pain medications can make you dizzy. You could get light headed when you suddenly stand up. Before standing up, you should sit for one minute prior to standing.

Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. This can be discussed with your doctor at your follow-up appointment.

After surgery, your lips and corner of your mouth may become chapped. Your lips should be kept moist with an ointment such as Vaseline.

Sore throats and pain when swallowing are not uncommon. The muscles become swollen. The normal act of swallowing can then become painful. This will subside in two to three days. Stiffness (trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event that will resolve in time.

Finally

Sutures are often placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures generally begin to dissolve within one week after surgery. Should the sutures remain longer than a week and/or become bothersome, the removal is simple and requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure.

After the 2-3 days, the pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur, call the office for instructions.

There will be a cavity where the tooth was removed. The cavity will gradually fill in with new tissue over the following month. In the meantime, the area should be kept clean, especially after meals, with salt-water rinses or a toothbrush.

Brushing your teeth is allowed — just be gentle at the surgical sites.

A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and/or pain radiating to the ear or temple may occur three to five days following your surgery. Please call the office if this should occur.

If you are involved in regular exercise, be aware that your normal nourishment is reduced. Your normal exercise level may cause dizziness or lightheadedness. If you get light headed, stop exercising, rest, and drink more fluids.

If you have any questions at all, ask us, we are only a phone call away. Do not hesitate to call the office with any questions/concerns.