After Wisdom Tooth Removal

The removal of impacted teeth is a serious surgical procedure and post-operative care is very important. You will be instructed prior to your surgery and also at the surgery appointment.  Written instructions and contact information for the Doctor will also be given.

Immediately Following Surgery

• The gauze pad placed over the surgical area should be kept in place for an  hour. After this time, the gauze pad should be removed, discarded and replaced as needed.  We will provide gauze for home care following surgery.
• 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 directed.
• Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
• Place ice packs to the sides of your face as directed to address swelling.
• Do not smoke.

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 gently rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for 60 minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for 60 minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.

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. 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. Two plastic bags filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be used intermittently 20 minutes on, 20 minutes off, for the first 48 hours.  After 48 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 normal reaction to surgery. Additionally, 48 hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling and help with stiffness.

Diet

Drink plenty of liquids after general anesthesia or IV sedation,  but DO NOT use straws. You may eat anything soft by chewing away from the surgical site(s). High calorie, high protein intake is very important. You should prevent dehydration by taking fluids regularly. 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 liquid should be taken daily. Try not to miss meals. 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

You can brush your teeth the night of surgery but rinse gently. The day after surgery you should begin rinsing at least five to six times a day with a cup of warm water mixed with a teaspoon of salt especially after eating. If a prescription mouth rinse was given, use as directed.

Discoloration

In some cases, discoloration of the skin follows swelling. 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  and call our office in the event of a rash or other unfavorable reaction.

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. You should sip slowly over a 15-minute period. When the nausea subsides, you can begin taking solid foods and the prescribed medicine. Please call the office if symptoms persist.

Other Complications

• If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature, call the office if you have any questions.
• A slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office.
• You should be careful going from the lying down position to standing. Some medications can make you dizzy, and you could get light headed when you suddenly stand up. Before standing up, you should sit for one minute and then stand.
• 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. Call our office if you have any concerns or questions.
• Your lips may be very dry following surgery, liberally apply lip balm or Vaseline.
• Sore throats and discomfort when swallowing are not uncommon. The muscles may be swollen and can cause the  normal act of swallowing to be uncomfortable. 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 with time. Moist heat after 48 hours will also help.

Finally

Sutures are 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 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 next month. In the meantime, the area should be kept clean, especially after meals with salt-water rinses, the prescribed mouth rinse or an irrigating syringe provided by our office. Your case is individual and no two mouths are alike. Do not accept well-intended advice from friends. Discuss your problem with the persons best able to effectively help you by calling our office with any questions.

Brushing your teeth is okay – 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 even pain to the ear may occur two to three days following surgery. Call the office if this occurs.

If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you, so take the time to recover before resuming your regular routine.