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 changed every 15 – 20 minutes until bleeding has stopped.
• 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 soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.
• 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 explanation.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is expected. Excessive bleeding may be controlled by placing a gauze pad over the area and biting firmly for 15 - 20 minutes. Repeat if necessary. 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 bleeding vessels. To minimize further bleeding, sit upright, and avoid strenuous exercise. If bleeding does not subside, call for further instructions.

Swelling

The amount of swelling 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 eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs may be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 36 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.

Pain

For moderate pain, two Tylenol or Ibuprofen (Motrin or Advil) may be taken every 4 hours unless otherwise instructed.

For severe pain, take the prescribed pain medicine as directed. The prescribed pain medicine may make you groggy and may slow your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.

Diet

After general anesthesia or I.V. sedation, drink plenty of liquids. Drink from a glass. Do not use straws. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away form the surgical sites. High calorie, high protein intake is very important. Nourishment should be taken regularly. Prevent dehydration by taking fluids regularly and increasing your fluid intake. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.

Keep the mouth clean

Avoid rinsing until the day following surgery. You can brush your teeth the night of surgery but rinse gently. The day after surgery you should begin rinsing at least 5-6 times a day especially after eating. Use warm water mixed with a ¼ teaspoon of salt.

Discoloration (Bruising)

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 post-operative occurrence, which may occur 2-3 days post-operatively.

Antibiotics

If antibiotics have been prescribed, please 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 or reactions.

Nausea and 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 slowly sip on coke, tea or ginger ale over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine. Call if this persists.

Other Complications

• Slight elevation of temperature immediately following surgery is expected. If the temperature persists, notify the office.
• Please be careful going from the lying down position to standing. Taking pain medications can make you dizzy. You may get light headed when you stand up suddenly. Before standing, you should sit for one minute then get up.
• 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. If not, they can be removed by us.
• The corners of your mouth may dry out or crack. Your lips should be kept moist with an ointment such as vaseline.
• Sore throats and pain when swallowing are common following surgery. This will subside in 2-3 days.
• Stiffness (Trimus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.

Finally

Sutures are sometimes placed in the area of surgery. Do not be concerned if they become dislodged. Most of the sutures used in our office are resorbable and will dissolve on their own.

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 our office for instructions.

There will be a hole where the tooth was removed. The space will fill in gradually with new tissue. In the mean time, the area should be kept clean especially after meals.

Please brush your teeth - just be gentle at the surgical sites.

A dry socket occurs 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 2-3 days following surgery. Call the office if this occurs.