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 an hour. After this time, the gauze pad should be removed and discarded. DO NOT PLACE ANOTHER.
- Do not rinse, spit out or use a straw for the first 24 hours
- 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 are able once leaving the office. This will usually help alleviate significant discomfort as the local anesthetic wears off.
- 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.
A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding, where your mouth is filling with bright red blood every 5 minutes, 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 sixty minutes. 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, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.
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 eventual repair. The swelling may not become apparent until the day following surgery and may not reach its maximum until 3-4 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Our ice pack may be used, or two baggies filled with ice or frozen peas or corn should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously for at least the first 24 hours. After 36 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm as the peak post surgical day is typically the third to fourth day. This is a normal reaction to surgery.
You should begin taking pain medication as soon as you are able after leaving the office. For moderate pain, Ibuprofen (Advil, Motrin) may be taken. Three 200mg over the counter tablets may be taken every 4-6 hours. If not able to take Ibuprofen (Advil, Motrin) one or two tablets of Tylenol or Extra Strength Tylenol may be taken every six hours. For severe pain, take two to three Ibuprofen along with the prescribed pain medication as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. It could also make you nauseaus or throw up. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery may reach its peak at 3-4 days and then subside more and more every day. If pain persists, it may require attention and you should call the office. Do not take any of the above medication if you are allergic or have been instructed by your doctor not to take it.
Do not use straws for the first 24 hours after surgery. Drink from a glass. 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. Refer to the section on suggested diet instructions at the end of the brochure. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake may be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. 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 rinse gently and let the water fall out. The day after surgery you should begin rinsing at least 5-6 times a day especially after eating with a cup of warm water.
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. Moist heat applied to the area may speed up the removal of the discoloration.
If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction and call the office. Call the office if you have any questions.
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. Very often it is the prescribed pain medication that is making causing your nausea/vomiting. You should then sip on coke, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and try only using the three Ibuprophen (Advil, Motrin) and less of the prescribed pain medicine.
- 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. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful. Call if you have any questions.
- Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
- 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 stand up suddenly. Before standing up, 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.
- If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as vaseline.
- Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. 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.