After Wisdom Teeth Extractions
Immediately Following Surgery
- The gauze pad placed over the surgical area should be kept in place for a half an hour. After this time, the gauze pad should be removed and replaced if bleeding persists.
- Avoid vigorous mouth rinsing or touching the wound area following surgery. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
- Start the prescribed pain medications before the local anesthetic is gone. This will allow your body to stay ahead of the pain and allow you to be comfortable during the healing process.
- Restrict your activities the day of surgery and resume normal activity when you feel comfortable. Limit heavy lifting (more than 10 pounds) for 1 week.
- 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 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 thirty 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.
- Avoid straws for 5 days and we recommend no spitting for 24 hours. If the saliva is too much, you can go to your sink and allow it to drool out.
- To minimize further bleeding, sit upright and avoid exercise. If bleeding does not subside, call our office 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 and eventual repair.
- The swelling will not become apparent until the day following surgery and will reach its maximum until 2-3 days post-operatively.
- If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery.
- Swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be rotated off and on, every 20 minutes while you are awake.
- After 48 hours, if ice has no beneficial effect, we recommend transitioning to heating pads or warm towels. This will continue to help reduce the swelling as well relieve muscle soreness/jaw stiffness.
Pain
- Begin taking pain medication prior to the local anesthetic wearing off.
- For moderate pain, Tylenol or Extra Strength Tylenol may be taken every 4-6 hours as directed on the packaging.
- Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen, bought over the counter comes in 200 mg tablets: 3-4 tablets may be taken every 6-8 hours as needed for pain.
- Do not exceed 3000mg of Tylenol OR 3200mg of Ibuprofen in any 24 hour period.
- For severe pain, the prescribed medication should be taken as directed.
- Do not take any of the above medication if you are allergic, or if you have been instructed by your doctor not to take it.
Diet
- After general anesthetic or I.V. sedation, liquids should be initially taken.
- Do not use straws. Instead, drink from a glass or use a spoon. The sucking motion can cause more bleeding by dislodging the blood clot.
- You may eat anything soft by chewing opposite the surgical sites. High calorie, high protein intake is very important. For patients who have had multiple teeth removed, foods that are soft, cold, and do not require chewing are best.
- Nourishment should be taken regularly. 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 5-6 glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, experience 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.
- Recommend mouth rinses 4-5 days AFTER surgery. Rinses will involve using the syringe provided and spraying warm salt water (or prescription mouth rinse if given) into the extraction sites. This should be performed 5-6 times a day 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 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.
Antibiotics
- 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.
- Please call our office if you have any questions or concerns.
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 sip on coke, tea, or ginger ale. Sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.
- If nausea persists call the office and anti-nausea medicine will be prescribed.
General Instructions
- 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 our office 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 medication 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 but rather bony walls which supported the tooth. These projections usually smooth out spontaneously; however, if not, our oral surgeons can remove them.
- 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 (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 which will resolve in time. Heating pads and slow jaw stretches are recommended to start 3 days after surgery.
Final instructions to patients
- Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged however this is no cause for alarm. Simply remove the suture from your mouth and discard it.
- The sutures will dissolve within 7-10 days after surgery. If a suture is irritating your gums or cheek, please call the office to schedule a time to come in and we will remove it. The removal of sutures requires no anesthesia or needles.
- The pain and swelling should subside increasingly each day following surgery.
- If your post-operative pain or swelling worsens or unusual symptoms occur, call our office for further instructions.
- There will be an open area (cavity) where the tooth was removed. The cavity will gradually close over the next month and will heal with new tissue. In the meantime, the area should be kept clean especially after meals with salt water rinses or a soft toothbrush.
- 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 2-3 days following surgery. If this occurs, please call our office for further instructions.
- If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.
