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

  • Keep the gauze pad in place over the surgical area for an hour. After this time, you may remove and discard the pad.
  • Avoid vigorous mouth rinsing or touching the wound area following surgery. This activity may initiate bleeding by causing the blood clot that has formed to become dislodged.
  • Take the prescribed pain medications before you begin to feel discomfort.
  • 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 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 one hour. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for one hour. 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 common. 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 2-3 days after surgery. However, the swelling may be minimized by the immediate use of ice packs. Ice packs or two baggies filled with ice should 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. 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, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every three to four hours or Ibuprofen, (Motrin or Advil) two-four 200 mg tablets may be taken every 3-4 hours.

For severe pain, take the tablets prescribed 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. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists you should call the office.

Diet

After general anesthetic or I.V. sedation, you should initially take liquids. Do not use straws. Drink from a glass. The sucking motion can dislodge the blood clot and cause more bleeding. You may eat anything soft by chewing away from the surgical sites. High calorie, high protein intake is very important. Take nourishment 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 lack of food by increasing your fluid intake. Take at least 5-6 glasses of liquid 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 are not to perform rinsing of any kind 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. Rinse with a cup of warm water mixed with a teaspoon of salt.

Discoloration

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is caused by blood spreading beneath the tissues. This is a normal occurrence, which may occur 2-3 days after surgery. Moist heat applied to the area may speed up return to normal color.

Antibiotics

If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics may be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. 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. 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 the prescribed medicine.

Other Complications

  • If numbness of the lip, chin, or tongue occurs there is no cause for alarm. The condition is usually temporary. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. Call Drs Dusek, Bailey, or Anton if you have any questions.
  • Slight elevation of temperature immediately following surgery is common. If the temperature persists, notify the office. Take Tylenol or ibuprofen 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 and then get up.
  • You may feel hard projections in your mouth. These projections are the bony walls which supported the tooth, and they will usually smooth out spontaneously. If not, they can be removed by Drs Dusek, Bailey, or Anton.
  • If the corners of your mouth are stretched, they may dry out and crack. You should keep your lips moist with an ointment such as Vaseline.
  • Sore throats and pain when swallowing are common. 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.

Finally

Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, but there is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures will dissolve approximately one week after surgery.

The pain and swelling should gradually subside after the third day following surgery. If your post-operative pain or swelling worsens or if unusual symptoms occur, call our office for instructions.

There will be an opening where the tooth was removed. The opening will gradually fill in with new tissue over the next month. In the meantime, keep the area clean with salt water rinses.

Your case is individual; no two mouths are alike. Do not accept well intended advice from friends. Discuss your problem with the persons best able to help you: Drs. Bailey, Anton, Seeba and Dusek or your family dentist.

Brushing your teeth is okay – just be gentle at the surgical sites.

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.