After Wisdom Tooth Removal
The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important to minimize complications and speed your recovery. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.
Immediately Following Surgery
- The initial gauze pad placed over the surgical area should be kept in place for an hour. After an hour, the gauze pad should be removed and discarded. If additional bleeding is noted, fold another piece of gauze into quarters and hold pressure on it over the extraction site for 45 minutes. Minimizing talking and jaw movement while biting on the gauze will help promote clotting.
- Vigorous mouth rinsing and touching the wound area should both be avoided. This may dislodge the blood clot that has formed and cause more bleeding.
Take the prescribed pain medications as soon as you begin to feel discomfort. This usually happens when the local anesthetic begins wearing off.
When lower wisdom teeth are removed, it is common to use a longer-acting local anesthetic. The numbness in your lip, chin, teeth, and tongue may persist for up to 12 hours after surgery.
- Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling (below) for further instruction.
- Caution: If you are lying down following surgery, make sure you sit for one minute before standing. Suddenly sitting or standing after lying down may cause you to become dizzy.
- Restrict your activities the day of surgery and resume normal activity when you feel comfortable. Avoid strenuous exercise for at least 48 hours following surgery.
Additional Aftercare Instructions
- A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon for 24 hours after surgery. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth and then placing a gauze pad over the area and biting firmly for 40 minutes. Repeat if necessary. If bleeding continues, you can bite on a moistened tea bag for 30 minutes. The tannic acid in the tea bag helps to form a clot by constricting bleeding vessels. To minimize further bleeding, sit upright and avoid vigorous movement. It is not unusual to have minor bleeding for several days after surgery if the surgical site is disturbed by talking or chewing food.
- Swelling around the mouth, cheeks, eyes, and sides of the face is common after oral surgery. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day after surgery and should peak by the third day. However, the use of ice packs immediately following surgery may help minimize the eventual swelling. Ice packs should be applied to the affected sides of the face for 20 minutes on/20 minutes off while you are awake. After 36 hours, ice has no longer has a beneficial effect and after 48 hours, you can apply moist heat to the area instead. It is normal for the jaw to be swollen or stiff for several days.
- In some cases, discoloration (or bruising) 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 and may not become visible until 2-3 days after surgery. Moist heat applied to the area may speed up the removal of the discoloration.
- For moderate pain, you may take 1-2 tablets of Tylenol every 3-4 hours. Ibuprofen may be taken instead of Tylenol. Ibuprofen bought over the counter comes in 200 mg tablets; 2-4 tablets may be taken every 3-4 hours as needed for pain.
- For severe pain, take the prescribed pain medication tablets as directed. The prescribed pain medicine will make you groggy and slow down your reflexes. Do not drive an automobile or work around machinery while using medication and do not drink alcoholic beverages. The pain should lessen every day. If pain persists or increases after 48 hours, call the office.
- If you had general anesthesia or I.V. sedation, you should start on liquids as soon as you are able. Avoid using straws as the sucking motion can dislodge the blood clot and cause more bleeding. Your food intake will be somewhat limited for the first few days and you should compensate for this by increasing your fluid intake. Nourishment should be taken regularly. You can use high calorie, high protein drinks or shakes until you are able to eat soft foods (such as scrambled eggs, applesauce, yogurt, etc). Once you are able to eat soft foods, you should chew away from the surgical site(s). You will feel better and heal faster if you continue to eat.
- Do not vigorously rinse your mouth the day of surgery. You can brush your teeth that night and gently rise your mouth, but be careful in the surgical area(s). The next day, you should begin rinsing at least 5-6 times daily, especially after eating. You can make a mouth rinse by mixing a teaspoon of salt into one cup of warm water. If you were prescribed an oral rinse you should use that in addition to the saltwater rinses.
- If you were prescribed antibiotics to help prevent infection, please take the tablets or liquid as directed on the bottle. If you develop a rash or have an unfavorable reaction, discontinue taking the antibiotics and call the office.
- If you are nauseous and/or vomiting following surgery, do not take anything by mouth (including prescribed medication) for at least an hour. You should then slowly sip Sprite, 7-Up, tea, or ginger ale over a fifteen minute period. When the nausea subsides, you should eat soft food and take the prescribed medication. If the nausea persists, please contact the office.
- Numbness of the lip, chin, or tongue may occur but is usually temporary. Please be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. Be careful. Call our office if you have any questions or concerns.
- Slight elevation of temperature immediately following surgery is not uncommon. Tylenol or ibuprofen should be taken to reduce the fever. If the temperature persists, notify the office.
- You may feel dizzy after surgery. Remember that you were not able to eat or drink prior to surgery. Additionally, taking pain medication can make you dizzy. If you are lying down following surgery, make sure you sit for one minute before standing. Suddenly sitting or standing after lying down may cause you to become dizzy.
- Occasionally, patients may feel hard projections in the mouth with their tongue. The projections are the bony walls which supported the tooth and usually smooth out on their own. If the do not smooth out of if they cause discomfort, they can be removed by the doctor.
- Your lips may dry out and crack from being stretched open. Keep lips moist with an ointment such as Vaseline.
- Sore throats and pain when swallowing are not uncommon. The muscles get swollen, which may make the normal act of swallowing very painful. This will subside in 2-3 days.
- Stiffness 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.
- Dissolving sutures are placed in the area to minimize post-operative bleeding and to help promote healing. Sometimes sutures become dislodged; this is not a cause for alarm. Simply removed the loose suture from your mouth and discard it. That sutures that remain will be removed when we see you for your post-operative follow-up appointment. The removal of sutures requires no anesthesia or needles and only takes a minute or so. There is minimal discomfort associates with this procedure.
- The pain and swelling should subside more and more each day after the second day following surgery. If your post-operative pain or swelling worsens or if any unusual symptoms occur, please call the office for instructions.
- There will be a hole where the tooth was removed. Over the next month, the hole will gradually fill in with the new tissue. In the meantime, the area should be kept clean through the use of a toothbrush and saltwater rinses. Brushing your teeth is okay — just be gentle!
- Your case is individual. No two mouths are alike. Do not accept well-intentioned advice from friends. Discuss your problem with the persons best able to effectively help you: Drs. Beadnell, Ugalde, Kupfer, Sharifi, or your family dentist.
- 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. 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. Avoid strenuous exercise for at least 48 hours after surgery. If you get lightheaded, stop exercising.