After Wisdom Tooth Removal

Home Instructions After Wisdom Teeth Extraction

The removal of impacted wisdom teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and complications such as infection and swelling can be minimized if these instructions are followed carefully.

Immediately Following Surgery

• The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded. If there is continued oozing or bleeding, place a new gauze pad over the surgical area and bite for another half hour. Continue this regimen until the bleeding subsides. 
• Vigorous mouth rinsing and/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 at the recommended time. This will usually coincide with the local anesthetic becoming diminished. The recovery nurse will specifically instruct you and your escort of pain control regimens, which will be given to you also in written form.  
• 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 a more thorough explanation.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon for the first day following surgery. 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 with a new gauze pad every 30 minutes as necessary. If bleeding continues, bite on a moistened black tea bag for thirty minutes. The tannic acid in the black tea 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 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, and if often expected relative to the surgery involved. 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. Ice packs should be applied to the sides of the face where surgery was performed, as soon as possible after your surgery. The ice packs should be left on, 20 minutes on, 20 minutes off, continuously for the first day. Applying ice in this manner, even if it is uncomfortable, will help minimize the amount of swelling you have. 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

Each individual’s reaction to surgery will vary depending on the degree of difficulty. The degree of pain may range from mild discomfort to severe pain. It is strongly recommended to follow the post-operative instructions closely, as this will make you as comfortable as possible in the days following your surgery.

Your oral surgeon will prescribe you some medication to take following your wisdom teeth extractions. The recovery nurse will explain to you and your escort any prescriptions given and will give you specific instructions to allow for the best pain control during your recovery period.

All prescribed medications should be taken as directed. Do not take any medication if you are allergic to them, or have been instructed by your doctor not to take it. It is best to avoid alcoholic beverages while you are taking the prescription medication. Pain or discomfort following surgery should peak 2-3 days following surgery and should subside more and more every day after the first few days. If pain persists beyond this, it may require attention and you should call the office.

Diet

Your body will require adequate fluid and nourishment for proper healing following your surgery. You should prevent dehydration by drinking lots of fluids regularly, avoiding the use of straws.

After you are finished biting on gauze and the blood clots have formed, you may eat anything that requires little to no chewing such as Jell-O, pudding, yogurt, apple sauce. Once the dental freezing has worn off, you can progress to a soft diet that could include pasta, soup, chicken, eggs, porridge, etc. 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 any meals. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.

Avoid small particle foods or foods that break down into crunch pieces, such as chips, popcorn, whole grain foods, foods with seeds, nuts, raw vegetables, rice, ground meat. These foods are more likely to get lodged in the surgical site and are difficult to rinse out. Avoiding these foods for a couple weeks is advised.

Keep the mouth clean

No rinsing of any kind should be performed until the day following surgery. The day after surgery you should begin gently rinsing your mouth with salt water, 5-6 times a day, especially after eating and before bed. Salt water can be made by  mixing a half teaspoon of salt into one cup of warm water. You can gently brush and floss the rest of your teeth 24 hours after surgery. Proper oral hygiene is necessary to ensure adequate healing. 

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 any other unfavorable reaction and contact our office immediately. 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 tea or ginger ale, and if needed you can take anti-nausea medications such as Gravol. 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. As reviewed prior to your 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. Call Drs Virdi, Humber, MacLennan or Lalli 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 could get light headed from low blood sugar or medications. Before standing up, you should sit for one minute before getting up.
• 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 period of time following surgery. This is a normal following your surgery and will subside in the first week or two following surgery.

Finally

Sutures may be placed in the area of surgery to minimize post-operative bleeding and to help healing. If you have sutures, they will dissolve, or weaken and fall out in the first 5-10 days following surgery. If your sutures need to be removed we will schedule you an appointment approximately one week after surgery for a quick healing check and suture removal. The removal of sutures usually coincides with little to no discomfort and only take a few minutes.

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 after 2-3 days following your surgery, call our office for instructions.

There will be a void where the tooth was removed. The void will fill in with new tissue gradually over the next few months. In the meantime, the area should be kept clean, especially after meals, with salt water rinses or a toothbrush.

Your case is unique, no two mouths are alike. Discuss any problems with the trained experts best able to effectively help you: Drs Virdi, Humber, MacLennan or Lalli or your family dentist.

A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. If you have symptoms of pain at the surgical site and even pain near the ear that occurs 4-5 days following surgery, call the office and speak to one of our nurses. They will instruct you as necessary.

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.