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 a half hour. After this time, the gauze pad should be removed and discarded.
- 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.
- Take the prescribed pain medications as you have been directed.
- Do not do strenuous activity nor heavy lifting for 4 days after the procedure.
- 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 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 gently 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, avoid strenuous activity and spitting. 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; it will reach a maximum point on 3 days post-opertively and then gradually go away. Sometimes swelling does not become apparent until the day following surgery. However, the 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 placed for 20 minutes then taken off for 20 minutes and then repeat this for up to 48 hours. After 48 hours, switch to warm compresses in the same fashion–on and off each 20 minutes. Please call if you are having swelling that is not going away after 4 days post-operatively.
For moderate pain, three or four tablets of 200mg Ibuprofen/Motrin/Advil for a total 600-800mg may be taken every 6 hours.
For severe pain, take the tablets prescribed as directed. The prescribed pain medicine may make you groggy and may 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, it may require attention and you should call the office.
If you did not receive a prescription pain medicine or your prescription pain medicine does not contain Tylenol/Acetaminophen/APAP then you may choose to take one or two tablets of Tylenol (325mg each) or Extra Strength Tylenol (500mg each) every six hours in addition to ibuprofen.
After sedation/anesthesia, room temperature liquids should be initially taken, however do not use straws (drink from a glass instead). The sucking motion from using a straw 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. Nourishment should be taken regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake to avoid dehydration. 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.
Keep the mouth clean
You can brush your teeth the night of surgery but avoid the surgical sites. You should begin gentle rinsing (by turning head from side to side allowing fluid to ‘slosh’ around rather than actively swishing) after eating meals with warm water mixed with a teaspoon of salt. If you were prescribed Periogard mouthrinse, use this in a similar fashion twice daily (after breakfast and before bed).
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. 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 room temperature 7up, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking soft foods and the prescribed medicine with caution since a lot of prescription pain medicines do cause nausea and vomiting.
- Prolonged numbness of the lip, chin, or tongue is usually temporary but may take weeks to resolve. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful. Please call Dr. Potaczek if you have any questions or if the numbness is not resolving after several weeks.
- 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 since 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 unlikely to be residual tooth fragments; they are most often the bony walls which supported the tooth, now exposed. These projections usually smooth out spontaneously of the first few weeks.
- 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 discomfort when swallowing are not uncommon and are related to swelling in the area. This will typically 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 related to swelling which will resolve in time. Warm compresses over the side of the jaws on postoperative day 3 and beyond can help resolve this.
- The discomfort and swelling should subside more and more each day after the 3rd day following surgery. If either worsens or unusual symptoms occur call our office for instructions.
Sutures are placed the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, this is no cause for alarm. Just remove the suture form your mouth and discard it. Most sutures placed for oral surgery are dissolvable and should fall out in 7-10 days.
There will be a cavity where the tooth was removed. The cavity will gradually over the next month fill in with the new tissue. In the mean time, the area should be kept clean especially after meals with salt water rinses or a toothbrush.
A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms may include throbbing pain at the surgical site, radiating pain to the ear, and foul odor. Dry sockets typically occur 2-3 days following surgery. Call the office if this occurs.