After Wisdom Tooth Removal
Wisdom Tooth Removal Post-Op Instructions
The removal of impacted 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 45 minutes to 1 hour. After this time, the gauze pad should be removed and discarded. You may need to repeat this several times.
- No smoking, no spitting, and no drinking through a straw for at least 72 hours.
- Rinse mouth gently with lukewarm salt water (1 teaspoon in 1 cup water) after 24 hours. Do not use mouthwash for 24 hours after extractions.
- Be cautious of extraction site while brushing teeth.
- Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished. Do not take pain medications on an empty stomach.
- 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.
A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. The gauze pad placed over the surgical area should be kept in place for 45 minutes to 1 hour. After this time, the gauze pad should be removed and discarded. You may need to repeat this several times. If excessive 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.
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 not reach its maximum until 2-3 days post-operative. 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 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.
For moderate pain, 1000 mg of Tylenol or Extra Strength Tylenol may be taken every 6 hours. You may choose to take 800 mg of Ibuprofen (Motrin or Advil) every 6 hours. You can also take Tylenol and Ibuprofen together, alternating Tylenol/Ibuprofen every 3 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. Do not consume alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain/soreness persists for more than 3 days, it may require attention and you should contact the office.
After general anesthetic or IV sedation only liquids should initially be consumed. Drink from a glass and do not use straws. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. A high calorie, high protein intake is very important. Our staff can provide suggested diet instructions. 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 any meals. You will feel better, have more strength, 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 up for one minute before standing.
Keep the mouth clean
No rinsing of any kind should be performed until 24 hours following surgery. The day after surgery you should begin rinsing at least 5-6 times a day, especially after eating, with a teaspoon of salt mixed into one cup of warm water.
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-operative. Moist heat applied to the area may speed up the removal of the discoloration. Whitening around extraction site may occur, white is dead tissue. Drink more water the whitening is caused by dehydration. If you remove the blood clot (white area) it will cause a dry socket, which is very painful, and will require another visit to our office.
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 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.
- If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As reviewed in your consultation, 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 Dr. Whittaker 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.
- Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls which supported the tooth. These projections usually smooth out on their own. If not, they can be removed by Dr. Whittaker.
- 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, 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.
- 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 near the ear may occur 2-3 days following surgery. Call the office if this occurs.
Sutures are placed in 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 from your mouth and discard it. The sutures will dissolve or come out on their own within 2 weeks time and if not contact our office. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is usually no discomfort associated with this procedure.
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, 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 month . In the meantime, the area should be kept clean, especially after meals, with salt water rinses.
Your case is unique, no two mouths are alike. Discuss any problems with the trained experts best able to effectively help you: Dr. Whittaker or your family dentist.
Brushing your teeth is okay – just be gentle at the surgical sites.
If you have any questions or concerns about caring for your oral health after your wisdom tooth removal, call Bryan Office Phone Number 419-636-4202!