After Wisdom Tooth Removal
Following post-operative instructions will allow for optimal healing and quicker recovery and prevent unnecessary pain and complications such as infection and swelling.
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.
- 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 once home, guaze is removed, and you can tolerate clear liquids. Taking the pain medication before the local anesthetic wears off will help optimize pain relief.
- Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
- Place ice packs or frozen vegetables to the sides of your face where surgery was performed for 20 minutes on and 20 minutes off will help decrease swelling.
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 moistened black tea bag wrapped in a guaze for thirty minutes. The tannic acid in the black tea helps to form a clot by contracting bleeding vessels. To minimize further bleeding keep head elevated, avoid rinsing or spitting, drink plenty of cold liquids 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-operatively. However, the swelling may be minimized by the immediate use of ice packs. Frozen vegetable bags or ice packs, should be applied to the sides of the face where surgery was performed. The ice packs should be left on 20 minutes, removed and replaced frequently when 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, over the counter medications such as Tylenol or ibuprofin (Motrin or Advil) should be sufficient. If you have no medical restrictions you may two to four 200 mg tablets every 4-6 hours of ibuprofin for a few days while recovering.
For severe pain, take the pain medication 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. Transition to over the counter pain medication as the discomfort decreases and activity increases. If pain persists, or if it gets better and then in a few days becomes much worse, it may require attention and you should call the office.
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.
After general anesthetic or IV sedation initially clear liquids should be consumed in case of stomach upset from the anesthesia. Drink from a glass and do not use straws. The sucking motion can cause more bleeding by dislodging the blood clot. On the day of surgery only have cold or lukewarm food or drink. At least 5-6 glasses of liquid should be taken daily. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. You may eat anything soft by chewing away from the surgical sites. Some suggests you may start with include; slurpies, jello, pudding, ice cream, scrambled eggs, yogurt, soup or oatmeal. Avoid hot spicy food or food with hard edges such as chips or nuts. Our staff can provide suggested diet instructions. Try not to miss any meals. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.
Keep the mouth clean
No rinsing of any kind should be performed until the day 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. If salt is not available rinsing with regular water will be sufficient.
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 medication 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 clear liquids, such as water, sports drinks, or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin advancing your diet slowly with thicker liquids, soft foods and the prescribed medicine. Avoid milk based products if nauseated.
- 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 the office 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 spontaneously. If not, they can be removed by Dr. Morris.
- 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 (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.
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 over 5-7 days.
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 or a toothbrush.
Brushing your teeth is okay – just be gentle at the surgical sites.
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. It can be treated by placing a medicated packing in the area.
Vigorous exercise should be avoided in the immediate post operative period. If you experience pain or throbbing when you return to exercise you should stop and approach more slowly.