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 one hour. After this time, the gauze pad should be removed and discarded. Gauze packs should be replaced throughout the day of surgery to help blood clot at the surgical sites.
- Vigorous mouth rinsing 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 medications as advised after your surgery.
- 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 the surgery was performed. Refer to the section on swelling for a more detailed 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 moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting the bleeding vessels. To minimize further bleeding, do over-exert yourself, sit upright and avoid exercise. 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. The swelling may not become apparent until the day following surgery and may not reach its maximum until 3-5 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two bags filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be kept in place while you are awake. After 36 hours, ice may have no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is usually no cause for alarm. This can be a normal reaction to surgery. Two days following surgery, the application of moist heat to the sides of the face is beneficial in helping your jaw return to normal function sooner.
For moderate pain, Tylenol or Extra Strength Tylenol may be taken every 4-6 hours and Ibuprofen (Motrin or Advil) may be taken every 6-8 hours, unless your doctor advises a different regimen or instructions. You may need to adjust doses or which medications you use for pain based on your medical history and this will be discussed at your consultation appointment with your surgeon.
For severe pain, your surgeon may prescribe medications to be taken 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 each day after your peak swelling (day 3-5). If pain persists, it may require attention and you should call the office.
After general anesthetic or IV sedation, clear liquids should be initially taken. Do not use straws. Drink from a glass. 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 and high protein intake is very important. 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 a single meal. 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 for one minute before standing.
Click here to learn more about what you should eat following your surgery. There are also many recipes that were designed for people recovering from mouth surgery.
Keep the mouth clean
You should avoid rinsing your mouth until the day following surgery. You can brush your teeth the night of surgery but rinse gently. The day after surgery, you should begin very gently rinsing roughly 5-6 times a day, especially after eating, with a cup of warm water mixed with a teaspoon of salt.
It is vital that you do not smoke during your recovery. Smoking may cause a dry socket, which can be very painful. You should avoid smoking and other tobacco products for 7 days after your surgery. Ideally with complete cessation of using tobacco products.
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 2-5 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 may 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 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 stated before 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. So be careful. Call our office if you have any questions or this sensation persists past the first day of your surgery.
- Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol and ibuprofen should be taken to reduce the fever, unless otherwise directed by your doctor.
- You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery. It was also difficult to take fluids. Taking pain medications can make you dizzy. 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. These 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 our doctors.
- 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 usually subsides 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.
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 from your mouth and discard it. The sutures may be removed approximately one week after surgery if they are still present. The removal of sutures requires no anesthesia or needles. It takes only a minute or so and there is no discomfort associated with this procedure. So it’s really nothing to worry about.
The pain and swelling should subside more and more each day following surgery after your peak swelling (3-5 days after surgery). If your post-operative pain or swelling worsens or unusual symptoms occur, call the office for instructions.
There will be a cavity where the tooth was removed. The cavity will gradually, over the next few months, fill in with the new tissue. In the meantime, the area should be kept clean; especially after meals with salt water rinses or a toothbrush.
Your case is individual, no two mouths are alike. Do not accept well intended advice from friends. Discuss your problem with the people best able to effectively help you: South Sound Oral Surgery or your family dentist.
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 to the ear may occur 3-5 days following surgery. Call the office if this occurs.
If you are involved in regular exercise, be aware that your normal nourishment intake will be reduced. Exercise may weaken you. If you get light headed, stop exercising.