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
Your surgeon and/or office staff will give you specific instructions to follow after surgery is completed. You can expect some bleeding for the next few hours. You will be asked to bite down gently on gauze, changing every 30 minutes until the bleeding stops. Even a little blood mixed with saliva can be alarming. Gentle oozing of blood for a few hours after surgery is common.
- A gauze pad placed over the surgical area should be kept in place for 30 minutes. After this time, the gauze pad should be removed and discarded. The gauze can be replaced several times until bleeding stops.
- 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.
- No Rinsing
- No Spitting
- No sucking through a straw
- No smoking
- Take the prescribed pain medications prior to local anesthetic wearing off.
- Restrict your activities and vigorous exercise for 3-5 days following surgery. Resume normal activity when you feel comfortable and the swelling has subsided.
- Place given 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. 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 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 common. This is the body’s normal reaction to surgery and eventual repair. The swelling may 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. Two baggies filled with ice, or the provided hands-free ice wraps , should be applied to the sides of the face where surgery was performed. The ice packs should be used in twenty minute intervals (20 min on, 20 min off) for the next 48 hours while awake. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery.
Some post-operative discomfort is to be expected. Mild to moderate pain is generally controlled with anti-inflammatory pain medications, which may be taken over the counter or as prescribed by Dr. Frawley. These include Ibuprofen (Motrin) and Advil. Moderate to severe post-op pain may require control with a prescribed narcotic pain medication. These medications may often be taken together, or in alternating doses. Please follow all prescription labels and instructions. Do not take any of the above medication if you are allergic to them, or have been instructed by your doctor not to take it. 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.
Immediately after nitrous oxide 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. Avoid hard and crunchy sharp foods. 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 and eating smaller and more frequent meals. 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 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. Listerine can be used 2-3 times a day. A prescription mouth rinse is often prescribed and should be used as directed.
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 3-7 days post-operatively. This is common in fair skinned individuals.
If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection, take until the bottle is completely empty. In the event of a rash or any other unfavorable reaction (eg. GI upset) contact our office or Dr. Frawley immediately.
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 immediate 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. If this condition lasts for several days please call the office.
- 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. Frawley.
- 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 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. Generally resorbable sutures are used, eliminating the need for a post-operative suture-removal appointment.
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 or Listerine rinses, and a provided irrigation syringe. It is not uncommon for food to collect in the extraction sites, it can be removed with the syringe or oral rinse.
All cases are different, as well as each individual healing process. Our office is always available if you have questions or concerns.
Brushing your teeth is encouraged – just be gentle at the surgical sites.
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.
A dry socket may occur when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of throbbing pain at the surgical site and even pain radiated to the ear may occur 3-5 days following surgery. This condition is usually treated with medicated packings. Smoking (e-cigs, vaping) is a common cause of dry socket and should be avoided for a week after surgery.
Call the office immediately if this occurs.