Wisdom Tooth Post Operative Instructions
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 30 minutes. Afterward, the gauze pad should be removed and discarded. If bleeding persists, replace with a premoistened gauze pad.
- 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 the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic wearing off.
- Restrict your activities the day of surgery and resume normal activity as you feel up to it.
- Place ice packs to the side(s) of your face where surgery was performed. Refer to the section on swelling for explanation.
A certain amount of bleeding will occur following surgery. Slight bleeding, oozing, or redness in the saliva is common. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a moist gauze pad over the area and biting firmly for thirty minutes. Repeat as necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to stop bleeding and form a clot by closing the bleeding vessels. To minimize further bleeding, stay calm, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.
Swelling after surgery is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is typical. This is the body’s normal reaction to surgery and helps set the stage for repair. Swelling becomes more apparent the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, swelling may be minimized by the immediate use of ice packs. A ziplock bag filled with ice, or an ice pack should be applied to the side(s) of the face where surgery was performed 20 minutes on/off. After 36 hours, ice has no beneficial effect. Thirty-six hours following surgery, the application of moist heat to the side of the face is beneficial in reducing the size of the swelling and speeding healing. Keep your head well above the level of your heart to decrease swelling (and thus pain) for the first 72 hours.
You may take 400 mg of Ibuprofen with each prescribed pain pill as long as you are not on a blood thinner or allergic to Ibuprofen.
For severe pain, take the prescribed pain pills 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. No alcoholic beverages. Pain and discomfort following surgery should subside more and more every day. If pain increases or persists, it may require attention and you should call the office.
Do not use straws; drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot(s). For the first 24 hours, only drink clear fluids like broths. After 24 hours you may eat anything soft by chewing away from the surgical sites. A high calorie, high protein diet is very important. Nourishment should be taken regularly. You should prevent dehydration by drinking fluids regularly. Your food intake will be limited for the first few days. Drink more fluids to compensate. Try not to miss any meals. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.
Keep your mouth clean
No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the night of surgery but rinse gently. Rinsing should be minimal to avoid a dry socket.
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 afterward, including the prescribed medicine. You should then sip on coke, tea or ginger ale 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 if you have any questions.
- Slight elevation of temperature immediately following surgery is common. If the temperature persists, notify the office. Tylenol or ibuprofen can be taken to reduce the fever.
- You should be careful going from the lying down position to standing. Poor diet and 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. They are not roots; they are the bony walls, which supported the tooth. These projections usually smooth out over time. If not, they can be smoothed.
- If the corners of your mouth were stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as vaseline.
- After surgery the muscles of the face and throat swell a bit. 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 usually placed in the area(s) 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. The sutures will be removed in the office approximately one week after surgery. 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 should subside more and more each day following surgery. If your post-operative pain worsens or unusual symptoms occur call me for instructions. Swelling often increases over 72 hours and is worse in the morning. This is normal.
There will be a “hole” where each tooth was removed. This hole will gradual fill in and round off. In the mean time, the area should be kept clean, especially after meals, by rinsing with warm water.
Your case is individual, no two mouths are alike. Do not accept well-intended advice from friends. Discuss your problem with the persons best able to effectively help you: Dr. Foss.
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 2-3 days following surgery. Call the office if this occurs.
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.