After Wisdom Teeth Removal

Home Care Instructions After Wisdom Tooth Surgery

The removal of impacted teeth is a surgical procedure that requires serious attention to post-operative care. Unnecessary complications 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 a half hour. After this time, if visible bleeding is present, the gauze pad should be replaced and the surgical site should be re-evaluated every 30 minutes. Most bleeding will cease by late evening.
  • 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 before the local anesthetic wears off.
  • 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 further explanation.

Bleeding

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 constricting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.

Swelling

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 2-3 days post-operatively. 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 placed alternating 20 minutes on / 20 minutes off until bedtime. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery.

Pain

Your doctor has prescribed the appropriate medications for you based on your surgical procedure and medical condition. Please follow the instructions as written on the bottle. If you have any questions or experience and untoward side effects, contact our office.

Diet

After general anesthetic or I.V. sedation, 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 form the surgical sites. High calorie, 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.

Keep the mouth clean

No heavy rinsing of any kind should be performed until the day following surgery, though light rinsing on the first day is allowed. It is imperative that oral hygiene is maintained after surgery. You should begin to brush your teeth the night of surgery, taking care to avoid disturbing the surgical site directly while brushing.  The day after surgery you should begin rinsing at least 5-6 times a day, especially after eating, with a cup of warm water mixed with a half teaspoon of salt.

Discoloration

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.

Antibiotics

If you have been placed on antibiotics, take the tablets or liquid as directed. Discontinue antibiotic use in the event of a rash or unfavorable reaction. Call the office if you have developed any reaction.

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 cola, 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 your nausea and/or vomiting persists for more than 6 hours, please call the office.

Other Complications

  • 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. Please contact your surgeon if the numbness persists beyond 24 hours.
  • Slight elevation of temperature immediately following surgery is not uncommon. It is imperative to maintain adequate fluid intake to avoid dehydration. A minimum of 8 ounces per hour for the first 8 hours is adequate. If a fever persists even though you are taking adequate fluids, please contact your surgeon.
  • You should be careful going from the lying down position to standing.  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 spontaneously.
  • 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 following general anesthesia. 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.

Finally

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 form your mouth and discard it. The sutures will be removed approximately one week after surgery, if necessary. 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 the office for instructions. There will be an opening where the tooth was removed. The opening will gradually fill in over time with the new tissue. Brushing your teeth is okay but care should be taken to avoid disturbing the surgical site. 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.