After Removal of Wisdom Teeth

Home Care After Wisdom Teeth Surgery

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 20 minutes. After this time the gauze pad should be removed and discarded.
  • 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. Do not spit or use straws.
  • 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 on the day of surgery and resume normal activity when you feel comfortable.
  • Place ice packs on the side(s) of your face where surgery was performed. Refer to the section below on Swelling for explanation.
  • Sit with your head elevated and use an extra pillow when sleeping.

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 clots from your mouth, then placing a gauze pad over the area and biting firmly for twenty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for twenty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. If the 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 will not reach its maximum until two to three days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. A plastic bag filled with ice or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be applied for 10 minutes on, 20 minutes off, for the first 24 hours while you are awake.

After 24 hours, ice has no beneficial effect. At this time, switch to the application of moist heat (a hot face cloth) to the side(s) of the face to help in reducing the size of the swelling.

Swelling or jaw stiffness may persist for two to three days, there is no cause for alarm. This is a normal reaction to surgery.

Pain

For moderate pain, two (2) tablets of acetaminophen (Tylenol®) 325 mg may be taken every six hours or three (3) ibuprofen (Motrin® or Advil®) 200 mg tablets may be taken every six hours. For best effect, alternate between these two medicines every three hours. This will achieve maximum benefit without the risk of overdose. If taking the prescribed medicine, substitute it for the acetaminophen (Tylenol®) because the prescribed medication contains acetaminophen.

For severe pain, take the prescribed medicine as directed. The prescribed pain medicine may 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. If pain persists, it may require attention and you should call the office.

Diet

After general anesthesia or IV sedation, start with a liquid diet. Drink from a glass. Do not use straws. The sucking action can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. High calorie, high protein nutrition 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. You should compensate for this by increasing your fluid intake. At least five to six (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.

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. Starting the day after surgery you should begin rinsing at least five to six (5-6) times a day, especially after eating, with an 8oz. glass of warm water mixed with a 1/2 teaspoon of salt.

Discoloration

Sometimes, 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 two to three days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.

Antibiotics

If you have been placed on antibiotics, take the medication as directed. Antibiotics are given to treat 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 flat Coke® or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides, you can begin sips of cool, clear liquids. Delay taking the prescribed medicine until the nausea subsides. You may take acetaminophen Tylenol®)

Other Conditions

  • 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 Dr. Kelly if you have any questions.
  • Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Acetaminophen (Tylenol®) or ibuprofen should be taken to reduce the fever.
  • You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery. Taking pain medications can make you dizzy. You could get light headed when you stand up suddenly. Before standing up, you should sit up 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 of the socket which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. Kelly.
  • 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® or Aquaphor®.
  • 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 of the jaw muscles (trismus) 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 not a cause for alarm. Just remove the suture form your mouth and discard it. The sutures will be removed approximately one week after surgery. The removal of sutures requires no anesthesia or needles. It usually takes less than a minute or so and there is no discomfort associated with this procedure. There is really nothing to worry about.

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 a hole where the tooth was removed. The hole will gradually fill in with the new tissue over the next month. 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 or seek “professional” information on the Internet. Discuss your problem with the persons best able to effectively help you: Dr. Kelly 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 severe pain at the surgical site not relieved by pain medication and a bad taste and even pain to the ear may occur 1-2 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.