After Wisdom Tooth Removal
Home Instructions After Wisdom Teeth Extraction
The post-operative care is very important after the removal of impacted wisdom teeth. Unnecessary pain and complications such as infection and swelling can be minimized if these 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, the gauze pad should be removed and discarded.
- 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.
- Take the prescribed pain medications before the numbing wears off. This will usually coincide with the local anesthetic becoming diminished.
- Restrict your activities 2-3 days after surgery. 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 more thorough explanation.
- Keep head elevated by sitting on a reclining chair or sleep with several pillows under your head for the first 48 hours.
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 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 not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operative. 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 left on continuously while you are awake. After 36 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.
You should begin taking the ibuprofen (if prescribed) and the over the counter acetaminophen or Tylenol (not prescribed) before the numbing or local anesthesia wears off and you feel okay swallowing. This typically will be within 2-4 hours after the surgery. We typically have patients take 600mg-800mg every 6-8 hours at the same time as 1-2 tabs of OTC (over the counter) extra strength acetaminophen (Tylenol). Studies have shown taking ibuprofen (Advil or Motrin) concurrently with acetaminophen (Tylenol) works better than rotating them or staggering the doses. We also recommend taking the Ultram or Tramadol (if prescribed) with the ibuprofen (Advil or Motrin) and Tylenol if needed. If you elected to take OTC ibuprofen (Advil or Motrin) it comes in 200mg tablets. You can take three to four OTC tablets of ibuprofen if you elected to not fill your prescription.
Do not exceed 3200mg daily for ibuprofen (Advil or Motrin) for an adult. Do not exceed 3000 mg daily of acetaminophen (Tylenol) for an adult.
For our pediatric patients please follow the instructions on the bottle as prescribed or the over the counter instructions if not given a prescription.
For our patients that elected to have the Exparel (long acting local anesthesia) injections you will hopefully have great pain relief for 2-4 days at the surgical sites. This does not mean no pain, as some discomfort is still normal. Please take the ibuprofen and Tylenol as needed and as explained above.
Most pain not responding to pain medicine is due to food impacted at the surgical site. Please use syringe as instructed by your doctor.
After general anesthetic or IV sedation, liquids should initially be consumed. Drink from a glass and do not use a straw. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat soft foods. Avoid chewing in the surgical site area for 5 days. A high calorie, high protein intake is very important. Our staff can provide suggested diet instructions. Nourishment should be taken regularly. You can prevent dehydration by taking fluids regularly; at least 5-6 glasses of liquid should be taken daily. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat and don’t skip meals.
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 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. Rinse with a teaspoon of salt mixed into one cup of warm water.
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 any other unfavorable reaction and contact our office immediately. 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 clear liquid such as tea or ginger ale. 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 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. Call Dr. Broadbent, Dr. Chandler, Dr. Hall, or Dr. McCormick if you have any questions.
- 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. Broadbent, Dr. Chandler, Dr. Hall, or Dr. McCormick.
- 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 throat and pain when swallowing are not uncommon. 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. Most often dissolving sutures are used, if not, the sutures will be removed approximately one week after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is usually no discomfort associated with this procedure.
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 hole or depression where the tooth was removed. This 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 rinses using a syringe.
Your case is unique, no two mouths are alike. Discuss any problems with the trained experts best able to effectively help you: Dr. Broadbent, Dr. Chandler, Dr. Hall, or Dr. McCormick 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 near 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.