After Wisdom Tooth Removal

Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.

We ask that you follow these instructions closely, as they will make you most comfortable following your procedure. 

Immediately Following Surgery

• The gauze pad placed over the surgical area should be kept in place for a half hour or until you arrive home. After this time, the gauze pad should be removed and discarded.
• Avoid vigorous mouth rinsing or touching the wound area following surgery. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
• Take the prescribed pain medication before the local anesthetic wears off. 
• Restrict your activities the day of surgery. 
• Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for explanation.

PAIN

Discomfort following oral surgery usually begins as the local anesthetic diminishes. Take the prescribed pain medications before the local anesthetic wears off to minimize any pain, unless otherwise instructed. For mild to moderate pain, take ibuprofen (Motrin or Advil) every 6 hours for the first 2 days after surgery.  This may provide adequate pain control and eliminate the need to take a narcotic. If the ibuprofen does not control your pain adequately, you can then take a narcotic pain medication, if one was prescribed. We recommend alternating between the ibuprofen and narcotic every 3 hours.

ANTIBIOTICS

It is important to take and finish the prescribed antibiotic as ordered. Antibiotics are given to help prevent infection. Notify the surgeon if a complication arises, such as a rash or other unfavorable reaction while taking any prescription drug. Please be aware that Penicillin, as well as other common forms of antibiotics, may reduce the effectiveness of oral contraceptives. You should consider another form of birth control while taking these medications.  

MEDICATION

When taking narcotic pain medication or sedatives you should not drive a car, use dangerous equipment, drink alcohol, or assume critical responsibilities. You should not drive a car for 24 hours after receiving an IV anesthetic. 

ACTIVITY

After an IV anesthetic you should have someone stay with you at home for at least 12 hours. Care should be taken to minimize the risk of falling and injuring yourself, particularly on stairs or in the bathroom. Bed rest during the first 24 hours will minimize pain, swelling and bleeding. Over exertion may initiate or intensify pain. Avoid excessive physical activity at work, school or play.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is normal during the first 24 hours. If there is a persistent ooze, moisten gauze packs with cold water, place over site and bite down with firm steady pressure for 30 minutes. Continue this every 30 minutes until the flow of blood stops.

If bleeding continues, you can also bite on a moistened tea bag for thirty minutes. The tannic acid in tea can help to form a clot by contracting bleeding vessels.

To minimize further bleeding, do not become excited, sit upright, and avoid exercise. Do not smoke or drink with a straw for one week following surgery. These things could disturb blood clot formation.

If bleeding does not subside, call for further instructions.

Swelling

This is common after oral surgery and may continue to increase during the first 24 to 72 hours. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and will subside. 

During the first 48 hours cold compresses or ice bags may be applied to the affected areas, 20 minutes on and 20 minutes off to minimize the swelling.  Starting the 3rd post-operative day, warm compresses can be used to facilitate the resolution of swelling.  

TIP: The more ice you use during the first day and second day, the less swelling you are likely to have.

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. Moist heat applied to the area may speed up the removal of the discoloration or bruising. 

Diet

After general anesthetic or I.V. sedation, liquids should be initially taken. Do not drink from a straw for one week. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot.

Food intake is generally regulated by the comfort of chewing. Soft foods and plenty of fluids are highly recommended. Avoid foods that are hard, brittle, hot and spicy for 5-7 days. 

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.

ORAL HYGIENE

Keeping the mouth clean is essential after oral surgery. Gently brush teeth and floss as needed, avoiding the surgical areas. 

After the first 24 hours gently rinse with a mild salt water solution, 1/4 teaspoon of salt dissolved in an 8 ounce glass of water. Repeat as needed. Diluted mouthwash can be used for a soft rinse. Avoid vigorous rinsing and spitting during the first 48 hours.

retainers

Retainers should be worn as soon as possible, based on your comfort level, unless otherwise instructed.

Finally

Sutures are placed in the area of the surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged. There is no cause for alarm, just remove the suture form your mouth and discard it. The sutures may be removed approximately one week after surgery if they haven’t already dissolved. 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.

There will be a cavity where the tooth was removed. The cavity will gradually fill in with new tissue over a 4 week period. In the mean time, the area should be kept clean with salt water rinses or a toothbrush.

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 3-4 days following surgery. Call the office if this occurs.