After Wisdom Tooth Removal
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 a half hour. 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.
- Take the prescribed pain medications as soon as you get home before you begin to feel discomfort.
- 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 explanation.
A certain amount of bleeding is to be expected following surgery. Continue to bite on the gauze provided for 30 to 45 minutes and change as needed. Slight bleeding, 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, squeeze-dried tea bag for sixty minutes and repeat as necessary. Chemicals in the dry tea bag helps to form a clot. To minimize further bleeding, sit upright and avoid exercise and/or becoming excited. If bleeding does not subside, call 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 may not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. The ice packs should be applied for 20 minutes and then removed for 20 minutes. After 48 hours, ice has no beneficial effect. Seventy-two hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.
For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every three to four hours or Ibuprofen, (Advil) two to four 200 mg tablets may be taken every 3-4 hours.
For severe pain, take the tablets prescribed 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. Avoid alcoholic beverages. If the discomfort continues you can alternate medications every 3 hours by taking 1 or 2 tablets of the prescribed pain medications then 3 hours later taking two to four 200 mg tablets of Ibuprofen.
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.
Initially, liquids should be taken. We recommend that you drink any kind of sports drink once the numbness wears off. Once the numbness wears off DO NOT USE STRAWS, just drink from a glass normally. The sucking motion 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 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.
Keep the mouth clean
NO RINSING OR SPITTING should be performed until the day following surgery. You can brush your teeth the night of surgery but avoid the surgical sites and rinse gently with water. DO NOT rinse with mouthwash for 3 to 5 days following the procedure. 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 teaspoon of salt. Three to four days after surgery, use the irrigation syringe provided to rinse. (Note: Do not use syringe if bone grafting or implants were placed.)
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 and notify the office.
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 a sports drink or ginger ale. When the nausea subsides you can begin taking solid foods and the prescribed medicine, but stop the narcotic pain medication.
- 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 the office 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 position to standing. You were not able to eat or drink prior to surgery and it will be difficult to take fluids. 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. These are not roots; they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed.
- 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.
- A sore throat and pain when swallowing are not uncommon. The muscles can become swollen making the normal act of swallowing painful. This will subside within 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 form your mouth and discard it. The sutures are self dissolving and will start to come out on their own approximately one week after surgery.
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 my office for instructions.
There will be a cavity where the tooth was removed. The cavity will gradually over the next month fill in with the new tissue. In the mean time, 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. Discuss your problem with the persons best able to effectively help you: Dr. Singh 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 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.