After Wisdom Tooth Removal

The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. 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.
  • Avoid touching the surgical site(s) inside the mouth or vigorous mouth rinsing after surgery. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
  • Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic wearing off which is usually 4-6 hours.  
  • Restrict your activities the day of surgery and rest as much as possible.  Day 2-3 could be more troublesome if you do not rest the first 24 hours after wisdom teeth surgery.
  • Place ice packs to the sides of your face where extractions were performed the first 24 hours.  Apply 15 minutes on and 15 minutes off.   
  • Do NOT use any type of straw for at least 24 hours.  Begin a liquid diet without a straw and increase to a soft food diet, if tolerable.  

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is common. Placing gauze over the site and applying pressure for a solid hour after arriving home will alleviate excessive bleeding.  Excessive bleeding may occur if constant talking happens or pressure is not being applied.  To control, wipe any old clots from your mouth, then place a gauze pad over the area and bite firmly for thirty minutes (after the initial hour at home). Repeat if necessary. If bleeding continues, bite on a moistened black tea bag for thirty minutes sitting upright keeping your head elevated. (The tannic acid in the black tea helps form a clot by contracting bleeding vessels).  After a few times of using the tea bags, call our office for further instruction.

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 will not become apparent until the day following surgery and will 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 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.

Pain

For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every 3-4 hours. Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken four times daily, not to exceed 3200mg daily for an adult. Consult our practice for individuals under 18. Do not take the two medications at the same time.

For severe pain, the prescribed medication should be taken as directed. Do not take any of the above medication if you are allergic to them, or have been instructed by your doctor not to take it. 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, please call our office.

Diet

After general anesthetic or IV sedation only liquids should initially be consumed. Drink from a glass and do not use straws. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft foods by chewing away from the surgical sites. A high calorie, high protein diet is very important. Our staff can provide suggested diet instructions. 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 any meals. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.

Oral Hygiene

No rinsing of any kind should be performed until the day after surgery. After which, rinsing at least 5-6 times a day is preferred, especially after eating.  Rinse with warm water mixed with 1 teaspoon of salt. Brush your teeth 24 hours after surgery ensuring extra care around the surgical sites. 

Discoloration

In some cases, discoloration of the skin follows swelling.  This is a normal post-operative occurrence, which may occur 2-3 days afterwards.  Moist heat applied to the area may help clear up the discoloration.

Antibiotics

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 with any questions.

Nausea or 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.

Other Information

  • 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. Kalant or Dr. Pink 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 Drs. Kalant or Pink.
  • 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. The muscles get swollen. 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 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. 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 after surgery. There will be a void where the tooth was removed. The 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 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 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 has been reduced. Exercise may weaken you. If you get light headed, stop exercising.

We want you to be comfortable, no two mouths are alike, please discuss any concerns you may have with our surgical team by calling our office.