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

  • After wisdom tooth extraction, it is important for blood clots to form to stop the bleeding and begin the healing process. That is why we ask you to bite down on gauze for 1 hour after your appointment.

    • Bite down gently but firmly on the gauze packs that have been placed over the surgical sites making sure they remain in
    • Do not change them for the first hour unless the bleeding is not controlled.
    • The packs may be gently removed after one hour.

EXERCISE CARE:  After the blood clot forms, it is important not to disturb or dislodge the clot as it aids in healing. DO NOT rinse your mouth, suck on straws, smoke, drink alcohol for 48 hours. You may brush your teeth gently.

PERSISTENT BLEEDING

Bleeding should never be severe. If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs. If bleeding persists or becomes heavy, you may substitute a tea bag (soaked in very hot water, squeezed damp-dry and wrapped in moist gauze) for another hour. If bleeding remains uncontrolled, please call our office.

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 two to three 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.

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

Pain

If you take the first pill before the anesthetic has worn off, you should be more easily able to manage any discomfort.

For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every three to four hours. You may choose to take Ibuprofen (Motrin or Advil) in which case you should take two to four 200 mg tablets every three to four 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. 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.

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 if you have any questions.

Diet

Drink plenty of fluids and eat nutritious cool, soft foods on the day of the extraction while the surgical site is numb (soups, pudding, yogurt, etc.).  Eat any nourishing food that can be eaten with comfort. Over the next several days you may gradually progress to solid foods. It is important not to skip meals! If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster. If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.

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 of any kind 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, with a teaspoon of salt mixed into one cup of warm water. If you were given a prescription for Peridex begin using the day following surgery. Follow the directions on the bottle. Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing but please make every effort to clean your teeth within the bounds of comfort.

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.

Other Complications

  • 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 our 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.
  • 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. Fuller, Dr. Tagoni, Dr. Westlund or Dr. Sarasin.
  • 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.

instructions for 1 week after surgery

If you have been given an irrigation syringe, begin irrigating the lower extraction site(s) 1 full week following surgery.

  • Fill the syringe with warm water (nothing too hot or too cold) because the extraction sites will be sensitive.
  • While using a mirror, gently pull the cheek out to the side, Use the other hand to hold the irrigation syringe. Use the mirror to locate the extraction site, just behind the last tooth. Place the tip of the irrigation syringe into the extraction site and gently flush out the site until there is no food debris present.
  • Use the syringe 3-4 times per day and especially before bed at night so food does not get left in the extraction sites during the healing process. 
  • Use the irrigation syringe until extraction sites are completely closed. (this can take several weeks)