After Wisdom Tooth Removal

Rapid and satisfactory recovery from oral operations are dependent on your post-operative care of the mouth. In some cases, little care may be necessary. Following a more extensive and complex operation, it is especially important that certain instructions be observed.

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.
• Do not rinse vigorously or touch the extraction site following surgery. This will initiate bleeding by dislodging 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 becoming diminished.
• 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 below on swelling for a more thorough explanation.

Bleeding

Bleeding is to be expected following the procedure. If excessive, wipe the blood from the mouth and wound. Place a roll of gauze over the wound and bite firmly for 30 minutes to create constant pressure. Repeat as necessary. A sitting position is best.

If bleeding continues, moisten a regular tea bag and place it on the bleeding area and bite on it for 20 minutes. The tannic acid that is present in the tea helps to form a clot by constricting the bleeding vessels.

Pain

Just like bleeding, pain is to be expected. Take two tablets of ibuprofen (200mg) every four to six hours as needed for pain. If you have been given a prescription for pain by the doctor, have the prescription filled and use it as directed. You can alternate using ibuprofen and the prescription pain medication if only one of the medications does not provide adequate pain relief.

Please note that alcohol and medication are not advisable. Do not consume alcohol while taking prescription medication under any circumstance. Please see below for more detailed information regarding your medication.

Swelling

Some swelling can be expected and may take a day or two to develop. Typically, the third day is the worst day for pain and swelling.

To soothe swelling, apply an ice pack to the jaw immediately upon your return home. Commercial ice packs or a frozen bag of peas can be used. This will help limit the swelling if applied shortly after your surgery has been completed.

The ice pack may be applied 20 minutes on and 20 minutes off for up to 8 hours. These cold applications are also very effective for the relief of pain after surgery. After the first 48 hours, application of moist/warm compresses may also aid in the reduction of swelling.

Please be advised that skin discoloration may accompany swelling. This is similar to a bruise and no further treatment is necessary. Moist heat applied to the area may speed up the removal of the discoloration.

Diet

A liquid diet is recommended for the first few hours following the procedure (water, juice, Gatorade) followed by a soft diet is recommended for several days before returning to a regular diet. Recommended foods are scrambled eggs, mashed potatoes, yogurt, puddings, and soft pasta. 

Drink from a glass and do not use straws. Sucking dislodges the natural blood clot formed to aid in healing the extraction site.

You may eat anything soft by chewing away from the surgical sites. High calorie and high protein intake are important for quick healing.

You should prevent dehydration by drinking fluids regularly. Your food intake will be limited for the first few days, so it is recommended that you increase your fluid intake. Do not miss meals. You will feel better, experience less discomfort and heal faster if you continue to eat.

Oral Hygeine

It is particularly important to maintain meticulous oral hygiene following oral surgery to minimize the chance of infection. You may begin gentle tooth brushing on the day of surgery followed by more thorough brushing the next day. Do not rinse vigorously or spit. Avoid using mouthwash for 24 hours and toothpaste that contains peroxide.

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. 

Antibiotics and Prescription Medication

If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics are given to prevent infection. Discontinue antibiotic use in the event of a rash or any other reaction and contact our office immediately.
Call the office if you have any questions regarding medications.

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.
• 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 that supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. Burns.
• 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 that will resolve in time.

Sutures

Sutures are placed in the area of surgery to minimize post-operative bleeding and help the healing process. 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.

Additional Post-Operative Considerations:

• 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 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.
• Your case is unique, no two mouths are alike. Discuss any problems with the trained experts best able to effectively help you: Dr. Burns 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.