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 at least one hour. After this time, the gauze pad should be removed and discarded.  Replace as necessary.
  • 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 before you begin to feel discomfort. The onset of discomfort 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 on swelling for explanation.

Bleeding

Bite on your gauze pack for a least one hour after leaving the office to allow a clot to form.  Slight bleeding is expected and you may have blood tinged saliva for up to 36 hours.  If bleeding is continuing, place folded damp gauze or a moist tea bag over the wound and bit firmly for at least 60 minutes with constant pressure.  Assume a semi-upright bed position, using 2 pillows.  Spitting and excess physical activity will cause bleeding. Do no use a drinking straw for 5-7 days.

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.  The ice packs should be use 20 minutes on and 20 minutes off while you are awake. After 36 hours, ice has no beneficial effect. Swelling or jaw stiffness can persiste 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 mild to moderate pain, take over-the-counter as needed.  For severe pain, take the pain medication prescribed as directed (do not combine with Tylenol).  Do not take any of these medications if you are allergic or have been instructed by a physician not to take them.  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.  WARNING:  Do not drive or operate mechanical equipment after taking pain medication.  Due to current federal law, most narcotic prescriptions can no longer be called in on weekends or evenings.

Diet

After I.V. anesthesia, liquids should be initially taken. Do not use straws. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away form 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. 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 for one minute before standing.

Keep the mouth clean

Do not rinse your mouth with anything in an effort to cleanse or freshen the mouth for 12 hours.  The day following the surgery, the mouth may be rinsed gently with warm salt water solution (1/2 teaspoon of salt in a large glass of warm water), after each meal and at bedtime.  After 24 hours, the teeth may be gently brushed but avoid the site of surgery.

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.

Antibiotics

If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics may be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions or symptoms of an allergic or adverse reaction.  Antibiotic Therapy may decrease oral contraceptive effectiveness.  Those taking birth control pills should consult their physician.

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 clear liquids. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.  If nausea and/or vomiting persists call the office for instructions.

For Your Own Safety

Do not drive, operate machinery, or sign any important or legal documents for 24 hours following intravenous anesthesia.  Do not drink alcoholic beverages.

Other Complications

  • 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 Drs. Hughes and Bays if you have any questions or if sensation does not begin to return within a few days.
  • Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Over the counter medication should be taken to reduce the fever.
  • You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery. It was also 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. 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. Hughes and Bays.
  • 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 (Trimus) 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 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. Otherwise, the sutures will dissolve spontaneously.

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 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: Drs. Hughes and Bays or your family dentist.

Brushing your teeth is okay after 24 hours – 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.

If any problems arise, please do not hesitate to contact our office before you contact your general dentist or physician.  The telephone is answered 24 hours 320-235-1803 or Willmar Office Phone Number 800-337-1778.