The removal of wisdom teeth, especially 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 to one hour. After this time, the gauze pad should be removed and replaced until the bleeding has subsided, this may take 48 hours.
  • 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 begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.
  • Restrict your activities for 1-3 days 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.
  • Avoid straws for the first 24-48 hours.

BLEEDING

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.

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 applied to the sides of the face where surgery was performed. The ice packs should be left onfor 20 minutes and off for 20 minutes while you are awake. After 24-36 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, Ibuprofen (Motrin or Advil) 2 (two) 200 mg tablets may be taken every 3-4 hours or as directed on the bottle.

For severe pain, take the medication prescribed by your surgeon as directed. The prescribed pain medicine may make you groggy and may 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. Do not take Tylenol while taking Norco or Percocet, as they contain Tylenol in them.

DIET

Drink plenty of clear liquids after surgery. Do not use straws just drink from a glass. 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. 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

No rinsing of any kind should be performed until the day following surgery. You can brush your teeth gently the day after surgery but rinse gently. Also, 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.

REMEMBER: A clean wound heals better and faster.

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 will 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.

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 soda, tea or water. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine. Call the office if nausea and vomiting persist.

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 if you have any questions.
  • Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Ibuprofen should be taken to reduce the fever.
  • Be careful going from the lying down position to standing.Taking pain medications can make you dizzy. 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 our surgeons.
  • 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 sometimes placed inthe 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. Some sutures are resorbable and in this case, will dissolve within 3-5 days. For those sutures which are not resorbable,theywill 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 no discomfort associated with this procedure. So it’s really nothing to worry about.

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 the office for instructions.

There will be a space where the tooth was removed. The space will gradually fill in over the next month with the new tissue. In the mean time, the area should be kept clean especially after meals with salt water rinses, a toothbrush or a cotton swab.
Click here to Print Post Operative Instructions

Your case is individual. Do not accept well intended advice from friends. Discuss your problem with the persons best able to effectively help you: Drs. Ingalls, Lesnick, Politano, O’Day, and Weinstein or your family dentist.

Brushing your teeth is okay – just be gentle at the surgical sites.

WHAT IS A DRY SOCKET?

A dry socket is when the blood clot becomes 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.