The removal of wisdom teeth or any impacted tooth 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.
- The gauze pad placed over the surgical area should be kept in place for a half hour.
- Vigorous mouth rinsing or touching the wound area following surgery should be avoided.
- Take the prescribed pain medications as soon as you begin to feel discomfort.
- 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 an explanation.
BLEEDING
A certain amount of bleeding is to be expected following oral 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 thick gauze pad over the area and biting firmly for 30 minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for 30 minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call the office for further instructions.
SWELLING
The swelling that is normally expected is usually proportional to the oral 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 three days (72 hours) post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two plastic bags filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be wrapped in a thin towel or cloth. The ice packs should be left on continuously while you are awake. After 48 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. Forty-eight hours following the dental treatment, 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 four to six hours or ibuprofen (Motrin or Advil) bought over the counter comes in 200 mg tablets: Two to three tablets may be taken every three to four hours as needed for pain. Please ensure that you follow the instructions on the package for over the counter medications.
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. Beyond post-operative day 3 (72 hours), 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.
Diet
While locally anesthetized (frozen), diet should be limited to cold, clear fluids. This is suggested to prevent burn injuries or inadvertent chewing of the lips/tongue while they are anesthetized. Drink liquids after general anesthesia or sedation, until the effects of the anesthetic have subsided. Do not use straws when drinking from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. Once the anesthetic effect has subsided, you may eat anything soft by chewing away from the surgical site(s). High calorie, high protein intake is very important. Try to maintain a normal diet. 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 five to six 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.
Keep The Mouth Clean
No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the night of surgery but rinse gently. The day after surgery you should begin rinsing at least five to six times a day with a cup of warm water mixed with a teaspoon of salt especially after eating.
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 postoperative occurrence, which may occur two to three 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 & 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 15-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 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 our Clinic if you have any questions.
- A 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 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 suddenly stand up. Before standing up, you should sit for one minute and 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 your surgeon.
- 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 two to three 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.
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. Generally whatever sutures don’t fall out will dissolve on their own.
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 cavity where the tooth was removed. The cavity will gradually fill in with new tissue 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 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: our Clinical staff 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 or dissolves on its own from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur two to three 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.