The removal of impacted teeth is a serious surgical procedure, so post-operative care is extremely 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 30 minutes. After this time, the gauze pad should be removed and discarded.
- Following surgery, avoid vigorously rinsing your mouth or touching the wound area, as this may dislodge the blood clot that has formed and initiate bleeding.
- Take the prescribed pain medications as soon as you begin to feel discomfort. This typically coincides with the diminishing of the local anesthesia.
- Restrict your activities the day of wisdom teeth extraction and resume normal activity when you feel comfortable.
- Place ice packs on the sides of your face where surgery was performed. Refer to the section on swelling for further explanation.
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 rinsing or wiping any old clots from your mouth, then placing a 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, avoid rigorous activities, excitement, and sitting upright. If bleeding does not subside, call our doctors for further instructions.
The swelling that is normally expected is typically proportional to the surgical procedure 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 may not peak until at least two to three days after the procedure. 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 continuously applied 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 wisdom teeth removal. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the swelling.
For moderate pain, one or two tablets of Tylenol or Extra-Strength Tylenol may be taken every three to four hours or two to four I200 mg tablets of buprofen (Motrin or Advil) may be taken 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 wisdom teeth extraction should subside more and more every day. If pain persists, it may require attention and you should call our office.
It is recommended to follow a mostly liquid and soft-food diet after undergoing general anesthesia or IV sedation. Drink directly from a glass and do not use straws, as 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 throughout the healing process. Refer to the section on Suggested Diet Instructions for more information. Nourishment should be taken in regularly. You should prevent dehydration by drinking 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 in daily. Try not to miss a single meal. You will feel better, have more strength, feel 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 wisdom teeth removal, 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 wisdom teeth removal. You can brush your teeth the night of surgery, but rinse gently. The day after surgery, you should begin rinsing with a cup of warm water mixed with a teaspoon of salt at least five to six times a day, especially after eating.
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 and may occur two to three days following surgery. Moist heat applied to the area may speed up the removal of the discoloration.
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 wisdom teeth extraction, do not take ingest anything by mouth for at least an hour, including the prescribed medicine. You should then sip on cola, tea or ginger ale. You should sip slowly over a 15-minute period. When the nausea subsides, you may begin eating solid foods and taking the prescribed medicine.
- If numbness of the lip, chin, or tongue occurs, there is no cause for alarm. As stated before surgery, this is usually temporary. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. Call our doctors if you have any questions.
- Slight elevation of temperature immediately following surgery is not uncommon. If high temperature persists, notify the office. Tylenol or Ibuprofen should be taken to reduce the fever.
- You should be careful moving from a lying down position to standing. Since you were unable to eat or drink prior to surgery, taking pain medications can make you dizzy. You may become light-headed when you stand up suddenly. You should sit for at least one minute before standing up.
- Occasionally, patients may feel hard projections in the mouth with their tongue. These are not roots, but rather the bony walls that supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by our doctors.
- 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. Since the muscles become swollen, the normal act of swallowing can become painful. This will subside within two to three 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 that will resolve over time.
Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, but this is no cause for alarm. Just remove the suture form your mouth and discard it. The sutures will be removed approximately one week after surgery by the doctor. The removal of sutures requires no anesthesia or needles and takes only a minute. There is no discomfort associated with this procedure, so there is no need to worry or become anxious.
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 from wisdom tooth removal. The cavity will gradually fill in with the new tissue within a month following surgery. In the interim, the area should be kept as clean as possible with salt water rinses or a toothbrush, especially after meals.
Each and every case is unique, as no two mouths are alike. Do not accept well-intended advice from friends. Discuss any issues with our surgeons or your dentist, as these are the individuals who are best qualified to assist you and make recommendations.
You may brush your teeth as long as you are gentle at the surgical sites.
A dry socket occurs when the blood clot is dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site or in the ear may occur two to three days following surgery. If you experience pain in these areas, contact our office immediately.
If you exercise regularly, be aware that your normal intake of nourishment is reduced following surgery. Exercise may weaken you, so stop exercising if you feel light-headed or dizzy.