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.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon for the first 1-3 days. Bleeding is best controlled by biting on the gauze provided. The gauze will initially need to be changed every 30 minutes to an hour. 2-3 of the gauze pads should be folded and placed over the surgical area. Pressure is then applied by biting on the gauze. As the bleeding lessens, the gauze can be changed less frequently. To minimize bleeding, avoid spitting, rinsing, or drinking through a straw. Dangerous bleeding after surgery is very unusual, however, if you are not able to control the bleeding with gauze and pressure, please contact the office.

Swelling

It is normal for you to experience some swelling following your surgery. This swelling will usually peak at 48 hours after your procedure. Swelling is best limited by the application of ice packs to the jaws and face for the first 48 hours. We recommend keeping the ice packs in place as much as possible during this time. Rest with your head elevated. Also, it is not unusual for the swelling to be greater on one side than on the other. After 48 hours the swelling should begin to lessen.

Pain

When you leave the office, you will likely still be numb from the local anesthetic. It is best to begin taking something for pain before the numbness wears off. Our advice is to take one of the prescribed pain pills in addition to over-the-counter medications. Unless contraindicated by a medical condition, adults should take up to 600 mg of Ibuprofen every 6 hours OR 550 mg of Naproxen every 12 hours for the first 3 days following surgery. Prescription pain medicine should not be needed after two days. If pain persists, it may require attention and you should contact the office.

Diet

After general anesthetic or I.V. sedation, 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.

Oral Hygiene 

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 5-6 times a day especially after eating with a cup of warm water mixed with a teaspoon of salt.

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 coke, tea or ginger ale. You should sip slowly over a fifteen-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 Drs. Spivey and Fahey if you have any questions.
  • 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. 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. Spivey and Fahey.
  • 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 may be placed as part of your surgical procedure. In most cases these sutures will dissolve and there is nothing you need to do. If the sutures do not dissolve, an appointment will have been made for you to have them removed. This is usually 12-14 days following surgery.

The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens call the office for instructions.

There will be a hole where the tooth was removed. The hole will gradually fill in with the new tissue over the next 2 months. In the mean time, the area should be kept clean especially after meals with water or salt water rinses.

Your case is unique, no two mouths are alike. Do not accept well intended advice from friends. Discuss any problems with the persons best able to effectively help you: Dr. David Spivey or Dr. Ross Fahey, 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 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.