After Wisdom Tooth Removal

The removal of wisdom teeth or other 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 you follow these instructions carefully.

Immediately Following Surgery

  • Keep the gauze pad placed over the surgical area in place for a half-hour following surgery. After this time, you should remove and discard the gauze pad.
  • You should avoid vigorous mouth rinsing, or touching the wound area, following surgery. This may cause the blood clot that has formed to become dislodged, subsequently causing more bleeding.
  • Take your prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the diminishing of the local anesthetic used during the surgical procedure.
  • You should restrict your activities the day of surgery. You can 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 further explanation.

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 become excited, sit upright, and avoid exercise. If bleeding does not subside, call Comfort Dental for further instructions.

Swelling

The amount of swelling normally expected is usually proportionate to the procedure. Swelling around your mouth, cheeks, eyes and sides of your face is not uncommon. This is your 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 two to three days post-operatively. Keep in mind, you can minimize this swelling with immediate use of ice packs. Two small bags filled with ice, or ice packs, should be applied to the sides of your face where surgery was performed. The ice packs should be left on continuously 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 surgery. Thirty-six hours following surgery, the application of moist heat to the sides of your face is beneficial in reducing the size of the swelling.

Pain

For moderate pain, you may take one or two tablets of Tylenol or Extra Strength Tylenol every three to four hours, or Ibuprofen, (Motrin or Advil) two to four 200 mg tablets every 3-4 hours.

For severe pain, take the medicine you have been prescribed for pain. Pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile, or work around machinery while taking pain medication. 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 Comfort Dental to discuss this.

Diet

After general anesthetic or I.V. sedation, liquids are very important. You will want to drink regularly. Do not use straws. The sucking motion can cause more bleeding by dislodging the blood clot. Drink from a glass. You may also eat soft foods by chewing away form the surgical sites. High calorie, high protein intake is very important. Again, 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 to include at least 5-6 glasses of liquid 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 suddenly stand from a lying position, you may become dizzy. If you are lying down following surgery, make sure you sit for a minute or two before standing. This will prevent dizziness.

Keep Your 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 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 any discoloration you experience.

Antibiotics

If you were prescribed antibiotics, take the tablets or liquid exactly as directed. Antibiotics are given to help prevent infection and must be taken until the prescription is gone. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call Comfort Dental 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 – sipping  regularly and slowly over a fifteen-minute period. When the nausea subsides, you can begin eating solid foods and any prescribed medicine.

Other Complications

  • If you experience numbness of your lip, chin, or tongue, don’t become alarmed. As we explained before your surgery, this swelling is usually temporary. You should remain aware that you could inadvertently bite your numb lip or tongue and not feel the resulting sensation. Be careful. Call Dr. Funderburk if you have any questions.
  • Immediately following surgery, a slight elevation of your body temperature is not uncommon. If the temperature persists, call Comfort Dental the office. Tylenol or ibuprofen should be taken to reduce the post-operative fever.
  • Be careful when going from a lying down position to standing. You didn’t eat or drink prior to surgery and fluids since may be challenging. This may make you dizzy. Also, pain medications may make you dizzy. When standing suddenly, you may get light headed; therefore, you should sit for a minute or two before standing.
  • Occasionally, patients feel hard projections in their mouth with their tongue. There is no need for alarm if this happens to you. Rest assured, those are not roots you feel. They are the bony walls, which supported your tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. Funderburk.
  •  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 some pain when swallowing, are not uncommon. Your muscles get swollen. The normal act of swallowing can then become painful. This will subside in two to three days.
  • Stiffness (Trismus) of your jaw muscles may make it difficult to open your mouth for a few days following surgery. This is a normal post-operative event and will resolve in time.

Finally

  • Sutures were carefully placed in the area of surgery to minimize post-operative bleeding, and to help healing. Sometimes your sutures may become dislodged. This is not cause for alarm. Just remove the suture from your mouth and discard it. The sutures will 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. In short, it’s really nothing to worry about.
  • The pain and swelling you experience should subside more and more each day following your surgery. If your post-operative pain or swelling worsens, or unusual symptoms occur, call Comfort Dental for further instructions.
  • There will be a pocket where the tooth was removed. Over the next month, this pocket will gradually fill in with the new tissue. In the meantime, the area should be kept clean, especially after meals, with saltwater 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: Dr. Funderburk and the team at Comfort Dental, or your family dentist.
  • Brushing your teeth is okay, just be extra gentle when brushing at the surgical sites.
  • A dry socket occurs 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 Comfort Dental 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.