The removal of impacted wisdom 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 30-45 minutes. After this time, the gauze pad should be removed and discarded. Vigorous 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 4-5 hours after surgery prior to the local anesthetic wearing off. It is important to eat something 10-15 minutes before taking any pain medicine. We have found yogurt or applesauce works well. 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.
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 placing a gauze pad over the area and biting firmly for 30-45 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 for further instructions.
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. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. Apply the ice packs 20 minutes every hour the first 24 hours. After 24 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. Twenty-four hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.
For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every 3-4 hours or Ibuprofen, (Motrin or Advil) 2-4 200mg tablets may be taken every 4-6 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 surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.
Good nutrition and adequate fluid intake are important after surgery. Soft foods and liquids are recommended for the first 24 hours after surgery (i.e., smoothies, instant breakfast, yogurt, ice cream, pudding, soup, applesauce etc). Avoid chips, nuts, and berries with seeds until surgical site(s) heal. Drink plenty of liquids. Avoid alcoholic beverages for 48 hours.
- 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. 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 1/8 teaspoon of salt. Do not use mouth wash.
- 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 prescribed medicine. You should then sip on coke, tea, or ginger ale. Please allow the carbonated drinks to go flat before drinking. You should sip slowly over a fifteen-minute period. When the nausea subsides, you can begin taking solid foods and prescribed medicine.
- Do Not
Do not drink through a straw for 3-5 days after surgery as it may cause a breakdown of the blood clot and be a potential cause of a dry socket.
Do not smoke for at least 48 hours, since it is detrimental to the healing process.
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. These sutures will dissolve. The pain and swelling will occur over the first 3 days following surgery. If your post-operative pain or swelling worsens after the 4th day or unusual symptoms occur, call the office for instructions. There will be a hole where the tooth was removed. The hole will gradually over the next month fill in with new tissue. 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: Your Oral Surgeon 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 the 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.
If at any time you have any questions regarding your surgery or recovery, please do not hesitate to call our office.