After Wisdom Tooth Removal

The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and complications such as infection and swelling can be minimized if these instructions are followed carefully.

Immediately Following Surgery

  • The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded.
  • Vigorous mouth rinsing and/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 as directed.  Usually following the scheduled dosing will minimize the post operative pain.
  • 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 the surgery was performed. Refer to the section on swelling for a more thorough explanation.
  • 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 UP FOR ONE MINUTE BEFORE STANDING.

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 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 black tea bag for thirty minutes.  To minimize further bleeding keep your head elevated and avoid sucking,  spitting or disturbing the blood clots.  If bleeding does not subside, call our office for further instructions.

Swelling

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.  Ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be placed intermittently while you are awake, 20 minutes on and 20 minutes off, for the first 48 hours after surgery.  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 the face is beneficial in reducing the size of the swelling.

Pain

For mild to moderate pain, over the counter pain medications like  Tylenol or  Ibuprofen may suffice.

For severe pain, take the pain medication 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 and discomfort following surgery should peak on the third day after surgery. If pain persists, it may require attention and you should call the office.

Diet

After intravenous general anesthesia clear liquids should initially be consumed. Drink from a glass and do not use straws. The sucking motion can cause more bleeding by dislodging the blood clot. You may start a soft diet and advance to a normal diet as you feel it can be tolerated.  You should prevent dehydration by taking fluids regularly.  Our staff can provide suggested diet instructions.  

Keep the mouth clean

Regular tooth brushing and flossing can start the day of surgery.  No rinsing of any kind should be performed until the day following surgery.  The day after surgery you should begin rinsing at least 5-6 times a day, especially after eating, with a teaspoon of salt mixed into one cup of warm water. 

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 medication as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or any other unfavorable reaction and contact our office immediately. 

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, an anti-nausea medication can be given.  You should then sip on water or ginger ale.  Avoid the narcotic pain medication as this is most likely causing the problem.  When the nausea subsides you can begin taking solid foods and the prescribed medications again. 

SUTURES

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. The sutures usually dissolve in approximately one week.

Complications

  • If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As reviewed in your consultation, this is usually temporary in nature. Please call the office 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. You could get light headed from low blood sugar or medications. Before standing up, you should sit for one minute before getting 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 you would like for the area to be evaluated, please do not hesitate to call our office. 
  • 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 (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 which will resolve in time.
  • Dry sockets can occur after extractions.  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 near the ear may occur one week following surgery. Call the office if this occurs.