After Wisdom Teeth extraction

Immediately Following Surgery

  • The gauze pad placed over the surgical area should be kept in place for a half hour. It can then be removed and discarded.

  • DO NOT rinse or use a straw for at least 24 hours. This may initiate bleeding by causing the blood clot that has formed to become dislodged. Do not touch the site as well.

  • Unfortunately, most oral surgery is accompanied by some degree of discomfort. We recommend you take a combination of Acetaminophen and Ibuprofen regularly. Recent studies on pain control are indicating that taking a non-steroidal anti-inflammatory drug such as ibuprofen (Advil®, Motrin®) together with acetaminophen (Tylenol®) has more significant post-operative pain relief than taking either drug alone. Also, the ibuprofen and acetaminophen combination has significantly more pain relief than narcotic medications such as codeine, hydrocodone (Vicodin®, Norco®, Lortab®), and oxycodone (Percocet®, Percodan®).

  • We suggest you take 600mg of ibuprofen and 1000mg of acetaminophen at the same time. If this does not give you adequate pain relief you can alternate the 600mg of Ibuprofen with the prescribed pain medication, eliminating the acetaminophen. All medication should not exceed the recommended dosage. Discomfort should subside daily.

  • Restrict your activities the day of surgery and resume regular 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.

  • 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.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Remember that even a small amount of blood mixed with saliva can be deceiving. 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 for further instructions.

Swelling

The swelling that is normally expected is usually equivalent to the type of surgery performed. 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 visible until the day following surgery and will not reach its peak until 2-3 days post-op. However, the swelling may be minimized by the immediate use of ice packs. Either 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 applied 15 minutes on/ 15 minutes off. After 36 hours, ice has no beneficial effect, and the application of moist heat to the sides of the face is more effective in reducing the swelling. If swelling or jaw stiffness persists for several days, there is no cause for alarm. Everyone is a little different, and this is a normal reaction to surgery.

Pain

Unfortunately, most oral surgery is accompanied by some degree of discomfort. We recommend you take a combination of Acetaminophen and Ibuprofen. Recent studies on pain control are indicating that taking a non-steroidal anti-inflammatory drug such as ibuprofen (Advil®, Motrin®) together with acetaminophen (Tylenol®) has more significant post-operative pain relief than taking either drug alone. Also, the ibuprofen and acetaminophen combination has significantly more pain relief than narcotic medications such as codeine, hydrocodone (Vicodin®, Norco®, Lortab®), and oxycodone (Percocet®, Percodan®).

We suggest you take 600mg of ibuprofen and 1000mg of acetaminophen at the same time. If this does not give you adequate pain relief you can alternate the 600mg of Ibuprofen with the prescribed pain medication, eliminating the acetaminophen. All medication should not exceed the recommended dosage. Discomfort should subside daily.

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.

Diet

After general anesthesia or I.V. sedation, liquids should be initially taken. Drink from a glass. DO NOT use straws. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. Drink enough liquid to prevent dehydration. Try not to miss a meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.

Keep the mouth clean

No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the night following 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 after surgery. 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. Not all procedures require antibiotics. 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 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 said before surgery, this is usually temporary. But you must still be careful! If your lip or tongue is numb, you could bite it and not feel the sensation.

  • Slight fever 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 were not able to eat or drink before surgery. It was also difficult to take fluids. 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 tooth roots, they are the bony walls that supported the tooth. These projections usually smooth out spontaneously.

  • 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 is not uncommon. When the muscles swell, the otherwise ordinary 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.

Sutures

Sutures are placed 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 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.

Some Final Things to Keep in Mind

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 the office for instructions.
Don’t worry, there will be a cavity where the tooth was removed. The hole will gradually fill in with new tissue over the next month. In the meantime, keep the area clean especially after meals with salt water rinses or a toothbrush.

  • No two mouths are alike. If you have any issues, give us a call.

  • 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 happens.

  • If you exercise regularly, keep in mind that your normal caloric intake is reduced. Activity may weaken you. If you get light headed, stop exercising.