After Wisdom Tooth Removal

Home Instructions After Wisdom Tooth Extraction

The removal of impacted wisdom 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

• Gauze is placed over the surgical area and should be kept in place for 1-2 hours. After this time, the gauze pad should be removed and discarded. Slight oozing is a common occurrence.
• Vigorous mouth rinsing and/or touching of 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 before the local anesthesia starts to wear off.
• Restrict your activities for approximately 1 week. Patients should start to feel better around 3-5 days after the procedure.
• Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for a more thorough 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  gauze over the area and biting firmly for about 60 minutes. Repeat if necessary. If bleeding continues, bite on a moistened black tea bag for 60 minutes. The tannic acid in the black tea helps to form a clot by contracting bleeding vessels. To minimize further bleeding, remain calm, sit upright in a chair and avoid exercise or strenuous activity. 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 by the third day post-surgery, may appear very swollen. This is normal.  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 the surgery was performed. The ice packs should be applied intermittently while you are awake. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Approximately 4-5 days following surgery, the application of moist heat to the sides of the face is beneficial in reducing stiff muscles.

Pain

You should begin taking pain medication before the local anesthetic starts wearing off.  Dr. Pierse will prescribe an anti-inflammatory will be moderate pain and a narcotic for breakthrough pain. If the anti-inflammatory is not helping with the pain, alternately taking the anti-inflammatory with the narcotic, as prescribed. Do not take the anti-inflammatory and narcotic at the same time. If you have any questions concerning the pain you are experiencing, or the taking of the prescribed medication, please call our office at any time. Consult our practice for individuals under 18. Do not take the two medications at the same time.

Additionally, for severe pain, the prescribed medication should be taken as directed. Do not take any of the above medication if you are allergic to them or have been instructed by your doctor not to take them. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside gradually over the course of  7 days. If pain persists, it may require attention and you should call the office.

Diet

Immediately after general anesthesia or IV sedation, only 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 eat anything soft by chewing away from the surgical sites. A high calorie, high protein intake is very important. Our staff can provide suggested diet instructions. 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 any meals. 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 up for one minute before standing.

Keep the mouth clean

No rinsing of any kind should be performed until the day following surgery. The day after surgery, and for 2-3 weeks thereafter, you should rinse with sea salt at least twice a day, especially after eating. The rinse should consist of one teaspoon sea 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 and if it does happen, it may appear 2-3 days after the surgery. Moist heat applied approximately 4-5 days after surgery may speed up the removal of the discoloration.

Antibiotics

If you have been placed on antibiotics, take them 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. 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 medication. You should then sip on coke, tea or ginger ale. Do not use a straw to sip the beverage. 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 reviewed in your consultation, 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. 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 a lying down position to standing. You could get light headed from low blood sugar, low blood pressure 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 not, they can be addressed by Dr. Pierse.
• 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.

Finally

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 will dissolve approximately one week after surgery. If the sutures do not dissolve, their removal requires no anesthesia or needles. It takes only a minute or so, and there is usually no discomfort associated with this procedure.

The pain and swelling should subside approximately 4-7 days after surgery. If your post-operative pain or swelling worsens or unusual symptoms occur, call our office for instructions.

There will be a void where the tooth was removed. The void will fill in with new tissue gradually over the next month. In the meantime, the area should be kept clean, especially after meals, with salt water rinses or a toothbrush.

While oral surgery is a common occurrence, you are an individual, and therefore, unique. Thus, because no two mouths are alike, we are here to address your personal and individual needs, concerns, experiences and responses to your surgery. Thus, Dr. Pierse and your POMS family are available to you and for you, at any point before, during or after the procedure. If you call our office after hours, Dr. Pierse will be notified and he will personally return your call to ensure you get the attention and care you very much deserve.

Brushing your teeth starting the day after surgery is acceptable. Brush regularly. Just be gentle at the surgical sites.

A dry socket may occur. This 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 3-5 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.

Contact Precision Oral and Maxillofacial Surgery online or by phone at Phoenix Office Phone Number (623) 518-2325.