After Wisdom Tooth Removal

The removal of impacted teeth is an involved 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 - 60 MINUTES. AFTER THIS TIME, THE GAUZE PAD SHOULD BE REMOVED AND DISCARDED WITH A FRESH GAUZE AS NEEDED.
• 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 AS SOON AS YOU BEGIN TO FEEL DISCOMFORT THIS WILL USUALLY COINCIDE WITH THE LOCAL ANESTHETIC EFFECT DIMINISHING.
• RESTRICT YOUR ACTIVITIES THE DAY OF SURGERY AND RESUME NORMAL ACTIVITY WHEN YOU FEEL COMFORTABLE. THIS COULD BE SEVERAL DAYS.
• PLACE ICE PACKS TO THE SIDES OF YOUR FACE WHERE SURGERY WAS PERFORMED. REFER TO THE SECTION ON SWELLING FOR EXPLANATION.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight oozing is not uncommon for up to 24 hours. Persistent bleeding may be controlled by first rinsing or wiping away any old clots from the surgical site. A thick gauze pad should then be placed directly over the incision site and held firmly in place for 30 minutes (bite on the gauze firmly). Repeat this, if necesary several times. If bleeding continues, moistened tea bag can be wrapped within a gauze pad and utilized as a pressure pack in a similiar fashion. The tannic acid in the tea bag to form a clot by contracting small blood vessels.

To minimize further bleeding, remain calm, sit upright, and avoid exercise or physical activity. If bleeding does not subside, please call the office for further instructions.

Swelling

Swelling is normally expected after wisdom teeth removal and is usually proportional to the degree of difficulty of the surgery. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is a normal reaction by the body to surgery and will help with healing. Most swelling will not become apparent until the second post-operative day. This will often not reach its maximum peak until the third post-operative day.

Swelling can be controlled by the immediate and extended use of ice packs. Ice packs, or baggies filled with ice chips, should be applied to the sides of the face overlying the surgical sites. The ice packs should be utilized on a 30 - minute on, 30 - minute off schedule. These are very helpful for 48 to 72 hours. Ice is extremely helpful in managing swelling and pain control during this time frame.

After 72 hours, the application of moist heat to the skin overlying the surgical sites can be beneficial in reducing the size of the swelling.

Discoloration

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to migration of blood underneath the soft tissues. This is a normal post- operative occurrence and is usually seen at the 2 - 4 day post - operative level. Application of moist heat to this area may speed up the resolution of the discoloration.

Pain Management

For severe pain, take the pain medicine prescription as directed. It is possible that the prescribed medication can make you sleepy and slow your reflexes. Do no operate machinery or drive an automobile while on prescription narcotic pain medicine. Alcoholic beverages should be avoided. In addition to the prescription pain medication that has been recommended by your doctor, Advil has been recommended for pain relief.  Two (2) hours after the prescription pain medicine, 800mg of Advil may be taken.  Two (2) hours later the prescription medicine may be repeated.  Two (2) hours after this, Advil may be repeated, etc.

For moderate pain, Extra Strength Tylenol can be taken in combination with Ibuprofen (Advil). A maximum dosage of 1000mg of Tylenol and 800mg of Advil may be taken every four hours. These are suggested maximum doses and are intended for use in well-developed, well-nourished adult patients. Please note, the combination of Advil and Tylenol should only be used if the prescription medication is not being taken.

Please do not smoke for at least one week after surgery, since this is very detrimental to healing and may cause a dry socket.

Diet

A liquid, blenderized, soft diet should be maintained over a 5 - 7 day time frame. Please refrain from utilizing straws; the sucking motion can cause increased bleeding by dislodging the blood clots, which are forming over the surgical sites.

A high calorie, high protein intake is important to maintain nutrition and proper nourishment. Frequent intake of fluids is important to prevent dehydration.

Oral Hygiene

Good oral hygiene is essential to good healing. You can brush your teeth the night of surgery but avoid rinsing. The day after surgery, you should begin rinsing with warm salt water on a 4 - 5 times per day basis. (Especially after meals) Maintaining excellent hygiene over the healing time frame will help avoid potential complications.

Antibiotics

If you have been placed on antibiotics, please take the medication as directed. Antibiotics are given to help prevent infection. Please discontinue the antibiotic use in the event of a rash or another unfavorable reaction. Please call the office if you have any questions should these reactions occur.

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for a one-hour time frame. This includes prescription medicine. You can then introduce fluids, such as Coca Cola, tea or ginger ale by slowly sipping these fluids over a 15-minute period. When the nausea subsides, you can begin taking soft foods and the prescribed medications.

If nausea and/or vomiting persist, anti-nausea medicine is available by prescription by calling the office.

Other Complications

• NUMBNESS OF THE LIP, CHIN, OR TONGUE REGION CAN OCCUR AFTER WISDOM TEETH REMOVAL. AS REVIEWED AT YOUR PRESURGICAL CONSULTATION, THIS NUMBNESS IS MOST OFTEN TEMPORARY IN NATURE. IT USUALLY SPONTANEOUSLY RESOLVES AS SWELLING AND BRUISING GOES AWAY.
• A SLIGHT ELEVATION IN TEMPERATURE IMMEDIATELY FOLLOWING SURGERY IS NOT UNCOMMON. TYLENOL OR ADVIL CAN BE TAKEN TO REDUCE FEVER. THE ORAL TEMPERATURE CAN BE FALSELY ELEVATED BY THE SURGICAL PROCEDURE. AN AUXILIARY TEMPERATURE WILL BE MORE ACCURATE. IF A FEVER PERSISTS, PLEASE NOTIFY THE OFFICE.
• STIFFNESS ( TRISMUS ) OF THE JAW MUSCLES MAY CAUSE DIFFICULTY IN MOUTH OPENING FOR THE FIRST FEW DAYS AFTER SURGERY. THIS IS A NORMAL POST-OPERATIVE FINDING IN MANY PATIENTS. THIS USUALLY RESOLVES QUICKLY AS SWELLING AND BRUISING GOES AWAY.
• SORE THROATS AND PAINFUL SWALLOWING ARE NOT UNCOMMON POST-SURGICALLY. THIS ALSO WILL SUBSIDE IN A 2 -3 DAY TIME FRAME.
• THE CORNERS OF THE MOUTH CAN BE STRETCHED RESULTING IN DRYING AND CRACKING AT THE EDGES. YOUR LIPS SHOULD BE KEPT MOIST WITH AN OINTMENT SUCH AS VASELINE OR A&D OINTMENT.
• DISSOLVEABLE SUTURES ARE USED IN THE AREAS OF INCISIONS TO CLOSE THE TISSUE, MINIMIZE POST-OPERATIVE BLEEDING, AND TO ASSIST IN HEALING. THESE SUTURES ARE DISSOLVEABLE. THEY TYPICALLY RESORB IN 7 - 10 DAYS.

If you have questions concerning your status, do not hesitate to call the office and discuss your concerns with the oral surgeon who performed your surgery.