After Wisdom Tooth Removal

The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. The recovery period will be much less eventful if the post-operative instructions are followed carefully.

Immediately Following Surgery

  • The gauze pad placed over the surgical area should be kept in place for 30-45 minutes.  The gauze should be changed as needed until the bleeding has stopped.  Moisten the gauze prior to placement.  The gauze should be removed when the patient eats, sleeps or the bleeding stops.
  • Avoid smoking, sucking through straws and spitting for the day of surgery and the first 5 days after surgery.  Vigorous mouth rinsing or touching the wound area following surgery should be avoided. These actions may initiate bleeding or result in a dry socket.
  • Eat something and take the prescribed pain medication as soon as you get home.  Continue to take the medications by the schedule provided for the remainder of the day.
  • Avoid vigerous physical activities for several days after surgery.
  • 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 bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled with direct pressure.  Place a moist gauze pad over the area and bite 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

Swelling is normal and is usually proportional to the level of difficulty of the surgery.  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 may not become apparent until 2 or 3 days following surgery.  It will not reach its maximum until 3-4 days post-operatively. The swelling may be minimized by the immediate use of ice packs.  Apply the ice packs to face 20 minutes on and 20 minutes off during waking hours for the first 24 hours.  After the first 24 hours,  the application of moist heat to the sides of the face is beneficial in reducing the amount of swelling.

Pain

Please take the prescribed pain medication as directed.  Begin taking this medication as soon as you get home from the office.  Do not wait for the pain to start before taking the pain medication.  Always eat before taking any narcotic pain medication to decrease the possibility of nausia.

Diet

Do not use straws. Drink from a glass. The sucking motion when the straw is used can cause more bleeding or dislodge the blood clot. For the first day, you may drink liquids and eat any food that does not require chewing.  Avoid hot foods and liquids while you are numb.  The day after surgery you can advance your diet to anything that you can tolerate.  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 a single meal. You will feel better, have more strength and heal faster if you continue to eat. 

Keep the mouth clean

No brushing or rinsing of any kind should be performed for the rest of the day after surgery.  Brushing can be started on the first post-operative day.  For the first 5 post-operative days, do not spit the toothpaste out.  To remove the toothpaste let it drool out of your mouth.  Spitting may result in a dry socket.  The day after surgery you should begin rinsing at least 5-6 times a day.  Always rinse 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 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 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 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 stated before surgery, 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. So be careful. Call Dr. Eggert 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.  Taking pain medication 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 roots, they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. Eggert.
  • 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 (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.

Finally

Sutures are often placed in the sugical area to minimize post-operative bleeding and to help healing.  Sometimes they become dislodged, this is no cause for alarm. Just remove the suture form your mouth and discard it.  The sutures typically begin to fall out 3-5 days after surgery.  If they are still present at your post-operative visit, they will be removed.  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. So it’s really nothing to worry about.

The pain and swelling should start to subside after the 5th post-operative day.  If your post-operative pain or swelling worsens after this point, call our office for instructions.

There will be a cavity where the tooth was removed. The cavity will gradually fill in with tissue over the next 6 weeks.  During this time, the area should be kept clean.  Rinse after meals and brush twice a day.  You will be given a syringe to help clean the extraction sites at your post-operative check-up.  Do not rinse out the sockets until one week after your surgery.

Your case is individual, no two mouths are alike. Do not accept well intended advice from friends. Discuss your problem with the individuals best able to effectively help you: Dr. Eggert or your family dentist.

Brushing your teeth is okay – just be gentle at the surgical sites.

A dry socket occurs when the blood clot gets dislodged prematurely from the tooth socket.  This results in severe pain that is unrelieved by your pain medication.  Dry sockets occur 3-5 days after your surgery.  Call the office if this occurs.

If you are involved in regular exercise, you will need to abstain from this for several days.