After Wisdom Tooth Removal

 

DAY OF SURGERY

FIRST HOUR: Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place.  Do not change them for the first hour unless the bleeding is not controlled.  The packs may be gently removed after one hour.  If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30 minutes.  The gauze may then be changed as necessary (typically every 30 to 45 minutes).  It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning.

 

EXERCISE CARE:  Do not disturb the surgical area today.  Do NOT rinse for the first 24 hours.  YOU MUST BRUSH YOUR TEETH AND THE SURGICAL SITE GENTLY!!!

PLEASE DO NOT SMOKE for at least 48 hours, since this is very detrimental to healing and may cause a dry socket.  Please refrain from any exercise or physical activity for the next 5 to 7 days.

OOZING:  Intermittent bleeding or oozing overnight is normal.  It is common for your saliva to be pink colored. Bleeding may be controlled by placing fresh gauze over the areas and biting on the gauze for 30-45 minutes at a time.

PERSISTENT BLEEDING:  Bleeding should never be severe.  If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs.  If bleeding persists or becomes heavy you may substitute a tea bag (soaked in very hot water, squeezed damp-dry and wrapped in moist gauze) for 20 or 30 minutes.  If bleeding remains uncontrolled, please call our office.

SWELLING:  Swelling is often associated with oral surgery.  It can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area.  This should be applied twenty minutes on and twenty minutes off during the first 24 hours after surgery.  If you have been prescribed medicine for the control of swelling, be sure to take it as directed. 

DIET:  Eat any nourishing food that can be taken with comfort.  Avoid extremely hot foods.  Do not use a straw for the first few days after surgery.  It is sometimes advisable, but not absolutely required, to confine the first day’s intake to liquids or pureed foods (soups, puddings, yogurt, milk shakes, etc.)  It is best to avoid foods like nuts, sunflower seeds, popcorn, etc., which may get lodged in the socket areas.  Over the next several days you may gradually progress to solid foods.  It is important not to skip meals!  If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster.  If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.

MEDICATIONS:  Unfortunately most oral surgery is accompanied by some degree of discomfort.  You will usually be given 2 prescriptions for pain medication.  Begin by taking one pill of each pain medicine (Motrin (Ibuprofen) and Vicodin (Hydrocodone)) together. Continue to take the 1 pill of Motrin every six hours and 1 pill of Vicodin every 4 hours.   If you take the first doses before the local anesthetic has worn off, you should be able to manage any discomfort better.  Some patients find that pain medicine causes nausea, but if you precede each pain pill with a small amount of food, chances for nausea will be reduced.  The effects of pain medications vary widely among individuals.  Remember that the most severe pain is usually within six hours after the local anesthetic wears off; after that your need for medicine should lessen.  If you find you are taking large amounts of pain medicine at frequent intervals, please call our office.  If you anticipate needing more prescription medication for the weekend, you must call for a refill during weekday business hours.  You will also usually be given an antibiotic to take for one week after your procedure. For your initial dose begin by taking two pills then one pill 4 times a day (after breakfast, lunch, and dinner and before bed).

NAUSEA:  Nausea is not uncommon after surgery.  Sometimes pain medications are the cause.  Nausea can be reduced by preceding each pain pill with a small amount of soft food, and taking the pill with a large volume of water.  Try to keep taking clear fluids and minimize dosing of pain medications, but call us if you do not feel better. Flat soda may help with nausea.

SHARP EDGES:  If you feel something hard or sharp edges in the surgical areas, it is likely you are feeling the bony walls which once supported the extracted teeth.  Occasionally small slivers of bone may work themselves out during the following week or so.  If they cause concern or discomfort, please call the office.


INSTRUCTIONS FOR THE SECOND AND THIRD DAYS

MOUTH RINSES:  Keeping your mouth clean after surgery is essential.  Use 1/4 teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful.  Repeat as often as you like, but at least two or three times daily.

BRUSHING:  Begin your normal oral hygiene routine as soon as possible after surgery.  Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth and the extraction sites within the bounds of comfort.

HOT APPLICATIONS:  Apply warm compresses to the skin over the areas of swelling (Moist Heat/Moist Heating Pad) for 20 minutes on and 20 minutes off to help soothe tender areas.  This will also help decrease swelling and stiffness.

HEALING:  Normal healing after tooth extraction should be as follows: The first two days after surgery are generally the most uncomfortable and there is usually some swelling.  On the third day you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be gradual, steady improvement.  If you don’t see continued improvement, please call our office. 

It is our desire that your recovery be as smooth and pleasant as possible.  Following these instructions will assist you, but if you have questions about your progress, please call the office.  Dr. Gold can be reached at any time after hours.  Calling during office hours will afford a faster response to your question or concern. PLEASE NOTE:  Telephone calls for narcotic (pain killer) prescription renewals are ONLY accepted during office hours.

Wearing your Prosthesis

Partial dentures, flippers, or full dentures, should not be used immediately after surgery for at least 10 days, as discussed in the pre-operative consultation.

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 [last_name] 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 not, they can be removed by Dr. Gold.
  • 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.