After Wisdom Tooth Removal

Post-Operative Care Instructions

The removal of impacted teeth is a 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

  • The gauze pad placed over the surgical area should be kept in place for one hour. After this time, the gauze pad should be removed and discarded.
  • Vigorous mouth rinsing and/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 becoming diminished.
  • Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
  • Place ice packs to the sides of your face where surgery was performed at least for the day of surgery.

   
   

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 a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened black tea bag for thirty minutes. The tannic acid in the black tea helps to form a clot by contracting bleeding vessels. To minimize further bleeding, sit upright and avoid activity. If bleeding does not subside, call our office at 817-741-2200 for further instructions.

   
   

Swelling

The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, and sides of the face is not uncommon. This is the body’s normal reaction to surgery. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2–3 days post-operatively. 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 surgery was performed. The ice packs should be left on continuously while you are awake. After 36 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.

   
   

Pain

For moderate pain, Ibuprofen (Motrin or Advil) bought over the counter comes in 200 mg tablets: take two or three 200 mg tablets every 4 hours.

For severe pain, take the tablets prescribed as directed. 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.

You may also take both Ibuprofen and the prescribed pills.  They can be taken at the same time or alternate between the two.

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 at 817-741-2200.

   
   

Diet

On the day of surgery, only liquids should be consumed. Drink from a glass and do not use straws. The sucking motion can cause more bleeding by dislodging the blood clot.  Starting the day after surgery, a soft diet can be eaten. This includes eggs, potatoes, pasta.

A high calorie, high protein intake is very important. 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 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 the day of surgery. The day after surgery you should begin rinsing at least 3 4 times a day, especially after eating, with a teaspoon of salt mixed into one cup of warm water.

   

   
   

Discoloration

In some cases, discoloration of the skin follows swelling. The development of black, blue, 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 tablets or liquid 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 at 817-741-2200 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. You should then sip on coke, tea, or ginger ale. You should sip slowly over a fifteen-minute period. You have also been prescribed a medication for nausea and vomiting to be used if needed. When the nausea subsides you can begin taking solid foods and the other 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 Dr. Parmer or Dr. Macholl  at 817-741-2200 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. Parmer or Dr. Macholl.
  • 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 are not uncommon. The normal act of swallowing can then become painful. This will subside in 2–3 days.
  • Stiffness of the jaw muscles may cause difficulty in opening your mouth for a week following surgery. This is a normal post-operative event which will resolve in time.

   
   

Final After Care Notes

Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. These stitches dissolve on their own and usually last for approximately one week.  If they come out earlier than a week, if there is no excessive bleeding then there is no cause for concern.

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 our office at 817-741-2200 for instructions.

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

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

A dry socket is when you lose the blood clot from the tooth socket. Symptoms of pain at the surgical site that may radiate up to near the ear may occur 2–3 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.

Your case is unique, no two mouths are exactly alike. Discuss problems with the trained experts best able to help you: Dr. Parmer or Dr. Macholl.  Please call us at 817-741-2200 if you have any questions or concerns.