After Wisdom Tooth Removal

Please call us at Scripps Medical Building, Carmel Valley Phone Number 858-793-3393 with any questions or concerns.

The removal of impacted teeth is a common surgical procedure. Post-operative care is very important. Unnecessary pain and complications can be minimized if these instructions are followed very carefully.

Immediately Following Surgery

  • The gauze pad placed over the surgical area should be kept in place for an hour. After this time, the gauze pad should be removed and discarded.
  • Mouth rinsing, spitting, sucking through a straw or touching the wound area following surgery should be avoided. This will initiate bleeding by causing the blood clot that has formed to become dislodged.
  • If instructed to do so, take ibuprofen as directed as soon as you remove the gauze from your mouth.
  • Take the prescription pain medications as instructed if you begin to feel discomfort. This may coincide with the local anesthetic (numbness) wearing off.
  • Restrict your activities and rest on the day of surgery. Resume normal activity when you feel comfortable or as instructed.
  • Keep ice packs over the sides of your face where surgery was performed. Refer to the section on Swelling for details.

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 upright for one minute before standing.

Bleeding

A small amount of oozing of blood can be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Bleeding may be controlled if needed by folding the provided gauze pad into a small square, moistening it with tap water and then placing it over the area and biting firmly for 30 minutes. Repeat if necessary. If bleeding continues, bite on a moistened “black tea” tea bag for 30 minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, sit upright, and avoid exercise and excessive movement. If bleeding does not subside, call our office at Scripps Medical Building, Carmel Valley Phone Number 858-793-3393 for further instructions.

Swelling

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 and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until two to three days post-operatively. However, the swelling may be minimized by the immediate and continuous use of ice packs. Plastic bags filled with ice, or ice packs should be applied to the sides of the face where surgery was performed for at least the first 24 hours. The ice packs should be left on continuously while you are awake. Remove for a short time if the areas become too cold. After 24 hours, ice has little beneficial effect. If swelling or jaw stiffness persists for several days, there is no cause for alarm. This is a normal reaction to surgery. Twenty-four hours following surgery, the application of moist heat to the sides of the face will be beneficial in reducing the size of the swelling, as is the use of warm saline mouthsoaks described below.

Pain

For moderate pain, if instructed at your appointment take two ibuprofen (Motrin or Advil) 200 mg tablets every four hours with a small amount of food or milk.

For severe pain, take the pain medication prescribed as directed. The prescribed pain medicine may make you groggy and may slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more each day. If pain persists, or worsens it may require attention and you should call our office.

Diet

Drink non-carbonated liquids for the first 24 hrs after surgery. Do not use straws when drinking from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. Maintain a non-chew diet while your mouth is still numb. Afterwards, you may eat anything soft by chewing away from the surgical site(s). High calorie, high protein intake is very important. Try to maintain a normal diet. You should prevent dehydration by drinking 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 five to six glasses of liquid excluding caffeinated or carbonated beverages should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat.

Keep Your Mouth Clean

No rinsing of any kind should be performed until the day following surgery. On the day after surgery you should begin warm saline mouthsoaks then gently rinse. The saline solution is prepared by mixing a level teaspoon of table salt in a 12 ounce glass of warm water. Perform the mouthsoaks at least five to six times a day for 2 minutes, especially after eating. Brush your teeth normally. Be gentle in the areas close to your surgery.

Discoloration

Occasionally, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the skin. This is a normal postoperative occurrence, which may occur two to three days after surgery. Moist heat applied to the area may speed up the resolution of the discoloration.

Antibiotics

If you have been prescribed antibiotics, it is very important to take the tablets or capsules as directed. Antibiotics are given to help fight infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction and call our office immediately.

Nausea & Vomiting

In the unusual 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 sip on flat Coke, tea, or ginger ale slowly over a 15-minute period. When the nausea subsides, you can begin taking solid foods and the prescribed medicine.

Other Concerns:

  • If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As explained before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite them and not feel the sensation. So be very careful. Call our office if you have any questions or concerns.
  • A slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists beyond 48 hours, notify our 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 medications can make you dizzy. You could get light headed when you suddenly stand up. Before standing up, you should sit upright for one minute and then get up slowly.
  • 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.
  • The corners of your mouth may dry out and crack. Keep the areas moist with an ointment such as Vaseline.
  • Sore throat and discomfort when swallowing is not uncommon. The muscles become swollen and the normal act of swallowing can then become uncomfortable. This will subside in two to three days.
  • Stiffness (trismus) of the jaw muscles may cause difficulty in opening your mouth widely for a few days following surgery. This is a normal post-operative event that will resolve in time. Warm saltwater soaks and compresses will speed your recovery.

Finally

Sutures may be 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. The sutures will typically dissolve in approximately three to five days after surgery. Occasionally sutures will need to be removed. Your doctor will tell you when.

After 24 hours, discomfort and swelling should gradually subside each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur, call our office for instructions.

There will be a socket where the tooth was removed. The socket will gradually fill in with new tissue over the next few months. In the meantime, the area should be kept clean especially after meals with rinses or as directed.

Your case is individual. No two mouths are alike. Do not accept well-intended advice from friends. If you have any questions please call our office to discuss your problem with the people best able to effectively help you.

A dry socket occurs when the blood clot becomes dislodged or dissolves prematurely from the tooth socket. Symptoms of increasing pain at the surgical site and even pain to the ear may occur several days following surgery. Call our office if you have concerns.

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 immediately.

Please call us at Scripps Medical Building, Carmel Valley Phone Number 858-793-3393 with any questions or concerns.