After Wisdom Tooth Removal

The removal of impacted wisdom teeth is a serious 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:

  • Place gauze over the surgical area and bite down firmly for at least one hour. Opening and closing and talking during this time will cause the site to continue to ooze and not clot. The gauze pad should be removed and replaced until the gauze is  pinkish in color.  At this point you can leave the gauze out.  If the site starts to bleed again replace with gauze apply pressure and start the process over again.
  • Take either 600mg of ibprofen or advil every 6 hours or 800mg of motrin every 8 hours.  If after taking the over the counter medicines and the patient is still having some discomfort, the patient can take the medicines that were prescribed for pain. 
  • Restrict your activities the day of surgery and resume normal activity when Dr. Clemenza advises you.
  • Place ice packs  to the sides of your face where surgery was performed. Refer to the section of 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 by putting firm pressure with gauze on any surgical sites. Keeping the gauze in place for one hour.   Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea helps to form a clot by contracting bleeding vessels.  If bleeding does not subside, call for further instructions.

Swelling

The swelling that is normal is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery.  You may notice that there seems to be more swelling over the next few days, this is not uncommon. Swelling may be minimized by the immediate use of ice packs which are available at our office.  Ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be placed 20 minutes on and  20 minutes off for the first 48-72 hours. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Seventy two 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, one or two tablets of Tylenol or Extra strength Tylenol may be taken every 4-6 hours, or three 200 mg Ibuprofen (Advil) tablets may be taken every 6 hours, or 800 mg of Motrin may be taken every 8 hours.

For severe pain take the tablets prescribed for pain as directed. The prescribed pain medicine will make you tired and will 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 every day. If pain persists, it may require attention and you should call the office.

Diet

After general anesthetic or I.V. sedation clear liquids should be taken first.(Do not use straws). Once you are tolerating clear liquids you then may advanced to soft foods. When eating anything soft chew away from the surgical sites.  Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. 

Keep the mouth clean

No rinsing of any kind should be done until the day following the surgery. You can gently brush your teeth the night of surgery.   The day after surgery you should begin rinsing at least 4-5 times a day, especially after eating. Use a cup of warm water (8 oz.) mixed with a teaspoon of salt.

Discoloration

Bruising and swelling is typical after any surgical procedures and should resume back to normal after a few days.

Antibiotics

If you have been placed on antibiotics, take as directed. Antibiotics will be given to help prevent infection. If a rash occurs please contact the physician.

Nausea and Vomiting

In the event of nausea and/or vomiting after surgery, do not take anything by mouth for at least an hour including the prescribed medicine.  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 it so be careful. Call Dr. Clemenza 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.
  • Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots, or pieces of tooth, they are bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. Clemenza.
  • 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 or chapstick.
  • Sore throats and pain with swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This should 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 normal post-operative event which will resolve in time.

Finally

  • Sutures are 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 dissolve approximately one week after surgery. Any removal of remaining sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure. The pain and swelling should subside more and more each day following surgery. If your post-operative pain and swelling worsens or unusual symptoms occur call our office for instructions.
  • There will be a cavity where the tooth was removed. The cavity will gradually over the next month fill in with the new bone and tissue. In the meantime, the area should be kept clean especially after meals with salt water rinses or a toothbrush.
  • Your case is individual, no two mouths are alike. Do not take seriously well intended advice from friends. Discuss your problem with the persons best able to effectively help you: Dr. Clemenza, staff or your family dentist.
  • Brushing your teeth is okay just be gentle to the surgical sites.
  • A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to 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 and exercise may weaken you. If you get light headed stop exercising.