After Wisdom Tooth Removal

The removal of impacted 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

  • The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed, discarded, and replaced if necessary.
  • Vigorous mouth rinsing 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 directed.  
  • Restrict your activities the day of surgery and resume normal activity when you feel comfortable or as instructed by your surgeon.
  • 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. Bleeding will be controlled by placing a gauze pad over the area and biting firmly for thirty minutes.  This will be repeated  if necessary. If bleeding continues, you will be instructed to 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, sit upright, and avoid talking while biting on the gauze, avoid movement and any form of  exercise.   If bleeding does not subside, call  the office for further instructions.  If bleeding concerns arise after office hours, please call the  emergency contact number provided at your surgical appointment.   

 Swelling

The swelling that is normally expected 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 and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 3-4 days postoperatively. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs,. or packs of frozen vegetables (frozen peas or corn)  should be applied to the sides of the face where surgery was performed. The ice packs should be used as directed, normally on for 30 minutes and off for 30 minutes for the first 24 hours only.  Swelling or jaw stiffness can persist for several days. This is a normal reaction to surgery. Please contact the office if you have concerns postoperatively.   

Pain

For pain management, take the pain medication prescribed by your surgeon as directed. The prescribed pain medicine can make you groggy and slow down your reflexes. Do not drive an automobile, work around machinery or drink alcoholic beverages while taking pain medication. 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 surgery, you will be on a soft, cold diet for the first 24 hours.  Do not use a straw for the first 24 hours following surgery.   The sucking motion can cause bleeding and dislodge the blood clot which forms in the surgical site.  High calorie, high protein intake is very important as  nourishment is an important part of the healing process.  Try not to miss a  meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat. Dietary instructions will be provided at your preoperative consultation. 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 for one minute before standing.

Keep the mouth clean

No rinsing or brushing of any kind should be performed until the day following surgery.  The day after surgery you should begin rinsing at least 4 times a day especially 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 postoperatively. 

Antibiotics

If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics may be given to help prevent infection and should be taken as directed.   Discontinue antibiotic use in the event of a rash or other unfavorable reaction and call the office to report this occurrence.  

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

  • Numbness of the lip, chin, or tongue may occur temporarily following surgery. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful and contact the office  if you have any questions or concerns.
  • Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. 
  • You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery. It was also difficult to take fluids. Taking pain medications 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 Drs. Hesterberg & Breda.
  • 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 (Trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days to several weeks following surgery.  This is a normal post-operative occurrence which should  resolve in time.

Finally

Sutures may be placed in the area of surgery to minimize post-operative bleeding and to help with healing.  The sutures will come out on their own, usually within 1 to 7 days following surgery.  

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 the office for instructions.

There will be a hole where the tooth was removed. The hole will gradually fill in with new tissue during the healing process.  The area should be kept clean especially after meals with salt water rinses or a soft toothbrush.

Your case is individual, no two mouths are alike. Do not accept well intended advice from friends. Discuss any concerns with the persons best able to effectively help you: Drs. Hesterberg & Breda. 

Brushing your teeth is okay – just be gentle at 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 3-7 days following surgery. Call the office if this occurs.