Pre and Post Surgical Instructions

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 and discarded.
  • 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 soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.  For more detailed instructions, please refer to our page: Management of Post-Operative Pain. 
  • 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. 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 for the first 24 hours. Excessive bleeding may be controlled by first gently irnsing or wiping any old clots from your mouth, then placing a moistened, folded gauze pad directly over the wound and biting firmly for a minimum of thirty minutes. Repeat if necessary.

If bleeding continues a tea bag, (blends such as Salada or Lipton), moistened in warm water and folded in gauze can be placed directly over the wound with firm pressure for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.

Swelling

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 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be used a minimum of 20 minutes at a time and applied frequently for the first three days.  After 72 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. On the fourth full day following  surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.

Pain

Please refer to our page on Management of Post-Operative pain.

Diet

After general anesthetic or I.V. sedation, clear liquids should be initially taken. Do not use straws. Drink from a glass. The sucking motion from a straw or a bottle can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away form the surgical sites. High calorie, high protein intake is very important. Refer to the page:  Post-Operative Diet Recommendations. Nourishment should be taken regularly. Drink plenty of fluids to prevent dehydration. 

Keep the mouth clean

Do not rinse for the first 24 hours following surgery. You may brush your teeth carefully the night of surgery but rinse gently. The day after surgery you should begin rinsing at least 5-6 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 the swelling. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively.  Moist heat applied to the area starting on the fourth post-operative day may speed up the removal of the discoloration.

Antibiotics

If you have been prescribed antibiotics, take them as directed.  If you believe that you are having an allergic or unfavorable reaction, call the office.

Nausea and Vomiting

If you have been prescribed a medication for nausea, (an anti-emetic), use this as directed.   Otherwise, do not take anything by mouth for at least an hour including other 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 cautiously 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 the sensation. So be careful. Call the office if you have any questions.
  • Slight elevation of temperature immediately following surgery is not uncommon.  Tylenol or ibuprofen may be taken to reduce the fever.
  • You should be careful changing abruptly a lying down to a standing position .  This is most  likely caused by the anesthesia or the medications you are taking.  Before standing up, you should sit for one minute then get up.
  • If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment with an SPF rating of 15 or better.
  • Sore throats and discomfort when swallowing is not uncommon. The muscles get swollen. The normal act of swallowing can then become uncomfortable. This will begin to subside in 3-5 days.
  • Stiffness (Trismus) 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.

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. Just remove the suture from your mouth and discard it. The sutures we use are routinely dissolvable.  They will fall out over the first few days following your normal hygiene.  This is normal.

There may be a cavity where the tooth was removed. This will gradually fill in over the next month. 

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 4-5 days following surgery. Call the office if this occurs.


CLICK HERE to download and print these instructions.