After Wisdom Tooth Removal
Attached is a PDF of the actual Post-surgery sheet that is typically given.
Recommendations following removal of 3rd molars.pdf
The removal of impacted teeth is a significant surgical procedure. Please follow these instructions carefully and pain and complications such as infection and swelling can be minimized.
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 replaced at hour intervals for approximately 3-4 hours. 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 BEFORE 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 if desired.
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 one hour. 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, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call our office for further instructions.
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 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs and following the medication regimen that is prescribed. Two baggies filled with ice, or ice packs, can 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 24 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.
For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every 3-4 hours. Ibuprofen (Advil or Motrin) may be taken in addition to Tylenol. Ibuprofen bought over the counter comes in 200 mg tablets: 4 tablets may be taken four times daily, not to exceed 3200mg daily for an adult. Consult our practice for individuals under 18.
For severe pain, the prescribed medication should be taken as directed. Do not take any of the above medication if you are allergic to them, or have been instructed by your doctor not to take it. 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.
After general anesthetic or IV sedation only liquids should initially be consumed. Drink from a glass and do not use straws. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. A high calorie, high protein intake is very important. We can provide suggested diet instructions. 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 5-6 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 until the day following surgery. The day after surgery you should begin rinsing at least 5-6 times a day, especially after eating, with a teaspoon of salt mixed into one cup of warm water. In addition use the prescribed mouth rinse as directed.
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 post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.
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 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, including the prescribed medicine. When the nausea subsides you can begin taking solid foods and the prescribed medicine. Please call our office if you are concerned or if nasusea persists.
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. Gray 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 or pieces of the tooth. They are bone that supported the tooth and now that the tooth is gone they are exposed and more prevalent. Usually these resolve spontaneously. If not, they can be removed by Dr. Gray.
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 following surgery. This is a normal post-operative event which will resolve in time.
Sutures are often placed in the area of surgery 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 placed will dissolve on their own in about 1-2 weeks and come loose. They generally do not need to be removed unless desired.
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 for instructions.
There will be a void where the tooth was removed. The void will fill in with new tissue gradually over the next month. In the meantime, the area should be kept clean, especially after meals, with salt water rinses or a toothbrush.
Remember, no two mouths are the same. Your case is unique and if you have questions please discuss them with the trained expert best able to effectively help you: Dr. Gray
Brushing your teeth is okay – just be gentle at the surgical sites.
Dry socket: This is generally when a blood clot gets dislodged or dissolved in the tooth socket prematurely. This then presents as a pain at the surgical site and even pain near the ear. Generally pain improved day by day and then at day 4-5 pain gets worse and pain medications do not seem to improve the situation. Sometimes it is associated with a bad taste, smell or odor. Please call Dr. Gray if you are concerned that this has occurred. Treatment will greatly improve your symptoms and speed you down the road to recovery.
Exercise in general is something we ask that you avoid full participation in until 5-6 days after surgery. Often because your normal nourishment intake is reduced exercise weakens you prematurely and unexpectedly. You should not be doing strenuous exercise for the first 5 days.