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. Remember, taking care of your wounds in the post-operative period is as important as the surgery itself!
- The gauze placed over the surgical area should be kept in place for 2 hours . After this time, the gauze should be removed and discarded. If bleeding persists, place fresh gauze over the area with good pressure for 1 hours. Repeat for 1 more hour if needed. Oozing is normal. Do NOT replace gauze unless there is active bleeding.
- 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.
- Restrict your activities the day of surgery and resume normal activity when you feel comfortable. Do not do too much too fast. Those are usually the individuals that encounter the most problems.
- Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for explanation.
- 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 wiping any old clots from your mouth, then placing gauze over the area and biting firmly for an hour without looking at it. Taking the gauze out prematurely is only going to encourage more bleeding! Repeat if necessary. If bleeding continues, 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, do not become excited, sit upright and avoid exercise. If bleeding does not subside, call the 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 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be applied 15 minutes on and 15 minutes off for a period of 72 hours. Ice PREVENTS swelling. 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. Usually after the morning of the third day, the swelling will dramatically drop off and you will appear and feel much better.
- You will be given a prescribed pain medicine. Take the tablets prescribed as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort usually maximizes by the 3rd or 4th day after surgery, but after that the pain should subside more and more every day. If pain persists, it may require attention and you should call the office.
- After general anesthetic or I.V. sedation, liquids should be initially taken. Do not use straws. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. High calorie, high protein intake is very important. Refer to the section on suggested diet instructions at the end of the brochure. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake can 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( Gatorade is an excellent choice). Try not to miss a single meal. 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 for one minute before standing.
- No rinsing of any kind should be performed until the day following surgery. You can brush your teeth 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 an 8 oz. glass of warm water mixed with 1/2 teaspoon of salt.
- 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 other unfavorable reaction. Call the office if you have any questions.
- In the event of nausea and/or vomiting following surgery, do not continue to take the narcotic pain medicine if you can not tolerate any intake. This may be the very thing that is is causing you to feel the way you do! You should sip on room temperature Gatorade or a similar product. Do not stop doing this if you continue to vomit. Just continue to sip the fluids until you start to tolerate them and keep them down. Your body absorbs the glucose in the beverage and eventually starts to cooperate. Once you are tolerating the liquids, you can slowly start to increase your diet. Only once you are keeping solid food down,should you consider taking the narcotic pain medicine. If you do not need the stronger pain medicine, don’t take it!
- 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 Dr. Ford 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 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 and 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 Dr. Ford.
- 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 (Trimus) 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. The earlier and more frequently that you do the stretching exercises shown to you ( three fingers width open), the less you will encounter this problem and the shorter time it will last. A great time to do your stretching exercises is between periods of icing.
Finally
- You may have dissolvable sutures. If so, they may take 3-4 weeks to dissolve. Try not to pick or prod at them as you might irritate the surgical site.
- Drains may be placed in the lower areas of surgery. If so, you will have an appointment to come back in 1 week for their removal. The drains are a little piece of gauze, about 1 1/2 inches long and 1/2 inch wide. They have a medication on them to help fight infection and help with swelling. Try to leave the drains in place until your next appointment. They may fall out, but you will still need to keep your appointment.
- 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 cavity where the tooth was removed. The cavity will gradually over the next month fill in with the new tissue. In the mean time, 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 accept well intended advice from friends. Discuss your problem with the persons best able to effectively help you: Dr. Ford .
- 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 2-3 days following surgery. Call the office if this occurs. In most cases, we are already addressing the possibility of dry socket with medicine that is on the lower drains. We do not see many cases of this.
- 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.