After Wisdom Tooth Removal

The removal of impacted third molars is a serious surgical procedure. Closely following postoperative care instructions is very important to limit complications, including infection, and to minimize pain, swelling, and discomfort.

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Immediately Following Surgery
Managing Bleeding
Managing Swelling
Pain Management
Diet After Surgery
Oral Hygiene
Skin Discoloration
Antibiotics
Nausea and Vomiting
Surgical Site
Other Complications

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Immediately Following Surgery

• Keep the gauze pad over the surgical area in place for a half hour. After that, remove and discard it.
• Avoid activities that can dislodge the clot and cause bleeding, including touching the surgical site and vigorously rinsing your mouth.
• As the local anesthetic wears off, you will begin to feel discomfort. Take your prescribed pain medication right away.
• Restrict your activities the entire day of surgery. Resume normal activity when you feel comfortable.
• Place ice packs on the sides of your face where surgery was performed to control swelling.

Bleeding

Slight bleeding – After surgery, slight bleeding, oozing, or redness in your saliva is uncommon.

Excessive bleeding – Blood-tinged saliva may create the appearance of a lot of bleeding but is no cause for concern. If you experience quantities of dark blood, this needs attention. Gently rinse or wipe any old clots from your mouth. Place a gauze pad over the area and bite firmly for 30 minutes. Repeat if necessary. If bleeding persists, bite on a moistened tea bag for 30 minutes. Tea contains tannic acid, which contracts bleeding vessels and helps form a clot. You can further minimize bleeding by sitting upright, avoiding over-excitement, and avoiding exercise. If excessive bleeding persists, call our office.

Swelling

Swelling is usually proportionate to the surgery involved. It becomes noticeable the day after surgery and reaches its maximum two to three days post-operatively. Swelling is the body’s normal reaction to surgery, and it starts the healing process. It can occur around your mouth, cheeks, eyes, and sides of your face.

After surgery, minimize swelling my immediately using ice packs. Two plastic sandwich bags filled with ice, or ice packs, should be applied to the sides of the face where surgery was performed. Use ice packs continuously while you are awake. After 36 hours, ice has no benefit. If swelling or jaw stiffness persists for several days, it is a normal reaction to surgery. Instead of ice packs, start applying moist heat to the sides of the face to reduce swelling.

Pain

Moderate pain – Take one or two tablets of Tylenol or Extra Strength Tylenol may be taken every three to four hours. Or take two to four 200 mg tablets of ibuprofen (Motrin or Advil) every three to four hours.

Severe pain – Take the prescribed medication as directed. It will make you drowsy, so avoid driving a vehicle or operating machinery. Avoid alcoholic beverages. Pain or discomfort should improve each day. If it persists, call our office.

Dry socket – This occurs when the blood clot is prematurely dislodged from the tooth socket. Sudden, severe pain at the surgical site and even in your ear may occur two to three days after surgery. Call our office if this occurs.

Diet

After general anesthesia or I.V. sedation, drink plenty of liquids directly from the glass. Liquids will prevent dehydration. Drink at least five to six glasses of liquid daily Avoid using a straw because the sucking motion can dislodge the blood clot and cause the surgical site to bleed.

You may soft food, but chew away from the surgical sites. Consume high-calorie, high-protein liquids or soft foods. Stay nourished and compensate for your limited food intake by drinking plenty of fluids. Proper nourishment will help you feel better, have more strength and less discomfort, and heal faster.

Oral Hygiene

Don’t rinse your mouth until the day following surgery. You can brush your teeth the night of surgery. The day after surgery, mix a teaspoon of salt with a cup of warm water. Rinse at least five to six times daily, especially after eating.

Skin Discoloration

Swelling can result in skin discoloration as blood spreads beneath the tissues. This is normal and may occur two to three days after surgery. Apply moist heat to help remove discoloration.

Antibiotics

Take the tablets or liquid as directed to help prevent infection. Discontinue use if you develop a rash or have an adverse reaction. Call our office if you have any questions.

Nausea and Vomiting

If you experience nausea or vomiting after surgery, do not take anything by mouth, included your prescribed medication, for at least an hour. Slowly sip on cola, tea, or ginger ale over a 15-minute period. When nausea subsides, you can eat and take the prescribed medicine.

Surgical Site

Sutures – Sutures (stitches) at the surgical site minimize post-operative bleeding and promote healing. If they become dislodged, remove and discard them. Otherwise, the sutures will be removed approximately one week after surgery. There is no discomfort associated with removing them, so no anesthesia or needles are needed to remove them.

Appearance of the site – There will be a cavity, or hole, where the tooth was removed. It will gradually heal and fill in with new tissue over the next month. Meanwhile, keep it clean, especially after meals. Use salt-water rinses or a toothbrush.

Other Complications

• Numbness – If you experience numbness in your lip, chin, or tongue, don’t be alarmed. This is normal and usually temporary. Be careful to avoid biting your lip, cheeks, or tongue.
• Mild fever – A mild fever immediately following surgery is not uncommon. If it persists, take Tylenol or ibuprofen to reduce the fever.
• Dizziness – Be careful when standing up from the lying down position. Your lack of nourishment before and after surgery can make you dizzy, and so can pain medication. Before standing, sit for one minute.
• Hard projections – If you can feel hard projections in your mouth with your tongue, they are the bony walls that supported the tooth. These projections usually smooth out spontaneously. If they don’t, your doctor will remove them.
• Dryness – The corners of your mouth are often retracted and stretched during surgery. Keep your lips moist with an ointment.
• Sore throat – Swollen muscles can cause a sore throat or pain when swallowing. This will subside in two to three days.
• Stiff jaw muscles – For a few days after surgery, it may be difficult to open your mouth. This is normal post-operative stiffness that will resolve in time.
• Exercise – Avoid exercise the day of surgery. Remember that your normal intake of nourishment is reduced. Exercise may dislodge the blood clot, weaken you, or cause dizziness. Resume exercise as directed by your doctor.