After Wisdom Tooth Removal
Fountaingrove Oral Surgery, Santa Rosa CA
The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and complications such as infection and swelling can be minimized if these 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 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 as soon as possible following your procedure to avoid post operative discomfort.
- Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
- Place ice packs on the sides of your face where surgery was performed. Refer to the section on swelling for a more thorough explanation.
Bleeding
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 placing a gauze pad over the surgical area and biting firmly for 20-30 minutes. 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 for a minimum of 3 days following your surgery. If bleeding does not subside, call our office for further instructions.
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 post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Ice packs or baggies filled with ice should be applied to the sides of the face where surgery was performed. The ice packs should be left on for 20 minutes, and removed for 20 minutes, alternating continuously while you are awake for the first 24 hours (you do not have to continue icing surgical sites throughout the night). After 36 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. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.
Pain
Taking the pain medications that your doctor has prescribed for you will help you to effectively manage any discomfort that you may experience. Please follow the directions on your prescription bottle and call our office if you have any questions. Keep in mind that taking your pain medications before your local anesthetic wears off will help you to control your discomfort more easily. It is important for you to have something to eat before you take any kind of medication. This will help to minimize the occurance of nausea or vomiting.
Do not take any medications if you are allergic to them, or have been instructed by your doctor not to take it. If you are taking a narcotic pain medicacation such as Norco or Percocet do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should gradually subside over the coarse of a week or so. If pain persists, it may require attention and you should call the office, especially if new pain and/or sweling occur.
Diet
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 and 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. Soft foods are recommended for at least the first week following our surgery. Soft foods include, scrambled eggs, mashed potatoes, soups, apple sauce, pasta, shakes/smoothies (without berries), soft fruits and vegetables etc. 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 3-5 times a day, especially after eating. Combine a half of a teaspoon of salt with one cup of warm water. Remember to rinse gently. Avoid brushing your teeth the first day of your surgery. Regular tooth brushing may resume the day following your surgery, avoiding the surgical sites with your tooth brush. Rinse gently. Good oral hygiene is very important to the overall healing process.
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 post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.
Antibiotics
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. 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
- 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. Hedayati 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; they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. Hedayati.
- 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.
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 will be removed approximately one week after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is usually no discomfort associated with this procedure.
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.
Your case is unique, no two mouths are alike. Discuss any problems with the trained experts best able to effectively help you: Dr. Hedayati or your family dentist.
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 near the ear may occur 2-3 days following surgery. Call the office if this occurs.
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.