After Wisdom Tooth Removal

Home Instructions After Wisdom Teeth Extraction

The removal of impacted wisdom 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 the first 2-3 hours and exchanged every 30 minutes.  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 on the day of surgery. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
  • Take the prescribed pain medications as soon as you obtain them from the pharmacy. This will usually coincide with the local anesthetic becoming diminished.
  • Restrict all strenuous physical activity for the first 72 hours after your surgery
  • Place ice packs to the sides of your face where surgery was performed. Ice packs should be left on for 20-30 minutes and then removed for 20-30 minutes. Continue this cycle for the first 24-48 hours after surgery.  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. If excessive bleeding occurs, place direct gauze pressure over the site with firm finger pressure and hold for 30 straight minutes.  Repeat this for at least 90 minutes until the bleeding stops.  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.

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. Peak swelling is typically seen by day 3 after surgery. Swelling may be minimized by the immediate use of ice packs following your surgery as outlined above. Two baggies filled with ice, or ice packs, should be applied to the sides of the face where surgery was performed. Ice packs should be left on for 20-30 minutes and then removed for 20-30 minutes. Continue this cycle for the first 24-48 hours after surgery.  If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. 

DIET

Drink plenty of fluids. Avoid hot liquids or food for the first 12 hours. Pureed foods, luke-warm soups, and liquids are ideal for the first week after surgery.  

PAIN

You should begin taking pain medication as soon as you receive your prescriptions from the pharmacy. Take your pain medication as instructed by your oral surgeon. Over the counter advil and tyelnol may be used either together or alternating.  Please be sure to read the maximum dosage limits on the respective bottle.  Generally speaking, peak pain occurs within the first 72 hours. After 72 hours, pain should improve each subsequent day.  

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 with a teaspoon of salt mixed into one cup of luke-warm water after each meal. If a prescription mouthwash was prescribed, you can use it after brushing your teeth for ~45seconds.

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 2-5 days post-operatively. 

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. Kallis or Dr. Kojanis 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 Drs. Kallis or Kojanis.
  • 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 at the discretion of your surgeon . 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.

Your case is unique, no two mouths are alike. Discuss any problems with the trained experts best able to effectively help you: Drs. Kallis or Kojanis 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.