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.
Please read and follow these instructions carefully. The after-effects of oral surgery vary per individual, so not all of these instructions may apply. Please feel free to call our office any time should you have any questions or are experiencing any unusual symptoms following your procedure.
Day of Surgery
Immediately After Surgery
Patients that had a local anesthetic should try and take it easy for the rest of the day. Patients who received a general anesthetic should return home from the office immediately upon discharge. Try to lie down with the head elevated until all the effects of the anesthetic have disappeared. Anesthetic effects vary by individual, and you may feel drowsy for a shorter/longer period of time. You should not drive a motor vehicle or operate any mechanical equipment for the rest of the day or longer if you feel any residual effect from the anesthetic.
Oral Hygiene and Care
The day of surgery; Do not rinse, brush or probe the area with any objects or your fingers. The day after surgery, use the soft tooth brush around the surgical site(s) to brush the teeth only. Do not brush/rub the gums in the surgical site. Use your regular tooth brush for the other teeth away from the surgical site(s). The day after surgery, start doing warm salt water soaks at least 3-4 times a day. A soak is not a vigorous rinse. You want to gently move the head back and forth to move the salt water around your mouth and let it fall out of the mouth into the sink. The salt water can be made with one glass of warm water and one tea spoon of salt. Do not use mouth wash, Listerine, peroxide or other oral rinses for the first 3-4 weeks.
Do not smoke for at least 4-5 days after your procedure since it is very detrimental to the healing process. This includes vapes, electronic cigarettes or other forms. Smoking is by far the leading cause of dry sockets.
Bite down gently but firmly on the gauze pack(s) that are initially placed over the surgical area making sure that they remain in place. Try to talk as little as possible to avoid moving the gauze packs. If significant bleeding persists, make sure the gauze are in the correct place. The gauze should be changed every 30 – 40 minutes. This is important to allow blood clot formation on the surgery site. Some bleeding is normal, and blood-tinged saliva may be present for 24 hours. Do not eat/drink the with gauze in your mouth. If bleeding persists after changing the gauze several times or becomes heavier, substitute a moist black tea bag such as Lipton (first moistened in water, squeezed out) on the area for 30-40 minutes. While the tea bag is in place, try to remain still on the couch or in bed. If bleeding continues, please call our office.
Avoid strenuous activity such as biking, running, swimming, heavy lifting for at least 2-3 days after your procedure or possibly longer as directed by your doctor. During the first 24 hrs, excessive physical activity can cause prolonged bleeding and can cause increased pain during the first several days.
Swelling or Bruising
Swelling is to be expected, and usually reaches its maximum in 3-4 days. To minimize swelling, cold packs or ice bag wrapped in a towel should be applied to the face on top of the surgical areas as soon as possible after surgery. Apply for 20 minutes, remove for 20 minutes then repeat this alternating procedure for the first day only. Applying ice after the first day can slow the healing process. If you were prescribed medicine for the control of swelling, be sure to take it as directed. Bruising may also occur, but should disappear soon. Tightness of the jaw muscles may cause difficulty in opening the mouth. These should resolve within 7-10 days. Keep lips moist with lip balm or Vaseline to prevent cracking or chapping.
On the day of surgery, it is advised to stick to liquids or pureed COOL foods. Day after surgery, you can have more solid foods like mash potatoes, soup, pasta, eggs, smoothies and then progress your diet back to normal as you feel comfortable. Avoid foods like nuts, seeds, chips or popcorn, which may get lodged in the surgical sites until the area(s) are completely healed. Proper nourishment aids in the healing process. If you are a diabetic, maintain your normal diet as much as possible and follow your physician’s instructions regarding your insulin schedule.
Pain and Medications
Most oral surgery is accompanied by some degree of discomfort. The local anesthetic administered normally has a 2-3 hour duration. We advise you to take pain medication within 2 hours following your surgery. If you had a minor procedure and only have only minor pain, try an over-the-counter medication such as Tylenol, Advil, or Aleve. If you do not achieve adequate pain relief, take the prescribed pain medication as directed. You may supplement the prescribed medication with an over the counter analgesic such as ibuprofen. We advise that you alternate the prescription pain pill with 600 – 800mg of Ibuprofen (Advil, Motrin) every 4-6 hrs. If you develop hives or a rash, discontinue all medication and contact the office immediately. Narcotic pain medication can make you drowsy, so you should not drive a car or perform any important tasks while taking the medication
If you were prescribed an antibiotic and are currently taking oral contraceptives, you should use an alternate method of birth control for the remainder of this cycle.
If you wear orthodontic appliances (retainers/Invisilign), replace them immediately after surgery unless otherwise instructed. If these appliances are left out of the mouth for any length of time, it is often difficult or impossible to reinsert them.
Instructions for the Following Days
Keeping your mouth clean after oral surgery is essential. Brush the teeth around the surgical site with the soft post operative tooth brush and the rest of your teeth with your normal brush. Soreness and swelling may prevent normal brushing of all areas, but make every effort to clean your teeth within your comfort level. Keep using warm saltwater soaks to clean your mouth at least 3-4 times daily for the next 2-3 weeks or until your follow up.
Other Possible Post-Surgery Effects
The blood clot on the surgical site may be lost causing a dry socket (usually on the 3rd to 5th day). There will be a noticeable, distinct, persistent pain in the jaw area, often radiating toward the ear and forward along the jaw which may cause other teeth to ache. If you do not see improvement the first few days after surgery, or if severe pain persists, please call the office to report your symptoms.
IV Site Irritation
Occasionally, the arm or hand near the site where the needle was placed to administer IV drugs may remain inflamed and tender. This is caused by chemical irritation in the vein. Aspirin and application of heat on the area will usually correct these symptoms.
Loss of sensation of the lip and chin may occur following lower wisdom teeth removal. This is usually temporary and typically resolves within a few weeks but may persist for up to a few months. If your symptoms persist, make sure to inform your doctor at the post operative visit.
It is our desire that your recovery be as smooth and pleasant as possible. If you have any questions about your progress or any symptoms you are experiencing, please call our office. After normal office hours, you may call the office number and the answering service will contact the doctor for you to address any questions or concerns.