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.

General Instructions

MOUTH RINSING

Unless otherwise directed, do not rinse your mouth the day of surgery. Beginning the next day, rinse your mouth gently, using a full glass (8oz) of warm water with 1/2 teaspoon of salt and a 1/2 teaspoon of baking soda. If you cannot get a supply of salt and baking soda, use warm water . Do this 3 – 6 times a day for the first week following surgery. Begin normal tooth brushing on the second day.

EATING

Keep taking nourishment. Begin by drinking liquids or eating soft foods such as: soup, eggs, pasta, ice cream, yogurt, oatmeal or mashed potatoes. As soon as possible eat solid food. You will feel better, have more strength, less pain, and heal faster, if you continue to eat. Drink at least 8 glasses of liquids daily, including plenty of fruit juices. Do not drink alcoholic or carbonated beverages. Do not use straws, spit or smoke. Avoid foods like nuts, sunflower seeds, or popcorn which may get lodged in the socket area. If you are a diabetic, maintain your normal diet as much as possible and follow your physician’s instructions regarding your insulin schedule.

DISSOLVING SUTURES

Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing.

Depending on the type of suture they can last anywhere from about2 days to 3 wks.

PRESCRIPTIONS

Following surgery you may be provided with a prescription for relief of pain. Take all medication as directed. If you have severe pain, fever, rash, or bodily illness, contact our office. Antibiotics are sometimes prescribed for infection. Nausea may be reduced by eating food prior to taking your medication.

SWELLING CONTROL

Some swelling can be expected. Apply an ice pack to the jaw for the first 24 -48 hours . Commercial ice bags or a simple plastic bag filled with crushed ice may be used.This will help limit swelling if applied soon after your surgery has been completed. The ice packs should be applied to the face for 20 minutes on and 20 minutes off; repeating this alternating procedure during the first 24 hours. For extensive surgical procedures apply ice packs for the first 48 hours. These cold applications are also very effective for the relief of pain after surgery. Swelling may be accompanied by skin discoloration.

SMOKING

You should avoid smoking during the first 7 days after surgery to aid in healing and prevent dry sockets.

SEDATION

Patients who have been sedated for surgery will have slower reflexes for a period of 24 hours. They may not drive a car or operate machinery and should not be left alone for this period of time. Please have someone with you when you first stand up in case of dizziness. Narcotic pain pills also cause slowing of reflexes and therefore driving a vehicle or operating machinery cannot be allowed for 24 hours after the last narcotic medication is taken.

BIRTH CONTROL PILLS

Some antibiotics may decrease the effectiveness of birth control pills, therefore it is recommended that you continue your regular birth control pill schedule, but rely on some other form of contraception for a full 30 days from your last dose of antibiotic.

PHYSICAL ACTIVITY

Limit physical activity during the first 24 – 48 hours after surgery.Over-exertion may lead to postoperative bleeding.

IN CASE OF BLEEDING

  1. After your teeth are removed, a gauze compress is placed on the wound and you are asked to bite down firmly on the gauze for 20 minutes. This will help stop bleeding and may be discarded after 20 minutes.
  2. Should bleeding continue, put a fresh, damp, folded gauze on the bleeding area, bite on this and hold in place for 30 minutes. This may have to be repeated 3 – 4 times. A moistened black tea bag can be used in place of the gauze.
  3. Lying down with your head raised on several pillows will also help stop bleeding.
  4. Smoking, spitting, and sucking on a straw prolongs bleeding and may cause a dry socket.
  5. Blood-tinged saliva may be present for 24- 48 hours and is normal.
  6. If these measures do not succeed, please call our office.
    Office phone: (218) 722-8377 answered 24 hours.

DRY SOCKETS

Dry socket is a painful delay in healing resulting in premature loss of the blood clot from a healing tooth socket. It typically occurs in 3- 5 % of patients,predominantly in lower molar areas. Typical symptoms include an increase in pain about the third or fourth day after surgery (sometimes a dull ache in the lower jaw often radiating up to the ear).Inability to get relief from prescribed pain medications (usually Ibuprofen every 6 hours accompanied by narcotics in between Ibuprofen doses) would indicate that you have a dry socket and possibly need a dressing placed. Please call the office where your surgery took place.Please contact us early in the day so we can see you as soon as possible.

STARTING ONE WEEK AFTER SURGERY

Lower extraction sites are prone to collecting debris. One week after surgery, healing has advanced to a point that you can and should start rinsing lower extraction sites with warm water from the syringe provided. Do this at least three times a day until the “sockets” are filled in with new gum tissue. It is no longer necessary to use the salt and baking soda rinses. This can take several weeks to a month or longer. It is possible that you might notice a little bleeding the first few times you rinse (this is normal). Call us if you have any questions.

EXPLANATION OF SYMPTOMS THAT MAY OCCUR

  1. Swelling follows nearly every tooth extraction. It is most marked on the 2nd or 3rd day, and begins to disappear on the 4th day.
  2. Stiffness of the jaws is also to be expected. This diminishes greatly by the 4th to 6th day after surgery.
    Hot applications after 48 hours, 20minutes on and 20 minutes off may relax stiff muscles.
  3. If your IV site becomes red and swollen, you can use moist heat 20 minutes on and 20 minutes off. Call our office to see if you should come in and have this examined.
    • 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 our office 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 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 one of our doctors.
    • 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 throat, pain when swallowing, and jaw muscle stiffness are not uncommon after oral surgery.This will subside in a few days.

Finally

Discomfort and swelling should subside progressively from the third day following surgery on. If your post-operative pain or swelling worsens or unusual symptoms occur callour 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. Discuss your problem with the persons best able to effectively help you: one of our doctors or your family dentist.

Brushing your teeth is important even at the surgical sites.

24 Hour Emergency Numbers:
(218) 722-8377 or 1-800-336-5495