After Wisdom Tooth Removal
Immediately following your surgery: Bite on the gauze placed over your surgical site for about an hour. After this time, the gauze should be removed, discarded, and replaced with a new pad.
Avoid vigorous mouth rinsing (swishing) or touching the wound area following the surgery. This may initiate bleeding by dislodging the newly formed blood clot.
To minimize any swelling, place ice packs to the sides of your face where surgery was performed.
Take the prescribed pain medications as soon as you can so it is digested before the local anaesthetic has worn off. Having something of substance in your stomach will help to coat it and minimize any nausea from pain medications.
Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
If you are active, your heart will be beating harder, and you can expect excessive bleeding and
throbbing from the wound.
NO SMOKING OR DRINKING FROM A STRAW UNDER ANY CIRCUMSTANCES.
Bleeding: A certain amount of bleeding is to be expected following surgery. On the skin where the surface is dry, bleeding clots in 10 minutes. In the mouth where things are wet, it takes 6-8 hours for the clot to gel up and the bleeding to subside. Slight bleeding and oozing causing redness in the saliva is very common. For this reason, the gauze will always appear red when it is removed. Saliva washes over blood clots and dyes the gauze red even after bleeding from the sockets has actually stopped.
First GENTLY rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for 3-4 hours may control excessive bleeding. Repeat as necessary.
If bleeding continues, bite on a cold moistened tea bag for 30 minutes. The tannic acid in the tea bag helps to form a clot by contracting blood vessels. This can be repeated several times.
To minimize further bleeding, sit upright, do not become excited, maintain constant pressure on the gauze (no talking or chewing) and avoid exercise.
IF BLEEDING DOES NOT SUBSIDE AFTER 6-8 HOURS, CALL THE OFFICE FOR FURTHER INSTRUCTIONS (289)-447-1680.
Swelling: The swelling that is expected is usually proportional to the surgery involved. There is usually a fair amount of cheek retraction involved with the removal of impacted wisdom teeth. Therefore, you should expect swelling of the cheek after your surgery.
The swelling will not become apparent until the day following the surgery and will not reach its maximum until 2-3 days post-operatively.
The swelling may be minimized by the immediate use of ice packs. Sealed plastic bags filled with ice, ice packs, or a bag of frozen peas wrapped in a washcloth should be applied to the side of the face where the surgery was performed.
The ice packs should be applied for 20 minutes on/ 20 minutes off for the afternoon and evening immediately following your extraction. After 24 hours, ice has no beneficial effect.
36 hours following the surgery, the application of moist heat to the side of the face may help in reducing the size of any swelling that has formed.
If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. Soft, puffy swelling that you can indent with your finger after oral surgery is very normal.
Bright red, rock hard, hot swelling that does not indent with finger pressure, which is getting bigger by the hour, would suggest infection. This usually would develop around day 3-4 after surgery when you would expect swelling to be going down, not up. If this should occur, please call our office at (289)-447-1680.
Temperature: It is normal to run a low-grade temperature (99-100F) for 7-10 days following oral surgery. This reflects your immune response to the normal bacteria that are present in your mouth. A high temperature (>101F) might exist for 6-8 hours after surgery, but no more than that.
2 Tylenol or 2-3 200mg Ibuprofen (Advil) every 4-6 hours will help moderate a temperature.
A temperature >101F several days after surgery, especially if accompanied by rock hard swelling and increased pain, are usually indicative of infection. You should call the office for instructions if this should occur.
Pain: Pain or discomfort following surgery is expected to last 4-5 days. For many patients, it seems the third and fourth day may require more pain medicine than the first and second day. Following the fourth day pain should subside more and more every day.
Many medications for pain can cause nausea or vomiting. It is wise to have something of substance in the stomach (yogurt, ice cream, pudding or apple sauce) before taking prescription pain medications and/or over the counter pain medications (especially aspirin or ibuprofen). Even coating the stomach with Pepto Bismol or Milk of Magnesia can help prevent or moderate nausea.
Do not drive an automobile or work around or operate heavy machinery if you are taking prescription pain medication.
Alcohol and prescription pain medicines DO NOT mix!
Diet: Drink plenty of fluids. Try to drink 5-6 eight-ounce glasses on the first day. Drink from a glass or a cup. DO NOT USE A STRAW. The sucking motion will suck out the healing clot and start the bleeding again.
Avoid hot liquids or food while you are numb, so you don’t burn yourself.
Soft foods and liquids can be eaten on the day of surgery. The act of chewing doesn’t damage anything, but you should avoid chewing sharp or hard objects at the surgical site for several days.
Return to a normal diet as soon as possible unless otherwise directed. You will find eating multiple small meals is easier than three regular meals for the first few days.
You will feel better, have more strength, less discomfort, and heal faster if you continue to eat.
If you suddenly sit up or stand from a laying position, you may become dizzy. Therefore, immediately following surgery, if you are laying down, make sure you sit for one minute before standing.
Solid foods you can eat after extraction: ice cream, milkshakes (DO NOT use a straw), jello, pudding, mashed potatoes and gravy, macaroni and cheese, yogurt, etc.
Liquids you can drink after extraction: Fruit juices, water, milk, very lukewarm beverages, Gatorade, Ensure Nutritional Drinks, Carnation instant breakfast
REMEMBER: Law of gravity- everything goes down. You may experience food getting trapped in the sockets. On the 2nd day after extractions, you may start rinsing your mouth with warm saltwater (8oz glass of warm water with 1 teaspoon of salt).
DO NOT HESITATE TO CALL THE OFFICE IF IN DOUBT.
Oral hygiene: Good oral hygiene is essential to the proper healing of any oral surgery site.
You can brush your teeth the night of surgery but rinse very gently. Vigorous rinsing should be avoided until the day following surgery.
The day after surgery you should begin rinsing at least 5-6 times a day especially after eating. Saltwater (a cup of warm water mixed with a teaspoon of salt) is ideal but plain water is also ok.
Mouthwash has an alcohol base to it so it may sting when it meets fresh oral wounds. After a few days, dilute mouthwash in half with tap water and rinse out your mouth. This will make it taste and smell better. You can gradually build up to full-strength mouthwash as you feel more comfortable.
Smoking: No smoking for 48 hours after surgery. Smoking slows healing dramatically. Nicotine constricts blood vessels, which slows the formation and expansion of the healing blood clot in the socket. This leads to a painful complication called “dry socket”.
After 48 hours, if you feel you need so much as one Tylenol or aspirin to control pain, you should avoid smoking of any kind. This usually reflects that the clot has not grown enough to cover all the exposed bone in the socket. The exposed bone is filled with raw nerve endings. Until the nerve endings are covered with a healthy blood clot, they will cause pain. Smoking will just slow this process significantly and make the pain even worse.
Therefore, if there is any question about smoking… DO NOT DO IT!
Activity: You should keep physical activities to a minimum for 6-12 hours following surgery.
If you are considering exercise, throbbing or bleeding may occur. If this happens, stop exercising.
Keep in mind that you are not taking normal nourishment. This may weaken you and affect your ability to exercise.
Other complications: 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 it, so be careful.
Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots, they are bony walls, which support the tooth (the walls of the tooth socket). These projections usually smooth our spontaneously. You may not notice this for days to weeks after surgery. If the rough edges bother your tongue or cheeks, call our office so Dr. Aurora Moldovan can evaluate the area and smooth them down for you.
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 (Trimus) of the jaw muscles may cause difficulty in opening your mouth for 7-10 days following surgery. This is a normal post-operative event, which will resolve in time. The muscles that operate the jaw are not used to holding open for prolonged times. The physical therapy of eating, talking, yawning, and chewing help the stiffness to resolve.
