After Wisdom Tooth Removal
The removal of impacted teeth is a 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 approximately 20-30 minutes. After this time, the gauze pad should be removed and discarded. If the area(s) appears to still be bleeding, you may replace the gauze pack for another 20-30 minutes.
- 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 you arrive home, before the local anesthetic has worn off.
- Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
- Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for a more thorough explanation.
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 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 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.
The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, and sides of the face is not uncommon. This is the body’s normal reaction to surgery and repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs, should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. 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 swelling.
Dr. Zalsman will prescribe pain medication for you following your surgery. The prescribed medication can make you sleepy and slow down your reflexes. Do not driver an automobile or work around machinery while taking pain medication. Avoid alcoholic beverages. Discomfort following surgery should subside more and more every day. You may choose to take Ibuprofen (Motrin or Advil), in which case you should take up to three 200 mg tablets every 4-6 hours. If your pain seems to persist or be worsening, please give our office a call.
After general anesthetic or IV sedation only liquids and soft foods should initially be consumed. Drink from a glass and do not use straws. The sucking motion can cause more bleeding by 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. Our staff can provide suggested diet instructions. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few day and 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.
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 several times a day, especially after eating, with a teaspoon of salt mixed into one cup of warm water. Avoid mouth washes and strong rinses, as these may be too harsh for the surgical areas.
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, yet slightly less common post-operative occurrence, and may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.
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 liquids such as tea, juice, or water. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.
- 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. Zalsman 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 may 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. Zalsman.
- 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.
Sutures are placed in the area of surgery to minimize post-operative bleeding and to aid in healing. Sometimes they become dislodged, and this is no cause for alarm. Just remove the suture from your mouth and discard it. Typically dissolvable sutures are used, and will come out on their own within a week. If non-dissolving sutures were placed, they will be removed at your post operative visit. 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.
There will be a space where the tooth was removed. The void will fill in with new tissue gradually over the next month, and this area should be kept clean by brushing and rinsing.
Your case is unique, no two mouths are alike. Discuss any concerns or questions with our office.