Surgical Instructions

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.

Immediately Following Surgery

The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded.
Vigorous mouth rinsing or touching the wound area immediately 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 possible before the local anesthetic begins to wear off. It is much easier to manage pain by staying ahead of it.
Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
Apply cold packs (15 minutes on. 15 minutes off) for the first 36 hours while awake.
If you suddenly sit up or stand from a lying position, you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.

Swelling

Swelling is the body’s normal response to surgery and the beginning of the healing process. Swelling will vary among individuals and according to different procedures. Swelling will increase over the first 48 hours, and subside over the next 5-7 days. Apply cold packs (15 minutes on, 15 minutes off) for the first 36 hours while awake. Keep the head elevated for the first 72 hours using pillows under the back and head while sleeping.

Bleeding

Minor bleeding or blood tinged saliva may continue for the first 12 to 24 hours. Bite on gauze for 30 minutes following surgery. Additional gauze changes every 30 minutes may be needed. If heavy bleeding still occurs, biting on a cold, moist washcloth or dampened tea bags can help further. Do not drink through a straw or suck on cough drops or candy for 1 week. Smoking is not allowed for 72 hours following surgery.

Bruising

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 postoperative occurrence, which may occur two to three days post-operatively. Warm, moist compresses applied to the area may speed up the removal of the discoloration.

Pain

Medication has been prescribed according to your anticipated level of discomfort. Take pain medication as soon as possible before the local anesthetic begins to wear off. Continue taking pain medication routinely as instructed by Dr. Hunter or the pharmacist. Take medication with soft food or milk to avoid nausea and stomach irritation. Do not drive, operate hazardous machinery or drink alcohol while taking pain medication.

Rinsing and Brushing

You may drink, but do not rinse for the first 24 hours following surgery. After 24 hours, gently rinse the mouth with warm salt water (1/2 teaspoon salt in a large glass of lukewarm water). Repeat after every meal, before going to bed and upon waking. There will be a hole/cavity where the tooth was removed. The cavity will gradually fill in with new tissue over the next month. In the meantime, the area should be kept clean, especially after meals with the salt-water rinses or a toothbrush. You may brush your teeth the day after surgery, being careful in the areas where surgery was performed.

Diet

A soft diet is best for the first 48 hours. Cool foods such as milk shakes, smoothies, ice-cream, applesauce and yogurt are well tolerated. Food should not be too hot as this can increase bleeding. Avoid excess alcohol and carbonated beverages for 72 hours. Avoid hard, crunchy foods for the first week following surgery. These foods can be introduced back into your diet as tolerated.

Sutures

If sutures were placed, they will dissolve in 5 to 7 days, unless you are specifically told that non-dissolvable sutures were used. Sutures may loosen or come out prior to your follow-up appointment (if scheduled). This is normal and is not a cause for concern.

Nausea & 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 clear liquids such as apple juice, tea or Gatorade. You should sip slowly over a 15-minute period. When the nausea subsides, you may resume eating solids and taking prescribed medicine.

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 careful to avoid biting your lip or tongue as it will be numb and you will not feel any sensation. Call Dr. Hunter if you have any questions.
A 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. Taking pain medications can make you dizzy. You could get light headed when you suddenly stand up. Before standing up, you should sit for one minute and then get up.
Occasionally, patients may feel hard projections in the mouth with their tongue. These 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. Hunter.
If the corners of your mouth are stretched, they may dry out and crack. These areas should be kept moist with an ointment such as Vaseline or Chapstick.
Sore throats and pain when swallowing are not uncommon. The muscles become swollen, the normal act of swallowing can then become painful. This will subside in two to three 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 that will resolve in time.
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 to the ear may occur two to three days following surgery. Call the office if this occurs.