Surgical Instructions

After Wisdom Tooth Removal

The removal of your impacted wisdom teeth is an outpatient surgical procedure. Post-operative care is very important. Unnecessary pain and complications of infection and swelling can be minimized if our instructions are followed carefully.

Immediately Following Surgery

  • The gauze pad placed over your surgical area should be kept in place for a half hour.  Bite on the pad firmly.  Once you get home, the gauze pad should be removed and discarded.
  • Vigorous mouth rinsing 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 before you begin to feel discomfort. This will usually coincide with a diminished local anesthetic (numbness) effect.
  • Restrict your activities on the day of surgery and resume normal activity when you feel comfortable.
  • Place ice packs to the outsides of your face where surgery was performed. Refer to the section on swelling for explanation.

Bleeding

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 first gently wiping any old clots from your mouth, then placing a moist gauze pad over the bleeding area and biting firmly for 30 minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for one hour.  The tannin in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid activity. If bleeding does not subside, call the office for further instructions.

Swelling

The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is common. This is the body's normal reaction to surgery and eventual repair. The swelling will not become apparent until 12 to 24 hours  following surgery and will not reach its maximum until after 3 days.  However, the swelling may be minimized by the immediate use of ice packs.  Ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on as directed by Drs. Fraser and Michaels while you are awake. After 36 hours, ice provides little benifit. 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 the size of the swelling.

Pain

For moderate pain, Tylenol (325 mg) two tablets may be taken every four hours or Ibuprofen (200 mg) three tablets may be taken every 6 hours.

For severe pain, take the prescription medication given to you by Drs. Fraser and Michaels as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive a car or work around machinery. Avoid alcoholic beverages. Pain or discomfort should subside each day following surgery. If pain persists, it may require our attention and you should call the office.

Diet

After general anesthesia or conscious IV sedation, sips of liquids should be taken initially.  Do not use straws. Drink only from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. High calorie, high protein intake is very important. Nourishment should be taken regularly. You should prevent dehydration by drinking fluids regularly.  At least 5-6 glasses of liquid should be taken daily. Try not to miss a single meal. 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 after surgery. You should not brush your teeth the night of surgery.  Twenty four hours after surgery,  you should begin rinsing at least 5-6 times a day, especially after eating,  with salt water.  The prescription mouth rinse should be used twice a day for one week starting 24 hours after surgery.

Discoloration

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 post-operative occurrence, which may occur 2-3 days later. Moist heat applied to the area may speed up the resolution of discoloration.

Antibiotics

If you have been placed on antibiotics, take the capsules or liquid as directed by Drs. Fraser and Michaels. Antibiotics will be given to help treat infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. 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 coke, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.

Other Complications

  • If prolonged numbness of your 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 Drs. Fraser and Michaels if you have any questions.
  • Slight elevation of temperature immediately following surgery is common. If your 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 is also difficult to take fluids after surgery. You may be dehydrated.  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, you can feel hard projections in your mouth with your tongue. These projections are not tooth roots.  They are the bony walls or socket that supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Drs. Fraser and Michaels.
  • If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with Chap Stick or Blistex.
  • Sore throat and pain when swallowing are not common. If the muscles of your throat are swollen, the normal act of swallowing can become painful. This will subside in 2-3 days.
  • Stiffness (Trimus) 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.

Finally

Sutures are placed the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged.  This is no cause for alarm. Just remove the suture form your mouth and discard it. The sutures placed after wisdom tooth surgery normally dissolve after 5 days.

The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur call our office for instructions.

There will be a "hole" where the tooth was removed. This area  will gradually heal over the next month and fill in with the new tissue. In the mean time, the area should be kept clean especially after meals with salt water rinses, a toothbrush, or an irrigation syringe as directed by Drs. Fraser and Michaels.

Your surgery was unique.  No two mouths are alike. Do not accept well-intended advice from your friends or family members.  Discuss your problem with the persons best able to effectively help you:  Drs. Fraser and Michaels or your family dentist.

Brushing your teeth is okay the day after surgery.   Just be gentle at the surgical sites.

A dry socket is when the blood clot becomes dislodged prematurely from the tooth extraction socket. Symptoms of pain at the surgical site and even pain to the ear may occur 2-3 days following surgery. Call our office if this occurs.

If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.