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

You have just undergone a surgical procedure.  Varying degrees of pain may continue for about one week following surgery.  You may also experience discomfort in the ears, the throat, the side of the head, and under your lower jaw.  There will be an opening where the tooth was removed.  Try to keep your fingers and tongue out of this area.

Try to limit your activities as much as possible on the day of surgery to reduce bleeding and permit formation of a clot in the wound. This is necessary for proper healing.  Surgical wounds of the mouth usually heal quickly and without complications. If you take the simple precautions described in this pamphlet, it will likely make your recovery an easier one.

Swelling

Some swelling is to be expected, and should not alarm you.  The most swelling usually occurs during the first 48 hours, and then begins to decrease.  Keeping your head elevated during this period can also help limit your swelling.  The amount of swelling varies from person to person and depends upon the complexity of your surgery.  If your swelling persists or increases, after the first 3 to 4 days, call our office. If a vein used to administer general anesthesia becomes sore and swollen, please notify our office.

Pain and Medications

We wish to inform you of our office policy: no pain medications can be called in after hours.

Most often, you will experience some discomfort for a few days following your procedure.  The prescription for pain should be filled only if needed, and taken as directed.  If you were not prescribed any medication or you have completed your prescription, take over the counter medications such as ibuprofen/ advil, naprosyn/ aleve, or acetaminophen/ tylenol as directed on the bottle.  Do not take any other pain medicines or sedatives with your prescribed drugs, unless your doctor has specifically directed you to do so.

Narcotics: it can be extremely dangerous to consume alcohol while you are taking narcotic pain medications.  Also, since these drugs can cause drowsiness or alter your perception it is advised you should not take them if you are driving any motor vehicle, operating machinery, or doing anything that requires alertness.

Increasing pain on the third to fifth day after tooth removal may indicate a problem with healing.  This pain is usually severe and unresponsive to pain medications. If this has occurred, contact the office immediately for an appointment.

Antibiotics:  when antibiotics are prescribed, please take them as directed and complete the entire amount that was given.  If you develop a rash, hives or persistent itching, you may be having an allergic reaction.  Stop taking the medication and call the office.  If you feel tightness in your chest or difficulty breathing, seek emergency medical care.

Birth control pill users:  please use alternative means of contraception and take extra precautions.  The use of prescription medications and antibiotics can cause your birth control pills not to work of be less effective.

Bleeding

Some oozing from the tooth socket may continue for the first 24 hours.  However, if there is more than slight oozing, the following procedures can help control the bleeding:

  1. Use clean gauze to gently remove the blood from your mouth and around surgical areas.  All blood clots that are not in the wound should be removed.  Do not attempt to remove anything from inside the socket.
  2. Place a clean folded gauze pad on the bleeding area / socket? not just between your teeth.
  3. Close your mouth tightly over the gauze pad so that there is pressure against the spot that is bleeding.  Make sure the gauze does not end up between your teeth, as it is crucial to put pressure directly over the area that is bleeding.
  4. Maintain the pressure for about 20 to 30 minutes.  Resist the urge to check on the site prior to this period of time.  Repeat the process if necessary.
  5. Avoid spitting and rinsing if bleeding such as this occurs.  Doing so will cause the bleeding to start again, or continue.
  6. If the bleeding has not come under control after a couple of attempts, a moistened tea bag can be placed over the site to aide in the clotting process.

Sutures

Sutures (stitches) may have been used after your surgery.  They will usually dissolve or fall out within a week.  If they are bothersome, they can be removed at your follow up appointment.  Occasionally longer lasting sutures are used.  You will be informed if this applies to you.  Please do not pick or pull at your stitches.

Oral Hygiene

After teeth are removed, wait until the following day to start your oral care. Begin rinsing your mouth with warm salt water (one-half teaspoon of salt in an 8 oz. Glass of warm water) at least five to six times a day. It is important to continue with the everyday brushing and hygiene of your mouth.  When brushing, be gentle near the surgical sites and stitches.  You are less likely to get a post-operative infection if your mouth and teeth are kept clean. 

Diet

During the first few days:  avoid hot temperature foods for the first 24 hours, avoid drinking through a straw, avoid spicy foods and carbonated beverages.  Not doing so could affect your healing or cause bleeding to start again.

After a local anesthetic, you should avoid chewing until the numbness has worn off.  After a general anesthetic, start out with clear fluids at first and gradually work up to a soft diet.  After you can chew comfortably, progress to a normal diet at your own pace.  Eat nutritious foods and eat as frequently as you can during the first few days.  If you find it difficult to keep your food down, please call the office for assistance.

Impacted Teeth

Oral care if you have had impacted teeth removed will be the same as for other oral surgery patients.  In addition, you may observe some of the following conditions.  Increased swelling & tightness in the muscles of your jaw may cause discomfort or difficulty with opening your mouth.  Adjacent teeth may ache, feel loose or be temperature sensitive.  Prolonged numbness or tingling in your lip or tongue, though rarely permanent, may last several weeks or months.  A slight fever for the first 48 hours is not uncommon, but if it persists, please call the office.

Smoking

Smoking is not advised for one week after surgery / tooth removal.  Smoking delays healing and can result in increased pain or a dry socket.  No smoking is a difficult rule to follow, but even the slightest bit may complicate your recovery.

Unusual Conditions

Please call the office if any of the following conditions are noted: 

1. Fever over 101 degrees.

2. Nose bleed or sinus congestion after surgery on the upper jaw. Do not blow your nose if this occurs. 

3. Severe, bright red bleeding that has not been controlled by following the instructions in this pamphlet.

4. Severe or large hard swelling after the 4th postoperative day.

5. Rash, difficulty breathing, severe vomiting, or any other suspected reaction to your medication(s).

Please Be Advised

The doctor can be reached after hours for emergencies by calling the office number on the front.  If you are having difficulties, if at all possible, we request you call during office hours to ensure prompt assistance with your problem. 

To download a copy of the postoperative instructions please click here.