After Wisdom Tooth Removal Instructions
The removal of impacted wisdom teeth is a serious 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 45 minutes to 1 hour. After this time, the gauze pad should be removed and discarded.
- 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 before the local anesthesia wears off.
- Restrict any physical activity for the first three days. Rest as much as possible and begin to resume normal daily activities as tolerated.
- Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for a more thorough explanation.
Slight bleeding, oozing, or redness in the saliva is normal for the first 2 days. Continued bleeding may be controlled by placing a gauze pad over the area and biting firmly for one hour. Repeat if necessary. If bleeding continues, bite on a moistened black tea bag for one hour. If bleeding does not subside, call our office for further instructions.
Swelling is a normal occurrence after surgery and typically peaks 24 to 48 hours after surgery. Swelling around the mouth, cheeks, eyes, and sides of the face is not uncommon. 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 for the first two days.
You should begin taking pain medication before the local anesthesia wears off. If prescribed, take ibuprofen every 6 hours for the first two days, then take it every 6 hours as needed. For moderate to severe pain, Dr. Haupt may prescribe Norco (hydrocodone/acetaminophen), which you can take every 6 hours, as needed. If you or your child prefer to avoid narcotics, over the counter Tylenol (acetaminophen) may be used instead of Norco. Tylenol and ibuprofen should be taken at the same time, every 6 hours, as needed. WARNING: do not take Norco and Tylenol at the same time, as they both contain acetaminophen and overdose can occur.
If you or your child have concerns regarding the use of narcotics (opioids) for pain control, please call our office to discuss alternative methods for optimum pain control.
Begin drinking room temperature fluids for the first several hours after surgery. Drink from a glass and do not use straws. The night of surgery, begin a non-chew diet with Ensure, Boost, or similar high calorie protein shakes. Your food intake may be limited for the first few days and you should compensate for this by increasing your fluid intake. For the following several days, continue with a soft diet. Anything that can easily be cut with a fork is generally soft enough to eat. Try not to miss any meals as you will feel better, have more strength, less discomfort and heal faster with proper nourishment.
Good oral hygiene is essential to good healing. Brush your teeth starting the day after surgery but be gentle initially while brushing the surgical areas. Use the prescribed Peridex (chlorhexidine) Oral Rinse after brushing your teeth. The Peridex should be used twice daily; after breakfast and before bed. Be sure to rinse for at least 30 seconds then gently spit it out. Warm salt water rinses (one teaspoon of salt in a cup of warm water) can be used at least 4-5 times a day as well, especially after meals.
Discoloration / Bruising
In some cases, discoloration or bruising 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 post-operatively and persist for 5-7 days.
If you have been prescribed 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.
Nausea and Vomiting
In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least one hour, including the prescribed medications. You should then sip on clear liquids such as Gatorade, ginger ale, or Sprite. You should sip slowly over a fifteen-minute period. Dehydration is a common cause for nausea and/or vomiting, so early adequate hydration following surgery is key. When the nausea subsides, you may begin taking more solid foods and the prescribed medications.
Stiffness 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 with gentle jaw exercises. Two days following surgery, begin passive jaw exercises by holding your mouth open for 10 seconds and stretching the surrounding muscles. This should be repeated 8-10 times per day.
- Slight elevation of temperature for the first 1-2 days following surgery is not uncommon. If the temperature persists, notify the office.
- You should be careful going from the lying down position to standing. You could get lightheaded 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. Haupt after a few weeks of healing.
- If stitches were placed, they will dissolve on their own in 1-2 weeks and do not have to be removed.
- There will be a void where the tooth was removed. The void will fill in with new tissue gradually over the next month. In the meantime, the area should be kept clean, especially after meals, with saltwater rinses or a toothbrush.
- Dry sockets are rare but may occur following the removal of lower wisdom teeth. Typical signs include new onset pain 3-4 days following surgery and is not controlled with the prescribed medications.