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 forthe first 30-60 minutes. After this time, the gauze pad should be removed and discarded. Over the next few days you will notice minor bleeding or oozing, which is normal. But it should progressively become less and less as the days pass.
  • 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 as soon as you begin to feel the onset of pain and discomfort. This will usually coincide with the local anesthetic becoming diminished. The first few days try to stay ahead of the pain and this will only aid in you getting some rest and healing as fast as possible/
  • Restrict your activities the day of surgery and gradually 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 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 rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid 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 exercise. If bleeding does not subside, call 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 not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 3-5 days post-operatively. However, the swelling may be minimized by the use of ice packs for the first 2 days. After surgery we will provide you with a specially designed ice compress to help you with this task. Addtionally, you can use any over-the-counter ice bag, or a plastic bag filled with frozen vegetables, or towel filled with ice on the cheek. Apply the ice as much as possible,20 minutes on; 20 minutes off. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery.

Pain

For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every three to four hours or Ibuprofen, (Motrin or Advil) two-four 200 mg tablets may be taken every 3-4 hours.

For severe pain, take the tablets prescribed as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.

Diet

After general anesthetic or I.V. sedation, liquids should be initially taken. Do not use straws. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away form the surgical sites. High calorie, high protein intake is very important. Refer to the section on suggested diet instructions at the end of the brochure. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. 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 a single meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat. Caution: 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-up.

Keep the mouth clean

No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the night of surgery but rinse gently while avoiding the site of surgery. The day after surgery you should begin rinsing at least 5-6 times a day especially after eating with a cup of warm water mixed with a teaspoon of salt.

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 post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.

Antibiotics

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. Then call the office to notify us of the situtation.

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. Many times this is due to the sedation or taking medications on an empty stomach. As with most medications, usually take eat something before taking any medications – Unless otherwise directed on the prescription bottle.

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 aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful. Call Drs. Sodeifi and Massoomi if you have any questions.
  • Slight elevation of temperature immediately following surgery is not uncommon. If a temperature of >101.5 persists over 12 hours, please notify the office first, then take some Tylenol or ibuprofen to reduce the fever.
  • You should be careful going from the lying down position to standing. Since you were not able to eat or drink prior to surgery, your body is in the state of dehyrdation. Should you suddenly stand-up it may make you lightheaded and “pass-out”. This may in turn lead to nausea and vomiting. This is why it is important for you take adequate amounts of fluids after surgery, to replish the fluids.
  • 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, on rare occasions they can be smoothenedby Drs. Sodeifi and Massoomi a few days to weeks later.
  • During surgerythe corners of your mouth are stretched by our instruments. This may lead todrying out and/or crack. Your lips should be kept moist with an ointment such as vaseline.
  • Sore throats and pain when swallowing are not uncommon. The muscles that move your jaw are manipulated during surgery and may becomeswollen. The normal act of swallowing can then 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

Resorbable sutures or stitches 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 will eventually fall-out spontanously or beremoved when the gums are fully healed. This may take a few weeks. Typically the removal of sutures requires no anesthesia or needles. It takes only a few secondsand there is no discomfort associated with this procedure. So it’s really nothing to worry about.

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 my office for instructions.

There will be a cavity where the tooth was removed. The cavity will gradually over the next month fill in with the new tissue. In the mean time, the area should be kept clean especially after meals with salt water rinses or a toothbrush.

Your case is individual, no two mouths are alike and no two teeth are alike. All four sites will act independent from one another. Do not expect all four site to feel the same way. Some days the lower left will be bothersome, the next day it wasy be the upper right. Just take things in stride and as long as things are progressively improving, then you are making great strides. Trynot to accept well intended advice from friends or family. Typically its the people with the worst experience that voice their opinions. Most studies put expected complications at less than 3% of the millions of third molars extractions that are performed each year. We are here to answer your questions. Please discuss any question or concern withDrs. Sodeifi and Massoomi

Brushing your teeth is okay – just be gentle at the surgical sites.

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 2-3 days following surgery. Call the office if this occurs, as this may require a special packing to be placed in the extraction site.

If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. You may not have the energy to exercise, furthermore exercising may weaken you. If you get light headed, stop exercising. Take it easy for the first two days, you will thank yourself later!